Forward-backward translation and cross-cultural validation of the Center for Epidemiologic Studies Depression scale among Tigrigna-speaking Eritrean refugees

The Center for Epidemiologic Studies Depression (CES-D) scale is a widely used instrument for studying depression in the general population. It has been translated into several languages. Cross-cultural relevance of the construct of depression and cultural equivalence of the CES-D items used to measure it are crucial for international research on depression. Given the increasing number of refugees from Eritrea entering the USA and Europe, there is a need among health care researchers and providers for an instrument to assess depressive symptoms in the native language of this vulnerable population. The paper aims to discuss these issues.

The study employed forward–backward translation and assessed the CES-D scale for cross-cultural research and depression screening among Tigrigna-speaking Eritrean refugees. Forward–backward translation, cognitive interview and semantic analysis were conducted to ensure equivalence of comprehension of the items and instructions between Tigrigna- and English-speaking samples. Multi-group confirmatory factor analysis was used to assess the measurement invariance of the translated version.

Translation efforts were successful as reflected by the results of semantic analysis and pilot testing. Evidence supporting the measurement invariance of data collected using the Tigrigna version of the CES-D was obtained from a sample of 253 Eritrean refugees in the USA.

The findings of this study provide support for reliability and validity of data collected using the Tigrigna version of the CES-D scale. This important tool for assessing depression symptoms among Eritrean refugees is now available for health care providers and researchers working with this vulnerable population.

This work is an original work of the authors and it has not been published previously.