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DATE: September 21, 2004

UM-Dearborn study demonstrates that standard psychological tools can be translated and revised to be reliable for testing elderly Arab-Americans

DEARBORN---A study by a faculty member at the University of Michigan-Dearborn and researchers at the Arab Community Center for Economic and Social Services (ACCESS) has demonstrated that standard tools used to measure depression and dementia can be adequately translated for use among elderly Arab Americans.

In addition to translating the tools into Arabic, the researchers modified some cultural references that were in the original tests. The result assures uniform testing, thus avoiding non-standardized use of the tests. The study was conducted among a sample of nearly 200 elderly Arabs and Arab Americans in southeastern Michigan.

Nancy Wrobel

The results not only prove the validity of the standard tests for depression when translated for this population, according to UM-Dearborn psychology Prof. Nancy Wrobel. "They also highlight the notion that even elderly minority group members in an area which is densely populated by their own group experience some difficulties with acculturation that may impact their mental health."

The long-term goal of the project is to improve the identification of dementia, depression and stress within this population through the translation and validation of commonly used diagnostic tests, Wrobel said.

Wrobel conducted the study with Dr. Mohamed F. Farrag, a psychologist associated with ACCESS, supported by a grant from the U.S. Administration on Aging, administered by Wayne County Senior Citizens' Services.

The project was completed in conjunction with The Senior Alliance-Area Agency on Aging 1-C, which serves the elderly in western and southern Wayne County.

Testing for depression and dementia in a particular ethnic group is a complicated process, she noted, made difficult by cultural and language differences. "In addition, cultural norms regarding family care of the elderly may contribute to a failure to identify treatable problems."

"The elderly individuals in this study appeared to be experiencing a substantial degree of stress, particularly stressed by pressures to be competent in English and pressures to acculturate," Wrobel said. "This suggests a high need for community intervention and support for this population."

They tested a sample of 198 elderly Arab Americans, representing nine different countries of origin, during 2003. The participants were recruited from various settings in the community, including senior housing, doctors' offices, mosques and community agencies. They ranged in age from 60 to 92, with a mean age of 69. There were 105 females and 93 males. All of them were Arabic speakers, with varying degrees of fluency in English, more than half reporting no English skills and fewer than 5 percent describing themselves as fluent in English.

The results show that a majority of this group needs substantial assistance with daily living and management of their own affairs. The data also suggest that the number of participants with symptoms of depression was much higher than the reported number who actually had received a diagnosis of depression before the study was started.
Overall, Wrobel and Farrag found that the standard international tests for mental health were accurate when translated into Arabic, including the Mini-Mental Status Exam, the Geriatric Depression Scale, the Multi-Dimensional Acculturative Stress Inventory and the "Clock Drawing Test."

As part of the study, these tests were translated from English into Arabic by Farrag, who is a licensed psychologist with experience among both English-speaking and Arabic-speaking populations. Then those versions were translated back into English by another translator and examined to find discrepancies in meaning from the original texts. All of the tests were administered in Arabic.

"The essential accomplishment here is the careful translation of the existing commonly used measures into Arabic," Wrobel said.

"Secondly, this work provides a summary of the range of problems existing in a sample of elderly minority group members in a particular community," she said.
Wrobel presented two papers based on this study at the American Psychological Association's annual convention last July in Honolulu. The first paper is "Validation of an Arabic version of the Mini Mental Status Exam in the Elderly" and her second is titled "The impact of Acculturation on Symptoms of Depression in an Elderly Arabic Sample."

Contact Chris Kenzie at The Senior Alliance, (734) 722-2830, for information regarding the study.

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