Psychiatry · Pediatrics · 4 h ago
PSC-Y Shows Within-Country Validity but Limits Cross-Country Comparisons
A measurement-invariance study analyzed the 35-item Pediatric Symptom Checklist–Youth Report in 5,810 children and adolescents aged 6–18 years across Ghana, Tanzania, Uganda, Haiti and Pakistan. The scale supported screening comparisons within countries, but differences in how some items functioned meant scores should not be directly compared across countries.
- Strong general PSC-Y factor found in five countries
- Cross-country metric invariance was not established
- Gender comparisons were supported within each country
- School-level findings varied in Ghana
Researchers analyzed baseline data from 5,810 children and adolescents aged 6–18 years who took part in school-based randomized trials in Ghana, Tanzania, Uganda, Haiti and Pakistan. They assessed the factor structure and measurement invariance of the 35-item Pediatric Symptom Checklist–Youth Report (PSC-Y), including comparisons across countries, gender and, in three African countries, school level as a proxy for developmental stage.
A strong general factor was found in all five countries (omega hierarchical >0.90). Configural invariance was supported across countries, but metric invariance was not: items concerning empathy, rule-breaking and anger expression functioned differently. Full metric, scalar and strict invariance were achieved across gender in all five countries. Tanzania and Uganda showed full invariance across school levels; Ghana required partial invariance after five items were freed.
The results support use of the PSC-Y total score for screening within each studied country and direct score comparisons between boys and girls there. They do not support direct comparisons of scores across countries. School level was only a proxy for developmental stage, and the findings do not establish diagnostic accuracy or clinical outcomes. The authors emphasize continued local validation and cultural contextualization.
In practice
For clinicians and researchers using the PSC-Y with children and adolescents in Ghana, Tanzania, Uganda, Haiti or Pakistan, the findings support interpreting total scores within the same country and comparing scores by gender within each country. They do not support direct comparisons of scores between these countries, because metric invariance failed and some items functioned differently. This is evidence about measurement properties, not diagnostic accuracy or treatment outcomes; age-related findings were assessed using school level as a proxy and varied by country.
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BMC Medicine: Cross-cultural validity of the Pediatric Symptom Checklist – Youth Report (PSC-Y) in five Global South countries: Implications for equitable child mental health screening ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.