Multicultural Understanding of Child and Adolescent Psychopathology: Implications for Mental Health Assessment

As an immigrant and a parent, my personal interest led me to the book Multicultural Understanding of Child and Adolescent Psychopathology by Thomas Achenbach and Leslie Rescorla. These authors, who have impressive credentials, are widely known for their expertise in child psychopathology. Particularly, one of the authors is the developer of instruments that have been used worldwide.

On the basis of the premise that what is known depends heavily on how it is known, the authors explore two distinct assessment methods: those empirically based and those diagnostically based. Although the former approach is referred to as "bottom-up" and the latter as "top-down," they are really the same in light of a standardized assessment method known as emic perspective.

The authors list numerous findings from research on similarities and differences across cultures in the problems that children manifest, in the prevalence and patterning of such problems, and in the correlates of the problems. All the findings are based on scores obtained with the two assessment approaches. Some notable results include the finding that effect sizes for culture are larger than effect sizes for gender and age, although variance within cultures is much larger than variance between cultures. Another interesting result is that Jewish-Russian immigrants in Israel appear to be more similar to their Israeli peers than to their Russian peers in suicidal symptoms and in general behavioral and emotional adjustment. In addition, a comparison of diagnoses made by British and American psychiatrists from the same clinical case information revealed low levels of agreement, indicating cultural differences in diagnostic practices even when psychiatrists received training in the same diagnostic systems, spoke the same language, and used the same information.

Although these findings are critical for multicultural understanding of child psychopathology, readers may also want to know which cultural aspects account for such differences. The findings could be related to cultural differences in childrearing practices, religion, and so forth. The lack of this valuable information may be related to methodological limitations of the two approaches. To explain their stance on multicultural research from the emic perspective, the authors quote the assertion made by Hermans and Kempen (1) that categorical thinking—for example, cultural dichotomies such as individualism versus collectivism—tends to reify abstractions concerning cultures as if cultures were objects.

Yet researchers also incur the same mistake if they seek multicultural understanding based solely on the standardized assessment approach because the method relies on categorical thinking and objectification. Standardized instruments may be limited in identifying cultural differences in child psychopathology that cannot be standardized. Readers of this book will have greater multicultural understanding of child psychopathology if they are aware of the limitation inherent in the standardized assessment method and strive to learn from the emic perspective that accounts for the differences reported in this book.