A culturally and linguistically specific deaf depression screener: Results of prototype development

Introduction: Because a reliable and valid depression screener in American Sign Language (ASL) does not yet exist, deaf individuals making primary care visits cannot easily be screened for depression, the most common mental health problem in the US. The most convenient format for delivering a visual ASL depression screener is via computer.Objective: To create and test a working computer prototype of an ASL Depression Screener Methods: Qualitative methods were used to inform ASL translations of items to meet DSM-IV depression criteria, and to detect any culturally experienced symptoms of depression. Methods included: focus groups for deaf persons receiving treatment for depression and deaf mental health clinicians; in-depth interviews with a signing psychiatrist and a mental health interpreter. A translation team used qualitative findings to construct a working ASL prototype on laptop computer. The resulting 14 item draft was administered to 35 deaf individuals receiving outpatient mental health treatment and 72 deaf individuals recruited from the community. Results: Qualitative analysis revealed that deaf persons use several different signs for depressed mood. Many identified a ‘boiling over' anger as frequently accompanying depressed mood. Using DSM-IV criteria, the ASL screener was able to distinguish deaf mental health outpatients from deaf persons recruited from the community. Using the prototype, preliminary depression rates were found to be 74% in the outpatients and 44% in the community sample ( ÷2 p=.004), indicating that depression may be higher in deaf than hearing populations. Validity and reliability testing of the ASL screener are now underway.