Validation of the Amharic version of Cognitive Assessment Interview (CAI-A) in people with schizophrenia in Ethiopia.

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    • Source:
      Publisher: Elsevier Science Publisher B. V Country of Publication: Netherlands NLM ID: 8804207 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2509 (Electronic) Linking ISSN: 09209964 NLM ISO Abbreviation: Schizophr Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam : Elsevier Science Publisher B. V., c1988-
    • Subject Terms:
      Schizophrenia*/physiopathology; Humans ; Ethiopia ; Male ; Female ; Adult ; Young Adult ; Reproducibility of Results ; Interview, Psychological ; Psychometrics/standards ; Middle Aged ; Cognitive Dysfunction/etiology ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/physiopathology ; Neuropsychological Tests/standards ; Adolescent ; Factor Analysis, Statistical ; Psychiatric Status Rating Scales/standards
    • Abstract:
      Assessing cognition with interview-based measures could be a low-resource alternative to traditional cognitive tests. We previously adapted the Cognitive Assessment Interview (CAI) into Amharic (CAI-A) for use with people with schizophrenia (PWS) in Ethiopia. This study examined the convergent and structural validity of the CAI-A in a group of 350 PWS sub-sampled from the Neuropsychiatric Genetics of African Populations - Psychosis (NeuroGAP-Psychosis) study, who fulfilled the inclusion criteria. Data were analyzed using confirmatory factor analysis (CFA), Spearman's correlation coefficient (ρ), multiple regression, and Item Response Theory (IRT). A one-factor solution best fits the items in the tool (factor loadings between 0.58 and 0.79), suggesting structural validity. The total score of the CAI-A moderately correlated with functioning (ρ = 0.44, p < 0.001) and symptom dimensions (ρ between 0.38 and 0.46, p < 0.001), suggesting convergent validity. Multiple regression showed that age (β = -0.06, 95 % CI (-0.12, 0.00), p = 0.044), the duration of illness (β = 0.08, 95 % CI (0.01, 0.14), p = 0.033), and medication side effects (β = 0.35, 95 % CI (0.21, 0.50), p < 0.001) were positively and significantly associated with the CAI-A total score. The IRT analysis suggested that the tool best functions among participants with moderate to severe impairment (difficulty coefficient between 0.05 and 2.73). We found that the CAI-A is a valid tool for use in Ethiopia. The moderate correlation with symptom and functional measures suggested that self-reported cognitive symptoms parallel other symptom dimensions and functional disability. The CAI-A can be used in clinical practice and research activities in PWS in Ethiopia when subjective assessment of cognition is desired.
      Competing Interests: Declaration of competing interest All the authors declare that they have no conflict of interest.
      (Copyright © 2024 Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: Cognitive Assessment; Cognitive Assessment Interview (CAI); Cognitive impairment; Ethiopia; Psychometric properties; Schizophrenia
    • Publication Date:
      Date Created: 20241107 Date Completed: 20241204 Latest Revision: 20241230
    • Publication Date:
      20241231
    • Accession Number:
      10.1016/j.schres.2024.10.019
    • Accession Number:
      39510019