Cultural adaptation of the facial emotion perception test for use in Zimbabwe: A pilot study

Background: In African countries, including Zimbabwe, about half of those with depression respond to first-line therapies like problem-solving therapy. Predicting who needs more intensive treatment is challenging. In the US and Europe, tools like the Facial Emotion Perception Test (FEPT) help match...

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Main Authors: Denford Gudyanga, Primrose Nyamayaro, Summer Frandsen, Rebecca Easter, Sarah Derveeuw, Pauline Thibaut, Alina Dillahunt, Conall O’Cleirigh, Leah Rubin, Scott A. Langenecker, Melanie Abas
Format: Article
Language:English
Published: AOSIS 2025-05-01
Series:South African Journal of Psychiatry
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Online Access:https://sajp.org.za/index.php/sajp/article/view/2434
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author Denford Gudyanga
Primrose Nyamayaro
Summer Frandsen
Rebecca Easter
Sarah Derveeuw
Pauline Thibaut
Alina Dillahunt
Conall O’Cleirigh
Leah Rubin
Scott A. Langenecker
Melanie Abas
author_facet Denford Gudyanga
Primrose Nyamayaro
Summer Frandsen
Rebecca Easter
Sarah Derveeuw
Pauline Thibaut
Alina Dillahunt
Conall O’Cleirigh
Leah Rubin
Scott A. Langenecker
Melanie Abas
author_sort Denford Gudyanga
collection DOAJ
description Background: In African countries, including Zimbabwe, about half of those with depression respond to first-line therapies like problem-solving therapy. Predicting who needs more intensive treatment is challenging. In the US and Europe, tools like the Facial Emotion Perception Test (FEPT) help match treatments to likely responders. However, its applicability in Zimbabwe is unexplored. Aim: To develop a racially diverse adaptation of the FEPT for Shona-speaking Zimbabweans. Setting: Outpatient primary healthcare clinics at Marondera Provincial Hospital and Chitungwiza Central Hospital, Zimbabwe. Methods: Facial Emotion Perception Test was adapted using the Ecological Validity Model’s eight constructs through a four-step process: expert consultation, preliminary content adaptation, iterative content adaptation, and finalising adaptation. Three focus groups and 12 cognitive interviews assessed cultural appropriateness, suitability, usability and acceptability of FEPT for Zimbabwean Shona speakers. Fifteen participants, including graduates, primary healthcare workers and individuals with lived experience of depression, took part. Results: Key adaptations of FEPT-Multiple-Races (MR)-Shona include: (1) added 20 black and 20 Asian face stimuli for cultural relevance; (2) improved stimuli resolution for clarity; (3) extended test duration from 6 to 10 minutes for repeatable tutorials; (4) provided bilingual instructions in Shona and English; (5) shifted to a low-cost touchscreen tablet, familiar to Zimbabwean participants. Conclusion: The adaptation shows promising cultural relevance and usability for Shona speakers. Further testing with diverse educational and contextual backgrounds is needed to enhance cross-cultural and ecological validity. Contribution: This study highlights the importance of culturally adapting cognitive performance tools that can potentially improve depression treatment outcomes in low-income countries.
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series South African Journal of Psychiatry
spelling doaj-art-e0663aed88274b9085b25bcb18a014892025-08-20T02:05:20ZengAOSISSouth African Journal of Psychiatry1608-96852078-67862025-05-01310e1e910.4102/sajpsychiatry.v31i0.2434779Cultural adaptation of the facial emotion perception test for use in Zimbabwe: A pilot studyDenford Gudyanga0Primrose Nyamayaro1Summer Frandsen2Rebecca Easter3Sarah Derveeuw4Pauline Thibaut5Alina Dillahunt6Conall O’Cleirigh7Leah Rubin8Scott A. Langenecker9Melanie Abas10Department of Mental Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, HarareDepartment of Mental Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, HarareOhio State University, ColumbusDepartment of Psychology, University of Illinois, ChicagoDepartment of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonDepartment of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonOhio State University, ColumbusMassachusetts General Hospital, Harvard Medical School, BostonDepartment of Neurology, John Hopkins University, BaltimoreWexner Medical Center, Faculty of Psychiatry and Behavioral Health, Ohio State University, ColumbusDepartment of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonBackground: In African countries, including Zimbabwe, about half of those with depression respond to first-line therapies like problem-solving therapy. Predicting who needs more intensive treatment is challenging. In the US and Europe, tools like the Facial Emotion Perception Test (FEPT) help match treatments to likely responders. However, its applicability in Zimbabwe is unexplored. Aim: To develop a racially diverse adaptation of the FEPT for Shona-speaking Zimbabweans. Setting: Outpatient primary healthcare clinics at Marondera Provincial Hospital and Chitungwiza Central Hospital, Zimbabwe. Methods: Facial Emotion Perception Test was adapted using the Ecological Validity Model’s eight constructs through a four-step process: expert consultation, preliminary content adaptation, iterative content adaptation, and finalising adaptation. Three focus groups and 12 cognitive interviews assessed cultural appropriateness, suitability, usability and acceptability of FEPT for Zimbabwean Shona speakers. Fifteen participants, including graduates, primary healthcare workers and individuals with lived experience of depression, took part. Results: Key adaptations of FEPT-Multiple-Races (MR)-Shona include: (1) added 20 black and 20 Asian face stimuli for cultural relevance; (2) improved stimuli resolution for clarity; (3) extended test duration from 6 to 10 minutes for repeatable tutorials; (4) provided bilingual instructions in Shona and English; (5) shifted to a low-cost touchscreen tablet, familiar to Zimbabwean participants. Conclusion: The adaptation shows promising cultural relevance and usability for Shona speakers. Further testing with diverse educational and contextual backgrounds is needed to enhance cross-cultural and ecological validity. Contribution: This study highlights the importance of culturally adapting cognitive performance tools that can potentially improve depression treatment outcomes in low-income countries.https://sajp.org.za/index.php/sajp/article/view/2434depressionadaptationpsychological testfacial emotion perception testnegative valenceresearch domain criteriazimbabwe
spellingShingle Denford Gudyanga
Primrose Nyamayaro
Summer Frandsen
Rebecca Easter
Sarah Derveeuw
Pauline Thibaut
Alina Dillahunt
Conall O’Cleirigh
Leah Rubin
Scott A. Langenecker
Melanie Abas
Cultural adaptation of the facial emotion perception test for use in Zimbabwe: A pilot study
South African Journal of Psychiatry
depression
adaptation
psychological test
facial emotion perception test
negative valence
research domain criteria
zimbabwe
title Cultural adaptation of the facial emotion perception test for use in Zimbabwe: A pilot study
title_full Cultural adaptation of the facial emotion perception test for use in Zimbabwe: A pilot study
title_fullStr Cultural adaptation of the facial emotion perception test for use in Zimbabwe: A pilot study
title_full_unstemmed Cultural adaptation of the facial emotion perception test for use in Zimbabwe: A pilot study
title_short Cultural adaptation of the facial emotion perception test for use in Zimbabwe: A pilot study
title_sort cultural adaptation of the facial emotion perception test for use in zimbabwe a pilot study
topic depression
adaptation
psychological test
facial emotion perception test
negative valence
research domain criteria
zimbabwe
url https://sajp.org.za/index.php/sajp/article/view/2434
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