Text Linguistics Approach in Clinical Survey Research and in Diagnostics of Mental Disorders

Svetlana Koudria, St.Petersburg State University, Department of the English Language and Cultural Studies; Russia
Elena Davtian, Russian State Pedagogical University named after A.I. Herzen, Department of Clinical Psychology; St.Petersburg City Psychoneurological Dispensary ¹7, Outpatients’ department ¹3; Russia

Problem. The reliability and significance of multinational survey research largely depend on the compatibility of linguistic tools used in different language communities to collect data. One of the major issues in survey research is how to achieve the equivalence of a survey questionnaire translated into different languages. Since the fundamental studies of survey tools lie within the domain of cognitive psychology (2), current clinical questionnaire translation studies describe only individual difficulties in obtaining equivalence, but reveal no systemic causes of those difficulties. Our study seeks to improve translation procedures through the use of the text linguistics approach.
There is also a tendency to use translated clinical research questionnaires for diagnostic purposes in psychiatry. This raises concerns among practicing psychiatrists (1), and makes psychiatrists turn to linguistic theory in search for the rationale and implications of such use of texts. We provide examples of how linguistic theory may be applied in order to support or reject usage of texts as a basis for diagnostics of mental disorders.
Methodology. Our methodology lies within the framework of text linguistics, and suggests two steps: 1. defining a questionnaire as a text type on the basis of the following four parameters: the author and the recipient of the text, the communicative purpose of the text, and the type of information that the text communicates. 2. Providing a functional description of the linguistic constituents of the questionnaire in their relation to the discursive features identified within step one. Using this functional description as a basis for judgments about translation solutions and the diagnostic potential.
Results. The methodology has been applied to 175 clinical questionnaires (4019 questions in total). The clinical research questionnaire has been defined as a highly interactive text with a double pragmatic orientation at two different recipients: the clinician and the patient. The double pragmatic orientation is best illustrated at the level of individual words (e.g. “fatigue”, “frustration”, “anxiety”, “agitation’, “motivated”). The double pragmatic orientation undermines some principles of the standard methodology of questionnaire translation (3), and challenges the use of translated questionnaires for diagnostic purposes.
Conclusions. Text linguistics helps to create a consistent theoretical base for deciding which constituents of the source questionnaire must be retained, and which constituents may be omitted in translation without disrupting the functionality of the translated text. Also, a functional description of the linguistic constituents of the questionnaire reveals the dangers of using questionnaires for diagnostic purposes in psychiatry.

1. Davtian E., Koudria S. 2014. A Word in Defense of Clinician (on the use of clinical research questionnaires in psychiatry).//Gannushkin Journal of Psychiatry and Psychopharmacotherapy. Vol. 16, No. 2, P. 59-64.//Moscow: MMA «MediaMedica». (In Russian)
2. Schwarz N., Sudman S. 1996. Answering Questions: Methodology for Determining Cognitive and Communicative Processes in Survey Research. Jossey-Bass Publishers.
3. Wild D., Grove A., Martin M., Eremenco S., McElroy S., Verjee-Lorenz A., Erikson P. 2005. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures. Value in Health. Volume 8. Number 2, P. 94 – 104.