South American Research Journal, 3(1), 59-65

ISSN 2806-5638

https://www.sa-rj.net/index.php/sarj/article/view/21

RESUMEN

Construct validity properties of the Beck

Anxiety and Depression Inventories in

Kichwa-speaking Cañari adolescents in

Ecuador

La evidencia epidemiológica sugiere que los trastornos

de ansiedad y depresión son comunes, y que a menudo se

evalúan mediante autoinformes. Sin embargo, la validez del

contenido de los autoinformes puede variar entre diferentes

culturas, lo que es relevante para los objetivos del presente

estudio. Por lo tanto, el propósito de este estudio fue evaluar

la validez del constructo mediante Análisis Factorial

Confirmatorio en una muestra de 230 estudiantes bilingües de

los cantones El Cañar, El Tambo y Suscal, que hablan

kichwa, una lengua indígena del Ecuador. El análisis de los

resultados se realizó utilizando la plataforma estadística R y

el paquete Lavaan. Los resultados demostraron que ambos

instrumentos tienen validez de constructo en la lengua

kichwa, con un RMSEA de 0,025, SRMR de 0.049, TLI de

Propiedades de validez del constructo de

los Inventarios de Ansiedad y Depresión de

Beck en adolescentes cañaris kichwa-

hablantes del Ecuador

_Á_n_g_e_l_C_h_u_c_h_o_-_C_u_v_i1

_C_a_r_l_o_s_A_n_d_r_a_d_e_-_B_a_y_o_n_a2

.920, CFI de 0.924 y X2/gl de 1.15. Además, el nivel de

fiabilidad fue alto, con un coeficiente ω de McDonald de

,964 para el inventario de depresión y 0,952 para el

1_C_e_n_t_r_o_E_d_u_c_a_t_i_v_o_C_o_m_u_n_i_t_a_r_i_o_I_n_t_e_r_c_u_l_t_u_r_a_l_B_i_l_i_n_g_ü_e_“_D_a_n_i_e_l

Clavijo Iglesias” del Sistema de Educación Intercultural

inventario de ansiedad. Por lo tanto, los autores del estudio

recomiendan su uso para evaluar la ansiedad y la depresión

en adolescentes en instituciones educativas bilingües que

hablan kichwa. En resumen, la validación de instrumentos de

evaluación es fundamental para garantizar la precisión y la

fiabilidad de los resultados obtenidos, especialmente en

culturas y grupos lingüísticos diferentes. El presente estudio

proporciona evidencia de la validez y la fiabilidad de dos

escalas de autoinforme para evaluar la ansiedad y la depresión

en adolescentes que hablan kichwa, lo que puede ayudar a

mejorar la atención y el tratamiento de estas condiciones en

este grupo de población.

Bilingüe del Ecuador, Comunidad de Cebadas, Cañar, Ecuador.

Asesoría en Investigación Académica (AiA) de Cabrera y

Andrade Cía. Ltda., Edif. Cámara de Industrias de Cuenca, Av.

Florencia Astudillo s/n., Cuenca, Ecuador.

Correspondence: angel.chucho@educacion.gob.ec;

andrade_carlos31@hotmail.com

Reception: January 1 , 2023 – Acceptance: July 4 , 2023 – Publication:

July 4 , 2023

ABSTRACT

Epidemiological evidence suggests that anxiety

disorders and depression are prevalent and often evaluated

through self-reports. However, the content validity of self-

reports can vary across cultures, which is pertinent to our

study's objectives. Thus, our study aimed to assess construct

validity using Confirmatory Factor Analysis among 230

bilingual students from the cantons of El Cañar, El Tambo,

and Suscal, who speak Kichwa, an indigenous language of

Ecuador. We conducted the analysis of the results using the

R statistical platform and the Lavaan package. The findings

demonstrated that both instruments exhibited construct

validity in the Kichwa language, as indicated by an RMSEA

of 0.025, SRMR of 0.049, TLI of 0.920, CFI of 0.924, and

X2/gl of 1.15. Moreover, the reliability level was high, with

a McDonald's ω coefficient of 0.964 for the depression

inventory and 0.952 for the anxiety inventory. Based on these

results, we recommend the utilization of these instruments for

assessing anxiety and depression in Kichwa-speaking

adolescents within bilingual educational institutions. In

summary, validating assessment instruments is crucial to

ensure the accuracy and reliability of obtained results,

particularly when dealing with different cultures and

language groups. This study offers evidence regarding the

validity and reliability of two self-report scales for assessing

anxiety and depression in Kichwa-speaking adolescents,

thereby contributing to the enhancement of care and treatment

for these conditions within this specific population group.

Palabras clave: ansiedad, depresión, inventario de

Beck, kichwa.

INTRODUCTION

Background

Until now, to measure anxiety and depression in

adolescents, inventories in Spanish have been used, which

makes it difficult to implement linguistic policies, as

established in numeral 9, article 347 of the Constitution of the

Republic of Ecuador (2008): "The State shall guarantee

education according to the language of its nationality"

(p.107); in this case, the Kichwa language. Given the absence

of an instrument that responds to the cultural and linguistic

conditions of this population, the objective of this study is to

adapt the Beck Inventory for measuring anxiety and

depression in Kichwa adolescents to Kichwa, in order to

respond to the social problems that these disorders represent

in adolescents of the native peoples of the cantons of El

Cañar, El Tambo and Suscal.

Anxiety and depression are disorders that have a

significant prevalence in the stages of childhood and

adolescence, where age is a determining factor in their

clinical expression (Sanchez and Cohen, 2020). COVID-19

health conditions have had an important impact on mental

health, with 27% of cases of anxiety and 15% of depression

in adolescents and young people between 13 and 29 years of

age being recorded in Latin America and the Caribbean

(UNICEF, 2020).

Key words: anxiety, depression, Beck inventory,

Kichwa.

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According to the DSM, depression and anxiety in

adolescents should be assessed with validated instruments in

the native language (Creswell et al., 2014). However, in

Ecuador, a diverse country with 18 indigenous nationalities

and 14 peoples whose mother tongue is Kichwa, the loss of

communication in this language is increasingly observed,

which extends to the psychological care processes provided

to this population.

Kichwa-speaking adolescents in Cañar, El Tambo and

Suscal cantons are evaluated by psychologists who only work

in Spanish. The mother tongue (Kichwa), which would allow

a better observation of the psychoemotional profile of an

adolescent, is not taken into account. Therefore, it is urgent to

have a tool to assess anxiety and depression in the mother

tongue of these students.

psychology practitioners (Bennett et al., 1997). Several

studies have explored the validity of these instruments for use

in diverse adolescent communities worldwide and across

different languages (Byrne et al., 2004). For instance, the

Spanish version of the Beck Anxiety Inventory has exhibited

sound psychometric properties (Sanz et al., 2012; Melipillán

Araneda et al., 2008).

However, no studies have yet examined the adaptation

of these instruments specifically for Kichwa-speaking

adolescents. The only existing adaptation to assess anxiety

and depression in a similar language is the Quechua version

of the DASS-21, which is designed exclusively for the adult

population.

Theoretical framework

This area helps to strengthen the intercultural bilingual

education system in the bilingual institutions distributed in

the Cañar, El Tambo and Suscal cantons, thus complying with

art. 57, which states:

The term adolescence, derived from the Latin word

adolescere, meaning "growing into adulthood" (Gaete, 2015,

p. 437), represents the transitional stage between childhood

and adulthood within the complex process of human

development. It is characterized by the progressive

maturation of physical, psychological, and social aspects,

ultimately leading to the formation of independent adults

(Gaete, 2015). In Ecuador, the adolescent population aged 12

to 17 years is estimated to be approximately 1.9 million

(Instituto Nacional de Estadísticas y Censos [INEC], 2010).

Anxiety and depression disorders often emerge during

childhood and adolescence, progressing gradually and

potentially becoming persistent and chronic (Riordan and

Singhal, 2018). Globally, depression ranks as the leading

cause of illness and disability within this age group, with

suicide ranking third among causes of mortality (WHO,

2014).

Anxiety can arise when individuals experience worry,

unease, or fear regarding anticipated or hypothetical future

events (Rector et al., 2008). It can be likened to fear, as it

emerges when children or adolescents perceive an immediate

threat, whether real or imaginary. While anxiety can serve as

an adaptive response to prepare individuals to face danger and

adapt to changes, it can also become pathological when it

occurs disproportionately or without justifiable factors

(Sanchez and Cohen, 2020).

Anxiety disorders have a significant impact on the

physical and mental well-being of individuals, resulting in

increased utilization of healthcare services, higher levels of

school absenteeism, and imposing a substantial economic

burden on families (Fineberg et al., 2013; Gómez and

Calderón, 2017). Ultimately, anxiety disorders significantly

and negatively affect an individual's quality of life and are

associated with deterioration in personal and social

functioning, often co-occurring with other disorders and

increasing the risk of suicide (Martínez and López, 2011;

Hoge et al., 2012).

The symptoms of anxiety primarily manifest at two

levels: a) physical symptoms, such as dizziness, fatigue,

palpitations, muscle pain, muscle tension, tremors, dry

mouth, excessive sweating, difficulty breathing, abdominal

pain, nausea, headache, and insomnia; and b) psychological

symptoms, including restlessness, feelings of dread, difficulty

concentrating, irritability, a constant state of vigilance,

avoidance of certain situations, and social isolation (Martinez

and Lopez, 2011; Remes et al., 2016).

Se reconoce y garantizará a las comunas, comunidades,

pueblos y nacionalidades indígenas de conforme con la

Constitución y con los pactos, convenios, declaraciones

y demás instrumentos internacionales de derechos

humanos, el derecho a mantener, desarrollar y fortalecer

libremente su identidad, sentido de pertenencia,

tradiciones ancestrales y formas de organización social

(

Constitución de la República del Ecuador, 2008, p. 26).

Due to this provision, indigenous peoples and

nationalities possess the entitlement to receive essential

services, including healthcare, in their native language.

Consequently, the absence of a psychological evaluation

instrument translated into Kichwa undermines the effective

assessment, identification, and treatment of mental health

issues among Kichwa adolescents, hindering their proper

development in this regard.

Justification

Article 29 of the Constitution of the Republic of

Ecuador (2008) stipulates that the "Estado garantizará el

derecho de las personas a aprender en su propia lengua y

ámbito cultural" (p. 17) - "The State shall guarantee the right

of individuals to learn in their own language and cultural

context." Similarly, article 343 emphasizes that "el sistema

nacional de educación integrará una visión intercultural

acorde con la diversidad geográfica, cultural y lingüística del

país y el respeto a los derechos de las comunidades, pueblos

y nacionalidades" (p. 106) - "The national education system

shall incorporate an intercultural perspective in accordance

with the geographic, cultural, and linguistic diversity of the

country, while respecting the rights of communities, peoples,

and nationalities." However, both the Student Counseling

Department (DECE) and the professionals working in the

field of education provide services exclusively in Spanish,

thereby impeding a thorough evaluation of anxiety and

depression disorders among Kichwa-speaking students.

Among the numerous scales available for identifying

depression and anxiety in adolescents, the Beck et al.

Depression Inventory (1961) and the Beck Anxiety Inventory

(

1988) have demonstrated substantial empirical evidence.

Since the 1960s, both instruments have exhibited high

effectiveness in assessing anxiety and depression (Ambrosini

et al., 1991; Teri, 1982), being utilized in adolescent

populations by both general psychology and clinical

According to the annual State of the Population report

published by the United Nations Population Fund (UNFPA,

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014), there are approximately 1.8 billion young people aged

0 to 24 worldwide, accounting for nearly 25% of the total

results in terms of model adequacy, internal consistency, and

correlations with other depression, anxiety, and stress scales.

Although limitations were noted regarding the representation

of subjects over 65 years of age in the sample, the findings

support the usefulness and reliability of the DASS-21 in the

Brazilian context.

Within this context, we propose to examine the validity

and reliability of Beck's anxiety and depression constructs in

the Kichwa language among Cañari students in Ecuador.

global population. Many of these individuals face

developmental challenges that require attention, with anxiety

being the most prevalent form of psychopathology,

surpassing rates of depression and conduct disorders, and

exhibiting prevalence rates ranging from 10% to 20%

(

Ochando and Peris, 2016; Riordan and Singhal, 2018;

Guerrero and Sanchez, 2019).

Among adolescents aged 15 to 19, elevated levels of

depression (including suicide) are associated with psychiatric

disorders and dissatisfaction with body image, contributing to

the three leading causes of mortality and illness worldwide.

In 2012 alone, an estimated 1.3 million adolescents

worldwide died from suicide related to depression (Pan

American Health Organization, 2014).

Early detection and treatment of these disorders are

crucial to minimize their impact on various aspects of an

adolescent's life, including their family, social interactions,

and academic performance, as well as to prevent their

persistence into adulthood (Guerrero & Sanchez, 2019).

Therefore, it is essential to have assessment tools that can

evaluate these symptoms in adolescents across different

contexts.

For instance, in Kenya, an adaptation of the Swahili

version of the Beck Depression Inventory-II was conducted

through in-depth interviews with 29 adult community

members to gain insights into their understanding of

depression and identify aspects of the BDI-II that required

adjustments. The validity assessment revealed culturally

relevant idioms and symptoms such as "thinking too much"

and "Kuchoka moyo" (having a tired heart), necessitating

modifications in the administration of the BDI to

accommodate the low literacy levels of the participants

METHODS

El presente estudio emplea un diseño de investigación

instrumental, específicamente un análisis factorial

confirmatorio, con el propósito de adaptar un instrumento a

un contexto específico (Cabrera-Tenecela, 2023). El análisis

factorial confirmatorio es una técnica estadística ampliamente

utilizada para evaluar la validez de constructo de un

instrumento de medición.

A total of 880 adolescent students who are bilingual in

Kichwa and Spanish, residing in Cañar, El Tambo, and Suscal

cantons, were included in the population. From this

population, a sample of 230 students was selected based on

their preference to respond in Kichwa when given the option

to choose between Kichwa and Spanish. The average age of

the participants is 15 years old (SD 3.09), with a minimum

age of 13 and a maximum age of 18. These students are

enrolled in the ninth and tenth grades of general basic

education, as well as the first, second, and third grades of high

school.

The questionnaire used in the study consists of 21 items

to assess anxiety and 21 items to assess depression. The

authors translated these items into Kichwa and had them

reviewed by linguists who are experts in the language. The

translation aimed to maintain fidelity to the original English

versions formulated by Beck.

Data collection was conducted using the online program

KoboToolbox, and the collected information was processed

in the R Studio platform. To analyze the construct validity,

Confirmatory Factor Analysis from the Lavaan package

(

Abubakar et al., 2016).

The importance of using validated psychological

instruments becomes evident from the aforementioned

examples. Validated instruments ensure the reliability and

validity of the results, enabling healthcare professionals to

make informed clinical decisions and recommend appropriate

treatments. Moreover, the use of validated instruments can

help reduce the stigma and discrimination associated with

these conditions, creating a more comfortable environment

for adolescents and facilitating better treatment outcomes

(

Rossel, 2012) was employed. This analysis allowed for the

calculation of robust fit indices, such as the diagonally

weighted least squares (DWLS) for small samples and non-

normally distributed data. The program facilitated the

determination of robust model fit measures, including

RMSEA (Root Mean Error), SRMR (Standardized Residual

Square Root), TLI (Tucker-Lewis Index), CFI (Comparative

Fit Index), and X2/gl (Chi-square Fit Index divided by

degrees of freedom). Additionally, Cronbach's alpha (α) and

McDonald's omega (ω) reliability coefficients were

computed to assess the internal consistency of each scale.

(

Argibay, 2006). Hence, it is crucial for healthcare

professionals to utilize validated instruments when assessing

depression and anxiety in adolescents.

Previous research has examined the adaptation and

validation of instruments like the BDI and the DASS-21 in

various linguistic and cultural contexts. For instance, Alansari

(

2006) assessed the appropriateness and consistency of the

BDI-II in an Arabic version developed by Ghareeb (2000).

The coefficient alphas were examined using samples of

university students from different Arab countries,

demonstrating favorable feasibility and consistency in the

Arab context, indicating its potential use in cross-cultural

research. Similarly, Giannakou et al. (2013) evaluated the

psychometric properties of the BDI-II in the Greek

population, showing high internal consistency, test-retest

reliability, and validity. Factor analysis revealed two factors

that accounted for 42.54% of the total variance, and a cutoff

score based on patient data was proposed. In another study,

Batistelli and Marcassa (2014) adapted and validated the

DASS-21 scale in Brazilian Portuguese, obtaining positive

RESULTS

The analysis conducted on the validity properties

demonstrates that the construct proposed by Beck et al.

remains intact when translating the instrument into the

Kichwa language. The achieved fit indices exhibit

exceptionally high values in all cases, indicating a significant

p-value for the exact chi-square statistic test, albeit not

extremely low (p=0.002). Regarding the root mean error of

approximation (RMSEA), it is expected to be below 0.08,

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even in its upper interval. In this instance, the upper interval

is 0.033, the lower interval is 0.016, and the attained value is

this threshold, reaching a value of 0.924. The Tucker-Lewis

Index also demonstrates a similar level to the CFI, with a

value of 0.920. Lastly, the X2/gl ratio yields a value below 2

points (specifically, 1.15), indicating successful fulfillment of

its purpose. Table 1 presents the attained indices.

.025. The standardized square root residual (SRMR), which

is also anticipated to be below 0.08, is observed to be 0.049

in this study. While the Comparative Fit Index (CFI) is

anticipated to equal or exceed 0.950, it falls slightly short of

Table 1

Analysis of absolute, incremental and parsimony indices for the generated models

X (gl)

RMSEA [IC 90%]

SRMR

TLI

CFI

X /gl

Model

936.991 (818gl)

.002

0.025 [.016 .033]

0.049

0.920

0.924

1.15

Note. RMSEA = Root mean error of approximation; SRMR = standardized root mean residual; TLI = Tucker-Lewis Index; CFI = Comparative fit index; X /gl =

Chi-square fit index divided by degrees of freedom

Figure 1 displays the factor loadings obtained during the

validation process, where each item exhibits a contribution

greater than or equal to 0.60. This signifies that all the items

provide substantial support for evaluating anxiety and

depression using the Kichwa questionnaire. Furthermore, an

inter-correlation level of 0.72 is observed between the two

scales, underscoring the importance of assessing both aspects

in non-clinical populations, although separate evaluations are

also possible.

Table 2 presents the outcomes of the construct's internal

consistency, revealing a high reliability for both depression

and anxiety. This is evidenced by the Cronbach's α and

McDonald's ω reliability coefficients, both of which exceed

0.950 in this study. Hence, depending on the circumstances,

it is feasible to evaluate each disorder individually or

collectively, as was done in this particular investigation.

It is important to note that the assessment of these

constructs should be conducted by a psychologist who can

interpret the results by summing the item scores and utilizing

cut-off points. For anxiety, the minimum levels are as

follows: minimal anxiety (0-7 points), mild anxiety (8-15

points), moderate anxiety (16-25 points), and severe anxiety

(26-63 points). For depression, the minimum levels are:

minimal depression (0-13 points), mild depression (14-19

points), moderate depression (20-28 points), and severe

depression (29-63 points).

Figura 1

Path analysis of the standardized values for the factor loadings for the Beck anxiety and depression scales

Note. ASIE means Anxiety and DEPRE means depression. P means item or question.

https://doi.org/10.5281/zenodo.8102377

South American Research Journal, 3(1), 59-65

ISSN 2806-5638

https://www.sa-rj.net/index.php/sarj/article/view/21

Table 2

Internal consistency analysis of the Beck Anxiety and Depression Inventory in Kichwa language.

Factors

α de Cronbach

ω de McDonald

Depression (DEPRE)

Anxiety (ANSIE)

0.961

0.952

0.964

0.952

DISCUSSION

In summary, although there are similarities in terms of

adapting and validating instruments for assessing depression

and anxiety in diverse cultural contexts, it is crucial to

acknowledge the differences concerning the assessed

languages, reported fit indices, and sample types. These

differences emphasize the importance of considering the

cultural and linguistic context when adapting and validating

psychological assessment instruments to obtain more precise

and meaningful results.

Hence, we can conclude that the translation of the Beck

Anxiety and Depression Inventory into Kichwa with the

Cañari dialect is a significant initiative that enhances access

to psychological care for indigenous peoples in Ecuador. The

application of the inventory among Kichwa-speaking

adolescents from Cañar, El Tambo, and Suscal cantons

involved the active participation of students who culturally

identify with Kichwa as their mother tongue (n=230) as well

as those who primarily identify with Spanish (n=210). Similar

to adaptations made in languages with limited speakers and

scarce textual resources in other countries (Abubakar et al.,

Limitations

The main limitation of our study is the size of the

sample selected. This sample may not be completely

representative of the total population, which limits the

generalizability of our findings to a broader context. Another

limitation to consider is the specificity of the population

studied. Our study focused on adolescent students in basic

general education and high school in the aforementioned

cantons. This limits the applicability of our results to other

populations, such as adults or people from different

geographical contexts. In summary, although our study has

provided valuable information on the adaptation and

validation of depression and anxiety assessment instruments

in the Kichwa language, it is important to take into account

the limitations of the sample size, the specificity of the

population studied, the translation of the items, the

assumptions of the factor analysis, and the reliability

assessment. These limitations highlight the need for future

research to address these issues and expand the applicability

of the instruments to different populations and contexts.

016), it was necessary to consult Kichwa and language

experts to ensure the translation and interpretation processes

preserved the meaning and reference of the original scale.

The scale has demonstrated satisfactory construct

validity in terms of dimensionality and reliability, as

evidenced by the exploratory factor analysis conducted

among the two population groups. Consequently, it is

recommended to offer the population under study the option

to choose psychological assessment instruments in the

language they primarily identify with. In this case, the

Kichwa version has exhibited an even better fit across all the

validated and reliable indices, while the Spanish version has

shown levels comparable to those tested in other studies. The

scale's validity aligns with Beck's original proposition, which

aimed to measure anxiety (Beck et al., 1988) and depression

(

Beck et al., 1961) in children and adults.

When analyzing the results obtained in our study, it is

notable to observe anxiety levels surpassing those reported in

other studies. Several authors have indicated anxiety

prevalence ranging from 10% to 20% (Ochando and Peris,

016; Riordan and Singhal, 2018; Guerrero and Sanchez,

019), figures lower than the 35% found within the analyzed

CONCLUSSION

Cañari population. This disparity underscores the

significance of assessing these behaviors, as they often have

severe repercussions on the population when associated with

self-injurious behaviors and even suicide (PAHO, 2014;

WHO, 2015).

Regarding the adaptation and validation of instruments

in languages other than English, our study, similar to those

conducted by Alansari (2006) and Batistelli and Marcassa

The adaptation and validation of the Beck Depression

and Anxiety Inventory to the Kichwa language has provided

promising results. The fit indices obtained indicate good

validity of the instrument, supporting its usefulness and

reliability for assessing depression and anxiety in non-clinical

populations of bilingual Kichwa-speaking and Spanish-

speaking adolescent students from Cañar, El Tambo and

Suscal cantons. Cronbach's alpha and McDonald's omega

reliability coefficients demonstrated high internal consistency

of the scales, and a significant inter-correlation was found

between them.

The results differ from other studies in terms of the

prevalence of anxiety in the population studied, with a

percentage of 35% that exceeds the findings reported in

previous research. However, it is important to consider the

limitations of the study, such as the size of the sample selected

and the specificity of the population studied, which limits the

generalizability of the results to other contexts and age

groups.

(

2014), focuses on this aspect. Encouragingly, both Alansari

2006) and Batistelli and Marcassa (2014) obtained reliability

values above 0.90, indicating high internal consistency in the

adapted instruments.

However, notable differences exist among these studies.

While our approach targeted non-clinical populations,

Alansari (2006) and Giannakou et al. (2013) included

samples of university students and patients from a mental

health center, respectively. Furthermore, Batistelli and

Marcassa (2014) assessed the DASS-21 scale, which

measures not only depression but also anxiety and stress,

unlike the other studies that specifically focused on

depression assessment.

Despite these limitations, the study has contributed to

the field of cross-cultural psychological assessment by

https://doi.org/10.5281/zenodo.8102377

South American Research Journal, 3(1), 59-65

ISSN 2806-5638

https://www.sa-rj.net/index.php/sarj/article/view/21

adapting and validating the inventory in a language other than

English, thus expanding its usefulness in different cultural

and linguistic contexts. These findings support the

importance of considering cultural and linguistic context

when adapting and validating psychological assessment

instruments.

of the Beck Depression Inventory-II to Greek

population. Hellenic Journal of Psychology, 10(2), 120–

46.

Gómez, C., Bohórquez, A., Tamayo, N., Rondóna, M., & Bautistac,

N. (2016). Trastornos depresivos y de ansiedad y

factores asociados en la población de adolescentes

colombianos, Encuesta Nacional de Salud Mental 2015.

In future research, it is recommended to expand the

sample and consider other populations, as well as to conduct

additional reliability analyses, such as temporal stability. In

addition, it would be relevant to further explore the factors

that contribute to the high prevalence of anxiety found in the

population studied, as well as the possible implications and

repercussions of these disorders on the health and well-being

of bilingual Kichwa-speaking and Spanish-speaking

adolescents.

50 –57.

http://www.scielo.org.co/pdf/rcp/v45s1/v45s1a08.pdf

Guerrero, F., & Sánchez, P. (2019). Trastornos por ansiedad y

trastorno obsesivo-compulsivo en la infancia y la

adolescencia. En M. Hidalgo, y P. Rodríguez (Eds),

Curso de psiquiatría del niño y del adolescente para

pediatras (pp. 135-162). Sociedad Española de

Medicina

Adolescencia.

https://www.cursopsiquiatriasema.com/tema-6-

trastornos-por-ansiedad-y-trastorno-obsesivo-

compulsivo-en-la-infancia-y-la-adolescencia/

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ISSN 2806-5638

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Annex

Questionnaire in Kichwa language

Response options:

DEPRESSION UNKUYMANTA RIKUCHIKUNA

.- Shuk

.- Ishkay

.- Kimsa

.- Chusku

.- Pichka

.- Sukta

.- Kanchis

.- Pusak

12.- Chunka Ishkay.

13.- Chunka kimsa

14.- Chunka Chusku

15.- Chunka Pishka

16.- Chunka Sukta

17.- Chunka Kanchis.

18.- Chunka Pusak

19.- Chunka Iskun

20.- ishkay Chunka

21.- Ishkay Chunka Shuk

.- Iskun

0.- Chunka

1.- Chunka Shuk

ANXIETY MANCHAY UNKUY RIKUCHIKKUNA

. Sinchiyashka, mana sayti

. Piña

. Chanka Chukchuywan

. Aychata umata mana samachiy ushay

.- Ashtawan llaki tukuna manchaywan

.- Urmarik shinalla uma muyuywan

. Yurak shunku sinchi utka kuyurikunawan

.- Yapa shuktakyarik

12 - Makikuna chukchuywan

13.- Mana kasilla mancharishkalla.

14.- Yuyayta chinkachik shina yuyaywan

15.- Chukarinalla yuyaywan

16.- Wañuna manchaywan

17. -Manchaywan

18.- Wiksa wakllirishkawan

19. Yuyay chinkariywan

20.-Ñawipi suktak kuskakunapi rupariywan

21.-Chiri ashtawanpash rupachik humpiwan

. - Pinkaywan manchaywan

0.- Chukchuywan

1.- Yuyay chinkarikuk shina

In the case of anxiety, the levels are minimum (0-7 points), mild (8-15 points), moderate (16 to 25 points) and severe (26-63 points).

While, in the case of depression it is minimum depression (0-13 points), mild depression (14-19), moderate depression (20-28) and

severe depression (29-63).

https://doi.org/10.5281/zenodo.8102377