Adult Archives - PsychTools

Young Mania Rating Scale (YMRS)

The Young Mania Rating Scale (YMRS) is a Clinician administered tool used to rate the severity of symptoms of mania (Young, Biggs, Ziegler & Meyer, 1978) across clinical and research settings. The YMRS was originally developed in 1978 and normed with psychiatric inpatients based on a semi structured interview and observations over an 8 hour period. Today the YMRS combines the clients self-report of symptoms of mania over the past 48 hours with the clinician observations during interview (Miller, Johnson & Eisner, 2009) and is now a commonly used tool to screen for manic symptoms and monitor the severity of manic symptoms (Lukasiewicz et al., 2013). Used to assess the severity of manic symptoms, this tool is often used to monitor the progress of interventions (Miller, Johnson & Eisner, 2009).

It is an 11 item scale assessing mood, motor activity/ energy levels, interest in sex, sleep, irritability, rate and frequency of speech, flight of ideas, grandiosity, aggressive behaviour, appearance, and insight into current presentation. It should be noted that the YMRS does not map onto the DSM 5 criteria for mania as it does not account for distractibility, increases in goal directed activity or excessive involvement in pleasurable activities that have a potential fir painful consequences (DSM-5). As such this tool is not a diagnostic assessment.

Each item is composed of 5 explicitly defined levels of severity. Severity ratings for 7 items are scored on a scale of 0 -4. The remaining 4 items are double weighted to account for poor cooperation of client when unwell and are scored on a scale of 0 – 8. Item ratings are sum to produce a total score between 0 -60. A score <29 indicates that the person is experiencing “severe” mania (Wciorka et al., 2011).

Although weighting items increases the complexity of scoring and interpreting, it has not affected the psychometric properties of the scale. The YMRS is reported to have high interrater reliability for total scores (0.93) and individual item scores (0.66 -0.92) (Young et al., 1978). It also has been found to have good internal reliability, with Cronback alpha coefficients ranging from 0.8 – 0.91. The YMRS has demonstrated high convergent validity with other assessment measures of mania including the Bech-Rafaelsen Mania Rating Scale (Spearman’s Rho = 0.90). Furthermore, the YMRS statistically differentiates between clients; before and 2 weeks after treatment (Young et al., 1978); mania from symptoms of ADHD (Serrano, Ezpeleta, Alda, Matalí, & San, L., 2011). Finially, the YMRS has demonstrated validity across cultural populations including Korea (Seon-Cheol & Joonjo, 2016) and Poland (Wciorka et al., 2011).

References

Lukasiewicz, M., Gerard, S., Besnard, A., Falissard, B., Perrin, E., Sapin, H., Tohen, M., Reed, C., Azorin, J.-M. and The emblem study group (2013), Young Mania Rating Scale: how to interpret the numbers? Determination of a severity threshold and of the minimal clinically significant difference in the EMBLEM cohort. Int. J. Methods Psychiatr. Res., 22: 46–58. doi:10.1002/mpr.1379

Miller, C. J., Johnson, S. L., & Eisner, L. (2009). Assessment Tools for Adult Bipolar Disorder. Clinical Psychology : A Publication of the Division of Clinical Psychology of the American Psychological Association, 16(2), 188–201. http://doi.org/10.1111/j.1468-2850.2009.01158.x

Seon-Cheol, P., & Joonjo, C. (2016). Using the Young Mania Rating Scale for Identifying Manic Symptoms in Patients with Schizophrenia. Yonsei medical Journal, 57, 1298-1299.

Serrano, E., Ezpeleta, L., Alda, J., Matalí, J., & San, L. (2011). Psychometric Properties of the Young Mania Rating Scale for the Identification of Mania Symptoms in Spanish Children and Adolescents with Attention Deficit/Hyperactivity Disorder. Psychopathology, 44(2), 125-132.

Wciorka, J., Schaeffer, E., Switaj, P., Waszkiewicz, J., Krasuska, K., Wegrzyn, J., & Wozniak, P. (2011). Bech-Rafaelsen Mania Scale and Young Mania Rating Scale–comparison of psychometric properties of the two instruments for rating a manic syndrome. Psychiatry Poland, 45, 61-78.

Young, R.C., Biggs, J.T., Ziegler, V.E., & Meyer, D.A. (1978). The rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry, 133, 429-435.

Penn State Worry Questionnaire for Adults (PSWQ-A)

Developed in America in 1990, the Penn State Worry Questionnaire for Adults (PSWQ) is the measure most frequently used to assess trait pathological worry in adults (Meyer, Miller, Metzger, & Borcovec, 1990). The PSWQ is a 16-item self-report questionnaire, derived from a factor analysis of 161 items believed to be related to worry. It is intended to measure an individual’s disposition to worry, as well as the frequency, intensity, and tendency for worry to be generalised (Meyer et al., 1990). Respondents are asked to rate each item on a 5-point Likert scale ranging from 1 (“not at all typical of me”) to 5 (“very typical of me”). Eleven of the items are positively scored in the direction of pathological worry (e.g. “my worries overwhelm me”), while the remaining five items require reverse scoring and indicate worry is not a problem (e.g. “I never worry about anything”). The scores from each item are added together to yield a total score that ranges from 16-80, with higher scores representing higher levels of pathological worry (Meyer et al., 1990).

The PSWQ is not a diagnostic tool; however, it is useful as a screening tool to detect pathological worry, and to evaluate therapeutic changes on worry (Meyer et al., 1990). It also successfully distinguishes GAD from other anxiety disorder groups, such as Post Traumatic Stress Disorder (Brown, Antony, & Barlow, 1992). Most GAD patients tend to show higher PSWQ scores (above 50), although some people with other diagnoses may sometimes report PSWQ levels similar to those with GAD (e.g. depression in Starcevic, 1995). This may be the result of high levels of comorbid GAD, or possibly because the DSM-IV does not allow a diagnosis of GAD if symptoms occur during episodes of other disorders (Chelminski & Zimmerman, 2003).

The PSWQ has been shown to have good internal reliability in samples consisting of older adults with GAD (Generalised Anxiety Disorder), community samples, and undergraduates, with cronbach alphas ranging from .88 to .95 (Startup & Erickson, 2006). It has also demonstrated favourable test-retest reliability over 8-10 weeks in a sample of college students (r= 0.92) (Meyer et al., 1990). In both clinical and community samples, the PSWQ has shown high convergent validity with other worry questionnaire measures, such as The Worry Domains Questionnaire (r=.67) (Tallis, Eysenck, & Mathews, 1992), and the student worry scale (r=.59) (Davey, Hampton, Farrell, & Davidson, 1992), and has shown high discriminant validity as it correlates significantly with anxiety and depression as measured by the State Trait Anxiety Inventory (trait r= .64-.79, state r = .49) (Meyer et al., 1990; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983) and the Beck Depression Inventory (r= .36-.62) (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961; Meyer et al., 1990).

It is also important to consider whether scores remain stable across demographic groups, or if any individual factors impact the PSWQ’s psychometric properties. With the regard to gender, no differences have been found (Meyer et al., 1990). In addition, the PSWQ has demonstrated to be valid in cross cultural populations, yielding good psychometric properties in samples in Korea (Lim Kim, Lee & Kwon, 2008), India (Parikh & Chhibber, 2016), and Germany (Stöber, 1995). In contrast to ethnicity, age is a factor that may influence PSWQ scores. Older adults have reported significantly lower scores than younger adults in both community (Gillis et al., 1995) and clinical samples (Hopko et al., 2003). Furthermore, older age may also impact the psychometric properties, as the PSWQ has demonstrated reasonable internal reliability and validity for this age group, but poor test-retest reliability (Davey & Wells, 2006). When a test has poor test-retest reliability, it makes it unclear whether the data is an accurate representation of a participant’s performance or whether extraneous variables interfered.

A major limitation of the PSWQ is that it does not capture worry changes over short periods of time. In some situations, a more frequent assessment of pathological worry is needed. To meet the need for a more frequent worry assessment, Stober and Bittencourt (1998) developed the PSQW- Past Week for weekly assessments of worry which also has good psychometric properties. Overall, the PSWQ appears to have sound psychometric properties and sensitivity to treatment change. It is a good choice for research and clinical studies to assess the intensity of pathological worry and to discriminate GAD from other disorders (Turk, Heimberg, & Mennin, 2004).

References

Beck, A.T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.

Brown, T. A., Antony, M. M., & Barlow, D. H. (1992). Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behaviour Research and Therapy, 30(1), 33-37.

Chelminski, I., & Zimmerman, M. (2003). Pathological worry in depressed and anxious patients. Journal of Anxiety Disorders, 17(5), 533-546

Davey, G. C., Hampton, J., Farrell, J., & Davidson, S. (1992). Some characteristics of worrying: Evidence for worrying and anxiety as separate constructs. Personality and Individual Differences, 13(2), 133-147.

Davey, G., & Wells, A. (2006). Worry and its psychological disorders. Chichester, England: Wiley. Gillis, M. M., Haaga, D. A., & Ford, G. T. (1995). Normative values for the Beck Anxiety Inventory, Fear Questionnaire, Penn State Worry Questionnaire, and Social Phobia and Anxiety Inventory. Psychological Assessment, 7(4), 450.

Hopko, D.R., Stanley, M.A., Reas, D.L., Wetherell, J.L., Beck, J.G., Novy, M.D., Averill, P. M. (2003). Assessing worry in older adults: confirmatory factor analysis of the Penn State Worry Questionnaire and psychometric properties of an abbreviated model. Psychological Assessment, 15, 173–183.

Lim, Y. J., Kim, Y. H., Lee, E. H., & Kwon, S. M. (2008). The Penn State Worry Questionnaire: Psychometric properties of the Korean version. Depression and Anxiety, 25(10).

Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28(6), 487-495.

Parikh, S., & Chhibber, K. (2016). Use of the Penn State Worry Questionnaire to identify individuals with GAD: An Indian perspective. Journal Psychology and Clinical Psychiatry, 6(5).

Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.

Startup, H. M., & Erickson, T. M. (2006). The Penn State Worry Questionnaire (PSWQ). In G. C. L. Davey, & A. Wells (Eds.), Worry and Its Psychological Disorders: Theory, Assessment and Treatment, 101-119. Chichester: Wiley.

Starcevic, V. (1995). Pathological worry in major depression: A preliminary report. Behaviour Research and Therapy, 33(1), 55-56.

Stöber, J. (1995). Worrying: A comparison of three questionnaires concerning everyday worries. Zeitschrift fuer Differentielle und Diagnostische Psychologie, 16, 50-63.

Stoeber, J., & Bittencourt, J. (1998). Weekly assessment of worry: an adaptation of the Penn State Worry Questionnaire for monitoring changes during treatment. Behaviour Research and Therapy, 36(6), 645-656.

Tallis, F., Eysenck, M., & Mathews, A. (1992). A questionnaire for the measurement of nonpathological worry. Personality and Individual Differences, 13(2), 161-168.

Turk, C. L., Heimberg, R. G., & Mennin, D. S. (2004). Assessment of worry and generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, and D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice, 219–247. New York: Guilford.

Positive and Negative Syndrome Scale (PANSS)

The Positive and Negative Syndrome Scale (PANSS) is a rating scale, designed on the premise that schizophrenia comprises of: positive syndrome, pertaining to productive symptoms; and negative syndrome, pertaining to deficit features (Depp et al, 2010). This clinical tool is employed: 1) upon an inpatient’s admission 2) at the outset of taking a new medication and 3) weeks/ months into treatment to gauge the effect of the intervention (Opler et al., 2006). PANSS has been published officially across 40 languages following internationally valued and sanctioned guidelines under the Multi Health Systems (MHS) Translation Policy (Khan et al, 2013). Validation studies conducted in 1994, conducted reliability and validity studies among 100 DSM-III-R schizophrenic patients. Cuesta and Peralta (1994) much like Opler (1987) found that the scores were normally distributed; while the construct validity was adequate, the positive and negative subscales when compared to Scales for the Assessment of Positive/Negative Symptoms, depicted high criterion validity. However the internal consistency was insufficient and factorial validity of the positive scale was poor. The scale was seemingly developed on the basis of independent components; furthermore, it oversimplified the negative and positive symptoms. PANSS has since had alternate versions released – PANSS – SCI which accompanies a structured clinical interview and IQ –PANSS, which acquires information from informants such as family/case workers (MHS, 2006). Despite complications with respect to length and ability to measure cognitive functioning, PANSS is considered a competent “stand-alone” clinical screening tool for psychosis due to its clinical predicting power and outcome.

Newer studies communicate the following psychometric properties:
Adequate Internal consistencies for positive (α = 0.73: Acceptable), negative (α = 0.83: Good), and general psychopathology (α = 0.79: Good) subscales. Good test-retest reliability with Pearson correlation coefficients at 0.80, 0.68, and 0.60 for the positive, negative and psychopathology subscales. Positive and negative scales showed good inter-rater reliability. Interclass correlation coefficients of 0.72 and 0.80, respectively. Inter-rater reliability was moderate (0.56) for the general psychopathology scale.

References

Canadian Agency for Drugs and Technologies in Health. (2011) A systematic review of combination and high dose atypical antipsychotic therapy in patients with schizophrenia. Ottawa: CADTH

Cuesta, M. J., & Peralta, V. (1995). Psychopathological dimensions in schizophrenia. Schizophrenia Bulletin, 21(3), 473-482.

Kay SR, Opler LA, Fiszbein A. Positive and Negative Syndrome Scale (PANSS; 2006) manual. Toronto, Ontario: MultiHealth Systems, Inc.

Khan, A., Christian Yavorsky, C., Liechti, S., Opler, M., Rothman, B., Diclemente, G., Lucic, L., Jovic, S., Inada, T. and Yang, L. (2013). Available at: http://A rasch model to test the cross-cultural validity in the positive and negative syndrome scale (PANSS) across six geo-cultural groups [Accessed 17 Sep. 2017].

Kumari S, Malik M, Florival C, Manalai P, Sonje S (2017) An Assessment of Five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used Symptoms Rating Scales in Schizophrenia and Comparison to Newer Scales (CAINS, BNSS). J Addict Res Ther 8: 324. doi: 10.4172/2155-6105.1000324

Maust, D., Cristancho, M., Gray, L., Rushing, S., Tjoa, C. and Thase, M. (2012). Psychiatric rating scales. [online] Experts.umich.edu. Available at: https://experts.umich.edu/en/publications/psychiatric-rating-scales [Accessed 17 Sep. 2017].

Opler, L. A., Opler, M. G. and Malaspina, D. 2006. Reducing guesswork in schizophrenia treatment: PANSS can target and gauge therapy, predict outcomes in clinical practice. Current Psychiatry, 5: 76–84.

Taylor, Grantley W; McCarley, Robert W; Salisbury, Dean F (2013) Early auditory gamma band response abnormalities in first hospitalized schizophrenia. Suppl Clin Neurophysiol 62:131-45

Bush-Francis Catatonia Rating Scale (BFCRS)

The Bush- Francis Catatonia Rating Scale (BFCRS) is a standardised, quantifiable examination of catatonia designed to screen and diagnose the possibility of catatonia. The BSRCS was designed by Bush, Fink, Petrides, Dowling and Francis in 1996 and is based on descriptors of catatonia from the literature and motor signs identified in the DSM-III, IV and ICD-10 criteria.

The BFCRS consists of a 23- item rating scale with the first 14 items comprising the Bush Francis Catatonia Screening Instrument (BFCSI). For screening, items 1-14 are marked as absent (0) or present (3). The presence of two or more of the screening items for 24 hours or longer meets the diagnosis for catatonia proposed by Bush et al. For severity, items 1-23 are rated using a scale of 0-3. The total BFCRS score is the sum of responses to all 23 items. The rating scale is accompanied by a standardised examination procedure consisting of nine steps. Sample procedures are: To assess for Echopraxia, the examiner scratches his head in an exaggerated way. To assess for Automatic Obedience, the examiner reaches into his pocket and states, ‘Stick out your tongue. I want to stick a pin in it.” (Bush et al., 1996)

The BFCRS was tested on a sample of 28 acutely ill patients presenting with catatonic syndrome from an acute psychiatric inpatient clinic and a university hospital. No information on gender is available (Wong, Ungvari, Leung and Tang, 2007). Both the BFCRS and the BFCSI showed a high inter-rater reliability: r= 0.93 and r = 0.95 respectively. Test re-test reliability was not studied because of the fluctuating course of the catatonic syndrome.

Validity was harder to assess because of the lack of established diagnostic criteria. Diagnostic agreement between cases in the BFCSI and previously published criteria for catatonia ranged from 75 – 100% (Bush et al., 1996). Validity of the scale was also examined by comparison with the sources from which it was derived. Of the 23 items, 96% were included in at least two sources (Bush et al.). The only language the BFCRS has been translated into is Portuguese and the scale remained as reliable and valid as in the original instrument (Santos Nunes et al., 2017).

The BFCRS is currently the preferred rating scale for the detection of catatonia due to its five minute administration time and reliability and validity. However, recent research found that the BFCRS-0 and BFCRS-R may be more suitable for a schizophrenic population (Wong et al., 2007). Wilson, Niu, Nicolson, Levine and Heckers (2015) also found it to have low reliability at the low severity level but good reliability at the moderate to severe level.

The BFCRS and examination procedure is freely available and can be accessed online at: Bush, G., Fink, M., Petrides, G., Dowling, F., Francis, A. (1996). Catatonia.1. Rating scale and standardized examination. Acta Psychiatrica Scandinavica, 93, 129-136.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Bush, G., Fink, M., Petrides, G., Dowling, F., Francis, A. (1996). Catatonia.1. Rating scale and standardized examination. Acta Psychiatrica Scandinavica, 93, 129-136.

Bush, G., Fink, M., Petrides, G., Dowling, F., Francis, A. (1996). Catatonia. II. Treatment with lorazepam and electroconvulsive therapy. Acta Psychiatrica Scandinavica, 93, 137-143.

Santos Nunes, A. L., Filgueiras, A., Nicolato, R., Alvarenga, J. M., Silveira, A. S., Assis da Silva, R., Cheniaux, E. (2017). Development and validation of the Bush-Francis Catatonia Rating Scale – Brazilian version. Arq Neuropsiquiatr, 75, 44-49.

Sienaert, P., Rooseleer, J., & De Fruyt, J. (2011). Measuring Catatatonia: A systematic review of rating scales. Journal of Affective Disorders, 135, 1-9. doi: 10.1016/j.jad.2011.02.012

Tandon, R., Heckers, S., Bustillo, J., Barch, D.M., Gaebel, W., Gur, R.E., … Carpenter, W. (2013). Catatonia in DSM-5. Schizophrenia Research, 150, 26-30. doi: 10.1016/j.schres.2013.04.034

Wilson, J. E., Niu, K., Nicolson, S. E., Levine, S. Z., & Heckers, S. (2015). The diagnostic criteria and structure of catatonia. Schizophrenia Research, 164, 256-262.

Wong, E., Ungvari, G.S., Leung, S.K., Tang, W.K. (2007). Rating Catatonia in patients with chronic schizophrenia: Rash analysis of the Bush-Francis Catatonia Rating Scale. International Journal of Methods in Psychiatric Research, 16, 161-170. doi: 10.1002/mpr.224

SCOFF Questionnaire

Background: The SCOFF questionnaire (Morgan, Reid and Lacey, 1999) is a five item measure, developed to serve as a simple, easy to remember screening tool for eating disorders. The instrument was designed for use by professionals and non-professionals alike and can be used in primary health care settings. The SCOFF items were developed via focus groups with eating disordered patients and specialists in the field (Morgan et al, 1999). Questions can be administered orally or in written format (Perry et al, 2002).

Population: Screening tool that can be used in general population to identify people who may be at risk or have an eating disorder.

Measurement: The SCOFF Questionnaire is a five-question screening tool designed to clarify suspicion that an eating disorder might exist rather than to make a diagnosis. The questions can be delivered either verbally or in written form.

S – Do you make yourself Sick because you feel uncomfortably full?

C – Do you worry you have lost Control over how much you eat?

O – Have you recently lost more than One stone (6.35 kg) in a three-month period?

F – Do you believe yourself to be Fat when others say you are too thin?

F – Would you say Food dominates your life?

An answer of ‘yes’ to two or more questions warrants further questioning and more comprehensive assessment. A further two questions have been shown to indicate a high sensitivity and specificity for bulimia nervosa. These questions indicate a need for further questioning and discussion.

Are you satisfied with your eating patterns?
Do you ever eat in secret?

Scoring: Each “yes” response to the five yes/no questions on the SCOFF is summed for the total score. Scores of 2 or greater were originally set a cut-off point for maximum sensitivity to detect anorexia and Bulimia nervosa (Morgan et al, 1999). A cut-off point of 3 has been suggested as the best compromise between sensitivity and specificity.

Psychometrics: A meta analyses of 15 studies examining the utility of the SCOFF found that the 5 questions of the SCOFF constitute a highly efficient tool for the detection of eating disorders, even by a non-specialist, in several languages. Its use as a screening tool is highly recommended.

Strengths: Readability, ease of use, time efficient, effective, available and validated in other languages.

Limitations: SCOFF is a Self-report measure, may be less effective for male and older people who may present with different symptomology, does not screen for excess exercise, past weight loss

Access: Free and easily accessible. The SCOFF was developed in the United Kingdom but items have been adapted for use in the United States (Morgan et al, 1999; Parker, Lyons and Bonner, 2005). German, Finnish, Spanish and Japanese translations of the SCOFF have also been developed.

References

Botella, J., Sepúlveda, A., Huang, H. and Gambara, H. (2013). A Meta-Analysis of the Diagnostic Accuracy of the SCOFF. The Spanish Journal of Psychology, 16. Doi:10.1017/sjp.2013.92

Garcia, F., Grigioni, S., Chelali, S., Meyrignac, G., Thibaut, F. and Dechelotte, P. (2010). Validation of the French version of SCOFF questionnaire for screening of eating disorders among adults. The World Journal of Biological Psychiatry, 11(7), pp.888-893. Doi:10.3109/15622975.2010.483251.

Garcia-Campayo, J., Sanz-Carrillo, C., Ibañez, J., Lou, S., Solano, V. and Alda, M. (2005). Validation of the Spanish version of the SCOFF questionnaire for the screening of eating disorders in primary care. Journal of Psychosomatic Research, 59(2), pp.51-55. Doi:10.1016/j.jpsychores.2004.06.005.

Lähteenmäki, S., Aalto-Setälä, T., Suokas, J., Saarni, S., Perälä, J., Saarni, S., Aro, H., Lönnqvist, J. and Suvisaari, J. (2009). Validation of the Finnish version of the SCOFF questionnaire among young adults aged 20 to 35 years. BMC Psychiatry, 9(1). Doi:10.1186/1471-244X-9-5.

Morgan, J., Reid, F. and Lacey, J. (1999). The SCOFF questionnaire: assessment of a new screening tool for eating disorders. BMJ, 319(7223), pp.1467-1468. Doi:10.1136/bmj.319.7223.1467.

Pannocchia, L., Fiorino, M., Giannini, M. and Vanderlinden, J. (2011). A Psychometric Exploration of an Italian Translation of the SCOFF Questionnaire. European Eating Disorders Review, 19(4), pp.371-373. Doi:10.1002/erv.1105.

Perry, L., Morgan, J., Reid, F., Brunton, J., O’Brien, A., Luck, A. and Lacey, H. (2002). Screening for symptoms of eating disorders: Reliability of the SCOFF screening tool with written compared to oral delivery. International Journal of Eating Disorders, 32(4), pp.466-472. Doi:10.1002/eat.10093.

Solmi, F., Hatch, S., Hotopf, M., Treasure, J. and Micali, N. (2014). Validation of the SCOFF questionnaire for eating disorders in a multiethnic general population sample. International Journal of Eating Disorders, 48(3), pp.312-316. Doi:10.1002/eat.22373.

Short Post-Traumatic Stress Disorder Rating Interview (SPRINT)

The SPRINT is a brief, global assessment for post-traumatic stress disorder (PTSD) that assesses symptoms of intrusion, avoidance, numbing and arousal, and related aspects of PTSD (somatic distress, stress vulnerability and impairment in function). Developed by Connor & Davidson (2001) for use with adults (18+ years), its design followed a need for a less time consuming, yet structured PTSD-specific measure.

The SPRINT is an eight-item self-report, with one item corresponding to each of the above symptoms, which is measured on a five-point likert scale (e.g. 0 = not at all, 4 = very much). The SPRINT includes two additional items that allows for the measurement of global improvement and symptom change over time, particularly useful for following up treatment. The assessment takes 5-10 minutes to complete. Sample items include:

How much have you been bothered by unwanted memories, nightmares, or reminders of the event?

How much would you get upset when stressful events or setbacks happen to you?

Scoring

Scores from each item are summed to attain a final score. The maximum score is 32 and represents the most severe symptom state, while a cutoff score of 14 has been suggested by authors to warrant further assessment using a structured interview for PTSD.

Psychometric properties

The SPRINT has demonstrated good test-retest reliability (ICC = .78), high internal consistency (α = .88), good convergent validity against a comparable PTSD symptom measure (Davidson Trauma Scale [DTS], r = .73) and good divergent validity against the Sheehan Social Support Scale (r = .10). A score of 14-17 has been associated with a 96% diagnostic accuracy. The SPRINT is sensitive to treatment effects, again significantly correlating with the DTS (r = .66). The SPRINT has also been found to correlate with the gold standard diagnostic assessment tool for PTSD, the Clinician Administered PTSD Scale (CAPS; Vaishnavi, Connor & Davidson, 2006).

Use & Availability

The SPRINT is time efficient, reliable, valid and freely available at https://www.ptsd.va.gov/professional/assessment/screens/sprint.asp, along with further information. The SPRINT is particularly useful in settings where rapid assessment is desirable, however it is not as comprehensive as the CAPS.

References

Connor, K. M., & Davidson, J. R. T. (2001). SPRINT: A brief global assessment of post-traumatic stress disorder. International Clinical Psychopharmacology, 16(5), 279-284.

National Center for Posttraumatic Stress Disorder. (2016). SPRINT. Retrieved from https://www.ptsd.va.gov/professional/assessment/screens/sprint.asp

Vaishnavi, S., Payne, V., Connor, K., & Davidson, J. R. T. (2006). A comparison of the SPRINT and CAPS assessment scales for posttraumatic stress disorder. Depression and Anxiety, 0, 1-4. doi: 10.1002/da.20202

Yale – Brown Obsessive Compulsive Scale (Y-BOCS)

The Yale-Brown Obsessive Compulsive scale was developed by Wayne Goodman and his colleagues to rate the severity and types of symptoms that a client my have. It is important to note that the Y-BOCS is not intended to diagnose OCD but is used to rate the severity of symptoms and can be administered throughout therapy to track improvements made by the client. The Y-BOCS is administered as a semi-structured interview where the client responds to questions that are asked by the interviewer. The severity of the obsessive symptoms and compulsive symptoms are rated separately to give the practitioner an idea of what symptoms are most prominent. The semi-structured interview also allows the practitioner to ask the client any additional questions that they may feel will be helpful in treating the client. The Y-BOCS is considered to be a valid and reliable measure with strong internal consistency for the symptom checklist and severity scale. Scoring the test is straight forward and categorises the clients score to having a mild case of OCD to an extreme case of OCD.

References

https://psychcentral.com/disorders/ocd/what-causes-obsessive-compulsive-disorder-ocd/ )

https://iocdf.org/about-ocd/treatment/

https://www.ncbi.nlm.nih.gov/pubmed/20528050

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958520/

http://www.brainphysics.com/ybocs.php

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994744/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994744/table/t1-jcnsd-8-2016-013/

http://www.novopsych.com/y-bocs.html

https://www.ncbi.nlm.nih.gov/pubmed/20528050

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958520/

Iowa Personality Disorder Screen (IPDS)

Structured interview-based methods for diagnosing Personality Disorders (PD) are considered among the best practices for diagnosing PD (Zanarini et al., 2000), but they are time consuming and involve specific training of the clinician. Therefore, several authors have advised that clinicians should first screen patients for PD to identify patients who need a more thorough evaluation (Rizeanu, 2016).

The Iowa Personality Disorder Screen (IPDS) was developed by Langbehn et al (1999) to serve as a brief interview-based measure, taking around 5 min to complete. It is an 11-item screening instrument used to evaluate whether a PD is present or absent in the psychiatric outpatient clinic setting (Langbehn et al., 1999). Most of the 11 items have follow up questions making up a total 19 possible questions. It can easily be integrated into standard diagnostic clinical interviews and initial validation research suggests that it is adequate in identifying patients requiring further evaluation to determine if they meet criteria for a personality disorder. Furthermore, a study by Trull and Armdur (2001) examined the effectiveness of the IPDS in a non-clinical sample of 103 undergraduate students and determined that it may be useful as a screening measure for PD in both clinical and nonclinical populations.

Retrospective analyses using 1,203 Structured Interview for Disorders of Personality-Revised (SIDP-R; Pfohl, Blum, Zimmerman,1995) interviews suggested that the IPDS items should provide good sensitivity and specificity (Langbehn et al., 1999). Furthermore, results from a prospective validation study, using a mixed group of 52 nonpsychotic inpatients and outpatients who were diagnosed showed that blind administration of the IPDS yielded excellent sensitivity (92%) and good specificity (79%). The IPDS shows promise as a quick PD screen for use in research settings or standard clinical interviews. Moreover, socio-demographic and psychopathological factors have been suggested to have little effect on the IPDS as screening instrument (Olssøn, Sørebø, & Dahl, 2011).

In a study by Morse and Pilkonis (2007) psychiatric and non-psychiatric samples were employed to compare the validity of three screening measures: the PD scales from the Inventory of Interpersonal Problems, a self-report version of the Iowa Personality Disorder Screen, and the self-directedness scale of the Temperament and Character Inventory. The screeners were highly correlated in a range from .71 to .77, despite their different theoretical origins. These findings suggest that the use of multiple screeners was not a significant improvement over any individual screener, and no single screener stood out as clearly superior to the others.

When using self-rating scales, clinicians should be mindful as individuals with PD see themselves in distorted ways and may not be able to give accurate accounts of their presenting difficulties (Klonsky, Oltmanns, & Turkheimer, 2002). Reports of symptoms have been shown to differ from those of their friends and families (Klonsky, Oltmanns, & Turkheimer, 2002), therefore interviews with people who know the patient well can improve the accuracy of a diagnosis.

This tool is not meant to be used as a diagnostic tool. Only a trained professional can properly diagnose a personality disorder. The formal diagnosis for a PD is ultimately a clinical decision that should be made by incorporating multiple sources and the screening measures are intended to aid clinicians in making decisions regarding identification of patients who are in need of a more thorough evaluation, but a formal diagnosis should not be given based exclusively on these data alone.
References

Langbehn DR et al. (1999). The Iowa Personality Disorder Screen: development and preliminary validation of a brief screening interview. J Pers Disord. Spring;13(1)75-89.

Morse, J. Q., & Pilkonis, P. A. (2007). Screening for Personality Disorders. Journal of Personality Disorders, 21(2), 179–198. http://doi.org/10.1521/pedi.2007.21.2.179

Olssen, I., Sørebø, Ø., & Dahl, A. A. (2011). A cross-sectional testing of The Iowa Personality Disorder Screen in a psychiatric outpatient setting. BMC Psychiatry, 11, 105. http://doi.org/10.1186/1471-244X-11-105

Pfohl, B., Blum, N., Zimmerman, M. (1995). Structured interview for DSM-IV personality SIDP-IV. Iowa City, IA. The University of Iowa.

Rizeanu, S. (2016). Screening measures for personality disorders. Romanian Journal of Experimental Applied Psychology, 7(2).

Siefert, C. J. (2010). Screening for Personality Disorders in Psychiatric Settings: Four Recently Developed Screening Measures, in Baer, L., Blais, M.A. (2010). Handbook of Clinical Rating Scales and Assessment in Psychiatry and Mental Health. N.Y: Human Press.

Trull, T.J. & Amdur, M. (2001). Diagnostic Efficiency of the Iowa Personality Disorder Screen Items in a Nonclinical Sample. Journal of Personality Disorders: Vol. 15, No. 4, pp. 351-357. https://doi.org/10.1521/pedi.15.4.351.19184

Trauma History Screen (THS)

The Trauma History Screen (THS) was developed by Carlson et al. (2011) to address the need for a brief, simple and easy-to-read tool to assess exposure to distressful events. THS contains 14 dichotomous items (‘Yes’ or ‘No’). Comprising of two constructs, the THS is designed to assess high magnitude stressor events (HMS) and events relating to significant and persisting posttraumatic distress (PDD). HMS items refers to global, sudden events known to illicit distress response to majority of individuals (for example, hurricane, earthquake), whilst PPD events refers to events associated with significant subjective distress persisting for longer than 1 month (e.g. abandonment by spouse). THS also assesses the individuals’ duration of distress and the distress level.

THS is intended as a preliminary assessment of exposure to HMSs and PPDs, and the subjective experiences of individuals. As such, THS does not include a formal cut-off scoring procedure. Instead, THS is a quick and useful tool assess trauma exposure and levels and duration of distress which could inform clinicians of therapeutic conceptualisation. Clinicians can therefore utilise further measures to confirm diagnoses if needed.

Tested across four samples (home veterans, clinical sample, community sample and university students), the THS test-retest correlations over 2 periods (between 1 week and 2 months) were found to be moderate and very high (ranging from .61 to .95). THS was found to be highly correlated to the more lengthy published measure of traumatic life events questionnaire (TLEQ) across a variety of samples such as veterans (r = .77) and young adults (r = .73). The THS is an easy-to-read tool, requiring a fifth grade reading level. It requires a short amount of time to administer and is available at no cost. While it has not been validated cross-culturally, the structure of THS can be replicated to reflect culturally appropriate items. (Jaber, 2012). One notable limitation of the THS is the reliance on self-report, which may not be entirely accurate and may be estimation influenced by current symptoms.

In sum, THS is a reliable and valid tool to assess exposure to traumatic events that is brief, cost effective, therefore easy to administer. It can be a valuable measure when conceptualising cases as well as a screening tool towards diagnosis.

References

Carlson, E.B., Smith, S. R., Palmieri, P. A., Dalenberg, C., Ruzek, J. I., Kimerling, R., Burling, T. A., Spain, D. A. (2011). Development and validation of a brief self-report measure of trauma exposure: the Trauma History Screen. Psychological Assessment, 23, 463–477.

Jaber, S. (2012). Developing a self-help guide for traumatised university students in Iraq. UK: University of Nottingham, PhD thesis.

The Trauma History Screen (2005). Available from http://www.ptsd.va.gov

Levenson Self-report Psychopathy Scale (LSRP)

The Levenson Self-report Psychopathy Scale (LSRP) was created in 1995 by Michael R Levenson. It is a measure of psychopathic/sociopathic (interchangeable) traits. Psychopathy/sociopathy are colloquial terms for Anti-social Personality Disorder.

Originally two Subscales, 26 items

-Primary psychopathy (psychopathic emotional affect) – 16 items
-Secondary psychopathy (psychopathic lifestyle) – 10 items

More current research proposes a three-way model (three sub-scales) which can be broken up into egocentricity, callousness and anti-social.

Example items

Success is based on survival of the fittest; I am not concerned with the losers
I find that I am able to pursue one goal for a long time
Looking out for myself is my top priority
I often admire a really clever scam

Validity checks

Internal validity – Cronbach’s alpha: .84 (Sellbom, 2009)
Has been validated with prison and non-prison samples (Sellbom, 2011)
Good test-retest reliability
Good convergent reliability with other psychopathy measures (Sellbom, 2011)

Cross-cultural evidence

The LSRP was originally developed for Western individuals, specifically a North American audience. The LSRP has since been translated into Chinese, and used for Chinese populations. Internal convergent and discriminate validity remained high (Shou, Sellbom & Han, 2016)

Advantages

Free to the public
Quick to administer
Valid across culture

Disadvantages

Not well validated in a clinical setting

References:

Levenson, M., Kiehl, K., Fitzpatrick, C. (1995). Assessing psychopathic attributes in a noninstitutionalized population. Journal of Personality and Social Psychology, 68, 151-158.

Shou, Y., Sellbom, M., & Han, J. (2016). Evaluating the Construct Validity of the Levenson Self-Report Psychopathy Scale in China. Assessment. doi: 10.1177/1073191116637421

Sellbom, M. (2011). Elaborating on the construct validity of the Levenson Self-report Psychopathy Scale in incarcerated and non-incarcerated Samples. Law and Human Behaviour, 6, 440 – 451.