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PubMed1982

Some problems concerning the reliability and structure of the scales in the inpatient multidimensional psychiatric scale (IMPS).

Two problems concerning the IMPS are revealed. First, the importance of an appropriate reliability measure is demonstrated in a sample of 124 inpatients. Widely divergent results are found using three different intraclass correlation coefficients. The one producing the highest results was used by Klett and McNair (1966) and by Behrends et al. (1971). However, the results from this measure only apply to certain types of investigation. A measure more applicable to most investigations in psychiatric research (the intraclass correlation coefficient of individual ratings with between-rater variance included) produced results that were clearly lower, although still acceptable, with an average correlation of 0.72 between the 12 scales. Secondly, the multiplication of item scores by 2 or 8 when forming the scale scores is shown to lead to unusual and undesirable scale distributions in a sample of 1932 inpatients. The resulting implications for assessing change scores on some of the IMPS scales are discussed.

Adolescent↗
PubMed1996

A psychometric comparison of the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale.

This study compared two measures of depression in a population with schizophrenia. Inpatients (n = 112) with schizophrenia, were assessed on the Hamilton (HDRS), and Calgary (CDSS) depression scales and the Positive and Negative Syndrome Scale (PANSS). Eighty-nine were reassessed 3 months later. A principal components factor analysis was applied to each depression scale. The relationship between measures of depression and positive and negative symptoms was explored using correlation, factor and regression analyses. There were no significant correlations between the total CDSS and positive or negative symptoms at either time. In contrast, the HDRS total score was correlated with both positive and negative syndromes at time 2. Moreover, a number of HDRS factors correlated significantly with the PANSS positive scale at both times and with the negative subscale score at time 2. Multiple regression analysis showed that the HDRS accounted for more of the variance in positive and negative symptoms scores than did the CDSS. The CDSS has fewer factors and less overlap with positive and negative symptoms than the HDRS. This suggests that it is a more specific measure of level of depression than the HDRS for individuals with schizophrenia.

Adult↗
PubMed1998

Factor structure of the Social Interaction Anxiety Scale and the Social Phobia Scale.

In the study of social anxiety, it is common to differentiate between social interaction versus performance anxiety. The Social Interaction Anxiety Scale was designed to assess social interaction anxiety, and the Social Phobia Scale to assess fear of scrutiny by others (Mattick and Clarke, 1989). In common use, these scales are typically administered together and treated as subscales of a larger measure. However, the joint factor structure of these instruments has never been examined; therefore, it is unclear whether or not the items on these scales actually represent distinct aspects of social anxiety. In the present study, a confirmatory factor analysis of the pooled items from the SIAS and SPS failed to adequately fit the data. An exploratory factor analysis yielded three factors: (1) interaction anxiety, (2) anxiety about being observed by others, and (3) fear that others will notice anxiety symptoms. However, hierarchical factor analysis suggested that these factors all load on a single higher-order factor, social anxiety. Relationships of the first-order factors to other measures of social and performance fear and avoidance are examined, and implications of our findings for the assessment of social phobia are discussed.

Adult↗
PubMedDate not supplied

Comparison of the internal state scale to clinician-administered scales in asthma patients receiving corticosteroid therapy.

Mood symptoms are reported frequently in asthma patients, particularly during corticosteroid therapy. This investigation compared the Internal State Scale (ISS), a self-report measure of symptoms of mania and depression, to the Hamilton Rating Scale for Depression (HRSD), Young Mania Rating Scale (YMRS), and Brief Psychiatric Rating Scale (BPRS) in a group of asthma patients (n=60 at baseline) before, during, and after a 1-2 week burst of prednisone. The depression and well being subscales of the ISS correlated well with HDRS scores. The perceived conflict subscale correlated with the BPRS scores. However, none of the ISS subscales correlated consistently and specifically with the YMRS in this population. Possible explanations for differences observed in bipolar versus asthma patients given the ISS are discussed. These data suggest the ISS may be a useful tool for depression symptoms and overall psychopathology in asthma patients and in patients receiving corticosteroid therapy. However, its ability may be attenuated outside of the population for which it was designed.

Anti-Inflammatory Agents↗
PubMed2003

Comparison of Turkish Injury Scale (TIS) with the Abbreviated Injury Scale (AIS).

According to the Turkish Penal Code, Section 456, an assailant is punished in a correlation to the severity of the victim's injury. In this study, the injury scale used in Turkey in the basis code 456 is compared with Abbreviated Injury Scale (AIS). For this aim, a total of 984 cases out of the total amount reported at the Traumatology Section of the Turkish Council for Forensic Medicine were randomly selected and evaluated retrospectively. In all, 40.7% of injuries were caused by blunt trauma, whereas 59.3% were caused by a penetrating trauma. According to the Turkish Injury Scale (TIS), 40.3% of the cases were scored to be of a first degree of injury, 15.6% as second degree and 44.1% as third degree. When compared, the score points 3, 4 and 5 in the AIS were seen to be nearly equivalent to the TIS of third degree. From this point of view, in the modified AIS 91.1% of first degree of injury, 51.2% of second degree and 97.2% of third degree of injury are harmonious with TIS. Generally, 83.2% of the cases are harmonious with the AIS system. The purpose of this study is to determine what was the source of differences and to focus on particular traumatic lesions in order to determine a possible rearrangement of the Turkish Injury Scale.

Abbreviated Injury Scale↗
PubMed1999

Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS).

BACKGROUND: Scales to measure the severity of different dimensions of auditory hallucinations and delusions are few. Biochemical and psychological treatments target dimensions of symptoms and valid and reliable measures are necessary to measure these. METHOD: The inter-rater reliability and validity of the Psychotic Symptom Rating Scales (PSYRATS: auditory hallucination subscale and delusions subscale), which measure several dimensions of auditory hallucinations and delusions were examined in this study. RESULTS: The two scales were found to have excellent inter-rater reliability. Their validity as compared with the KGV scale (Krawiecka et al. 1977) was explored. CONCLUSIONS: It is concluded that the PSYRATS are useful assessment instruments and can complement existing measures.

Adult↗
PubMed1998

The development of a scale to assess war-time atrocities: the War Events Scale.

The War Events Scale (WES) was developed to assist clinicians with the assessment of war zone veterans' exposure to, and participation in war-time atrocities distinct from combat, and their current distress from these events. Data concerning content validity, test-retest reliability, internal consistency, as well as correlational data with the Combat Exposure Scale and the Mississippi Scale are presented. Results indicate that the WES does have adequate internal consistency and test-retest reliability, and correlates moderately with the Combat Exposure and Mississippi Scales. Initial results suggest that the WES may be helpful in collecting extremely sensitive information concerning the exposure of war zone veterans to atrocities.

Combat Disorders↗
PubMed2001

The Derriford Appearance Scale (DAS59): a new psychometric scale for the evaluation of patients with disfigurements and aesthetic problems of appearance.

The DAS59 has been designed and developed to meet the need for an objective measure of the spectrum of psychological distress and dysfunction that is characteristic of disfigurements, deformities and aesthetic problems of appearance. Content validity has been assured by basing the scale's items on a detailed autobiographical study of representative patients. Internal consistency is high (0.98) and test-retest reliabilities are good (general population: 0.75; clinical population: 0.86). Correlations with other appropriate standardised tests show good criterion validity and good construct validity. Factor analysis of 2741 data sets (general population and clinical population) identified three factors that are not feature specific and two that are (bodily and sexual features, facial features). The DAS59 thus generates a full-scale score and five factorial sub-scale scores. The DAS59 has been standardised on the clinical population across a range of patient groups and on the general population subdivided into those concerned and those not concerned about appearance. The DAS59 is highly sensitive as a measure of change following treatment with large and significant preoperative-postoperative reductions in full-scale and factorial scores of patients treated for facial features or bodily/sexual features. The DAS59 offers benefits for patient selection in both cosmetic and reconstructive plastic surgery and in the evaluation of outcome. It provides valid and reliable data for clinical audit and governance and for evaluating the merits of one treatment protocol against another.

Adult↗
PubMed2004

Simple bedside assessment of level of consciousness: comparison of two simple assessment scales with the Glasgow Coma scale.

Neurological assessment is an essential component of early warning scores used to identify seriously ill ward patients. We investigated how two simple scales (ACDU - Alert, Confused, Drowsy, Unresponsive; and AVPU - Alert, responds to Voice, responds to Pain, Unresponsive) compared to each other and also to the more complicated Glasgow Coma Scale (GCS). Neurosurgical nurses recorded patients' conscious level with each of the three scales. Over 7 months, 1020 analysable measurements were collected. Both simple scales identified distinct GCS ranges, although some overlap occurred (p < 0.001). Median GCS scores associated with AVPU were 15, 13, 8 and 6 and for ACDU were 15, 13, 10 and 6. The median values of ACDU were more evenly distributed than AVPU and may therefore be better at identifying early deteriorations in conscious level when they occur in critically ill ward patients.

Attitude of Health Personnel↗
PubMed1979

The Bech-Rafaelsen Mania Scale and the Hamilton Depression Scale.

In a study of 18 patients with manic symptomatology and 31 patients with melancholic symptomatology the Bech-Rafaelsen Mania Scale (BRMS) and the Hamilton Depression Scale (HDS) have been compared. The results showed that the inter-observer reliability of the BRMS was adequate compared with the HDS. Both scales are constructed for assessing the severity of manic or melancholic states, and no difference was found in the total BRMS or HDS score between the various diagnostic groups, when the patients were classified by an index of the course and symptomatology otive disorder, using the Multi-axial Classificetion System for Affective Disorders (MULTI-CLAD). The homogeneity of the BRMS seemed more adequate than that of the HDS, when each item was correlated to the corresponding total score. Although the homogeneity of the BRMS needs to be evaluated by other statistical models than correlation analysis, our results seem to indicate that the improvement in assessing manic-melancholic states quantitatively is a matter of redefining items or incorporating new items in the melancholic rather than the manic part of these rating scales.

Adult↗
PubMedDate not supplied

Alzheimer's Disease Assessment Scale: the validation of the scale in Greece in elderly demented patients and normal subjects.

INTRODUCTION: The Alzheimer Disease Assessment Scale (ADAS) is a scale specifically structured for the assessment of the cognitive decline and behavioral disorder seen in Alzheimer disease (AD) patients. AIM OF THE STUDY: The validation of ADAS in the Greek population. MATERIAL: One hundred and thirty-one subjects took part in the current study. Fifty of them were nondemented subjects (35 normal subjects and 15 suffering from age-associated memory impairment) and 81 demented patients (68 AD patients and 13 vascular dementia, VD, patients). METHOD: Diagnosis was made according to DSM-IV and NINCDS-ADRDA criteria. Hachinski Ischemia Scale was used to help to differentiate between AD and VD patients. Geriatric Depression Scale was used to quantify depressive symptomatology. MMSE and CAMCOG were used to assess the cognitive functioning of all subjects and FRSSD for the assessment of daily functioning. All subjects underwent a complete laboratory and biochemical testing, according to the protocol proposed in CAMDEX. All demented patients underwent brain CT. RESULTS: ADAS-Cog discriminates perfectly AD patients and nondemented subjects at the score level of 13/14 and/or 14/15. Principal components analysis, using only AD patients, revealed 4 factors: cognitive, psychotic, depressive, and 'severe apraxia' factors. CONCLUSION: ADAS is suitable for use in the discrimination between AD patients and nondemented subjects. It is also suitable for a more comprehensive assessment of the clinical symptomatology of AD patients, and for the evaluation of new therapeutic methods for AD, as well.

Age Factors↗
PubMedDate not supplied

The Skin Picking Impact Scale (SPIS): scale development and psychometric analyses.

The Skin Picking Impact Scale (SPIS) is a self-report instrument developed to assess the psychosocial consequences of repetitive skin picking. An initial 28-item scale was administered to 31 individuals with severe self-injurious skin picking and 78 individuals with non-self-injurious skin picking. Item difficulty levels and part-whole correlations resulted in a 10-item scale with good internal consistency. SPIS scores for those with self-injurious skin picking were significantly higher than for those with non-self-injurious skin picking. SPIS scores for those with self-injurious skin picking correlated with duration of daily picking, satisfaction during picking, and shame subsequent to picking, as well as Beck Depression Inventory and Beck Anxiety Inventory scores. Sensitivity and specificity analyses indicate that a scale cutoff score of 7 optimally discriminates individuals with self-injurious skin picking from those with non-self-injurious skin picking.

Adult↗
PubMed2003

The category test perseveration, loss of set, and memory scales: three new scales and their relationship to executive functioning measures.

The Category Test (CT) is a neuropsychological measure that taps into multiple domains of complex reasoning but yields a single error score, limiting the use of the test. In this study, three new CT scales were developed to assess specific aspects of executive dysfunction: Perseveration, Failure to Maintain Cognitive Set, and Inability to Recall and Re-Initiate Past Behavior. The relationship of these scales to well-established neuropsychological measures was examined in head-injured individuals and schizophrenia patients. The CT Perseveration score was correlated with the Wisconsin Card Sorting Test (WCST) Perseverative Responses score, but also with measures from the Wechsler Memory Scale-Revised and the California Verbal Learning Test. The CT Memory score correlated with other memory measures, but also with the WCST Perseveration measure. Although future studies designed to test discriminant and convergent validity are warranted, these scales may be useful in determining specific aspects of impaired CT performance.

Adult↗
PubMed2004

The Bipolar Affective Disorder Dimension Scale (BADDS)--a dimensional scale for rating lifetime psychopathology in bipolar spectrum disorders.

BACKGROUND: Current operational diagnostic systems have substantial limitations for lifetime diagnostic classification of bipolar spectrum disorders. Issues include: (1) It is difficult to operationalize the integration of diverse episodes of psychopathology, (2) Hierarchies lead to loss of information, (3) Boundaries between diagnostic categories are often arbitrary, (4) Boundaries between categories usually require a major element of subjective interpretation, (5) Available diagnostic categories are relatively unhelpful in distinguishing severity, (6) "Not Otherwise Specified (NOS)" categories are highly heterogeneous, (7) Subclinical cases are not accommodated usefully within the current diagnostic categories. This latter limitation is particularly pertinent in the context of the increasing evidence for the existence of a broader bipolar spectrum than has been acknowledged within existing classifications. METHOD: We have developed a numerical rating system, the Bipolar Affective Disorder Dimension Scale, BADDS, that can be used as an adjunct to conventional best-estimate lifetime diagnostic procedures. The scale definitions were informed by (a) the current concepts of mood syndrome recognized within DSMIV and ICD10, (b) the literature regarding severity of episodes, and (c) our own clinical experience. We undertook an iterative process in which we initially agreed scale definitions, piloted their use on sets of cases and made modifications to improve utility and reliability. RESULTS: BADDS has four dimensions, each rated as an integer on a 0 - 100 scale, that measure four key domains of lifetime psychopathology: Mania (M), Depression (D), Psychosis (P) and Incongruence (I). In our experience it is easy to learn, straightforward to use, has excellent inter-rater reliability and retains the key information required to make diagnoses according to DSMIV and ICD10. CONCLUSIONS: Use of BADDS as an adjunct to conventional categorical diagnosis provides a richer description of lifetime psychopathology that (a) can accommodate sub-clinical features, (b) discriminate between illness severity amongst individuals within a single conventional diagnostic category, and (c) demonstrate the similarity between the illness experience of individuals who have been classified into different disease categories but whose illnesses both fall near the boundaries between the two categories. BADDS may be useful for researchers and clinicians who are interested in description and classification of lifetime psychopathology of individuals with disorders lying on the bipolar spectrum.

Bipolar Disorder↗
PubMed2006

A comparison of five simplified scales to the out-of-hospital Glasgow Coma Scale for the prediction of traumatic brain injury outcomes.

BACKGROUND: The 15-point Glasgow Coma Scale (GCS) frequently is used in the initial evaluation of traumatic brain injury (TBI) in out-of-hospital settings. We hypothesized that the GCS might be unnecessarily complex for out-of-hospital use. OBJECTIVES: To assess whether a simpler scoring system might demonstrate similar accuracy in the prediction of TBI outcomes. METHODS: We performed a retrospective analysis of a trauma registry consisting of patients evaluated at our Level 1 trauma center from 1990 to 2002. The ability of out-of-hospital GCS scores to predict four clinically relevant TBI outcomes (emergency intubation, neurosurgical intervention, brain injury, and mortality) by using areas under receiver operating characteristic curves (AUROCs) was calculated. The same analyses for five simplified scales were performed, and compared with the predictive accuracies of the total GCS score. RESULTS: In this evaluation of 7,233 trauma patients over a 12-year period of time, the AUROCs for the total GCS score were 0.83 (95% confidence interval [CI] = 0.81 to 0.84) for emergency intubation, 0.86 (95% CI = 0.85 to 0.88) for neurosurgical intervention, 0.83 (95% CI = 0.82 to 0.84) for brain injury, and 0.89 (95% CI = 0.88 to 0.90) for mortality. The five simplified scales approached the performance of the total GCS score for all clinical outcomes. CONCLUSIONS: In the evaluation of injured patients, five simplified neurological scales approached the performance of the total GCS score for the prediction of four clinically relevant TBI outcomes.

Adolescent↗
PubMed1989

Fiber optic probe augmented sonic scaling versus conventional sonic scaling.

Several factors, including access and visualization problems, make total deposit removal during scaling and root planing procedures extremely difficult. This study examined the effectiveness of a mode of therapy designed to improve access and visualization for sonic scaling compared to closed sonic instrumentation. Teeth with moderate to deep probing depths in six patients scheduled to receive immediate dentures were divided into three experimental groups: Group I, sonic scaling with access augmented by interdental papilla reflection and fiber optic illumination/transillumination (34 surfaces); Group II, closed sonic scaling (34 surfaces); and Group III, untreated controls (35 surfaces). Immediately after treatment the experimental teeth were extracted, stained with toluidine blue, and interproximal areas evaluated for remaining accretions with a microscope-digitizing pad-computer system. Group I had a significantly lower percentage (P less than 0.01) of remaining subgingival accretion coverage than Group II (1.30 +/- 0.25% vs 6.35 +/- 1.08%), and both Group I and II demonstrated significantly (P less than 0.01) fewer deposits than the control surfaces (46.61 +/- 4.32%). These findings suggest that minimal tissue reflection and fiber optic illumination/transillumination are beneficial adjuncts to deposit removal in moderate to deep periodontal pockets.

Coloring Agents↗
PubMed1977

Relationship between the Geriatric Interpersonal Evaluation Scale and the WAIS Verbal Scale.

27 psychogeriatric patients at Harlem Valley Psychiatric Center were tested by separate examiners on the WAIS Verbal Scale and the Geriatric Interpersonal Evaluation Scale to determine the relationship between these two tests. The sample was restricted to patients who were judged clinically to be "in contact," i.e., oriented as to time, place, and person. The correlation between the WAIS Verbal IQs and the geriatirc scale raw scores was .80; correlations with the individual verbal subscale scores ranged from .58 to .76. Relative advantages and disadvantages of the geriatric scale are discussed.

Aged↗
PubMed1990

[Standardization of a modular and hierarchic cognitive evaluation scale applicable to dementia. A French version of the Hierarchic Dementia Scale].

We tested a revised version of the Hierarchic Dementia Scale (HDS), proposed by Cole and Dastoor (1980), in order to improve its clinical usefulness and to enrich our knowledge about ageing. The scale was built with 20 subtests which covered the entire range of cognitive and motor functions. Each subtest was hierarchically organized so that success in a item implied success in inferior items. This hierarchical principle was time-saving and was validated by Cole and Dastoor. 149 control subjects performed this test. They were equally divided in 4 age-groups (55-64, 65-74, 75-84, 85-97) and 2 educational levels. None of these subjects had previous history of somatic or neuropsychiatric disease. They were completely self-sufficient in daily life. A large part of the controls failed in the most difficult items of some subtests: Learning, Calculation, Mental Control, Drawing, Recall, Similarities, Constructional Praxis. For these subtests, significantly different mean-scores were observed between age-groups and educational levels. However, the influence of each factor was variable from one subtest to another. Moreover, subgroups seem to exist in our population according to specific difficulties in some of these subtests. This study calls for caution in the interpretation of results in demented patients. Comparisons with other psychometric tools remain to be performed. This scale seems to be more useful for the quantification and follow-up of cognitive deficits than for the early diagnosis of dementia. In addition, this scale, which briefly explores many aspects of cognitive functions, seems especially useful to approach the heterogeneity of DAT.

Aged↗