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[The "AMDP scale for dissociation and conversion (AMDP-DK)": development of an observer-rated scale and first psychometric properties].

The AMDP scale for dissociation and conversion (AMDP-DK) represents an observer-rated scale for the assessment of dissociative and conversive phenomena, which closes the gap between available self-report questionnaires and time-consuming structured interviews with their respective disadvantages. The instrument comprises 30 operationalized items, which are rated according to the AMDP rules, and which are theoretically-driven divided into the subscales dissociation (15 items), conversion (9 items) and a "formal" dimension (6 items) to cover associated phenomena. In a sample of psychiatric inpatients (n = 73) the covered symptoms showed a great variety of frequency and intensity. The AMDP-DK and its subscales had good internal consistency (Cronbachs alpha between 0.76 and 0.85). A factor-analysis mostly replicated the theoretically constructed subscales. The convergent and divergent validity of the scale was good, as well as its ability to discriminate between high- and low-dissociating patients. The findings are discussed with regard to the psychometric properties and the relevance for the theories of dissociation and conversion.

Adolescent↗

Statistical modelling in analysis of outcome after trauma Glasgow-Coma-Scale and Innsbruck-Coma-Scale.

AIM OF THE STUDY: The current study investigated the Glasgow-Coma-Scale (GCS) and the Innsbruck-Coma-Scale (ICS) for accuracy and reliability of prehospital prediction of non-survival. METHODS: 254 patients were scored immediately after trauma. RESULTS: Both scales equally predicted non-survival with low scores (p < 0.001). The ICS was slightly better in overall prediction of patient outcome (ICS: 84.98%; GCS: 82.68%), but more importantly, statistical analysis (logistic regression model) showed a greater distance between the median scores of survivors and non-survivors, when scored with the ICS (survival: 12; non-survival: 3) than when scored with the GCS (survival: 7; non-survival: 4). CONCLUSION: The results of the present study not only suggest that it is possible to predict mortality prior to therapy for any individual GCS and ICS coma score, but also indicated the ICS to be safer to use than the GCS because of the greater distance of the median scores for survivors and non survivors.

Adolescent↗

Rating scale analysis of the Agitated Behavior Scale.

OBJECTIVE: Evaluate the measurement properties of the Agitated Behavior Scale (ABS) using rating scale analysis. SAMPLES: Sample 1: 900 observations of 100 individuals with traumatic brain injury; Sample 2: 204 observations of 102 persons with dementia; Sample 3: 241 observations of 6 individuals with anoxia. RESULTS: The calibration indicated that the rating scale was used as intended. The hierarchies of item difficulty were similar across samples. Person and item separation values were within the acceptable range for the TBI sample. Generally, the items work well together, however 3 items misfit the measurement model moderately. CONCLUSIONS: Agitation as measured by the ABS is best represented as a unitary construct. Results provide additional support for the reliability and validity of the ABS.

Brain Injuries↗

The Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale. Reliability, comparability, and predictive validity.

In a psychiatric rehabilitation study, 154 concurrent ratings were performed using the 30-item Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS). Although both instruments had excellent interrater reliability, the PANSS was consistently better: on the 18 symptom items the two instruments share, the PANSS had higher intraclass r's on 14; for the syndromes, the PANSS was higher than the BPRS on positive, negative, and total. Weighted Kappas comparing shared items revealed that most were not interchangeable, with only three coefficients in the excellent range. However, syndrome scale scores were very highly correlated and resulted in similar classification for negative schizophrenia. Ten of the 12 items of the PANSS not included in the BPRS had low zero-order correlations with BPRS items, which suggests that they measure symptoms distinct from those measured by the BPRS and should add to clinical predictive power. This proved true in our study of rehabilitation of patients with schizophrenia. PANSS symptom ratings explained up to 55% of the variance on seven measures of work performance, whereas the BPRS had lower predictive power on six of the seven measures. We concluded that the PANSS may be superior to the BPRS in clinical research on schizophrenia and that most BPRS items are not interchangeable with identically named PANSS items.

Adult↗

Depression and somatic symptoms scale: a new scale with both depression and somatic symptoms emphasized.

The authors' preliminary study selected 22 items for Depression and Somatic Symptoms Scale (DSSS), including depression subscale (DS) and somatic subscale (SS). The aim of the study was to test reliability and validity of the DSSS. The study enrolled 135 consecutive outpatients (34 male and 101 female) experiencing a major depressive episode (the MDE group), 95 of whom (25 male and 70 female) accepted 1 month of treatment (the treatment group). Diagnosis was confirmed by using the Structured Clinical Interview for 4(th) edition with text revision Diagnostic and Statistical Manual Axis I Disorders. The DSSS and Hamilton Depression Rating Scale (HAMD) were given and evaluated. Cronbach's alpha was used to assess internal consistency. The correlation between the improvement percentage (IP) for the HAMD and the IP for the DSSS was calculated for the treatment group. Factor analysis was performed by using the principal-axis factoring method with promax rotation. Cronbach's alpha values of the DSSS and its subscales ranged from 0.73 to 0.94. Pearson correlation coefficients for the relationship between the DSSS and HAMD ranged from 0.63 to 0.86. In the treatment group, DSSS and HAMD scores were significantly decreased after treatment and the IP for the HAMD and the DSSS were similar and correlated (correlation coefficient = 0.78). The results of the factor analysis demonstrated that most of the items in DS and SS appropriately loaded in Depression and Somatic factors, respectively. The discriminative ability of the DSSS for anxiety comorbidities was not inferior to that of the HAMD. Therefore, the DSSS is reliable and sensitive to the treatment and has acceptable convergent, factorial, and distinct-groups validities. Because it assesses both depression and somatic symptoms, DSSS may overcome the deficiency of other depression scales with few somatic items.

Adult↗

Factor study of the Hamilton Rating Scale for Depression and the Bech Melancholia Scale.

In this study, a sample (n = 234) of elderly people between the ages of 60 and 95 was evaluated. Items from the Hamilton Rating Scale for Depression and the Bech-Rafaelsen Melancholia Scale were factorialized using the oblique rotation method oblimin. Three clinically significant factors were obtained, accounting for 41% of variance. The first was interpreted as a dimension of inhibition and melancholic depression; the second, insomnia; and the third, somatic and psychic anxiety. It is concluded that the set of items on both scales increases the capacity for evaluating melancholic aspects of depression. In the interpretation of factor analysis, the possible artifact represented by the repetition of similar items must be kept in mind. Despite the loss of simplicity oblique rotation implies, it is considered preferable to orthogonal rotation since it allows for a greater congruity with clinical situations.

Aged↗

Yale-Brown Obsessive Compulsive Scale and US National Institute of Mental Health Global Obsessive Compulsive Scale in Turkish: reliability and validity.

Fifteen patients with DSM-III-R diagnosis of obsessive-compulsive disorder (OCD) were rated according to the Turkish version of the Yale Brown Obsessive Compulsive Scale (Y-BOCS) and the US National Institute of Mental Health Global Obsessive Compulsive Scale (NIMH-GOCS) by 7 raters independently from audiotaped interviews. Patients also completed the Maudsley Obsessive Compulsive Inventory (MOCI). Interrater reliability of Y-BOCS and NIMH-GOCS were very good as well as correlations between these two scales. The correlations of MOCI with Y-BOCS and NIMH-GOCS were not significant. We found Y-BOCS and NIMH-GOCS to be reliable and valid instruments in assessing the severity of OCD. These findings suggest that MOCI may not be a suitable instrument for assessing the severity of OCD.

Female↗

Validation of the Chinese-Cantonese version of the hospital anxiety and depression scale and comparison with the Hamilton Rating Scale of Depression.

OBJECTIVE: The aim of this study was to validate the Chinese-Cantonese version of the Hospital Anxiety and Depression Scale (HADS) and to compare it with the Hamilton Rating Scale of Depression (HRSD) as a screening tool for depressive disorders in general hospital in-patients. METHOD: The Chinese-Cantonese version of the HADS was administered to general hospital in-patients seen on a consultation basis, and psychiatric diagnoses were made according to DSM-III-R. The subjects were further rated independently with the HRSD. RESULTS: The Chinese-Cantonese version of the HADS was found to have good internal consistency and external validity, with favourable sensitivity and specificity for screening for psychiatric disorders. However, its performance was marginally inferior to that of the HRSD. The scale also performed poorly in identifying major depression. CONCLUSION: The HADS has limitations with regard to identification of depressive disorders. However, despite its shortcomings, it remains one of the best paper-and-pencil tests for screening psychiatric disorders in the medically ill.

Adult↗

Validation of the Delirium Rating Scale-revised-98: comparison with the delirium rating scale and the cognitive test for delirium.

The DRS-R-98, a 16-item clinician-rated scale with 13 severity items and 3 diagnostic items, was validated against the Cognitive Test for Delirium (CTD), Clinical Global Impression scale (CGI), and Delirium Rating Scale (DRS) among five diagnostic groups (N=68): delirium, dementia, depression, schizophrenia, and other. Mean and median DRS-R-98 scores significantly (P<0.001) distinguished delirium from each other group. DRS-R-98 total scores correlated highly with DRS, CTD, and CGI scores. Interrater reliability and internal consistency were very high. Cutoff scores for delirium are recommended based on ROC analyses (sensitivity and specificity ranges: total, 91%-100% and 85%-100%; severity, 86%-100% and 77%-93%, respectively, depending on the cutoffs or comparison groups chosen). The DRS-R-98 is a valid measure of delirium severity over a broad range of symptoms and is a useful diagnostic and assessment tool. The DRS-R-98 is ideal for longitudinal studies.

Adolescent↗

The relationship between discharge readiness inventory scales and the brief psychiatric rating scale.

OBJECTIVE: Important relationships exist between chronic psychiatric patients' symptoms of disorder and their readiness to be discharged from inpatient treatment. Behavioral rating scales can supplement clinical decision making by standardizing information about patients' functioning. The authors assessed whether two different behavioral measures described the same dimensions of disordered behavior in an older chronic patient population. METHODS: Multivariate correlation analysis (canonical analysis) was used to assess relationships between items on the Brief Psychiatric Rating Scale and the scales in the Discharge Readiness Inventory. RESULTS: Three significant correlation variates were found. The variates reflected patterns of positive psychiatric symptomatology with a low level of psychosocial competence, a low level of symptomatology with a low level of psychosocial competence, and paranoid symptomatology with a high level of psychosocial competence. CONCLUSIONS: The presence or absence of psychiatric symptomatology and possibly the type of symptomatology are relevant in assessing patients' readiness for discharge.

Activities of Daily Living↗

The Melancholia Scale and the Newcastle Scales. Item-combinations and inter-observer reliability.

The reliability of the total scores on three rating scales (Melancholia Scale and the two Newcastle Scales) and the algorithms leading to the Feighner, Research Diagnostic Criteria, and the DSM-III subtypes of depression have been compared. The degree of inter-observer agreements for the various item-combinations was significantly higher than would be expected by chance. The average agreement for each assessment system ranged from 80 to 93 per cent. This 7 to 20 per cent lack of total agreement probably reflects the limitation of clinical assessments including the influence of halo effects.

Adult↗

Tetracycline fibers plus scaling and root planing versus scaling and root planing alone: similar results after 5 years.

This paper presents 5-year data pertaining to a subgroup of patients from a previous investigation who were treated with scaling and root planing plus tetracycline fibers. The parent study demonstrated that 6 months after therapy, scaling and root planing plus tetracycline fiber therapy was significantly better at reducing probing depth and gaining clinical attachment than scaling and root planing alone. However, the long-term data presented here show a regression from the original gains in clinical attachment levels in the fiber group. Ultimately, the use of fibers provided no significant advantage with regards to probing depth reduction or clinical attachment gain. Within the power of this study, which would have required 1.78 mm of change in clinical attachment to show a difference, there was no significant difference between the treatments at 5 years. This study underscores the need for additional long-term evaluation of this mode of therapy.

Analysis of Variance↗

Convergent and discriminant validities of the Scales of Independent Behavior and the revised Vineland Adaptive Behavior Scales.

The relation between the Scales of Independent Behavior (SIB) and the revised Vineland Adaptive Behavior Scales (VABS) was examined. Subjects were 53 children ages 3 through 7. A correlation of .83 was found between the SIB Broad Independence Score and the VABS Adaptive Behavior Composite. Campbell and Fiske's criteria for convergent and discriminant validity were applied to six of the scales that were common to both instruments. Results indicated that the most valid subscales were Personal Living Skills, Communication Skills, and Community Living Skills.

Activities of Daily Living↗

The Phobic Avoidance Rating Scale: a psychometric evaluation of an interview-based scale.

An interviewer rating scale for the measurement of (agora)phobic avoidance, the Phobic Avoidance Rating Scale (PARS), is described and psychometrically evaluated. The criteria of avoidance used are purported to correct weaknesses of the sets of criteria used in self-report instruments. Two samples with inpatients satisfying DSM-III-R criteria for unipolar depressive and/or anxiety disorder were studied. Intercorrelational and factor analyses revealed 3 dimensions among agoraphobic fears: separation fears, social fears and simple phobic fears. Overall, the 3 subscales constructed from these dimensions proved to have good reliability, validity, and sensitivity to change following treatment. The internal consistency of the social subscale seemed to be somewhat low. The PARS should be well suited to assess avoidance among agoraphobic patients on separate dimensions and to distinguish patients with agoraphobia from other psychiatric patients. It seems to be the first interviewer rated agoraphobic scale that is psychometrically investigated and should ideally be used for research purposes in combination with a self-report instrument.

Adult↗

Concurrent validity of the adaptive behavior scale as assessed by the Vineland Social Maturity Scale.

The correlation between the Adaptive Behavior Scale (ABS) and the Vineland Social Maturity Scale (the Vineland) was investigated using a sample of 98 subjects from a state residential facility for mentally retarded individuals. Pearson correlations between the raw scores of the two scales revealed a high degree of association between the Vineland and Part One of the ABS. The correlation between the Vineland total score and ABS Part One sum score equaled .79. The Part One domain correlations ranged from .44 (Physical Development) to .77 (Language Development), with a mean of .64. Part Two of the ABS showed little relationship to the Vineland. The Part Two total score correlation was .11, and the mean Part Two domain correlations was .20.

Adaptation, Psychological↗

[Validity of the Behavior Observation Scale for Intramural Psychogeriatrics: a comparison with the BOP (Evaluation Scale Elderly Patients) and NOSIE-30 in a psychogeriatric assessment clinic for the elderly].

The Validity of the Dutch Behavior Rating Scale for Psychogeriatric Inpatients GIP was demonstrated in a study comparing it to well-known rating scales such as the BOP and NOSIE-30 (n = 195). The GIP has the additional advantage of specifically describing the emotional and affective characteristics of psychogeriatric patients. Interrater reliability (Cohen's kappa) of all three rating scales was modest, which might be explained by the type of setting: a short stay clinic for the elderly where rapid behavioural changes can occur. Using a regression analysis technique a new compact GIP dependency subscale was constructed showing excellent predictive value in relation to the more elaborate BOP dependency subscale.

Aged↗

The Performance Status Scale for Head and Neck Cancer Patients and the Functional Assessment of Cancer Therapy-Head and Neck Scale. A study of utility and validity.

BACKGROUND: The goal of this investigation was to examine the relationship between, and application of, two disease specific quality of life (QL) measures currently being employed for head and neck cancer patients: the Functional Assessment of Cancer Therapy-Head and Neck Scale (FACT-H&N) and the Performance Status Scale for Head and Neck Cancer Patients (PSS-HN). METHODS: The FACT-H&N and PSS-HN were administered to 151 head and neck cancer patients with a range of disease sites, treatment status (on vs. off treatment), and treatment modalities (surgery, radiation, and chemotherapy). RESULTS: FACT-H&N subscale and total scores and PSS-HN subscale scores proved sensitive to patients groups (showed significant and clinically meaningful differences) on the basis of treatment status (on vs. off treatment) and global performance status (Karnofsky scores). The pattern of correlations between FACT-H&N and PSS-HN subscales supported the scales' construct (convergent vs. divergent) validity. The strongest and most significant associations were observed between PSS-HN Normalcy of Diet and Eating in Public, and the head and neck subscale (HNS) of FACT-H&N, both of which were designed to measure the unique problems of head and neck cancer patients. More modest associations were observed between subscales measuring physical and functional areas of performance, social functioning, and emotional well-being. CONCLUSIONS: The FACT-HNS was found to be reliable and valid when applied to head and neck cancer patients. It clearly adds information to that collected by the parent (core) instrument. The PSS-HN also provides unique information, independent of that provided by the Karnofsky or the FACT-H&N. This study supported the multidimensional nature of QL for head and neck cancer patients, and thus the importance of assessing disease specific concerns in addition to general health status when assessing functional and QL outcome.

Adolescent↗