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PubMed2002

Treatment planning with the Psychopathy Checklist-Revised (PCL-R).

The Psychopathy Checklist-Revised (PCL-R) is an essential component of any assessment protocol within forensic and correctional settings. Both nomothetic and idiographic interpretations aid the clinician in screening and treatment planning. Whereas the PCL-R can be effective in identifying those who are at highest risk of disrupting treatment efforts and jeopardizing the safety of those around them, through item analysis, it also provides clues to the nonpsychopath's unique treatment needs. Specific recommendations are offered regarding the implementation of the PCL-R for screening and treatment planning, and illustrative case examples are provided to enliven essential points.

Antisocial Personality Disorder↗
PubMed2005

The child behavior checklist together with the ADHD rating scale can diagnose ADHD in Korean community-based samples.

OBJECTIVE: The purpose of this study was to examine the clinical validities and efficiencies of the Child Behavior Checklist (CBCL) and the ADHD Rating Scale-IV (ARS) in identifying children with attention-deficit hyperactivity disorder (ADHD) in Korean community-based samples. METHOD: A large sample of elementary school students (n = 1668) participated in this study. We used the CBCL and the ARS as the screening instruments. Diagnoses were determined by clinical psychiatric interviews and confirmed by DSM-IV-based structured interviews. RESULTS: Of the 46 subjects who underwent clinical psychiatric interviews, 33 were diagnosed as having ADHD. A T score of 60 with regard to the Attention Problems profile of the CBCL resulted in a reasonable level of sensitivity or positive predictive value in the diagnosis of ADHD. In both the parent and teacher reports of the ARS, 90th percentile cut-off points resulted in a high level of predictive value. The highest levels of specificity and positive predictive value were obtained when we combined the CBCL (T > or = 60 in Attention Problems) and the ARS (parent-teacher total > or = 90th percentile) reports. CONCLUSIONS: These findings suggest that the combined use of the CBCL and the ARS could serve as a rapid and useful clinical method of predicting or even diagnosing children with ADHD in epidemiologic case definitions.

Attention Deficit Disorder with Hyperactivity↗
PubMed2006

Psychopathy checklist score predicts negative events during the sentences of prisoners with Hare psychopathy: a prospective study at a German prison.

OBJECTIVE: This study examined the predictive validity of the German translation of the Psychopathy Checklist-Screening Version (PCL-SV) for negative events during the course of the prison sentence of German prisoners. METHOD: Using the PCL-SV, we investigated 145 offenders in a German prison at the start of their sentences. We then compared the extreme groups identified by the PCL-SV--the high and low scorers--using a prospective design with respect to negative events and factors during the course of the sentences. This involved the standardized collection of data on both objective records of disciplinary incidents and subjective impressions from prison staff on the basis of operationalized criteria. RESULTS: The high scorers were involved in significantly more disciplinary incidents and were also rated significantly less favourably by prison staff than the low scorers. CONCLUSION: Until now, the PCL has only been shown to predict recidivism following release from prison. The results of our study show that the PCL also has predictive validity for problems during the course of the sentence. It is therefore recommended that the PCL be used routinely at the start of the prison sentence to estimate the likelihood of subsequent difficulties.

Antisocial Personality Disorder↗
PubMed2006

What does the use of a computerized checklist mean for patient-centered care? The example of a routine diabetes review.

The authors examine the interaction between nurses and patients with type 2 diabetes during routine consultations in primary care settings in the United Kingdom. Through preconsultation interviews, the authors identified the patients' expectations. The article draws on videotaped consultations with 25 patients with type 2 diabetes. Using conversation analysis, the authors examine the use of a rigid agenda, imposed via a computerized checklist, and consider how far this is able to suppress the patient's agenda. They consider the potential impact for the patient and the factors that might encourage the clinician, and the nurse specifically, to adopt a narrowly task-based approach to the consultation. They identify two potentially conflicting strands within contemporary diabetes care, patient-centered practice and an emphasis on biomedical audit, and suggest that achievement of the former might be compromised by the demands of the latter.

Adolescent↗
PubMed2000

The psychopathy checklist--screening version: an examination of criteria and subcriteria in three forensic samples.

The development and refinement of psychopathy represent a critical issue in clinical and forensic practice. During the last decade, important advances in the operationalization of psychopathy were achieved, primarily through the development of the Psychopathy Checklist (PCL) and its subsequent versions (PCL-R and PCL:SV). PCL ratings are based primarily on item descriptions or subcriteria. The current study serves to break new ground as the first systematic investigation of PCL:SV subcriteria by addressing their psychometric properties and exploring their construct and criterion-related validation. Previously unanalyzed data from three samples were integrated: female offenders, male forensic patients, and male adolescent offenders. Results largely support the use of subcriteria as homogeneous components of criteria and provide strong initial evidence of their construct validity. Results are less conclusive regarding criterion-related validity. For female offenders, they suggested the potential value of specific PCL:SV subcriteria for predicting verbal aggression. Confirmatory factor analysis provided encouraging results on the applicability of the standard two-factor model of psychopathy. However, a first-order principal axis factoring suggested further refinements in our understanding of psychopathy.

Adolescent↗
PubMed2000

Six- and ten-item indexes of psychological distress based on the Symptom Checklist-90.

Clinicians, provider organizations, and researchers need simple and valid measures to monitor mental health treatment outcomes. This article describes development of 6- and 10-item indexes of psychological distress based on the Symptom Checklist-90 (SCL-90). A review of eight factor-analytic studies identified SCL-90 items most indicative of overall distress. Convergent validity of two new indexes and the previously developed SCL-10 were compared in an archival sample of posttraumatic stress disorder patients (n = 323). One index, the SCL-6, was further validated with archival data on substance abuse patients (n = 3,014 and n = 316) and hospital staff (n = 542). The three brief indexes had similar convergent validity, correlating .87 to .97 with the SCL-90 and Brief Symptom Inventory, .49 to .76 with other symptom scales, and .46 to .73 with changes in other symptom measures over time. These results indicate the concise, easily administered indexes are valid indicators of psychological distress.

Adult↗
PubMed2000

Brief psychosocial assessment of a clinical sample: an evaluation of the Personal Problems Checklist for Adults.

In light of the requirements for managed health care organizations to use assessment instruments that are psychometrically sound, cost and time efficient, and theoretically useful, the present study examined the psychometric properties of one such potential instrument, the Personal Problems Checklist for Adults (PPCA). Designed to measure problems in 13 areas of everyday functioning, the PPCA along with the Brief Symptom Inventory were completed by 132 individuals in an outpatient drug rehabilitation program. Counselor ratings on the Adjective Check List were also obtained. Results clearly showed that personal problems as measured by the PPCA were related to self-reported psychological symptoms and to perceptions by their counselors. The PPCA proved to have good psychometric properties and warrants greater attention by testing psychologists given its potential to meet criteria set forth by managed health care.

Activities of Daily Living↗
PubMed2004

Psychometric properties of the life events checklist.

The Life Events Checklist (LEC), a measure of exposure to potentially traumatic events, was developed at the National Center for Posttraumatic Stress Disorder (PTSD) concurrently with the Clinician Administered PTSD Scale (CAPS) to facilitate the diagnosis of PTSD. Although the CAPS is recognized as the gold standard in PTSD symptom assessment, the psychometric soundness of the LEC has never been formally evaluated. The studies reported here describe the performance of the LEC in two samples: college undergraduates and combat veterans. The LEC exhibited adequate temporal stability, good convergence with an established measure of trauma history -- the Traumatic Life Events Questionnaire (TLEQ) -- and was comparable to the TLEQ in associations with variables known to be correlated with traumatic exposure in a sample of undergraduates. In a clinical sample of combat veterans, the LEC was significantly correlated, in the predicted directions, with measures of psychological distress and was strongly associated with PTSD symptoms.

Adult↗
PubMed2005

Reliability and Validity Evaluation of the Psychopathy Checklist: Screening Version (PCL:SV) in Swedish correctional and forensic psychiatric samples.

This study evaluated the structural reliability, construct-related validity, and cultural validity generalization of the Hare Psychopathy Checklist: Screening Version (PCL:SV) in a sample of more than 560 male and female Swedish forensic psychiatric treatment patients, forensic evaluation patients, and criminal offenders. Structural reliability was excellent for most indices. PCL:SV scores were higher for males than females for total and Part 1 scores (interpersonal/affective features) but not for Part 2 (behavioral features). With some exceptions, PCL:SV scores were meaningfully related to aggression to others, a measure of risk for violence, substance use problems, personality disorder (positive), and psychosis (negative). Correlations between PCL:SV and aggression were larger for females than males, although the difference was smaller when personality disorder was held constant. The structural reliability and pattern of validity coefficients were comparable in these Swedish samples to other non-North American samples. Implications for the cross-cultural manifestation and correlates of psychopathy are discussed.

Adolescent↗
PubMed2006

Incremental validity analyses of the violence risk appraisal guide and the psychopathy checklist: screening version in a civil psychiatric sample.

This study compares two instruments frequently used to assess risk for violence, the Violence Risk Appraisal Guide (VRAG) and the Psychopathy Checklist: Screening Version (PCL:SV), in a large sample of civil psychiatric patients. Despite a strong bivariate relationship with community violence, the VRAG could not improve on the predictive validity of the PCL:SV alone, even though the VRAG includes several ostensible violence risk factors other than psychopathy. Moreover, incremental validity analyses indicated that the remaining VRAG items accounted for little or no variance in violent outcomes once psychopathy scores were controlled. Conversely, the PCL:SV continued to account for considerable variance after controlling for the VRAG. These results reflect the limited validity of the VRAG items in civil psychiatric samples beyond the variance that is explained by the PCL:SV alone.

Antisocial Personality Disorder↗
PubMed1999

The 2-year test-retest reliability of the Psychopathy Checklist Revised in methadone patients.

The 2-year test-retest reliability of the Psychopathy Checklist-Revised (PCL-R) was examined in 200 men and 25 women methadone patients. Stability of the PCL-R was generally good whether it was evaluated as a dichotomous or dimensional measure. Utilizing a diagnostic cutoff score of 25 or more the intraclass correlation coefficients (ICCs) were.48 for men and.67 for women. For the Total PCL-R score ICCs were.60 and.65 for men and women, respectively. Factor 1 was more reliably measured in women compared to men (.63 vs.43). For men, Factor 1 was significantly less reliable than Factor 2 or the Total score. For women, Factor 2 was significantly less reliable than the Total PCL-R score or Factor 1.

Adult↗
PubMed2005

Screening ADHD problems in the sports behavior checklist: factor structure, convergent and divergent validity, and group differences.

The Sports Behavior Checklist (SBC) is subjected to a principal components analysis, and subscales are correlated with subscales of the Conners' Revised Parent Form and the Social Skills Rating System. Both of these analyses are conducted to determine the construct validity of the instrument. A subsample of lower socioeconomic status individuals is used to compare ADHD and control group differences on the subscales of the SBC. The authors find that a six-factor solution, as proposed by the original authors, accounted for 71.5% of the variance. As hypothesized, subscales on the SBC are low to moderately related to subscales on the anchor measures. Significant group differences are found on the Aggression, Emotional Reactivity, and Injury subscales. Implications and limitations are discussed.

Attention Deficit Disorder with Hyperactivity↗
PubMed2006

Can the Children's Communication Checklist differentiate autism spectrum subtypes?

The study explored whether children with high functioning autism (HFA), Asperger syndrome (AS), and pervasive developmental disorder not otherwise specified (PDD-NOS) can be differentiated on the Children's Communication Checklist (CCC). The study also investigated whether empirically derived autistic subgroups can be identified with a cluster analytic method based on the Autism Diagnostic Interview-Revised. Fifty-seven children with HFA, 47 with AS, 31 with PDD-NOS, and a normal control group of 47 children between 6 and 13 years participated. Children with HFA, AS, and PDD-NOS showed pragmatic communication deficits in comparison to the controls. Little difference was found between the three subtypes with respect to their CCC profile. A three-cluster solution explained the data best. The HFA cluster showed most autism characteristics, followed by the combined HFA + AS cluster, and then the PDD-NOS cluster. The findings support the autism spectrum concept based on severity of symptom impairment rather than distinct categories.

Adolescent↗
PubMed2006

Reproducibility of the STARD checklist: an instrument to assess the quality of reporting of diagnostic accuracy studies.

BACKGROUND: In January 2003, STAndards for the Reporting of Diagnostic accuracy studies (STARD) were published in a number of journals, to improve the quality of reporting in diagnostic accuracy studies. We designed a study to investigate the inter-assessment reproducibility, and intra- and inter-observer reproducibility of the items in the STARD statement. METHODS: Thirty-two diagnostic accuracy studies published in 2000 in medical journals with an impact factor of at least 4 were included. Two reviewers independently evaluated the quality of reporting of these studies using the 25 items of the STARD statement. A consensus evaluation was obtained by discussing and resolving disagreements between reviewers. Almost two years later, the same studies were evaluated by the same reviewers. For each item, percentages agreement and Cohen's kappa between first and second consensus assessments (inter-assessment) were calculated. Intraclass Correlation coefficients (ICC) were calculated to evaluate its reliability. RESULTS: The overall inter-assessment agreement for all items of the STARD statement was 85% (Cohen's kappa 0.70) and varied from 63% to 100% for individual items. The largest differences between the two assessments were found for the reporting of the rationale of the reference standard (kappa 0.37), number of included participants that underwent tests (kappa 0.28), distribution of the severity of the disease (kappa 0.23), a cross tabulation of the results of the index test by the results of the reference standard (kappa 0.33) and how indeterminate results, missing data and outliers were handled (kappa 0.25). Within and between reviewers, also large differences were observed for these items. The inter-assessment reliability of the STARD checklist was satisfactory (ICC = 0.79 [95% CI: 0.62 to 0.89]). CONCLUSION: Although the overall reproducibility of the quality of reporting on diagnostic accuracy studies using the STARD statement was found to be good, substantial disagreements were found for specific items. These disagreements were not so much caused by differences in interpretation of the items by the reviewers but rather by difficulties in assessing the reporting of these items due to lack of clarity within the articles. Including a flow diagram in all reports on diagnostic accuracy studies would be very helpful in reducing confusion between readers and among reviewers.

Advisory Committees↗
PubMed2006

Reliability and validity of the ESRD Symptom Checklist--Transplantation Module in Norwegian kidney transplant recipients.

BACKGROUND: The aim of the study was to validate the Norwegian version of a self-administered 43-item questionnaire designed to assess quality of life in kidney transplant recipients, the End-Stage Renal Disease Symptom Checklist--Transplantation Module (ESRD-SCL). METHODS: In total, 53 kidney transplant recipients from one university-affiliated hospital responded to a questionnaire including the ESRD-SCL and the Short Form 36 (SF-36). We assessed internal consistency reliability and test-retest reliability with 2 weeks between assessments. Construct validity was assessed by correlations of the ESRD-SCL subscales with related and unrelated SF-36 scales, demographic, and clinical characteristics. RESULTS: Subscales of the ESRD-SCL showed good internal consistency reliability (Cronbach's = 0.72-0.81) and for the aggregate total scale alpha was 0.94. Test-retest reliability median 14 days apart was excellent with intraclass coefficients ranging from 0.87 to 0.95. The pattern of correlations of the ESRD-SCL scales with related and unrelated scales SF-36 scales and demographic and clinical characteristics gave support to the construct validity of the ESRD-SCL. CONCLUSION: The Norwegian translation of the ESRD-SCL showed satisfactory internal consistency reliability, test-retest reliability and construct validity, at the level of the original German version.

Adult↗
PubMed2004

The STRS (shortness of breath, tremulousness, racing heart, and sweating): A brief checklist for acute distress with panic-like autonomic indicators; development and factor structure.

BACKGROUND: Peritraumatic response, as currently assessed by Posttraumatic Stress Disorder (PTSD) diagnostic criterion A2, has weak positive predictive value (PPV) with respect to PTSD diagnosis. Research suggests that indicators of peritraumatic autonomic activation may supplement the PPV of PTSD criterion A2. We describe the development and factor structure of the STRS (Shortness of Breath, Tremulousness, Racing Heart, and Sweating), a one page, two-minute checklist with a five-point Likert-type response format based on a previously unpublished scale. It is the first validated self-report measure of peritraumatic activation of the autonomic nervous system. METHODS: We selected items from the Potential Stressful Events Interview (PSEI) to represent two latent variables: 1) PTSD diagnostic criterion A, and 2) acute autonomic activation. Participants (a convenience sample of 162 non-treatment seeking young adults) rated the most distressing incident of their lives on these items. We examined the factor structure of the STRS in this sample using factor and cluster analysis. RESULTS: Results confirmed a two-factor model. The factors together accounted for 68% of the variance. The variance in each item accounted for by the two factors together ranged from 41% to 74%. The item loadings on the two factors mapped precisely onto the two proposed latent variables. CONCLUSION: The factor structure of the STRS is robust and interpretable. Autonomic activation signs tapped by the STRS constitute a dimension of the acute autonomic activation in response to stress that is distinct from the current PTSD criterion A2. Since the PTSD diagnostic criteria are likely to change in the DSM-V, further research is warranted to determine whether signs of peritraumatic autonomic activation such as those measured by this two-minute scale add to the positive predictive power of the current PTSD criterion A2. Additionally, future research is warranted to explore whether the four automatic activation items of the STRS can be useful as the basis for a possible PTSD criterion A3 in the DSM-V.

Journal Article↗
PubMed2006

The accuracy of the Italian version of the Hypomania Checklist (HCL-32) for the screening of bipolar disorders and comparison with the Mood Disorder Questionnaire (MDQ) in a clinical sample.

BACKGROUND: The study measured the accuracy of the Italian version of the Hypomania Checklist (HCL-32) for self-assessment as a screening instrument for bipolar disorder (BPD) in a psychiatric setting and compared results with a previous study, carried out in a comparable sample and in the same setting, using the Mood Disorder Questionnaire (MDQ). METHODS: 123 consecutive subjects attending a psychiatric division were screened for BPD using the Italian translation of the HCL-32, and diagnostically interviewed with the SCID by physicians. The sample of the previous study using the MDQ consisted of 154 subjects. RESULTS: On the basis of the SCID: 26 received a diagnosis of bipolar/schizoaffective disorder, 57 were diagnosed as having at least another psychiatric disorder in Axis-I, whilst 40 were unaffected by any type of psychiatric disorder. Comparing the bipolar with all other patients the HCL-32 showed a good accuracy: cut-off 8: sensitivity 0.92-specificity 0.48; cut-off 10: sensitivity 0.88-specificity 0.54; cut-off 12: sensitivity 0.85-specificity 0.61. The accuracy for BPD-II (10) remains good: cut-off 8: sensitivity 0.90-specificity 0.42; cut-off 10: sensitivity 0.80-specificity 0.47; cut-off 12: sensitivity 0.80-specificity 0.54. The comparison with the MDQ performance shows that both screening tools may show good results, but HCL-32 seems to be more sensitive in detecting BPD-II. CONCLUSION: Our results seem to indicate good accuracy of HCL-32 as a screening instrument for BPD in a psychiatric setting, with a low rate of false negatives, and a fairly good degree of identification of BPD-II.

Journal Article↗
PubMed1996

Comparisons among the Yale-Brown Obsessive-Compulsive Scale, compulsion checklist, and other measures of obsessive-compulsive disorder.

BACKGROUND: The Yale-Brown Obsessive-Compulsive Scale (YBOCS) and Compulsion Checklist (CC) were compared with one another and with five other measures to assess their place in measuring the outcome of obsessive-compulsive disorder (OCD). METHOD: Data came from a randomised trial of 46 patients with OCD who completed eight Weeks of treatment by exposure and response prevention. Using a structured modelling analysis, the YBOCS and the CC were compared with a latent factor derived from five other variables (Target Rituals, Target Obsession, Clinical Global Impression, Avoidance, Disability) of baseline severity and change after treatment, and also directly with those variables. RESULTS: Both the YBOCS and the CC were accurate and sensitive measures of OCD. The YBOCS related slightly more than did the CC to the latent factor and to Disability directly. The YBOCS related slightly more to Disability than it did to other measures. Inter-assessor and self kappa assessor reliability was high. CONCLUSIONS: The 10-Item YBOCS plus the 4-item Disability scale are a simple and efficient way to measure important aspects of OCD in clinical practice.

Behavior Therapy↗