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Factor structure and discriminant validity of the SCL-90 in a veteran psychiatric population.

This study tested whether the symptom dimension subscales derived for the Symptom Checklist-90 (SCL-90) by factor analysis could be replicated in a new sample. It was administered to 442 veterans undergoing psychiatric treatment at a VA psychiatric outpatient clinic. Factor analysis using the principal-components method yielded a factor structure different from those previously reported for other populations. The first factor extracted, Depression, explained 37% of the variance of the entire instrument, or more than eight times the variance explained by the second factor. Only five of the nine reported SCL-90 symptom subscales emerged in this study; the Anxiety and Psychoticism subscales disappeared, and the Paranoia and Interpersonal Sensitivity subscales merged. In this population the instrument seems to measure a single global distress factor instead of nine independent symptom subscales as reported previously. This finding was corroborated by the fact that depressed, anxious, and schizophrenic patients showed no differences in SCL-90 symptom profile shapes, although they did differ in overall symptom intensity.

Adult

A comparison of cognitive measures in low back pain: statistical structure and clinical validity at initial assessment.

Four cognitive measures--MHLC, PLC, CSQ and PRSS/PRCS--were directly compared in 120 U.K. patients with chronic low back pain. 80% of the individual items in the PLC and 86% in the CSQ had satisfactory test-retest reliability, as had most of the scales of the CSQ and the PLC PC scale. The items and the scales of the MHLC and the PRSS/PRCS had lower reliability. The factor structures of the PLC and the PRSS/PRCS bore close similarity to the original descriptions. The CSQ structure was similar to the original but further investigation of its psychometric properties is required. The structure of the MHLC was not replicated. Considerable communality was found between the cognitive measures. The strongest relationship found in this study was between the CSQ and PRSS catastrophising scales and depressive symptoms. There was also a relationship among cognitive measures and both disability and work loss which persisted even after controlling for severity of pain and depressive symptoms. The present results suggest that the concept of catastrophising has greatest potential for understanding current low back symptoms and that the CSQ may be the most useful measure of this. Other work, however, suggests that the PLC may also be of value in following change and predicting response to treatment.

Adaptation, Psychological

A closer look at the Autism Behavior Checklist: discriminant validity and factor structure.

The psychometric properties of the Autism Behavior Checklist (ABC; Krug, Arick, & Almond, 1980a, 1980b), a 57-item screening checklist for autism was investigated. Professional Informants completed the ABC on 67 autistic and 56 mentally retarded and learning-disabled children. The autistic children were the total population of autistic children aged 6-15 in two circumscribed suburban and rural regions. Using the total score, the ABC accurately discriminated 91% of the children, with 87% of the autistic and 96% of the nonautistic group correctly classified. Moreover, the accuracy of classification was virtually identical when only the more heavily weighted checklist items were used. A 3-factor model accounted for 32% of the total variance in the checklist. Seventeen items loaded .4 or more on Factor 1, 12 items loaded on Factor 2, and 10 items loaded on Factor 3. The present results fail to provide empirical support for a single unidimensional scale for autism. Also, there is little support for subdividing the checklist into five subscales based on symptom areas.

Adolescent

Factor structure and construct validity of the Denman Neuropsychology Memory Scale.

Correlational data on the recently published Denman Neuropsychology Memory Scale (DNMS; Denman, 1984) were subjected to a series of factor analyses. Although a major feature of the DNMS is computation of Verbal, Non-Verbal and Full Scale Memory Quotients, the factor analyses did no support this practice. Since the factor results demonstrated initial support for the construct validity of some of the DNMS subtests, it is recommended that interpretation be based on subtest performance. The present results and suggested future investigations of DNMS construct validity are discussed in relation to current issues in clinical memory assessment.

Adolescent

Two-dimensional real-time ultrasonic imaging of the heart and great vessels. Technique, image orientation, structure identification, and validation.

Conventional M-mode echocardiography has become established as a diagnostic tool for noninvasive evaluation of cardiovascular diseases. Now the advent of two-dimensional real-time echocardiography has opened a new era of investigation. This paper describes in detail the technique of a complete two-dimensional ultrasonic examination of the heart and great vessels. Four transducer locations were commonly utilized--namely, parasternal, apical, subxiphoid, and suprasternal notch positions. The tomographic sections of the heart obtained along the long and short axes of the heart and great vessels by utilizing the above positions were validated by detailed anatomic and contrast echocardiographic techniques.

Echocardiography

Cross-validation of the factor structure of the Toronto Alexithymia Scale.

The Toronto Alexithymia Scale (TAS) is a self-report measure of the alexithymia construct. In previous studies with college students, the TAS demonstrated excellent psychometric properties including a 4-factor structure theoretically congruent with the alexithymia construct. The present study attempted to cross-validate the factor structure of the TAS with samples of normal adults, psychiatric outpatients and college students. Congruence coefficients comparing the similarity of the factor structures for these three samples indicated good congruence for all four factors. The results provide further support for the validity of both the TAS and the alexithymia construct. In addition, the results provide evidence of the applicability of the scale to normal adult and clinical samples.

Adult

Reliability and validity of the objective structured clinical examination in assessing surgical residents.

The purpose of this research was to assess reliability and construct validity of the objective structured clinical examination (OSCE) for evaluating the clinical skills of surgical residents. Reliability refers to precision of the examination and construct validity to the degree to which the examination can discriminate between different levels of training. Twenty-seven second postgraduate year surgical residents took a 38-station OSCE representing seven surgical specialties and that tested history-taking, physical examination, problem-solving, technical skills, and attitudes. A couplet methodology was used wherein a patient encounter was followed by written questions aimed at testing problem-solving and patient management capabilities. Thirty-six standardized patients were trained and 36 surgeons served as examiners marking from structured checklists. Overall reliability, Cronbach's alpha, was 0.89. Construct validity was examined by comparing the scores of the residents with those of a group of graduates of foreign medical schools applying for a "pre-internship" program. For 17 of 19 stations that both groups took, the residents performed significantly better (p less than 0.01). Individual station validity was significant for 32 of 38 stations (r = 0.36 to 0.82, p less than 0.05). The examinations took 3.83 hours at a cost of $5,293 (Canadian dollars). The OSCE has been shown to be a reliable method of assessing clinical skills of surgical residents, construct validity has been established, and inter-item validity confirmed. Reliabilities achieved exceed those traditionally required for both acceptance and promotion decisions.

Analysis of Variance

Validity, reliability, and factor structure of the Anorectic Cognitions Questionnaire.

Several authors have hypothesized cognitive distortion as central to the psychopathology of anorexia nervosa and bulimia. However, there have been few investigations of these hypotheses. Equally as important, psychometrically sound devices for assessing these cognitions are notably lacking. The purpose of this investigation is to examine the psychometric characteristics of the Anorectic Cognitions Questionnaire (MAC). This study reports on initial item development, initial concurrent validity, factor structure, initial item refinement, and internal consistency. Results indicated that the MAC has good concurrent validity, three theoretically defined factors were empirically supported, and the scale is internally consistent.

Adult

Reliability and validity of an objective structured clinical examination for assessing the clinical performance of residents.

Clinical performance of residents should be assessed as reliably and validly as possible. This study investigated the reliability and validity of an objective structured clinical examination (OSCE) for assessing clinical performance of internal medicine residents. Residents were required to take a 17-patient OSCE in their first and second year. Reliability of the OSCE was 0.40. Validity studies indicated second-year students were significantly better than third-year students for five of six OSCE skill scores; first-year students were significantly better for three scores. Resident's scores for diagnosis, plan, and total significantly increased on their second OSCE. Generally faculty overall ratings of residents' clinical performance did not correlate with OSCE scores. American Board of Internal Medicine certifying examination scores were consistently positively correlated only with diagnosis. This 17-case OSCE is a feasible method for obtaining moderately reliable, valid data not available from other sources about the clinical performance of residents. More cases should be added to increase its reliability.

Clinical Competence

On the validity of an Augmented Structured Interview for measuring subcomponents of the Type A behavior pattern.

This study was designed to provide validity data for the Augmented Structured Interview (ASI), which has been developed to measure subcomponents (as opposed to the global) Type A behavior pattern (TABP). Eighty subjects from a large private southwestern medical center were administered a self-report measure of the TABP (the Jenkins Activity Survey--JAS) and the ASI. Forty of the subjects were being treated for post-infarction coronary heart disease (CHD). The remaining forty subjects did not possess documented CHD. The obtained ratings for all the six ASI-measured Type A subcomponents were significantly higher for the CHD than for the non-CHD group. A discriminant functions analysis revealed that the ASI was superior to the JAS in correctly classifying CHD and non-CHD subjects. These outcomes are interpreted as providing initial support for the validity of the ASI.

Adult

Cross-cultural validity of the Miami Structured Interview--1 for type A in children: the American-Hellenic Heart Study.

The Miami Structured Interview--1 was developed (1) to assess Type A behaviour in a broader age range of children than tested with previous interviews, and (2) for cross-cultural studies. This study examined the validity of the Miami Structured Interview--1 for assessing Type A behavior in 507 American and Greek preadolescent (ages 7-11) and adolescent (ages 12-16) boys. The interview was scored on voice stylistics such as speed of speech, word emphasis, and latency of response. Validity was tested using the Matthews Youth Test for Health (MYTH), a teacher rating scale of Type A behaviors. Interview determined Type A's received significantly higher MYTH scores than non Type A's for American adolescents (p less than 0.05), Greek preadolescents (p less than 0.01), and Greek adolescents (p less than 0.05). The interview also identified extreme groups of Type A's and Type B's for American adolescents (p less than 0.01) and Greek preadolescents (p less than 0.05). The findings support the cross-cultural validity of the Miami Structured Interview--1 and the Type A construct for children. Limitations of the Miami Structured Interview--1 are discussed.

Adolescent

Cross-validation of the factor structure of the Aberrant Behavior Checklist for persons with mental retardation.

The original factor structure of the Aberrant Behavior Checklist was cross-validated with an American sample of 470 persons with moderate to profound mental retardation, including nonambulatory individuals. The results of the factor analysis with varimax rotation essentially replicated previous findings, suggesting that the original five factors (Irritability, Lethargy, Stereotypic Behavior, Hyperactivity, and Inappropriate Speech) could be cross-validated by factor loadings of individual items. The original five scales continue to show high internal consistency. These factors are easily interpretable and should continue to provide valuable research and clinical information.

Adult

Comparison of DSM-III and DSM-III-R diagnoses for prepubertal children: changes in prevalence and validity.

A structured and reliable diagnostic procedure based on a revised version of the Diagnostic Interview Schedule for Children for children, parents, and teachers was used to assign both DSM-III and DSM-III-R diagnoses to 177 outpatient boys aged 7 to 12 years. Compared to their DSM-III counterparts, DSM-III-R oppositional defiant disorder was 25.5% less prevalent, DSM-III-R dysthymia was 37.8% less prevalent, and DSM-III-R conduct disorder (CD) was 44.3% less prevalent. However, DSM-III-R attention deficit hyperactivity disorder was 14.4% more prevalent than DSM-III attention deficit disorder with hyperactivity. The two definitions of CD were compared to exemplify an empirical approach to diagnostic validation. The DSM-III-R diagnosis of CD appears to be more valid as it is more strongly associated with police contacts, school suspensions, and history of antisocial personality disorder in the biological father, but both CD diagnoses are associated with family histories of criminal convictions.

Child