Verdien av en norsk modifikasjon av Wechsler-Bellevue pröven i diagnostikken av intellektuell reduksjon på organisk grunnlag

Abstract

Aim: The objective of the study was to evaluate the efficacy of the Outcome Questionnaire 45 (OQ-45) with feedback in a Swedish psychiatric outpatient population using a randomized controlled design. Method: In all 1720 patients made at least one regular visit to the clinics in the period 12 February 2007 to 10 February 2008 and received information about the study. Of these, 374 patients (22%) agreed to participate. After written consent, 188 patients were randomized to the feedback group and 186 patients to the control group. Those constituted the intention-to-treat (ITT) group. Two hundred and sixty-two patients (70%) completed the OQ-45 questionnaire at least twice, and they were included in the per-protocol analysis. Those who improved less than expected and were at risk for treatment failure were called alerted patients. Results: There was a tendency that patients who received feedback improved more than the controls in OQ-45 total score. In the ITT analysis, the P-value was 0.061 and the effect size g = 0.21. In the per-protocol analysis the P-value was 0.076 and the effect size g = 0.24. In the intervention group, 27% of the patients were alerted because of risk of treatment failure vs. 28% in the control group (reaching level of alertness). The OQ-45 differences between the intervention and control groups did not significantly differ for patients who were alerted/reaching level of alertness and for non-alerted patients (g = 0.17 and g = 0.28, respectively). Conclusions: The feedback group had a tendency to improve more than the control group, possibly indicating that the method is effective, and the result (basically) supports previous findings.     

The development,validity, and reliability of the auditory vocal hallucination rating scale questionnaire (AVHRS-Q)

Purpose

The Auditory Vocal Hallucination Rating Scale Questionnaire (AVHRS-Q) is a short self-report measure assessing several characteristics of auditory vocal hallucinations (AVH) that was derived from a validated clinical interview (the auditory vocal hallucination rating scale; AVHRS). This study investigated the internal reliability, convergent validity, and divergent validity of the AVHRS-Q using two clinical samples.

Methods

In sample I, 32 psychiatric patients with AVH were recruited from an academic hospital service and assessed with the AVHRS and the AVHRS-Q. Data for sample II were retrospectively retrieved from a pseudonymised Routine Outcome Monitoring (ROM) database collected in the context of mental healthcare at the same academic hospital service. Data from 82 psychiatric patients with AVH were retrieved, who completed the AVHRS-Q, and measures of psychological distress (the Outcome Questionnaire; OQ-45, and the Symptom Checklist; SCL-90) and quality of life (the Manchester Short Assessment of Quality of Life; MANSA).

Results

The AVHRS-Q showed good internal consistency in both samples. Severity scores of the AVHRS-Q were strongly correlated to the severity scores of the AVHRS (r = 0.90, p < 0.01). The AVHRS-Q and AVHRS did not differ in the identification of mild and severe voice-hearers [X² (1, N = 32) = 15.71]. AVHRS-Q severity scores had moderate correlations with measures of psychological distress (OQ-45, r = 0.43, p < 0.01; SCL-90, r = 0.50, p < 0.05) and quality of life (MANSA, r = − 0.22, p < 0.01).

Conclusions

The AVHRS-Q demonstrated good reliability, convergent validity, and divergent validity, suggesting it can be applied in both clinical and research settings for a quick and reliable assessment of AVH.

     

A self-report version of the Ways of Responding: Reliability and validity in a clinical sample

Objective: The Ways of Responding (WOR) instrument measures compensatory skills, a central construct in some theories of the mechanism of cognitive therapy for depression. However, the instrument is time-consuming and expensive to use in community settings, because it requires trained independent judges to rate subjects’ open-ended written responses to depressogenic scenarios. The present study evaluated the reliability and validity of a self-report version of the WOR (WOR-SR) in a community mental health sample with depressive symptoms (N?=?467). Method: Subjects completed the WOR-SR, a modified version of the original WOR, and other measures of depressive symptoms, dysfunctional cognitions, functioning, quality of life, and interpersonal problems at multiple time points. Results: An exploratory factor analysis confirmed the two-factor structure of the WOR-SR. The positive and negative subscales both demonstrated excellent internal consistency (Cronbach’s alphas?=?.91) and moderate convergent validity with other measures. Conclusion: The WOR-SR is a reliable and valid measure of compensatory skills in patients receiving treatment for depression at community mental health centers.     

Psychometric evaluation of the Swedish version of Rosenberg’s self-esteem scale

Background: The widely used Rosenberg’s self-esteem scale (RSES) has not been evaluated for psychometric properties in Sweden.

Aims: This study aimed at analyzing its factor structure, internal consistency, criterion, convergent and discriminant validity, sensitivity to change, and whether a four-graded Likert-type response scale increased its reliability and validity compared to a yes/no response scale.

Methods: People with mental illness participating in intervention studies to (1) promote everyday life balance (N?=?223) or (2) remedy self-stigma (N?=?103) were included. Both samples completed the RSES and questionnaires addressing quality of life and sociodemographic data. Sample 1 also completed instruments chosen to assess convergent and discriminant validity: self-mastery (convergent validity), level of functioning and occupational engagement (discriminant validity). Confirmatory factor analysis (CFA), structural equation modeling, and conventional inferential statistics were used.

Results: Based on both samples, the Swedish RSES formed one factor and exhibited high internal consistency (>0.90). The two response scales were equivalent. Criterion validity in relation to quality of life was demonstrated. RSES could distinguish between women and men (women scoring lower) and between diagnostic groups (people with depression scoring lower). Correlations >0.5 with variables chosen to reflect convergent validity and around 0.2 with variables used to address discriminant validity further highlighted the construct validity of RSES. The instrument also showed sensitivity to change.

Conclusions: The Swedish RSES exhibited a one-component factor structure and showed good psychometric properties in terms of good internal consistency, criterion, convergent and discriminant validity, and sensitivity to change. The yes/no and the four-graded Likert-type response scales worked equivalently.     

Evaluating WAIS–IV structure through a different psychometric lens: structural causal model discovery as an alternative to confirmatory factor analysis

Abstract

Objective: Since the publication of the WAIS–IV in the U.S. in 2008, efforts have been made to explore the structural validity by applying factor analysis to various samples. This study aims to achieve a more fine-grained understanding of the structure of the Dutch language version of the WAIS–IV (WAIS–IV–NL) by applying an alternative analysis based on causal modeling in addition to confirmatory factor analysis (CFA). The Bayesian Constraint-based Causal Discovery (BCCD) algorithm learns underlying network structures directly from data and assesses more complex structures than is possible with factor analysis. Method: WAIS–IV–NL profiles of two clinical samples of 202 patients (i.e. patients with temporal lobe epilepsy and a mixed psychiatric outpatient group) were analyzed and contrasted with a matched control group (N = 202) selected from the Dutch standardization sample of the WAIS–IV–NL to investigate internal structure by means of CFA and BCCD. Results: With CFA, the four-factor structure as proposed by Wechsler demonstrates acceptable fit in all three subsamples. However, BCCD revealed three consistent clusters (verbal comprehension, visual processing, and processing speed) in all three subsamples. The combination of Arithmetic and Digit Span as a coherent working memory factor could not be verified, and Matrix Reasoning appeared to be isolated. Conclusions: With BCCD, some discrepancies from the proposed four-factor structure are exemplified. Furthermore, these results fit CHC theory of intelligence more clearly. Consistent clustering patterns indicate these results are robust. The structural causal discovery approach may be helpful in better interpreting existing tests, the development of new tests, and aid in diagnostic instruments.     

Validity of the Swedish version of the Strengths and Difficulties Questionnaire (SDQ-Swe)

The Strengths and Difficulties Questionnaire (SDQ) is an internationally widely used, brief screening instrument for mental health problems in children and teenagers. The SDQ probes behaviours and psychological attributes reflecting the child's difficulties as well as strengths, and targets hyperactivity/inattention, emotional symptoms, conduct problems, peer problems and prosocial behaviour. Also, the instrument taps the impact aspect, i.e. whether the child is judged to suffer from emotional or behavioural problems severe enough to cause distress or social impairment. Studies of the original English SDQ, as well as of translations into several other languages, attest to a compelling usefulness and validity of the instrument. In this investigation, the adequacy of the Swedish adaptation of the SDQ (SDQ-Swe) was tested in comparisons between parent reports on 5-15-year-old children drawn from a community sample (n=263) and from a child psychiatric sample (n=230). Results showed that the instrument differentiated well between the community and the psychiatric samples, the latter displaying more symptoms, fewer strengths and more social impairment. Moreover, ROC analyses showed satisfactory sensitivity and specificity of the principal scales of the SDQ-Swe at proposed cut-offs. Hence, results showed adequate validity of the SDQ-Swe, suggesting that this new instrument, an instrument in tune with the ideas of contemporary child psychiatry and psychology, is a useful tool for mental health screening in children and adolescents.     

Psychometric properties of an interviewer‐administered version of the Kessler Psychological Distress scale (K10) among Dutch,Moroccan and Turkish respondents

The Kessler Psychological Distress scale (K10) is an instrument that is widely used to screen for mental disorders, but information is lacking on its psychometric qualities in non‐Western samples. This study used a population‐based sample (N = 725) to assess the reliability and validity of the K10 across ethnic groups in an urban area. The results were generally supportive of the K10 as a reliable and valid instrument to screen for anxiety and depression in all three groups. Cronbach's alpha was high (0.93) and the results indicated the existence of a solid single factor structure. Item bias in relation to ethnic background was minor. In each group, there was good criterion validity with respect to one‐month DSM‐IV diagnosis for depressive and/or anxiety disorder. The results nevertheless highlight the importance of cross‐cultural validation, as we found different cut‐off values for ethnic subgroups to obtain optimal sensitivity and specificity for detecting depressive and/or anxiety disorders. Copyright © 2009 John Wiley & Sons, Ltd.     

Differential effectiveness of group,individual, and conjoint treatments: An archival analysis of OQ-45 change trajectories

Objective: While empirically-supported treatment (EST) choices are continually expanding, choices regarding formats for delivery (individual only, group only, or conjoint [simultaneous individual &; group]) are often determined by agency resources or clinician preference. Studies comparing individual and group formats have produced mixed results, while recent meta-analytic reviews support format equivalence. Method: We employed a multilevel model to test for outcome differences using the OQ-45 on an outpatient archival data set of clients receiving individual-only (n?=?11,764), group-only (n?=?152) or conjoint (n?=?1557). Results: Individual and group outcomes were equivalent with some analyses showing conjoint trailing. Moderators of change included initial distress, treatment duration, intra-group dependency, and format. Conclusions: Results support meta-analytic findings of format equivalence in a naturalistic setting for group and individual. Referral practices and future results are discussed.     

The German version of the revised Adolescent Sleep-Wake Scale (rASWS) – A validation study in pediatric pain patients and school children

ObjectiveSleep problems are common in children and adolescents with chronic pain. The revised Adolescent Sleep-Wake Scale (rASWS) is an internationally well-established instrument to assess sleep quality in adolescents. So far, no German version is available. The study aimed to provide a validated German version of the rASWS, specifically for use in children and adolescents with chronic pain.MethodsThe translated questionnaire was validated in a sample of N = 159 pediatric outpatients with chronic pain (8–17 years; 65.4% female), who presented to a specialized pediatric pain center. For cross-validation a community sample of N = 1348 school children was analyzed.ResultsConfirmatory factor analysis was conducted to examine the factor structure of the original 10-item 3-factor model in the sample of children and adolescents with chronic pain, which showed poor model fit. Model modifications were carried out by deleting 3 items with low factor loadings stepwise. The overall model fit of the final 3-factor model containing 7 items was excellent. Cronbach's α of the derived scales ranged from 0.74 to 0.86. Cross-validation in a community sample of school children confirmed the superiority of the 7-item model. The convergent validity of the measure was proved by moderate correlations between the rASWS and self-reported sleep problems. Associations with chronic pain characteristics were evident for pain-related disability.ConclusionsThe use of the 7-item version of the rASWS for German-speaking children and adolescents with and without chronic pain is recommended as a self-report measure of sleep quality.     

The Patient's Experience of Attunement and Responsiveness Scale

Objective: This study sought to test the correlation between the patient's experience of attunement and responsiveness, and treatment outcome. Method: Utilizing a new measure—the Patient's Experience of Attunement and Responsiveness (PEAR) Scale—we asked both patients and therapists to rate their experience of a therapy session immediately after that session. Scores on the PEAR Scale were then correlated with two measures of treatment outcome. We obtained 405 total PEAR Scale administrations from 38 patient–therapist dyads across multiple sessions. Results: Exploratory factor analyses revealed a three-factor structure for the patient version of the scale and a two-factor structure for the therapist version. Patient ratings on the PEAR Scale were significantly correlated with OQ-45 and a 1-item measure of global outcome measured for the concurrent session. Conclusion: These findings suggest attunement during a therapy session may be an important predictor of concurrent session outcome.     

Factorial structure and psychometric properties of the reminiscence functions scale

Objectives: This study reports on the psychometric properties and the factorial structure of the Reminiscence Functions Scale (RFS), a 43-item self-report instrument used to assess the frequencies of reminiscence for distinct functions.

Method: The factorial validity (exploratory factor analysis, n = 453; confirmatory factor analysis, n = 456), the invariance of factorial structure across gender (males = 228; females = 240), and psychometric properties were examined.

Results: They support an eight-factor structure similar to the original one, yet question the value of a few of the items. Cronbach's alphas for the various subscales ranged from 0.76 to 0.87. Test–retest reliability ranged from r = 0.48–0.63.

Conclusion: The RFS is confirmed as a psychometrically sound instrument for use in research on the functions of reminiscence with samples of older adults.     

Corticosteroidpsykose med Kristusforestilling hos kvinne

Abstract

Introduction: Aggression has been linked to several psychiatric disorders. None of the available instruments validated in Mexico is able to classify aggression as impulsive or premeditated. The Impulsive/Premeditated Aggression Scale (IPAS) is a self-report instrument designed to characterize aggressiveness as predominately impulsive or premeditated. Objective: The aim of the study was to determine the validity and reliability of the IPAS in a sample of Mexican psychiatric patients. Method: A total of 163 patients diagnosed with affective, anxiety or psychotic disorder were included. A principal-component factor analysis was performed to obtain construct validity of the IPAS impulsive and premeditated aggression subscales; convergent validity as well as internal consistency of subscales were also determined. Results: The rotated matrix accounted for 33.4% of the variance. Significant values were obtained for convergent validity and reliability of the IPAS subscales. Conclusion: The IPAS is an adequate instrument, which might be used to differentiate the type of aggressive behavior in Mexican psychiatric patients.     

The assessment of skin picking in adolescence: psychometric properties of the Skin Picking Scale-Revised (German version)

Background: Skin picking disorder has received growing attention since the release of DSM-5, yet there are no evidence-based assessment instruments for adolescent samples.

Aim: The present study examines the psychometric properties of the Skin Picking Scale-Revised (SPS-R, German version) in adolescents.

Methods: A total of 76 adolescents (96% female) completed the SPS-R, the Clinical Psychological Diagnostic System (KPD-38), and a questionnaire assessing demographics and clinical characteristics online.

Results: The SPS-R had high internal consistency (α?=?0.89) and significant small-to-medium correlations with reduced competence skills, psychological impairment, general life satisfaction, social support, and social problems on the KPD-38. Similar to prior findings for adults, an exploratory factor analysis suggested a two-factor model for the SPS-R in adolescents. Group comparisons failed to show significant differences on SPS-R scores between participants with and without dermatological conditions.

Conclusions: The current results suggest that the SPS-R can be useful in adolescent samples as a reliable and valid instrument for the assessment of skin picking severity. Future research investigating scale validity and factor structure in a clinical sample of adolescent skin pickers is warranted.     

Factorial structure and psychometric properties of a brief version of the Reminiscence Functions Scale with Chinese older adults

Objective: The current study aims to examine the factorial structure and psychometric properties of a brief version of the Reminiscence Functions Scale (RFS), a 14-item assessment tool of reminiscence functions, with Chinese older adults.Method: The scale, covering four reminiscence functions (boredom reduction, bitterness revival, problem solving, and identity) was translated from English into Chinese and administered to older adults (N = 675). Confirmatory factor analysis and hierarchical confirmatory factor analysis were conducted to examine its factorial structure, and its psychometric properties and criterion validity were examined.Results: Confirmatory factor analysis supports a second-order model comprising one second-order factor and four first-order factors of RFS. The Cronbach's alpha of the subscales ranged from 0.75 to 0.90.Conclusion: The brief RFS contains a second-order factorial structure. Its psychometric properties support it as a sound instrument for measuring reminiscence functions among Chinese older adults.     

Are fatigue symptoms and chronic fatigue syndrome following Q fever infection related to psychosocial variables?

ObjectiveFatigue is known as one of the most common long-term sequelae of Q fever infections. The study aimed to determine the prevalence of fatigue symptoms, chronic fatigue, and chronic fatigue syndrome (CFS) in a sample of patients who were exposed to Q fever (Coxiella burnetii) infection compared to controls, and to contrast Q fever patients with and without fatigue symptoms related to somatoform symptoms, hypochondriacal worries and beliefs, psychosocial complaints, and social support.MethodsCross-sectional study of 84 Q fever exposed patients from a specific region in Jena (Germany) and 85 matched controls using standardized questionnaires (MFI, SF-12, CDC-SI, SOMS, Whiteley Index, OQ-45 and F-Sozu). Diagnostic interviews were performed to validate questionnaire results in a smaller subsample.ResultsPatients who were exposed to a Q fever infection in the past indicated more fatigue symptoms and chronic fatigue than controls (54.8 vs. 20%, 32.1 vs. 4.7%) but did not show more criteria for a CFS (1 patient in each group). Q fever patients showing fatigue symptoms revealed significantly higher scores in the SOMS, the Whiteley-Index, and higher psychosocial complaints measured with the OQ-45. Their health related Quality of Life was reduced, no differences were found related to perceived social support.ConclusionAlthough in our sample fatigue symptoms were common among Q fever patients, we found no increased prevalence of CFS in contrast to several other studies. The combination of fatigue symptoms with other psychosocial symptoms/problems support the view of a biopsychosocial etiology of fatigue symptoms.     

A short screening instrument for mental health problems: The Symptom Checklist-27 (SCL-27) in Poland and Germany

Abstract

Objective. The symptom checklist SCL-27 is a short, multidimensional screening instrument for mental health problems. It contains six scales: depressive, dysthymic, vegetative, agoraphobic and sociophobic symptoms; symptoms of mistrust; and a global severity index (GSI-27). Methods. A survey of two student samples from Poland and Germany (n ～ 400) is presented. Results. Most scales of the SCL-27 showed good to satisfactory reliability (i.e. Cronbach's α > 0.70). Some items displayed different characteristics in students than in non-student samples. These discrepancies can be explained partly by the particular situation students face and partly by some country-specific or language-specific aspects of the measuring instrument. Differences between Polish and German students were marginal at best; in general, the Polish students tended to assent more easily to the items of the SCL-27 than did the German students. Conclusions. The SCL-27 is suitable for international comparisons. In both, Germany and Poland, students display a characteristic response pattern that differs from those of other samples. It can be applied as a separate instrument or for reanalysis of data collected with the SCL-90_R.     

Changing relations among cognitive abilities across development: implications for measurement and research

Objective: The constructs of intelligence and executive function (EF) are commonly used in neuropsychological, cognitive, and developmental research, and in the context of clinical assessment. Yet, we have a limited understanding of the changing age-related associations among these cognitive constructs and the implications for measurement and research. The objectives of this study were to compare hypothetical models using intellectual abilities (non-age corrected scores of intelligence or IQ) and experimental measures of EF and to better understand the role of age in determining the associations between these cognitive abilities at two different periods of development. We also incorporated prediction of ADHD-related difficulties. Method: We examined intellectual abilities and EF in a typically developing child sample (N = 250) and young-adult sample (N = 329). We used confirmatory factor analysis to estimate models for each developmental period: a one-factor model of general cognitive ability and a two-factor model of intelligence and EF. ADHD-related difficulties were regressed on the factors from each model. Results: Age was more strongly related to all cognitive abilities in the child sample than in the young-adult sample. In the factor analytic models, higher amounts of cognitive test score variance were explained by both models in the child sample than in the young-adult sample. Further, in the child sample, the general cognitive ability factor (combining intellectual abilities and EF) was a significant predictor of ADHD-related difficulties, but the separate intellectual ability and EF factors were not. Conclusions: Variables highly associated with age (such as intellectual ability and EF) should not be statistically controlled when assessing cognitive constructs especially in child samples when there is rapid change in cognitive abilities.     

The Italian version of the Family Assessment Device

The aim of the study was to evaluate in a heterogeneous Italian sample (n= 340) the psychometric properties of the Italian version of the Family Assessment Device (FAD), a 60-item questionnaire assessing family functioning. The questionnaire was administered to psychiatric (n= 116), medical (n= 114) and non-clinical samples (n = 110). In a sample of 30 non-clinical subjects the temporal stability of the FAD was investigated. The results showed a good temporal stability for Problem Solving, General Functioning, Communication, and Affective Responsiveness scales, and a good internal reliability of the scale. Factor analysis of the Italian version provided discrepancies with the hypothesized structure of the instrument, leading to the identification of seven slightly different dimensions. The proposed seven-factor model of the instrument did not provide a good fit to our data. The results of our study suggest the need for a major improvement in the adaptation of the FAD in the Italian setting. Accepted: 10 February 1998