Adult ADHD Self-Report Scales

OVERVIEW
The Adult ADHD Self-Report Scale (ASRS) Symptom Checklist was developed by the World Health Organization (WHO) to provide a valid self-assessment of current ADHD symptoms in adults.  A growing body of literature supports the ASRS as a screening tool in both general and clinical populations. The scale consists of 18 items that correspond directly to the 18 DSM-IV symptoms for both inattention and hyperactivity. Its brevity and simplicity mean it is easy to administer and score. The ASRS is not a diagnostic tool. It does not provide information on childhood symptoms, which is necessary in making an ADHD diagnosis. The scale also only assesses frequency, not the functional impact of symptoms.  It is more suitable as a screening or symptom tracking tool and should not be used as the sole basis for clinical diagnosis.

PSYCHOMETRIC PROPERTIES
The initial validation study by Kessler and colleagues was conducted with a community-based sample of 154 US adults, each of whom completing a structured, clinician-administered interview, followed by the ASRS. The authors found adequate sensitivity (56%), excellent specificity (98%), and excellent classification accuracy (97%).

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Alcohol Use Disorders Test
Appearance Anxiety Inventory

OVERVIEW
The AAI is a 10 question self-report scale that measures the cognitive and behavioral aspects of body image in general, and body dysmorphic disorder (BDD) in particular. This scale is useful as part of a diagnostic procedure for BDD as well as symptom monitoring during treatment.

PSYCHOMETRIC PROPERTIES
The AAI was developed by Veale and his colleagues. They examined the psychometric properties in a clinical sample (i.e., those diagnosed with BDD) and non-clinical community sample in the UK. The AAI was found to have good convergent validity, with correlations of .55 with the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder and .58 with the Patient Health Questionnaire-9.  Internal consistency was high, with a Cronbachs Alpha of .86. Two subscales were found using factor analysis:

  1. Avoidance
  2. Threat Monitoring

The BDD validation sample had a median AAI score of 26 at diagnosis and 11 after CBT treatment. The non-clinical community sample was used to establish the normal levels of appearance anxiety among relatively healthy individuals. Their mean score was 15.

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Autism Spectrum Quotient-10 (Adolescent Version)

OVERVIEW
The AQ-10 (Adolescent Version) is designed for teenagers 12-15 years old with suspected autism who does not have a learning disability.Because frontline health professionals needed a “red flag” tool to aid their decision making about whether to make a referral for a full diagnostic assessment for an autism spectrum condition in children and adults, Simon Baron-Cohen and his colleagues at Cambridge's Autism Research Center created the Autism-Spectrum Quotient.  In its original form, the Autism Spectrum Quotient is a 50-item measure. The AQ-10 was developed due to the need for a briefer instrument to determine an individual's position on the autism-normality continuum. All versions (adult, teen and child) of the AQ-10 are recommended for the recognition, referral, provisional diagnosis, and management of those with an autism spectrum condition.

PSYCHOMETRIC PROPERTIES
In Simon Baron-Cohen and colleagues research, clinical samples of more than 1,000 individuals with Autism Spectrum Condition (ASC) were used consisting of 449 adults, 162 adolescents, 432 children and 126 toddlers; and they used a control (non-clinical) sample of 3,000 individuals consisting of 838 adults, 475 adolescents, 940 children, and 754 toddlers. They all completed full-length versions of the AQ. The 10 best items were selected on each instrument to produce short versions: AQ-10 (Adult, Adolescent, and Child).

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Autism Spectrum Quotient-10 (Adult Version)

OVERVIEW
Because front-line health professionals needed a “red flag” tool to aid their decision making about whether to make a referral for a full diagnostic assessment for an autism spectrum condition in children and adults, Simon Baron-Cohen and his colleagues at Cambridge's Autism Research Center created the Autism-Spectrum Quotient.  In its original form, the Autism Spectrum Quotient is a 50-item measure. The AQ-10 was developed due to the need for a briefer instrument to determine an individual's position on the autism-normality continuum. All versions (adult, teen and child) of the AQ-10 are recommended for the recognition, referral, provisional diagnosis, and management of those with an autism spectrum condition.

PSYCHOMETRIC PROPERTIES
In Simon Baron-Cohen and colleagues research, clinical samples of more than 1,000 individuals with Autism Spectrum Condition (ASC) were used consisting of 449 adults, 162 adolescents, 432 children and 126 toddlers; and they used a control (non-clinical) sample of 3,000 individuals consisting of 838 adults, 475 adolescents, 940 children, and 754 toddlers. They all completed full-length versions of the AQ. The 10 best items were selected on each instrument to produce short versions: AQ-10 (Adult, Adolescent, and Child).

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Autism Spectrum Quotient-10 (Child Version)

OVERVIEW
The AQ-10 (Child Version) is designed for children 4-11 years old with suspected autism who does not have a learning disability. Because frontline health professionals needed a “red flag” tool to aid their decision making about whether to make a referral for a full diagnostic assessment for an autism spectrum condition in children and adults, Simon Baron-Cohen and his colleagues at Cambridge's Autism Research Center created the Autism-Spectrum Quotient.  In its original form, the Autism Spectrum Quotient is a 50-item measure. The AQ-10 was developed due to the need for a briefer instrument to determine an individual's position on the autism-normality continuum. All versions (adult, teen and child) of the AQ-10 are recommended for the recognition, referral, provisional diagnosis, and management of those with an autism spectrum condition.

PSYCHOMETRIC PROPERTIES
In Simon Baron-Cohen and colleagues research, clinical samples of more than 1,000 individuals with Autism Spectrum Condition (ASC) were used consisting of 449 adults, 162 adolescents, 432 children and 126 toddlers; and they used a control (non-clinical) sample of 3,000 individuals consisting of 838 adults, 475 adolescents, 940 children, and 754 toddlers. They all completed full-length versions of the AQ. The 10 best items were selected on each instrument to produce short versions: AQ-10 (Adult, Adolescent, and Child).

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Autism Spectrum Screening Questionnaire

OVERVIEW
The high-functioning Autism Spectrum Screening Questionnaire (ASSQ) is a 27-item checklist assessing symptoms characteristic of Asperger syndrome and other high-functioning autism spectrum disorders in children and adolescents (6 - 17 years old) who have intelligence levels that are at least in the range of mild mental retardation.  Parents and teachers answer on behalf of their children and students. It is designed to be an initial screen for autism spectrum disorders and especially Asperger’s syndrome. This test is not diagnostic.

PSYCHOMETRIC PROPERTIES
A study was conducted using a sample of children diagnosed with Asperger’s by a psychologist specializing in the disorder and a child psychiatrist.  The study found that this clinical sample scored an average of 25, which was similar to those of an autism spectrum disorder group from the main sample. Convergent validity was determined by a Pearson correlation between parent ratings on the ASSQ and Rutter Scale, which was 0.75.  Optimal cutoff scores were estimated, using Receiver Operating Characteristic analysis. Findings indicate that the ASSQ is a useful brief screening device for the identification of autism spectrum disorders in clinical settings.

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Big Five Inventory

OVERVIEW
The Big Five Inventory is a 44 item self-report personality test designed to measure the Big Five personality traits. This assessment is appropriate for people between the age of 16 and 81.

The Big Five traits are:

  1. Extraversion – The tendency to seek stimulation, talkativeness and related to positive emotions.
  2. Agreeableness – The tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others.
  3. Conscientiousness / Intellect – The tendency to show self-discipline, act dutifully, and aim for achievement.
  4. Emotional Stability – Low scores on the Emotional Stability scale indicate the tendency to experience unpleasant emotions easily, such as anger, anxiety, depression, or vulnerability.
  5. Openness – Reflects the degree of intellectual curiosity, creativity and a preference for novelty and variety.

PSYCHOMETRIC PROPERTIES

Personality psychologists are interested in what differentiates one person from another and why we behave the way that we do. Personality research, like any science, relies on quantifiable concrete data which can be used to examine what people are like. This is where the Big Five plays an important role. The Big Five was originally derived in the 1970's by two independent research teams -- Paul Costa and Robert McCrae (at the National Institutes of Health), and Warren Norman (at the University of Michigan)/Lewis Goldberg (at the University of Oregon) -- who took slightly different routes at arriving at the same results: most human personality traits can be boiled down to five broad dimensions of personality, regardless of language or culture. These five dimensions were derived by asking thousands of people hundreds of questions and then analyzing the data with a statistical procedure known as factor analysis. It is important to realize that the researchers did not set out to find five dimensions, but that five dimensions emerged from their analyses of the data. In scientific circles, the Big Five is now the most widely accepted and used model of personality.

SCORING THE BIG FIVE INVENTORY
Results consist of five scores, one for each of the personality domains, scored from 10 to 50. Low scores on Emotional Stability has been shown to correlate with psychopathology while higher extraversion and agreeableness is correlated with psychological well-being.

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Bipolar Spectrum Diagnostic Scale

OVERVIEW
Authors of the Bipolar Spectrum Diagnostic Scale (BSDS) conducted a study of the Mood Disorders Questionnaire and concluded that the MDQ had good sensitivity for bipolar I disorder (70%) but a less impressive sensitivity for bipolar II disorder and bipolar disorder not otherwise specified. The goal then of the BSDS was to improve recognition of milder, sub-threshold, forms of the bipolar spectrum and thus be effective across the entire bipolar spectrum severity range. The BSDS consists of a paragraph, 19 sentences in length, describing individuals who have symptoms of bipolar disorder. The individual being examined reads the paragraph and decides how closely it applies to him or her in these two ways: (1) the paragraph, as a whole; and (2) each of the paragraph’s 19 sentences separately and specifically.

PSYCHOMETRIC PROPERTIES
The initial study of the BSDS involved 71 patients with major depressive disorder or bipolar disorder. Before conducting the study, the authors intuitively suggested that a cutoff of 12 represented a positive screen.  At this cutoff, the sensitivity of the BSDS was 76%, and its specificity was 85%. They examined the performance of the scale at other cutoff points and ultimately recommended a cutoff score of 13 because it yielded the best combination of sensitivity (75%) and specificity (93%) in distinguishing bipolar disorder from major depressive disorder.

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BORDERLINE SYMPTOM LIST-23

OVERVIEW
The Borderline Symptom List (BSL-23) is derived from the original Borderline Symptom List, which consists of 95 items (BSL-95). The BSL-23 is a well-established self-rating instrument used to assess the severity of borderline disorder. It is not, however, used to diagnose Borderline Personality Disorder.  It is a self-report questionnaire asking the patient to evaluate their symptoms for the past week. The BSL-23 can be used to test the effectiveness of treatments being undertaken by the patient as it is sensitive enough to detect changes between assessments, and the BSL-23’s brevity allows it to be used weekly with low patient burden.

PSYCHOMETRIC OVERVIEW
Research demonstrates good psychometric properties, comparable to its considerably longer counterpart (i.e., BSL-95).  There is also a high correlation between the BSL-23 and BSL-95 scores from all samples they tested and the BSL-23's internal consistency was also high, with Cronbach’s α ranging between 0.94–0.97.  Six grades of severity were validated from comparisons with established instruments such as the International Personality Disorders Examination, the Structured Clinical Interview for DSM-IV, the Global Severity Index of the Symptom Checklist, the Global Assessment of Functioning (GAF), and the Beck Depression Inventory (BDI-II).

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Burden Scale for Family Caregivers - Short Version

OVERVIEW
An informal caregiver’s (CG) subjective burden is an important aspect of the care she or he provides. It is linked to various outcomes such as health and mortality risk. The Burden Scale for Family Caregivers- Short Form (BSFC-s) measures the subjective burden in informal CGs. The risk of physical psychosomatic complaints, which is a consequence of subjective CG burden, can be determined by using a classification system that was developed (and validated) to deduce the necessity for action and to give concrete recommendations for interventions.  The BSFC-s assesses the negative effects of subjective CG burden, which assists healthcare providers in making concrete recommendations to address it. Effective interventions can help to prevent the development of additional health impairments in informal CGs and to reduce medical costs.

PSYCHOMETRIC PROPERTIES
Researchers demonstrated that the BSFC-s is a reliable and valid scale for measuring subjective burden in informal CGs.  They conducted a cross-sectional study involving 386 informal CGs applying for an initial grade or upgrade in the care they are providing to obtain funds through the health insurance system (in Bavaria, Germany).  Researchers analyzed the reliability and the convergent and discriminant validity using the short form of the Giessen Symptom Complaints List-24 (GBB-24), the Caregiver Strain Index, the Patient Health Questionnaire-9, as well as other measures. Results confirmed the convergent and discriminant validity of the BSFC-s with these scales at a p-value < 0.001. To develop a classification system, they compared the percentile ranks of the GBB-24 with the respective BSFC-s sum scores and their distributions and derived three classification categories.

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CAGE-AID

OVERVIEW
The CAGE questionnaire is used to test for alcohol abuse and dependence in adults. The CAGE-AID version of the tool has been adapted to include drug use. These tools are not used to diagnose diseases, but only to indicate whether a problem might exist. The questions are most effective when used as part of a general health history and should NOT be preceded by questions about how much or how frequently the patient drinks or uses drugs. The reason for this is that denial is quite common among persons abusing alcohol or other drugs; and for the same reason, the CAGE-AID questions focus the discussion on the behavioral effects of drinking or drug use rather than the number of drinks or drugs one uses. The downside of this approach is that questions do not discriminate well between active and inactive drinkers or drug users.  This, following positive scores on the CAGE-AID with questions regarding usual consumption patterns such as frequency, quantity, and heaviest consumption will help the clinician discern this distinction.

PSYCHOMETRIC PROPERTIES
The CAGE-AID exhibits the following:
Sensitivity and Specificity for One or more Yes responses are 0.79 and 0.77, respectively
Sensitivity and Specificity for Two or more Yes responses are 0.70 and 0.85, respectively

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Cambridge Empathy Quotient Scale for Adults

OVERVIEW
The Cambridge Empathy Quotient (EQ) is a self-report 60-item questionnaire designed to assess high functioning autism, which is believed to be a disorder of empathy and essential for normal social functioning. The EQ gauges empathy using 40 empathy items and 20 filler/control items. The 20 filler/control items were included to distract the respondent from a relentless focus on empathy.

PSYCHOMETRIC PROPERTIES
Baron and colleagues validated the EQ with 197 healthy control volunteers and 90 people with high-functioning Autism. The EQ distinguishes reliably between the clinical and control groups (p < .05). The authors also found sex differences in the control group with women scoring significantly higher. In addition, the EQ was found to have high retest reliability over a period of 12 months. The EQ demonstrated strong face validity using the following definition: "Empathy is the drive or ability to attribute mental states to another person/animal and entails an appropriate affective response in the observer to the other person’s mental state." Each of the 40 empathy items were rated as belonging to this definition by a panel of six experimental psychologists, while five out of six rated all 20 control items as not belonging. Lawrence and colleagues found the EQ possessed strong inter-rater reliability and retest reliability. They also found that the EQ has a moderate correlation with the 'empathetic concern’ and ‘perspective taking’ sub-scales of the Interpersonal Reactivity Index, another measure of empathy which the authors of the EQ considered to be the best empathy measure before creating their own.

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CHILD MANIA RATING SCALE - PARENT VERSION

OVERVIEW
The Child Mania Rating Scales (CMRS) are 21-item diagnostic screening measure designed to identify symptoms of mania in children and adolescents ages 9–17 using diagnostic criteria from the DSM-IV as reported by parents and teachers. The measure interviews the child's mood and behavior symptoms, asking parents and teachers to rate how often the symptoms have caused a problem for the child in the past month.

PSYCHOMETRIC PROPERTIES
Clinical studies have found the CMRS-P to be reliable and valid in the assessment of children's bipolar symptoms. The CMRS has also been found to be useful in differentiating cases of pediatric bipolar disorder from ADHD or no disorder, as well as delineating bipolar subtypes. A meta-analysis comparing the different rating scales available found that the CMRS was one of the three best performing scales in terms of telling cases with bipolar disorder apart from other clinical diagnoses.

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Clinical Anger Scale

OVERVIEW
The Clinical Anger Scale (CAS) is an objective, self-report that measures the psychological symptoms presumed to have relevance in the understanding and treatment of clinical anger. Twenty-one sets of statements were prepared for this purpose; the format of which was chosen from one of Beck's early instruments was used to design the Clinical Anger Scale. The following symptoms of anger were measured by the CAS items:

PSYCHOMETRIC OVERVIEW

Several specific analyses were conducted to examine the psychometric properties of the Clinical Anger Scale (CAS). Factor analysis was conducted to examine the factorial validity of the instrument, and reliability coefficients were computed to examine the internal consistency and stability of the CAS. Also, in addition to providing evidence for the convergent and divergent validity of the CAS, an ancillary purpose of the present study was to provide preliminary evidence for its validity by examining some personality, psychopathological symptomotology, behavioral, and family environmental correlates of clinical anger. Factor analysis of the Clinical Anger Scale confirmed essentially a uni-dimensional item structure; reliability analyses also demonstrated adequate alphas (i.e., internal consistency) and test-retest coefficients (i.e., stability) for the CAS; and other results indicated that the CAS was unrelated to social desirability influences. Additional findings indicated that clinical anger was positively associated with several anger-related concepts (e.g., trait anger, state anger, anger-in, anger-out, anger-control). Other results showed that the Clinical Anger Scale was related in predictable ways to men's and women's psychological symptoms, personality traits, and early family environments.

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Clinical Outcomes in Routine Evaluation - 10

OVERVIEW
The CORE-10 is a ten item easy-to-use assessment measure for common presentations of psychological distress.  It is designed for screening and over the course of treatment to track progress. The measure is a shortened version of the 34 items CORE, both of which ask respondents to self-report symptoms over the past week.

PSYCHOMETRIC PROPERTIES
Barkham and his colleagues validated the CORE-10 in primary care patients as well as the general population, finding an internal reliability (Cronbach's alpha) of 0.9.  Based on their analysis it was determined that scores of 11 or above indicated clinically significant psychological distress, and scores above 13 likely indicated depression, with a sensitivity and specificity of .92 and .72, respectively.

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COPE INVENTORY - Brief Form

OVERVIEW
The Coping with Problems Experienced - Brief Form (COPE-Brief) is a 24 item self-report questionnaire designed to measure effective and ineffective ways that people cope with stressful life events. “Coping” is defined broadly as an effort used to minimize distress associated with negative life experiences. The scale is often used in health-care settings to ascertain how patients are responding to a serious diagnosis, and it can be used to measure other stressful life events such as assaults, natural disasters, and financial problems.

PSYCHOMETRIC PROPERTIES
The Cope-Brief was developed as a short version of the original 60-item COPE scale The Cope-Brief was initially validated on 168 participants who had been impacted by a hurricane. Subsequent factor-analysis with heart failure patients indicated two major factors:

  1. Avoidant Coping (denial, substance use, behavioral disengagement, self-distraction, and self-blame).
  2. Approach Coping (active, positive re-framing, planning, acceptance, seeking emotional ad informational support).

The COPE-Brief has good internal consistency when the data is grouped  among caregivers of individuals with dementia, r = 0.72 – 0.84, and among caregivers of individuals with acquired brain injury, r = 0.55–0.75. The Brief COPE showed good internal consistency when used with caregivers of individuals with advanced cancer, with Cronbach’s alpha ranging from 0.54–0.91 for both the avoidant and active coping styles. The COPE-Brief also has adequate test–retest reliability for caregivers of individuals with dementia over a 1-year and 2-year period (intraclass correlation coefficient ranges from 0.44–0.72 depending on the scale).  The scale also showed adequate criterion validity (predictive) over a 2-year testing period for changes in caregiver burden (0.32–0.33) among caregivers of individuals with dementia. Additionally, dysfunctional coping among caregivers of individuals with acquired brain injury, per the COPE-Brief, was significantly related to increased depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (r = .59).

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CRAFFT QUESTIONNAIRE (VERSION 2.1)

OVERVIEW
The CRAFFT is an acronym for Car, Relax, Alone, Forget, Family, Friends, Trouble.  This screening tool consists of six questions intended to identify adolescents who may have simultaneous risky alcohol and other drug use disorders. The CRAFFT is a valid means of screening adolescents for substance-related problems and disorders.

PSYCHOMETRIC PROPERTIES
The CRAFFT is an efficient and effective health screening tool designed to identify substance use, substance-related riding/driving risk, and substance use disorder among youth ages 12-21. It has been implemented as part of universal screening efforts in thousands of busy medical and community health settings, as it yields information that can serve as the basis for early intervention and patient-centered counseling. The CRAFFT is the most well-studied adolescent substance use screener available and has been shown to be valid for adolescents from diverse socioeconomic and racial/ethnic backgrounds. It is recommended by the American Academy of Pediatrics’ Bright Futures Guidelines for preventive care screenings and well-visits, the Center for Medicaid and CHIP Services’ Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program, and the National Institute of Alcohol Abuse and Alcoholism  Youth Screening Guide. The current version of the tool, the CRAFFT 2.1, includes evidence-based revisions to increase the sensitivity and specificity of the tool and includes vaping as a method of administration for marijuana use.

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Depression, Anxiety, and Stress Scale

OVERVIEW
The DASS-21 is the short form of the DASS-42, a self-report scale designed to measure three negative emotional states.  These three scales show strong internal consistency and they yield meaningful discrimination and should help clinicians measure their clients’ current negative emotional state(s) and changes in their state(s) throughout the course of treatment.

  • DEPRESSION SCALE: dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest/involvement, anhedonia, and inertia
  • ANXIETY SCALE:  autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect
  • STRESS SCALE:  difficulty relaxing, nervous arousal, and being easily upset/agitated, irritable/over-reactive and impatient

PSYCHOMETRIC PROPERTIES
The DASS-21 was developed from a sample of 950 first year university students. Their responses were checked for validity against outpatient groups suffering from anxiety, depression, and other mental disorders. While the test was developed with individuals older than 17 year of age, due to the simplicity of language, there has been no compelling evidence against the use of the scales for children as young as 12.  Consistent with the DASS-42, the DASS-21 has internal consistency and concurrent validity in acceptable to excellent ranges.

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Depression Scale for Children (CES-DC)

OVERVIEW

The Depression Scale for Children - Center for Epidemiological Studies (DSC-CES) is a 20 item self-report questionnaire for young people between the ages of 6 and 17. It asks them to rate how many depressive symptoms they have experienced in the last week. This measure is useful for tracking depressive symptoms over time.

PSYCHOMETRIC PROPERTIES

Psychometric characteristics of the DSC-CES were evaluated with 148 child and adolescent psychiatric inpatients. The sample were diagnosed with major depression, dysthymic disorder or another serious mental disorder requiring an inpatient admission. Psychometric properties were adequate, with an internal consistency of .89, and sensitivity was 80% with a cutoff score of 15. However, please note that the DSC-CES was not able to differentiate between inpatients admitted for depression or another mental illness.

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Depression Self-Rating Scale for Children

OVERVIEW
Peter Birleson developed a self-rating scale for depression in childhood (DSRS-C) as part of his Master of Philosophy Thesis at the University of Edinburgh in 1978. In its present form, the DSRS-C is an 18-item self-rating scale; significantly shorter than the 37-item inventory from which it emerged. As the DSRS-C (a) does not include the assessment of other symptoms, (b) the developmental status of a child, nor (c) the history of disturbances or its context, it is not intended to be used as a diagnostic tool for depression in children and adolescents. Rather, its intended use is to measure moderate to severe depression in childhood and for health professionals to employ as a quick and cost-effective screener for depression before administering costly diagnostic measures.

PSYCHOMETRIC PROPERTIES
Eighteen of the original 37 items were found to separate depressed groups from others in a statistically significant way and now comprise the current DSRS-C.  Reliability and validity of the self-rating scale was found to be satisfactory. Individual items had correlations between .65 and .95.  Retest reliability of the DSRS-C for the clinical group was .80; showing a highly satisfactory degree of stability.  Furthermore, internal consistency using a the split-half method was found to be 0.86. The DSRS-C was tested for clinical validity on an independent population of 155 children between the ages of 8 and 14 who were attending a child psychiatry outpatient clinic. These children were grouped into a depressed population and "others". Children who scored 15 and over were significantly more likely to have a depressive diagnosis (major depression or dysthymia). The positive predictive value of the total DSRS-C score was almost as good as the global score of the history of depression and appearance of depression evaluated at interview by child psychiatrists. Please note that, while those with a depression diagnosis scored highly, many other children with dysphoric mood also scored over 15, such as those with a conduct disorder, mixed emotional and conduct disorder, and other problems including school refusal.

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Difficulties in Emotion Regulation Scale

OVERVIEW
The Difficulties in Emotion Regulation Scale (DERS) contains 36 items and measures problems related to the regulation of emotion.  The DERS helps patients identify areas for emotional growth, especially those with Borderline Personality Disorder, Generalized Anxiety Disorder or Substance Use Disorder. The DERS assesses several factors related to emotional arousal: modulation, awareness, understanding, and acceptance, as well as the ability to act in desired ways regardless of emotional state.

PSYCHOMETRIC PROPERTIES
Gratz & Roemer (2003) found that the DERS had high internal consistency, good test–retest reliability, and adequate construct and predictive validity. Based on a sample of 427 adults presenting at an outpatient clinic diagnosed with one or more DSM-5 disorder, this tool showed good internal consistency (Hallion et al., 2018).

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Drug Abuse Screening Test-10

OVERVIEW

The Drug Abuse Screen Test (DAST-10) was designed to provide a brief, self-report instrument for population screening, clinical case finding and treatment evaluation research. It can be used with adults and older youth. The DAST-10 yields a quantitative index of the degree of consequences related to drug abuse.

PSYCHOMETRIC PROPERTIES
Research findings support the DAST as a reliable and valid drug abuse screening instrument that measures a unidimensional construct.The DAST-10 was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r = 0.76) when correlation with the Drug Use Disorders Identification Test was measured and to have a Cronbach's alpha of 0.92. In addition, a single component accounted for 59.35% of total variance, and the DAST-10 had sensitivity and specificity scores of 0.98 and 0.91, respectively, when using the optimal cut-off score of 4. Additionally, the DAST-10 showed good discriminant validity as it significantly differentiated patients with drug use disorder from alcohol dependents.

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DYADIC ADJUSTMENT SCALE - REVISED

OVERVIEW
The Dyadic Adjustment Scale - Revised (DAS-R)  The DAS-R gives a quick snapshot of multiple dynamics within a given relationship as well as an overall assessment of the stability of the relationship. The DAS-R assesses relationships within four overarching categories including.

  1. Consensus in decision making
  2. Values and affection
  3. Satisfaction in the relationship with respect to stability and conflict regulation
  4. Cohesion as seen through activities and discussion

PSYCHOMETRIC PROPERTIES
Construct validity for the DAS-R is supported by its high correlation with a similar measure, the Locke-Wallace Marital Adjustment Test (MAT). The correlation between the DAS-R and the MAT was .68. In addition, the correlation between the DAS-R and the original Dyadic Adjustment Scale (DAS) was .97. In terms of discriminant validity, the DAS-R has been found to successfully differentiate between 81% of distressed and non-distressed cases.

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Eating Attitudes Test - 26

OVERVIEW
The Eating Attitudes Test-26 (EAT-26) began as 40 questions used to identify the presence of “eating disorder risk” based on attitudes, feelings and behaviors related to eating. It was developed in response to a National Institute of Mental Health (NIMH) consensus panel that recognized a need for screening large populations to increase early identification of anorexia-related symptoms. Additionally, the NIMH wanted a measure that could be used to examine the social and cultural factors involved in the development and maintenance of eating disorders. The original 40 items were reduced after a factor analysis, which revealed only 26 independent items. The EAT-26 should be used as the first step in a two-stage screening process.  Individuals who score above the cut-off point should be referred to a qualified professional to determine if they meet the diagnostic criteria for an eating disorder.  In this vein, the EAT-26 should only be used as a screener for general eating disorders, as research has not shown it to be a valid instrument in making specific diagnoses. The measure can be used with adolescents and adults and with special risk samples such as athletes.

There are three subscales:

  1. Dieting
  2. Bulimia and Food Preoccupation
  3. Oral Control

There are also 4 questions that are not included in the calculation of the above scores but are major risk factors important to the health of people with an eating disorder.

PSYCHOMETRIC PROPERTIES
Garner and his colleagues validated the EAT-26 with 160 females with anorexia nervosa and compared the results to a sample of 140 healthy females. Thus, the EAT-26 is well-validated with female samples, with scores on the EAT-26 being highly predictive of scores on the original EAT-40, which demonstrates the briefer versions high internal consistency.

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Edinburgh Postnatal Depression Scale

OVERVIEW
Postpartum depression is the most common complication of childbearing and rates of help-seeking for postnatal depression are generally low, making screening important. The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item self-report questionnaire designed to identify mothers at risk for prenatal and postnatal depression. The scale indicates how the mother has felt during the previous week. In doubtful cases it may be useful to repeat the tool after 2 weeks. The scale will not detect mothers with anxiety, phobias, or personality disorders.

PSYCHOMETRIC PROPERTIES
Cox and his colleagues carried out a validation study on 84 mothers using the Research Diagnostic Criteria for Depressive Illness obtained from Goldberg’s Standardized Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity and was also sensitive to change in the severity of depression over time.  In another study, 103 post-partum women completed the EPDS and were interviewed using the Diagnostic Interview Schedule.  A cut-off score of 12.5 on the EPDS identified all nine women who reached criteria for major depression. At this threshold the sensitivity (true "cases" identified) of the EPDS was 100%, its specificity (true "non-cases" identified) 95.7%, and its positive predictive value (those who tested as positive and identified as such) was 69.2%.

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Flourishing Scale

OVERVIEW
This is a brief 8-item measure of the respondent’s self-perceived success in important areas such as relationships, self-esteem, purpose, and optimism. The scale provides a single psychological well-being score and can be used to provide useful feedback for how to improve one’s life and provides useful stimulus for self-reflection. The Flourishing Scale is best used with individuals who have adjustment disorders, or other similarly "mild" conditions, seeking to enhance their lifestyle, not for those whose problems are due to serious mental illness.

PSYCHOMETRIC PROPERTIES
The scale was evaluated in a sample of 689 college students from six locations (in the USA and Singapore). It was found to accurately measure subjective well-being.  Other well-being measures were administered to determine the convergence of the new scales with established measures, including the Satisfaction with Life Scale, the 4-Item Scale of Happiness, and the Positive and Negative Affect Schedule.  Factor analysis revealed one strong factor with an eigenvalue of 4.2, accounting for 53 percent of the variance in the items, and no other eigenvalue above 1.0. The factor loading ranged from .61 to .77. The test has a Cronbach’s alpha of .87 and a temporal stability over one month of .71.

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Generalized Anxiety Disorder - 7

OVERVIEW
The GAD-7 is a brief measure of symptoms of generalized anxiety disorder as described in DSM-IV. This assessment asks patients to evaluate their level of symptoms over the last two weeks and can be used to track treatment progress over time. Given the GAD-7's simple language it is appropriate for individuals as young as 14.

PSYCHOMETRIC PROPERTIES
Many factor analyses confirm the 1-dimensional structure of the GAD-7. Internal consistency was identical across all subgroups (alpha = 0.89).  Inter-correlations with the Patient Health Questinnaire-2 and the Rosenberg Self-Esteem Scale were r = 0.64 and r = - 0.43, respectively.  Approximately 5% of subjects had GAD-7 scores of 10 or greater, and 1% had GAD-7 scores of 15 or greater.

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Geriatric Depression Scale - Long Form

OVERVIEW
The Geriatric Depression Scale (GDS) was designed specifically for the elderly as a screening instrument for depression, and it has been tested and used extensively with the older population in many settings, including community, acute care, and long-term care.  In its original form, the GDS is 30-items. Participants are asked to respond by answering 'yes' or 'no' as to how they have felt over the past week.  (Sheik & Yesavage created a short form of the GDS in 1986, which contained 15 items.) The GDS may be used with healthy, medically ill, and mild to moderately cognitively impaired older adults. The GDS is not a substitute for a diagnostic interview by mental health professionals. It is a useful screening tool in the clinical setting to facilitate assessment of depression in older adults, especially when baseline measurements are compared to subsequent scores.

PSYCHOMETRIC PROPERTIES
The validity and reliability of the tool have been supported through both clinical practice and research. The GDS has a high degree of internal consistency with a Cronbach’s alpha coefficient and split-half reliability that both = 0.94. The retest reliability is 0.85 for one week apart and 0.85 for one month apart, demonstrating that within these time limits scores remain stable.  The GDS is a valid tool for discriminating symptom severity, and the presence vs. absence of depression based on DSM-IV criteria.  The GDS has high correlations with the Zung Self-Rating Depression Scale and the Hamilton Rating Scale for Depression (.84 and .83, respectively).  Sensitivity (true positives) and specificity (true negatives) at a cutoff of 11 were 84% and 95%, respectively, and at a cutoff of 14 were 80% and 100%, respectively. This provides good evidence that scores of 11 or more should be considered a possible indicator of depression. Note too that the GDS maintains its reliability and validity when administered by phone.

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Geriatric Depression Scale - Short Form

OVERVIEW
Depression is broadly defined as a mood disorder that has affective, cognitive, and physical signs and symptoms that range from mild to severe and may progress with time. In its most severe form, there may be suicidal thoughts, psychotic features such as hallucinations and delusions, and excessive somatic complaints. The Geriatric Depression Scale (GDS) was designed specifically for the elderly as a screening instrument for depression. The GDS has been tested and used extensively with the older population. It is a 30-item questionnaire in which participants are asked to respond by answering 'yes' or 'no' about how they felt over the past week.  Sheik & Yesavage created a shorter form in 1986 (15 items) called the Geriatric Depression Scale:Short Form (GDS:SF). There are other screening and assessment tools for depression, but the GDS: SF stands out as the best tool to use with older adults.

PSYCHOMETRIC PROPERTIES
In a study by Friedman and colleagues of 960 functionally impaired, cognitively intact primary care patients ages 65 and older, they reported moderate internal consistency (a Cronbach a coefficient of 0.75) and that the functional status of the older adult did not significantly affect the scale's reliability. The GDS showed moderate correlations with measures of depressed mood and life satisfaction, and the GDS:SF accurately identified 89% of those who were not depressed, which varied with the cutoff score: 75% and 65% with cutoff scores of 6 and 5, respectively. In another study, the GDS: SF and the Hamilton Depression Rating Scale were compared in 148 outpatients with Parkinson disease. Although the Hamilton Depression Rating Scale, per its design, provided a more comprehensive evaluation of depressive symptoms, the GDS: SF identified critical symptoms of depression in those with Parkinson disease.

 

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Hoarding Rating Scale

OVERVIEW
The Hoarding Rating Scale is a brief 5-item scale that can be given as a semi-structured clinician interview or as a questionnaire. This tool includes 5 questions about clutter, difficulty discarding, excessive acquisition, and the resulting distress and impairment caused by hoarding.

PSYCHOMETRIC PROPERTIES
The Hoarding Rating Scale-Interview is a psychometrically sound diagnostic instrument for determining the presence and severity of hoarding disorder. Indeed, it showed an excellent internal consistency as well as a high test-retest and cross-context reliability. Both convergent and discriminant validity has been established by the reported correlations between the HRS-I and many of the other hoarding and non-hoarding measures.

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Hogan Drug Attitude Inventory

OVERVIEW
The Hogan Drug Attitude Inventory consists of a questionnaire that is completed by the patient. It includes a series of questions, each with true/false answers, pertaining to various aspects of the patient’s perceptions and experiences of treatment. The original scale consists of 30 questions, but a short form consisting of 10 questions has also been validated. Awad, 1993) The patient should be asked to read each statement in the questionnaire (see page 3) and decide whether they believe it to be true or false (or mostly true/false) as applied to their own experience with medications (only those medications used for the patient’s mental health needs). They should circle their answers in ink on the form. Scoring The DAI-30 (page 3) contains 15 items that a patient who is fully adherent to their prescribed medication (and so would be expected to have a ‘positive’ subjective response to medication) would answer as ‘True’, and 15 items such a patient would answer as ‘False’.

PSYCHOMETRIC PROPERTIES
Schizophrenic patients' self-reports of their experience of neuroleptic treatment were used as the basis for the construction of a scale predictive of drug compliance. Reliability analysis of the responses of 150 patients indicated high internal consistency in the 30-item scale, and preliminary validation in the form of discriminant classification accurately assigned 89% of the sample to complaint and non-compliant groupings. Both discriminant and factor analyses suggest that maximum variability in responding is accounted for by items reflecting how the patient feels on medication, rather than what he knows or believes about medication.

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Holmes-Rahe Life Stress Inventory

OVERVIEW
In 1967, psychiatrists Thomas Holmes and Richard Rahe examined over 5000 patient’s medical records to determine whether stressful events cause illnesses. Patients ranked a list of 43 life events based on a relative score. Each event, called a Life Change Unit (LCU), had a different ‘weight’ for stress. More events mean a higher score. The higher the score, and the larger the weight of each event, the more likely the patient would become ill. Their results were published as the Social Readjustment Rating Scale, now commonly known as the Holmes and Rahe Stress Scale.  Subsequent validation supported the links between stress and illness

PSYCHOMETRIC PROPERTIES
Rahe validated the scale in 1970 as a predictor of illness using 2500 US sailors rating scores of ‘life events’ over the previous 6 months. Over the subsequent 6 months, detailed records were kept of the sailors’ health. The correlation between stress scale scores and illness supported a link between life events and illness, including visits to medical clinics, or medical dropouts from underwater demolitions training. The scale was also assessed against different populations within the USA (African, Mexican and white American groups) and cross-culturally, comparing Japanese and Malaysian with American populations. Malaysians exhibited different attitudes implying different stress at the same score. This suggests weakness of the SRRS in certain areas, with different cultural group reactions to different life events. In 1978 Gerst tested SRRS reliability and found that rank ordering remained extremely consistent both for healthy adults (r = 0.96–0.89) and patients (r = 0.91–0.70).

 

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Impact of Events Scale - Revised

OVERVIEW
The Impact of events Scale - revised (IES-R) is a short self-report questionnaire designed to measure post-traumatic stress disorder (PTSD).  It is best used for recent and specific traumatic events and can be used for repeated measurements over time as a way to monitor progress. The IES-R consists of 22 questions, five of which were added to the original IES to better capture the DSM-IV criteria for PTSD. The IES-R is an appropriate instrument to measure the subjective response to a specific traumatic event in an adult or senior population. The IES-R consists of a total subjective stress score as well as three subscales:

  1. Intrusion (intrusive thoughts, nightmares, intrusive feelings and imagery, dissociative-like re-experiencing)
  2. Avoidance (numbing of responsiveness, avoidance of feelings, situations, and ideas)
  3. Hyperarousal (anger, irritability, hypervigilance, difficulty concentrating, heightened startle)

PSYCHOMETRIC PROPERTIES
The IES-R was validated using a specific traumatic event as a reference in the directions to the patient and a specific time frame of “the past seven days."  The scale discriminates between a variety of traumatized groups vs. non-traumatized groups in the general population.  The avoidance and intrusion subscales show good internal consistency. These subscales also measure different dimensions of the response to stress. The hyperarousal subscale has good predictive validity regarding trauma, while the intrusion and avoidance subscales detect relevant differences in the clinical response to traumatic events of varying severity.  The IES’s two-factor structure is stable over different types of events; it can discriminate between stress reactions at different times after the event; and it has convergent validity with observer-diagnosed post-traumatic stress disorder.

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INTERNATIONAL PERSONALITY ITEM POOL - 5 FACTOR MODEL

OVERVIEW
The Big Five Inventory is a self-report inventory designed to measure the Big Five Dimensions: (1) extraversion, (2) agreeableness, (3) conscientiousness, (4) neuroticism, and (5) openness. It is quite brief for a multidimensional personality inventory (44 items total) and consists of short phrases with relatively accessible vocabulary.This assessment is appropriate for people between the age of 16 and 81.

The five domain constructs are:

  1. Extraversion – The tendency to seek stimulation, talkativeness and related to positive emotions.
  2. Agreeableness – The tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others.
  3. Conscientiousness / Intellect – The tendency to show self-discipline, act dutifully, and aim for achievement.
  4. Emotional Stability – This is the reverse of the “neuroticism” subscale found on the NEO-PIR. Low scores on the Emotional Stability scale indicate the tendency to experience unpleasant emotions easily, such as anger, anxiety, depression, or vulnerability.
  5. Openness – Reflects the degree of intellectual curiosity, creativity and a preference for novelty and variety.

PSYCHOMETRIC PROPERTIES
The IPIP-5 was developed by Goldberg (1999) using the International Personality Item Pool. It has been shown to correlate highly with the corresponding NEO-PI-R domain scores, with correlations that range from .85 to .92 when corrected for unreliability (International Personality Item Pool, 2001). The IPIP-5 scales also outperformed the NEO-PI-R versions of the same constructs as predictors of a number of clusters of self-reported behavioral acts. Buchanan, Johnson and Goldberg (2005) evaluated the validity with 2,448 participants. Factor analysis supported the construct formation, and correlated significantly with behavioral criteria. Lamers et al (2012) conducted another validation study with a sample of 1161 Dutch participants between the ages of 18 and 88, stratified for demographic variables. Gow et al. (2005) also conducted a validation study with 906 participants in Scotland and provide gender and age related norms.

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Kessler Psychological Distress Scale

OVERVIEW
The Kessler Psychological Distress Scale (K10) is a simple measure of psychological distress. The K10 scale involves 10 questions about emotional states each with a five-level response scale. The measure can be used as a brief screen to identify levels of distress. The tool can be given to patients to complete, or alternatively the questions can be read to the patient by the practitioner.

PSYCHOMETRIC PROPERTIES
A strong association has been demonstrated between high scores on the K10 and the Composite International Diagnostic Interview relative to the diagnosis of anxiety and affective disorders.  There is a lesser but significant association between the K10 and other mental disorders.  Sensitivity and specificity data support use of the K10 as a screening instrument to identify anxiety and depression in the community and to monitor treatment outcomes.

SCORING
Scores range from 10 to 50 with higher scores indicating a greater likelihood that the respondent has a mental disorder, or a higher severity of psychological distress. Scores usually decline with psychological treatment. Those patients whose scores remain above 24 after treatment should be reviewed. In addition to the K10, practitioners should use their clinical judgment as to whether a patient is distressed. The 2001 Victorian Population Health Survey adopted a set of cut-off scores that may be used as a guide for screening for psychological distress.  Scores can be split into four main categories:

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Leeds Dependence Questionnaire

OVERVIEW
The Leeds Dependence Questionnaire (LDQ) is a 10-item, self completion questionnaire designed to measure dependence upon a variety of substances. The LDQ is capable of measuring change in dependence and can therefore be used to follow treatment progress and evaluate treatment outcomes. It shows sensitivity to change over time through the range of mild to severe dependence. The LDQ measures dependence in abstinent patients as well.  Because the LDQ is only 10 questions, it is readily incorporated into everyday practice.

PSYCHOMETRIC PROPERTIES
Research shows that the LDQ is a psychometrically sound measure of substance dependence, useful across a variety of substances, and useful in a clinical setting. Young adults (N=300) in residential substance dependence treatment were studied. The LDQ was shown to have concurrent validity: scores obtained from the LDQ were compared to scores obtained at the same time using the Severity of Alcohol Dependence Questionnaire.  The LDQ demonstrated construct validity: alpha factoring extraction revealed a single factor accounting for 63% of the variance in reported dependence severity. And the LDQ’s internal consistency was exceedingly high: Cronbach's alpha was 0.94 and re-test reliability was 0.95.

SCORING
All items are scored 0, 1, 2, or 3.  The Leeds Addiction Unit Recommends using the following categories:

  • 0 = No dependence
  • 1 - 10 = Low to moderate dependence
  • 11 - 20 = Moderate to high dependence
  • 21 - 30 = High dependence

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Liebowitz Social Anxiety Scale

OVERVIEW
The Liebowitz Social Anxiety Scale (LSAS) is a 24-item, self-rated scale used to assess how social anxiety plays a role in your life across a variety of situations. The LSAS was developed by psychiatrist and researcher Dr. Michael R. Liebowitz. The scale might be used in research studies to determine the level of social anxiety experienced by participants, in clinical settings to assess a particular patient's symptoms, or by people who are concerned that what they are experiencing might be the signs of an anxiety disorder. Experts now recommend routine anxiety screening for all women and girls over the age of 13, so the LSAS is one type of screening tool that you may encounter during a routine doctor's visit.

PSYCHOMETRIC PROPERTIES
Several studies have been conducted to examine the reliability and validity of the scale. Overall, researchers have found that all versions of the scale have excellent internal consistency or reliability. The LSAS measure has also shown to be strongly associated with other current measures of social anxiety, indicating that it has good convergent validity.

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Meaning In Life Questionnaire

OVERVIEW
The Meaning in Life Questionnaire (MLQ) is a 10-item questionnaire designed to measure two dimensions of meaning:
1. Presence
2. Search
The Presence scale measures how much respondents feel their lives have meaning. The Search scale measures how much respondents strive for meaning and understanding in their lives. The MLQ has been identified as a potential mediator of the link between religiousness and psychological health. Meaning in life may be an effective conduit through which counselors and clients can discuss "ultimate" matters, even when they do not share similar perspectives on religion.

PSYCHOMETRIC PROPERTIES
The MLQ’s authors used multiple methods and measures of to test their hypothesis that meaning in life mediated the relation between religiousness and life satisfaction, as well as self-esteem and optimism. Their research found that the MLQ has good internal consistency. The presence scale demonstrated coefficient alphas ranging in the low to high .80s, and the search scale yielded alphas in the mid .80s to low .90s. In addition, a multitrait-multimethod matrix demonstrated the convergent and discriminant validity of the MLQ subscales across time and informants, in comparison with 2 other meaning scales. The MLQ offers several improvements over current meaning in life measures, including no item overlap with distress measures, a stable factor structure, better discriminant validity, a briefer format, and the ability to measure the search for meaning.

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Memorial Delirium Assessment Scale

OVERVIEW
The Memorial Delirium Assessment Scale (MDAS) is a 10-item scale used to assess for the presence and severity of delirium. The MDAS is a widely used and validated screening tool developed by W. Breitbart for delirium in cancer patients to measure the severity of delirium, and it reflects all the main diagnostic criteria for delirium, as well as the symptoms of delirium, according to the DSM IV of the American Psychiatric Association .

The MDAS is structured as a 10-item, 4-point clinician-rated scale (possible range 0–30) designed to quantify the severity of delirium in medically ill patients.

This instrument measures relative impairment in domains itemized as follows:

  1. awareness
  2. orientation
  3. short-term memory
  4. digit span
  5. attention capacity
  6. organizational thinking
  7. perceptual disturbance
  8. delusions
  9. psychomotor activity
  10. sleep–wake cycle

PSYCHOMETRIC PROPERTIES
Research indicates that the MDAS is a reliable tool for assessing the severity of delirium among medically ill populations and that it can be reliably scored by multiple raters. Also, the MDAS is highly correlated with existing measures of delirium and cognitive impairment. One study used multiple raters who jointly administered the MDAS to 33 patients, 17 of whom met DSM-IV criteria for delirium, 8 met diagnostic criteria for another cognitive impairment disorder, and 8 had non-cognitive psychiatric disorders. Results indicate high levels of inter-rater reliability (r = 0.92), as well as high levels of internal consistency (coefficient alpha = 0.91).  Mean MDAS ratings differed significantly between delirious patients and the comparison sample of patients with other cognitive impairment disorders or no cognitive disorder.  Another study compared MDAS ratings made by one clinician of 51 medically hospitalized delirious patients to ratings made by a second clinician of delirium using the Delirium Rating Scale and the clinician's global ratings of delirium severity, and of these patients’ cognitive functioning using the Mini-Mental State Examination. Results demonstrated a high correlation between MDAS scores and ratings on the Delirium Rating Scale (r = 0.88), the Mini-Mental State Examination (r = − 0.91), and the clinician's global ratings of delirium severity (r = 0.89).

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Michigan Alcoholism Screening Test - Short Version

OVERVIEW
The Michigan Alcoholism Screening Test (MAST) is one of the oldest and most accurate alcohol screening tests available for alcohol problems. It was developed for the general public and is simple to take and administer. Questions on the MAST relate to the patient's self-appraisal of social, vocational, and family problems frequently associated with heavy drinking, and it targets various problems associated with excessive alcohol use in the medical, relational, and legal arenas. The Short Michigan Alcohol Screening Test (SMAST) is a 13-item questionnaire that requires a 7th grade reading level, and only a few minutes to complete. It was developed from the Michigan Alcoholism Screening Test. Evaluation data indicate that it is an effective diagnostic instrument, and does not have a tendency for false positives, as does the Michigan Alcoholism Screening Test. It is strongly recommended that the DAST-10 be used along with the SMAST unless there is a clear indication that the client uses alcohol but does not use any other drug at all.  A score of 1 or 2 indicates that there is no alcohol problem and no further action is needed at this time. A score of 3 indicates a borderline alcohol problem and further investigation is necessary. A score of 4 or more indicates that there may be an alcohol problem and that a full assessment is needed.

PSYCHOMETRIC PROPERTIES
Th MAST is a face-valid self-report instrument that has long been regarded as an accurate and practical measurement choice in a variety of clinical settings, making it one of the most commonly-used direct screening measures for detecting problematic alcohol use. The MAST is supported by numerous empirical studies reporting robust estimates of internal structural and external score validity, including an extensive psychometric synthesis of 103 studies using this instrument.

 
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Michigan Alcoholism Screening Test - Short Geriatric Version

OVERVIEW
The Michigan Alcoholism Screening Test (MAST) is one of the oldest and most accurate alcohol screening tests available for alcohol problems. It was developed for the general public and is simple to take and administer. Questions on the MAST relate to the patient's self-appraisal of social, vocational, and family problems frequently associated with heavy drinking, and it targets various problems associated with excessive alcohol use in the medical, relational, and legal arenas.

PSYCHOMETRIC PROPERTIES
Th MAST is a face-valid self-report instrument that has long been regarded as an accurate and practical measurement choice in a variety of clinical settings, making it one of the most commonly-used direct screening measures for detecting problematic alcohol use. The MAST is supported by numerous empirical studies reporting robust estimates of internal structural and external score validity, including an extensive psychometric synthesis of 103 studies using this instrument.

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Mood and Feelings Questionnaire-Parent Report

OVERVIEW
The Mood and Feelings Questionnaire (Short Version) – Parent Report (MFQ-P) is a 13-item measure assessing recent depressive symptomatology in children 6-17 years old. The MFQ-P asks the parent to report how their child has been feeling or acting in the past few weeks.

PSYCHOMETRIC PROPERTIES
The MFQ-P shows convergent validity with other measures of child depressive symptoms, like the Children’s Depression Inventory and the Diagnostic Interview Schedule for Children. The present measure also has high internal consistency and a unidimensional factor structure. The MFQ-P can also discriminate between clinically depressed and non-depressed children. It should be noted that, when the MFQ-P score is combined with the self-report version score for the same child, there is better depression status discrimination with the combined score than with either measure alone. The MFQ-P was also validated in a sample of parents of more the 500 sixth grade students.  After independently diagnosing the students, they found that the MFQ-P was moderately accurate at discriminating depressed and non-depressed children. This study provided data for a non-depressed sample (n = 476) and depressed children sample (n=36).

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Mood and Feelings Questionnaire-Self Report

OVERVIEW
The Mood and Feelings Questionnaire - Self Report (MFQ-SR) is a 13-item tool that measures recent depressive symptomatology in children aged 6-17 years. The MFQ-SR asks the child to report how they have been feeling or acting in the past two weeks.

PSYCHOMETRIC PROPERTIES
The MFQ-SR has good convergent validity with other measures of child depressive symptomatology, like the Children’s Depression Inventory and the Diagnostic Interview Schedule for Children. The MFQ-SR can discriminate between clinically depressed and non-depressed children in the general population. It should also be noted that, combining the MFQ-SR discriminates with the The Mood and Feelings Questionnaire - Parent-Report discriminates clinical status better than either measure alone. The present measure has a unidimensional factor structure and high internal consistency. The measure was also validated on more than 500 sixth grade students. Researchers conducted interviews with these students and determined that the MSQ-SR discriminated between depressed and non-depressed children with moderate accuracy.

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Mood Disorder Questionnaire

OVERVIEW

Accurate identification of bipolar spectrum disorder (BD) is of concern as it often goes unrecognized or is inaccurately diagnosed. The Mood Disorder Questionnaire (MDQ) was created to address the need for accurately screening individuals with BD. The MDQ is presented in a self-report format and not used for diagnostic purposes, only as a screening tool.  A comprehensive evaluation should follow a positive screen.

PSYCHOMETRIC PROPERTIES

A study using the MDQ at five US psychiatric clinics in the United States demonstrated that the MDQ had a 0.73 sensitivity and a 0.90 specificity. The researchers then conducted testing in a general population, which identified a 0.28 sensitivity and a 0.97 specificity. An additional study assessed the effectiveness of the MDQ in unipolar and bipolar depressive patients and found 0.58 sensitivity (higher sensitivity for bipolar 1) and 0.67 specificity. Lastly, testing in a primary care setting revealed 0.58 sensitivity and 0.93 specificity. The MDQ is indeed a useful screening tool for BD, demonstrating validity in clinical settings and across cultures. However, consideration should be given to its higher sensitivity for BD-1 detection compared to BD-2 and BD-unspecified.

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Novaco Anger Inventory- Short Form

OVERVIEW
The Novaco Anger Inventory - Short Form (NAI - SF) was adapted from the long form (Novaco, 1975) and contains 25 of the original 90 items. The NAI – SF measures the degree of provocation or anger people would feel if placed in certain situations. Anger is significant in terms of assessment and treatment, across a wide range of clinical disorders. The central characteristic of anger in the context of clinical conditions is that it is “dysregulated”; its activation, expression, and effects occur without appropriate controls. Unregulated anger has been found to be associated with physical and psychological health impairments. It is detrimental to one’s cardiovascular system, and anger occurs in conjunction with a wide range of psychiatrically classified disorders, including a variety of impulse control dysfunctions, mood disorders, personality disorders, and forms of schizophrenia, especially paranoid schizophrenia. The activation of anger has long been recognized as a feature of clinical disorders that result from trauma, such as dissociative disorders, brain-damage syndromes, and especially posttraumatic stress disorder. Anger also appears in mental state disturbances produced by general medical conditions, such as dementia, substance abuse disorders, and neurological dysfunctions resulting from perinatal difficulties.

PSYCHOMETRIC PROPERTIES
The NAI-SF displays a convergent validity of .46 with the Buss-Durke Hostility Inventory, and .41 with the Aggression subscale of the Personality Research Form as well as a test-retest reliability of between .78 and .91. In order to ascertain the validity of the Short Form a factor analysis was applied to the current full data set at intake (N = 207) and 4 factors with an eigenvalue above 1.00 were derived. However, one factor derived an eigenvalue of 12.62 and accounted for over 50% of the variance. Only one item had a higher factor loading on any of the factors other than factor one. The factor loadings for factor one ranged between .53 and .79, with an average loading of .71. It is suggested that this scale, therefore, reliably only consists of one factor (anger). A Cronbach’s alpha of .96 was derived for the scale with an average inter-item correlation of .49, an item-total correlation of between .50 and .77, and a split-half reliability of .93.

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Obsessive-Compulsive Inventory - Revised

The Obsessive-Compulsive Inventory - Revised  (OCI-R) is a short version of the Obsessive-Compulsive Inventory (Foa, Kozak, Salkovskis, Coles, & Amir, 1998) and is a self-report scale for assessing symptoms of Obsessive-Compulsive Disorder (OCD). It consists of 18 questions that a person endorses on a 5-point Likert scale.

Scores are generated by adding the item scores. The possible range of scores is 0-72. Mean score for persons with OCD is 28. Recommended cutoff score is 21, with scores at or above this level indicating the likely presence of OCD. 

This article reports on the development of a revised version of the Obsessive-Compulsive Inventory (OCI; E. B. Foa, M. J. Kozak, P. Salkovskis, M. E. Coles, & N. Amir, 1998), a psychometrically sound, theoretically driven, self-report measure. The revised OCI (OCI-R) improves on the parent version in 3 ways: It eliminates the redundant frequency scale, simplifies the scoring of the subscales, and reduces overlap across subscales. The reliability and validity of the OCI-R were examined in 215 patients with obsessive-compulsive disorder (OCD), 243 patients with other anxiety disorders, and 677 nonanxious individuals. The OCI-R, which contains 18 items and 6 subscales, has retained excellent psychometric properties. The OCI-R and its subscales differentiated well between individuals with and without OCD. Receiver operating characteristic (ROC) analyses demonstrated the usefulness of the OCI-R as a diagnostic tool for screening patients with OCD, utilizing empirically derived cutscores.

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Opioid Risk Tool - Female Version

The ORT is a brief, self-report or clinician rated screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse among individuals prescribed opioids for treatment of chronic pain. Patients categorized as high-risk are at increased likelihood of future abusive drug-related behaviors. This tool is best administered to patients upon an initial visit prior to beginning opioid therapy. The ORT measured the following risk factors based on scientific literature: personal and family history of substance abuse; age; history of preadolescent sexual abuse; and certain psychological diseases.

The Opioid Risk Tool (ORT) is a validated screening instrument commonly used in practice to evaluate the risk of future aberrant opioid use among chronic nonmalignant pain patients who receive prescribed opioids for pain relief. In other words, the tool quantifies the risk of developing an opioid use disorder (OUD). The assumption is that there would be predisposing factors, including behavioral factors and

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Opioid Risk Tool - Male Version
OVERVIEW
The ORT is a brief, self-report or clinician rated screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse among individuals prescribed opioids for treatment of chronic pain. Patients categorized as high-risk are at increased likelihood of future abusive drug-related behaviours. This tool is best administered to patients upon an initial visit prior to beginning opioid therapy. The ORT measured the following risk factors based on scientific literature: personal and family history of substance abuse; age; history of preadolescent sexual abuse; and certain psychological diseases.

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Patient Health Questionnaire - 9

OVERVIEW
The PHQ-9 is the nine item depression subscale of the Patient Health Questionnaire, and is a widely used tool for assisting primary care clinicians in diagnosing depression as well as monitoring treatment. The PHQ-9 is based directly on the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual Fourth Edition (DSM-IV).

PSYCHOMETRIC PROPERTIES
The PHQ-9 was administered to 6,000 patients in eight primary care clinics and seven obstetrics-gynecology clinics. The PHQ-9 has good construct and criterion validity; both were assessed against a structured mental health professional interview in a sample of 580 patients.

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Penn State Worry Questionnaire

OVERVIEW
The PSWQ is a 16-item self-report scale designed to measure the trait of worry. The PSWQ has been found to distinguish patients with generalized anxiety disorder (GAD) from other anxiety disorders. This questionnaire can be
used in clinical and non-clinical settings. It is considered by many to be the “gold-standard” for assessing worry. Since its development in 1990, the PSWQ has become a widely used self-report tool for pathological worry and GAD. The items on the scale assess the occurrence, intrusiveness, pervasiveness, and other characterizing features of an individual’s experience with worry. The scale has been shown to identify worry, over and above anxiety and depression.

PSYCHOMETRIC PROPERTIES
The PSWQ has been validated in student and clinical samples. Research has demonstrated that those with GAD have significantly higher PSWQ scores than people with other anxiety disorders, such as obsessive-compulsive disorder.
Scores on the PSWQ are positively correlated with other measures of pervasive worry. The PWSQ also has high internal consistency and good test-retest reliability.

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PTSD CHECKLIST FOR DSM-5

 

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Religious Coping Activities Scale

Pargament et al (1990) measured a wide range of religious/spiritual coping methods. The items were developed through a literature review and through interviews with clergy and adults who were dealing with various crises. The items were factor analyzed in a sample of more than 500 members of mainline Protestant and Roman Catholic churches, with respondents facing a variety of life crises.

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Rosenberg Self-Esteem Scale

OVERVIEW
The Rosenberg Self-Esteem Scale (RSES) measures self-esteem using ten items answered on a four-point Likert scale (there are scoring versions that use a Guttman scale). The RSES is one of the most widely used measures of self-esteem. Self-esteem is not a unitary construct and has been divided equally to measure two 5-item facets:

  1. Self-competence: one’s view of their instrumental value, such as feeling confident, capable and efficacious.
  2. Self-liking: one’s view of their intrinsic value, such as feeling good about oneself and socially relevant.

A central assumption in psychology has been that high self-esteem is beneficial and low self-esteem is detrimental. However, a more nuanced view of self-esteem is emerging, suggesting the benefits of high trait self-esteem are restricted to enhanced initiative and happiness, and with self-focus and achievement. As such, high self-esteem can produce costs in terms of loss of relatedness, increased competitiveness, and lower concern for group well-being. Some argue that psychologists should be less concerned in fostering self-esteem and more concerned with the processes by which individuals pursue it. Despite higher self-esteem not always being more adaptive, evidence shows that self-esteem is negatively related to disorders of mood and anxiety.  In fact, higher self-esteem has been shown to be protective against some mental disorders.

PSYCHOMETRIC PROPERTIES
The RSES has good predictive validity, as well as internal consistency and test-retest reliability. Cronbach coefficient has been shown to be high (M = 0.81) supporting the internal coherence of the scale. Retest reliability over a period of 2 weeks reveals correlations of .85 and .88, indicating excellent stability. The RSES demonstrates a Guttman scale (questions framed as "yes/no") coefficient of reproducibility of .92, indicating excellent internal consistency.

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Satisfaction With Life Scale

OVERVIEW
The Satisfaction With Life Scale (SWLS) is a 5-item instrument designed to measure global cognitive judgments of satisfaction with one’s life. The questions are open to interpretation, making this scale suitable for adults with a range of background. The SWLS appears to have promise for use in clinical settings. It has been found that clinical and wellness counseling populations score lower on life satisfaction and also that their scores tend to increase during the course of treatment.

PSYCHOMETRIC OVERVIEW
Subjective well-being is conceptualized as consisting of two major components: emotional and cognitive. The SWLS was designed to measure the cognitive component. A series of validation studies demonstrate that the SWLS has a single factor, high internal consistency, is reliable and is content appropriate for a wide range of groups. Convergent validity was established through high correlations with other well-being measures, including the Fordyce Scale and the Giunn Scale. Additionally, the SWLS has a low correlation (.09) with measures of affect intensity, showing that it is likely to be reliable over affective states.

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SCOFF Questionnaire

OVERVIEW
The need to improve health care for patients with anorexia nervosa and bulimia nervosa has long been recognized by many national mental health committees.  Healthcare workers in primary care are at the forefront of screening and managing these disorders.  Unfortunately, the assessment tools available to primary healthcare professionals can take a long time to administer and may need to be interpreted by specialists, which will delay or even preclude the care for some people with eating disorders. The SCOFF questionnaire was designed to address this problem. Its administration is brief, is easy to give, and helps both in the identification and treatment of eating disorders.

PSYCHOMETRIC PROPERTIES
The SCOFF showed excellent validity and reliability in a large study involving 341 women.  They were asked to take the SCOFF.  A researcher who was blind to each woman's score on the SCOFF conducted a clinical diagnostic interview based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (fourth edition). A receiver operating curve set the optimal threshold for the questionnaire at two or more positive answers to the five questions. With this cut off, the SCOFF questionnaire detected all four cases of anorexia nervosa and bulimia nervosa and seven of nine cases of eating disorders not otherwise specified (test sensitivity = 85%).  In the 328 women confirmed not to have an eating disorder, the questionnaire indicated 34 false positives (test specificity = 89%).

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Six-Item Cognitive Test

OVERVIEW
The Six-Item Cognitive Impairment Test (6CIT) is a brief cognitive function test and is widely used in primary care settings. The 6CIT correlates highly with the Mini Mental State Examination (MMSE). Some researchers suggest that the 6CIT has advantages over the MMSE in hospital settings. The 6CIT was more sensitive in detecting mild dementia (sensitivity 80%) than the MMSE (sensitivity 51.43%; cut-off 23/24), demonstrating potential usefulness as a screening tool in primary care.

PSYCHOMETRIC PROPERTIES
Tuijl (2009) evaluated the Six Item Cognitive Impairment Test (6-CIT) as a screening tool for cognitive impairment in 253 older general inpatients and outpatients in two Dutch hospitals diagnosed with cognitive impairment. These authors found that the 6-CIT was able to predict dementia based on Mini Mental Status Exam (MMSE) score of ≤23.

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Social Interaction Anxiety Scale

OVERVIEW
The Social Interaction Anxiety Scale (SIAS) is a 20 item self-report scale designed to measure social interaction anxiety defined as “distress when meeting and talking with other people." This tool is helpful in tracking social anxiety symptoms over time, and it may be helpful as part of an assessment for social phobia or other anxiety related disorders.

PSYCHOMETRIC PROPERTIES
The SIAS has been compared to other scales that measure social anxiety, including the Social Phobia and Anxiety Inventory. They were highly significantly correlated (r = 0.86) suggesting the scales tap similar constructs. Clinician-rated severity of social phobia has also been found to be moderately related to SIAS scores. The SIAS has been found to have strong sensitivity to treatment change. However, it does not distinguish between social phobia and other anxiety disorders. Accordingly, it is recommended that the SIAS should be used as a tool to track treatment progress and should not be heavily relied upon for differential diagnosis.

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South Oaks Gambling Screen

The SOGS consists of 20-items based on DSM- III criteria for pathological gambling.  The South Oaks Gambling Screen (SOGS) is a 20-item questionnaire based originally on DSM-III criteria for pathological gambling. It may be self-administered or administered by nonprofessional or professional interviewers.  The SOGS offers a convenient means to screen clinical populations of alcoholics and drug abusers, as well as general populations, for pathological gambling.

PSYCHOMETRIC PROPERTIES

There is research demonstrating the value of using the SOGS is dimensionally. the current results reaffirm its utility with both DSM-IV and DSM-5 criteria. The SOGS demonstrated a strong correlation with interview ratings of DSM-IV pathological gambling (PG) symptoms (r = .66). Findings were consistent across White and African American groups. For implementation of DSM-5 criteria, as an authentic clinical screen, a relatively permissive cut point of 8 maintains sensitivity in excess of 97%.

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South Oaks Gambling Screen - Revised for Adolescents

The SOGS consists of 20-items based on DSM- III criteria for pathological gambling.  There is research demonstrating the value of using the SOGS is dimensionally. the current results reaffirm its utility with both DSM-IV and DSM-5 criteria.

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Valuing Questionnaire

OVERVIEW
Values are personal principles someone has chosen to guide their behavior. The Valuing Questionnaire (VQ) is a 10-item self-report designed to measure “valuing”, which refers to actions one takes to live in accordance with values, rather than simply pleasant outcomes or satisfaction with life.

The VQ measures two constructs:

  1. Progress: enactment of values, perseverance, and including clear awareness of what is personally important.
  2. Obstruction: avoidance of unwanted experience, distraction from values by inattention to values or undue attention to distress.

When used as a monitoring tool during treatment, client success is indicated by increasing Progress Scores and decreasing Obstruction Scores.

PSYCHOMETRIC PROPERTIES
Smout and colleagues found that the VQ supported a 2-factor solution. They observed a negative correlation (r=-.66) between the two factors and, as expected, a pattern emerged of different responding between the community sample and clinical sample. Scores were significantly lower in the clinical sample (M = 13) compared to the community (M = 17), and the clinical sample scored higher on Obstruction (M = 19) compared to the university sample (M=12). Concurrent validity was established using the Satisfaction with Life Scale, the Valued Living Questionnaire, and the Acceptance and Action Questionnaire-II.

 

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Vancouver Obsessional Compulsive Inventory

OVERVIEW
The VOCI is a self-report assessment of a range of obsessions, compulsions, avoidance behavior, and personality characteristics of known or theoretical importance in obsessive-compulsive disorder (OCD). It contains 55 questions rated on a five-point scale. It is useful in tracking the underlying cognitive structure of OCD and assessing symptoms over time. This scale is a more up-to-date revision of the Maudsley Obsessional Compulsive Inventory-Revised MOCI-R).

PSYCHOMETRIC PROPERTIES
Thordarson evaluated the factor structure of the MOCI-R and modified the scale to produce a test with a high level of internal consistency and high loading factors. He and his colleagues established the validity of the VOCI through testing individuals with known diagnoses of either OCD (n = 88), or depression or anxiety (n = 60). These scores were compared to a community adult group (n = 39) and a student group (n = 200). A comparison between the mean score for the OCD sample and the mean for each comparison groups was conducted. The OCD group scored significantly higher than the other groups on the VOCI (a) Total score, (b) Contamination, (c) Checking, (d) Just Right, and (e) Indecisiveness subscales. A t-test analysis was also undertaken to see if the scale could discriminate between different subtypes of OCD. The results clearly support the known-groups validity of the Contamination, Checking, Obsessions, and Hoarding subscales. The use of the re-test technique demonstrated that the reliability among OCD groups is high, with all coefficients 0.9 or above after 47 days. For the student sample, however, retest reliability was poor (r = 0.5 to 0.6).

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Vanderbilt ADHD Diagnostic Parent Rating Scales

OVERVIEW
The Vanderbilt ADHD Diagnostic Parent Rating Scales (VADPRS) is used to help diagnose Attention Deficit/Hyperactivity Disorder (ADHD) in children between the ages of 6 and 12. It is comprised of 5 questions, includes all 18 of the DSM-IV criteria for ADHD and should be completed by a parent of the child. As well as identifying inattentive, hyperactive/impulsive, or combined sub-types of ADHD, it can also be used to identify symptoms of frequent co-morbidities, including oppositional defiance/conduct disorder, anxiety, and depression.

PSYCHOMETRIC PROPERTIES
Using a sample of the teachers (n = 601) and parents (n = 587) from 5 Oklahoma school districts, the VADPRS was assessed for construct validity by confirmatory factor analysis of the 53 items that made up the 4 scales of inattention, hyperactivity, conduct/oppositional problems, and anxiety/depression problems. The data fit well once discarding conduct items that were infrequently endorsed. Reliability was evaluated from internal consistency, re-test, and inter-rater agreement perspectives. Criterion validity was evaluated via comparisons to a structured psychiatric interview with the parents using the Diagnostic Interview Schedule for Children-IV. Retest reliability exceeded .80 for all summed scale scores. The VADPRS produced a sensitivity of .80, specificity of .75, positive predictive value of .19, and negative predictive value of .98 when predicting an attention-deficit hyperactivity disorder (ADHD) that combined the teacher's Vanderbilt ADHD Diagnostic Teacher Rating Scale and parent diagnostic interview responses.

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Vanderbilt ADHD Diagnostic Teacher Rating Scales

OVERVIEW
The Vanderbilt ADHD Diagnostic Teacher Rating Scales (VADTRS) is used to help in the diagnostic process of Attention Deficit/Hyperactivity Disorder (ADHD) in children between the ages of 6 and 12. It is comprised of 43 questions, includes all 18 of the DSM-IV criteria for ADHD and should be completed by a teacher of the child. As well as identifying inattentive, hyperactive/impulsive, or combined sub-types of ADHD, it can also be used to identify symptoms of frequent co-morbidities, including oppositional defiance/conduct disorder, anxiety, and depression.

PSYCHOMETRIC PROPERTIES
Confirmation of construct and convergent validity, as well as strong reliability, supports the utility of the Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS) as a diagnostic rating scale for attention-deficit hyperactivity disorder. From 41 elementary schools in five Oklahoma school districts (urban, suburban, and rural), all the teachers (n = 601) and a sample of parents (n = 587) were studied. Construct validity using exploratory factor analysis showed that the 35 items fit well into the theoretical four-factor structure of inattention, hyperactivity, conduct/oppositional problems, and anxiety/depression problems. A sub-sample of teachers completed the Strengths and Difficulties Questionnaire, which demonstrated high convergent validity for each sub-scale (Pearson's correlations > .72). Predictive validity was examined using a sample of high- and low-risk children whose parents completed the Diagnostic Interview Schedule for Children-IV, which yielded sensitivity (.69), specificity (.84), positive predictive value (.32), and negative predictive value (.96). Reliability was evaluated from internal consistency, test-retest, and inter-rater agreement perspectives. Estimates of the KR20 coefficient for a binary item version of the scale ranged from .85 to .94.

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Young Mania Rating Scale

OVERVIEW
The Young Mania Rating Scale (YMRS) is a commonly used tool to screen for manic symptoms and to monitor the severity of manic symptoms. The YMRS was normed with psychiatric inpatients based on a semi-structured interview and observations over an 8-hour period. Today’s YMRS combines the client’s self-report of symptoms of mania over the past 48 hours with the clinician’s observations during interview. The YMRS assesses mood, motor activity/energy levels, interest in sex, sleep, irritability, rate and frequency of speech, flight of ideas, grandiosity, aggressive behavior, appearance, and insight into current presentation. The YMRS does not map onto the DSM 5 criteria for mania as it does not account for distractibility, increases in goal directed activity or excessive involvement in pleasurable activities that have a potential for painful consequences. As such, the YMRS is not a diagnostic assessment. On the other hand, it may be used to discern clinically meaningful information about mood disorders in youths. The YMRS is best used with the YMRS Parent Report of symptoms of mania.

PSYCHOMETRIC PROPERTIES
The YMRS is reported to have high interrater reliability for total scores (0.93) and individual item scores (0.66 -0.92). It also has been found to have good internal reliability, with Cronbach alpha coefficients ranging from 0.8 – 0.91. The YMRS has demonstrated high convergent validity with other assessment measures of mania including the Bech-Rafaelsen Mania Rating Scale (Spearman’s Rho = 0.90). Furthermore, the YMRS statistically differentiates between clients before treatment vs. two weeks after treatment, as well as symptoms of mania from symptoms of ADHD.  Finally, although weighting items (see scoring) increases the complexity of scoring and interpretation, it does not affect its psychometric properties.

 

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Young Mania Rating Scale - Parent Version

OVERVIEW
The Young Mania Rating Scale - Parent Version (YMRS-PV) is eleven questions that parents are asked about their child's present state. The YMRS-PV assesses mood, motor activity/energy levels, interest in sex, sleep, irritability, rate and frequency of speech, flight of ideas, grandiosity, aggressive behavior, appearance, and insight into current presentation.  The YMRS-PV does not map onto the DSM 5 criteria for mania as it does not account for distractibility, increases in goal directed activity or excessive involvement in pleasurable activities that have a potential for painful consequences. As such, the YMRS-PV is not a diagnostic assessment.  On the other hand, the YMRS-PV may be used to discern clinically meaningful information about mood disorders in youths. The YMRS-PV is best used with the client's self-report of symptoms of mania over the past 48 hours.  It is commonly used to screen for manic symptoms, monitor severity of mood disorders, and to measure progress of interventions. In situations where the odds of a bipolar diagnosis are high to begin with, such as a child with mood symptoms and 2 parents with bipolar disorder, the YMRS-PV can be extremely helpful.  But for most groups of people, the most that a high score can do is alert the clinician and the child's parent(s) of the possibility of a mood disorder.  The YMRS-PV is akin to a screening test for prostate cancer; identifying most cases of bipolar but with a high false positive rate.

PSYCHOMETRIC PROPERTIES
Parents of 117 children (aged 5 to 17) presenting to an outpatient research center completed a P-YMRS.  The children underwent a diagnostic evaluation including a semi-structured instrument (Schedule for Affective Disorders and Schizophrenia for School-Age Children) and a clinical evaluation by a child and adolescent psychiatrist in more than 75% of the subjects.  Factor analyses suggested one dimension, with a total score showing acceptable internal consistency (α = .75).  Logistic regressions discriminated bipolar mood disorder (BPM) vs. unipolar disorder; BPM vs. disruptive behavior disorder; and BPM vs. any other diagnosis.  Classification rates exceeded 78%.

 

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Zarit Burden interview

OVERVIEW
Because caregivers are often so focused on their family member’s needs, they fail to take care of themselves, and it is all too common for a caregiver to experience a health crisis of their own. The need then for evaluation and treatment services for those who are suffering due to caregiver burden cannot be overstated. The Zarit Burden Interview (ZBI) assesses perceived burden among people caring for others with disabilities. The ZBI has its roots in Zarit’s 29-item questionnaire self-report measure used by many aging agencies. The revised version contains 22 items.  Zarit and his colleagues found that burden was more than just the number, or the type of tasks for which the patient required assistance. The ZBI uncovers sources of stress, which allows for the formulation of more effective treatment interventions.

PSYCHOMETRIC PROPERTIES
A study using a sample of 312 Canadian caregivers found that the ZBI has good internal consistency and reliability (Cronbach’s alpha coefficient = .92), which was not significantly improved by the removal of any of the 22 items. In another study by Herbert and colleagues, scores on the ZBI were unrelated to age, gender, locale, language, living situation, marital status, or employment status, indicating the measure is appropriate for use with a variety of populations. Scores were found to be positively correlated (p < .001) with behavioral problems in the older adult patients and depression scores of the caregivers (R2 = .57), as measured by the Center for Epidemiological Studies Depression Scale.

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Zung Self-Rating Depression Scale

OVERVIEW
The Zung Self-Rating Depression Scale (Zung SRD) is a self-administered survey that serves to quantify the depressed status of adult patients. There are 20 items that rate the four common factors of depression, divided into 4 subscales:

  1. core depressive factor
  2. cognitive factor
  3. anxiety factor
  4. somatic factor

PSYCHOMETRIC PROPERTIES
Knight and colleagues validated the Zung SRD with 2,120 New Zealanders between 16 and 89 years of age. High estimates of reliability based on internal consistency statistics were found, with females scoring higher. Split-half reliability studies in a psychiatric population found a correlation 0.73 and in a community survey of 1,173 subjects, Cronbach’s alpha was 0.79.  Zung demonstrated good discrimination between depressed from non-depressed. He reported in his study that a group of depressed outpatients' mean score was 59, whereas a control group's (hospital staff) mean score was 26. Romera and colleagues examined the validity of the four factors of depression in 1049 patients with major depressive disorder. They found that the (1) Core, (2) Cognitive, (3) Anxiety, and (4) Somatic factors had high coefficients of congruence of 0.98, 0.95, 0.92 and 0.87, respectively.

 

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Alpha factor analysis extracts factors from data that can be generalized to broader groups of people or situations.

Concurrent validity is a form of criterion validity. Test “A”, for example, demonstrates concurrent validity if, during the same occasion in time, it correlates with Test “B”.

Construct validity means that a test designed to measure a particular construct (i.e. intelligence) is actually measuring that construct.

Convergent validity is a sub-type of construct validity. Convergent validity takes two measures that are supposed to be measuring the same construct and shows that they are related.

Cronbach’s alpha is a measure of internal consistency, or how closely related a set of items are as a group. It is considered to be a measure of scale reliability.

Criterion validity is the extent to which operationalizing a construct, such as a test, relates to, or predicts, a theoretical representation of the construct (i.e., a criterion).

Discriminant validity is a sub-type of construct validity. Discriminant validity shows that two measures that are not supposed to be related are, in fact, unrelated.

An eigenvalue is a measure of how much of the variance, of the observed variables, is explained by a factor.  Any factor equal to or greater than 1 explains more variance than a single observed variable.

Face validity is the least sophisticated measure of validity. It simply answers the question as to whether a test appears, at face value, to measure what it claims to. Tests in which the purpose is clear, even to naïve respondents, are said to have high face validity.

Factor Analysis is a statistical technique that reduces a large number of variables into a fewer numbers of factors. Factor Analysis extracts maximum common variance from all variables and puts them into a common score.

Inter-Rater Reliability measures the similarity of data collected by different raters are. If, for instance, raters significantly differ in their observations then either measurements or methodology are not correct and need to be refined.

Intraclass correlation measures the reliability of ratings or measurements for clusters of data, i.e., data that has been collected as groups or sorted into groups.

Logistic regression is used to explain the relationship between a test’s binary score (e.g., yes/no, good/bad) and one or more independent variables.

The multitrait-multimethod matrix is an approach to examining construct validity that organizes convergent and discriminant validity evidence for comparison of how a measure relates to other measures.

Negative predictive value is the probability that subjects with a negative screening test truly don’t have the disease.

Norm-referenced data compares and ranks test takers in relation to one another.  To that end, norm-referenced scores are generally reported as a percentage or percentile ranking.

Predictive validity is a type of criterion validity.  Test “A”, for example, is a valid predictor if it can forecast the outcome of Test “B”, which is utilized at some point later in time.

Positive predictive value is the probability that subjects with a positive screening test truly have the disease.

A p-value is a measure of the probability that an observed difference could have occurred just by random chance. The lower the p-value, the greater the statistical significance of the observed difference.

A receiver operating characteristic curve, is a graphical plot that illustrates the diagnostic ability of a binary classifier system under varying thresholds. It was  developed during World War II to differentiate signal from noise in radar detection. Hence its name.

Reliability refers to the consistency of measurement across items, time, raters, observers, or some other dimension that could add variability to scores.

Retest reliability measures test consistency or the reliability of a test measured over time. In other words, give the same test twice to the same people at different times to see if the scores are the same.

The split-half method assesses the internal consistency, or the extent to which all parts of the test contribute equally to what is being measured, by comparing the results of one half of a test with the results from the other half.

The sensitivity of a test (also called the true positive rate) is defined as the proportion of people with the disease who will have a positive result.  Therefore, a highly sensitive test can be useful for ruling out a disease if a person has a negative result.

Specificity is the percentage of true negatives (e.g. 90% specificity = 90% of people who do not have the target disease will test negative).

T-test analysis measures the size of the difference between two samples of data. Higher t values indicate larger differences between the two sample sets. In other words, a large t-score indicates that the groups are different.