Symptom severity predicts prolonged recovery after sport-related concussion, but age and amnesia do not. Evaluation of Neuropsychiatric Function in Phenylketonuria: Psychometric Properties of the ADHD Rating Scale-IV and Adult ADHD Self-Report Scale Inattention Subscale in Phenylketonuria. Relation between subjective fogginess and neuropsychological testing following concussion. Development of a brief measure to assess quality of life in obesity. Predicting Slow Recovery From Sport-Related Concussion: The New Simple-Complex Distinction Is neuropsychological testing useful in the management of sport-related concussion? HISTORY OF MULTIPLE SELF‐REPORTED CONCUSSIONS IS NOT ASSOCIATED WITH REDUCED COGNITIVE ABILITIES Concussions in amateur rugby union identified with the use of a rapid visual screening tool Hypertonic Saline as a Therapy for Pediatric Concussive Pain: A Randomized Controlled Trial of Symptom Treatment in the Emergency Department The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. The “Value Added” of Neurocognitive Testing after Sports-Related Concussion A measure for assessing patient perception of provider support for self-management of bipolar disorder. Development and Psychometric Evaluation of the Flexilevel Scale of Shoulder Function A Comparison of Psychometric Properties Between Internet and Paper Versions of Two Depression Instruments (BDI-II and MADRS-S) Administered to Clinic Patients Prevalence of neurocognitive and balance deficits in collegiate aged football players without clinically diagnosed concussion. Reliability and validity of the PDS and PSS-I among participants with PTSD and alcohol dependence. Psychometric Properties of the Osteoporosis-Specific Morisky Medication Adherence Scale in Postmenopausal Women with Osteoporosis Newly Treated with Bisphosphonates Relationship between Postconcussion Headache and Neuropsychological Test Performance in High School Athletes Recovery of cerebral blood flow following sports-related concussion. Use of the King–Devick test for sideline concussion screening in junior rugby league Reliability of a Graded Exercise Test for Assessing Recovery From Concussion The 16-Item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression Women's initiative for non-smoking (WINS) VI: reliability and validity of health and psychosocial measures in women smokers with cardiovascular disease.
OBJECTIVE To identify predictors of prolonged symptoms in athletes who sustain concussions . STUDY DESIGN This was a multicenter prospect i ve cohort study of patients in 2 sport concussion clinics . Possible predictors of prolonged symptoms from concussion were compared in 2 groups , those whose symptoms resolved within 28 days and those whose symptoms persisted beyond 28 days . C and i date predictor variables were entered into a logistic regression model that was used to generate aORs . RESULTS A total of 182 patients met the inclusion criteria during the study period . The mean patient age was 15.2 ± 3.04 years . More than one-third of the patients ( n = 65 ) underwent  computerized neurocognitive testing  on their initial visit . On univariate analyses , Post-Concussion Symptom Scale ( PCSS ) score and all composite scores on computerized neurocognitive testing were apparently associated with prolonged symptom duration . Sex , age , loss of consciousness at time of injury , and amnesia at time of injury were not associated with prolonged symptom duration . After adjusting for potential confounding , only total PCSS score was associated with the odds of suffering prolonged symptoms . CONCLUSION Further efforts to develop clinical tools for predicting which athletes will suffer prolonged recoveries after concussion should focus on initial symptom score BACKGROUND Previous qualitative research among adults and parents of children with phenylketonuria ( PKU ) has identified inattention as an important psychiatric aspect of this condition . The parent-reported ADHD Rating Scale-IV ( ADHD RS-IV ) and the Adult ADHD Self-Report Scale ( ASRS ) have been vali date d for measuring inattention symptoms in persons with attention-deficit/hyperactivity disorder ( ADHD ) ; however , their psychometric attributes for measuring PKU-related inattention have not been established . OBJECTIVE The primary objective of this investigation was to demonstrate the reliability , validity , and responsiveness of the  ADHD RS-IV  and  ASRS inattention symptoms subscales in a r and omized controlled trial of patients with PKU aged 8 years or older . METHODS A post hoc analysis investigated the psychometric properties ( Rasch model fit , reliability , construct validity , and responsiveness ) of the ADHD RS-IV and ASRS inattention subscales using data from a phase 3b , double-blind , placebo-controlled clinical trial in those with PKU aged 8 years or older . RESULTS The Rasch results revealed good model fit , and reliability analyses revealed strong internal consistency reliability ( α ≥ 0.87 ) and reproducibility ( intraclass correlation coefficient ≥ 0.87 ) for both measures . Both inattention measures demonstrated the ability to discriminate between known groups ( P < 0.001 ) created by the Clinical Global Impression-Severity scale . Correlations between the ADHD RS-IV and the ASRS with the Clinical Global Impression-Severity scale and the age-appropriate Behavior Rating Inventory of Executive Function Working Memory subscale were consistently moderate to strong ( r ≥ 0.56 ) . Similarly , results of the change score correlations were of moderate magnitude ( r ≥ 0.43 ) for both measures when compared with changes over time in Behavior Rating Inventory of Executive Function Working Memory subscales . CONCLUSIONS These findings of reliability , validity , and responsiveness of both the ADHD RS-IV and the ASRS inattention scales , in addition to content validation results , support their use for the assessment of inattention symptoms among persons with PKU aged 8 years or older in both clinical and research setting The purpose of this study was to examine the relation between the subjective report of feeling foggy at one-week post concussion and acute neuropsychological outcome . The outcome variables were derived from a computerized neuropsychological screening battery , Immediate Post-Concussion Assessment and Cognitive Testing ( ImPACT ) . Participants were 110 high school students who sustained a sports-related concussion and were evaluated 5 - 10 days post injury ( M = 6.8 days ) . Athletes were divided into two groups on the basis of self-reported fogginess . The first group reported no fogginess ( n = 91 ) , whereas the second group reported experiencing some degree of fogginess ( n = 19 ) on a 6-point scale . The athletes with persistent fogginess experienced a large number of other post-concussion symptoms , compared to the athletes with no reported fogginess . In addition , the athletes with persistent fogginess had significantly slower reaction times , reduced memory performance , and slower processing speed . Thus , athletes with any degree of self-reported fogginess at one-week post injury are likely to have adverse effects from their concussions in multiple domains OBJECTIVE Obesity research ers have a growing interest in measuring the impact of weight and weight reduction on quality of life . The Impact of Weight on  Quality of Life question naire ( IWQOL ) was the first self-report instrument specifically developed to assess the effect of obesity on quality of life . Although the IWQOL has demonstrated excellent psychometric properties , its length ( 74 items ) makes it somewhat cumbersome as an outcome measure in clinical research . This report describes the development of a 31-item version of the IWQOL ( IWQOL-Lite ) . RESEARCH METHODS AND PROCEDURES IWQOLs from 996 obese patients and controls were used to develop the IWQOL-Lite . Psychometric properties of the IWQOL-Lite were examined in a separate cross-validation sample of 991 patients and controls . RESULTS Confirmatory factor analysis provided strong support for the adequacy of the scale structure . The five identified scales of the IWQOL-Lite  ( Physical Function , Self-Esteem , Sexual Life , Public Distress , and Work ) and the total IWQOL-Lite score demonstrated excellent psychometric properties . The reliability of the IWQOL-Lite scales ranged from 0.90 to 0.94 and was 0.96 for the total score . Correlations between the IWQOL-Lite and collateral measures supported the construct validity of the IWQOL-Lite . Changes in  IWQOL-Lite scales over time correlated significantly with changes in weight , supporting its sensitivity to change . Significant differences in IWQOL-Lite scale and total scores were found among groups differing in body mass index , supporting the utility of the IWQOL-Lite across the body mass index spectrum . DISCUSSION The IWQOL-Lite appears to be a psychometrically sound and clinical ly sensitive brief measure of quality of life in obese persons Objective : Following the Second International Conference on Concussion in Sport in 2005 , a summary agreement statement was published that introduced new terminology for sport-related concussions . This new classification system is binary ( ie , “ simple ” versus “ complex ” concussions ) . Athletes who are slow to recover ( ie , > 10 days ) are classified as having complex concussions . The purpose of this study was to determine if high school football players , retrospectively classified as having a simple or a complex concussion , could be differentiated in the first 48 after injury on the basis of symptom reporting or neuropsychological testing . Design : Case-control study . Setting : Pennsylvania high school football programs . Participants : The total sample consisted of 114 concussed high school football players who were identified through a 3 year prospect i ve cohort study . Interventions : All completed a computerized neuropsychological screening evaluation within 72 hours of injury . They were followed clinical ly until they recovered and were cleared to return to play . They were classified retrospectively as having a simple ( n = 55 ) or complex ( n = 59 ) concussion based on their recovery times . Main Outcome Measurements : Neurocognitive test performance and symptom ratings . Results : Within 72 hours after injury , athletes with complex concussions performed more poorly on neuropsychological testing and reported more symptoms than those with simple concussions . Athletes with complex concussions who were slow to recover were 18 times more likely to have 3 unusually low neuropsychological test scores than those with simple concussions ( 95 % CI = 2.3 - 144.9 ) . Athletes with previous concussions did not recover more slowly . Conclusions : This study provides evidence that supports and refutes the clinical usefulness of the new simple-complex concussion classification system OBJECTIVE Neuropsychological ( NP ) testing has been used for several years as a way of detecting the effects of sport-related concussion in order to aid in return-to-play determinations . In addition to st and ard pencil- and -paper tests , computerized NP tests are being commercially marketed for this purpose to professional , collegiate , high school , and elementary school programs . However , a number of important questions regarding the clinical validity and utility of these tests remain unanswered , and these questions present serious challenges to the applicability of NP testing for the management of sport-related concussion . Our purpose is to outline the criteria that should be met in order to establish the utility of NP instruments as a tool in the management of sport-related concussion and to review the degree to which existing tests have met these criteria . DATA SOURCES A comprehensive literature review of MEDLINE and PsychLit from 1990 to 2004 , including all prospect i ve , controlled studies of NP testing in sport-related concussion . DATA SYNTHESIS The effects of concussion on NP test performance are so subtle even during the acute phase of injury ( 1 - 3 days postinjury ) that they often fail to reach statistical significance in group studies . Thus , this method may lack utility in individual decision making because of a lack of sensitivity . In addition , most of these tests fail to meet other psychometric criteria ( eg , adequate reliability ) necessary for this purpose . Finally , it is unclear that NP testing can detect impairment in players once concussion-related symptoms ( eg , headache ) have resolved . Because no current guideline for the management of sport-related concussion allows a symptomatic player to return to sport , the incremental utility of NP testing remains question able . CONCLUSIONS / RECOMMENDATIONS Despite the theoretic rationale for the use of NP testing in the management of sport-related concussion , no NP tests have met the necessary criteria to support a clinical application at this time . Additional research is necessary to establish the utility of these tests before they can be considered part of a routine st and ard of care , and concussion recovery should be monitored via the st and ard clinical examination and subjective symptom checklists until NP testing or other methods are proven effective for this purpose OBJECTIVE The long-term impact of sports-related concussion is uncertain . Several studies using traditional neuropsychological measures have found a relationship between a previous history of concussion and reduced cognitive abilities . In contrast , studies using computerized neuropsychological measures have typically found no relationship between concussion history and cognition . In the present study , we examined the association between a self-reported concussion history and cognition using traditional and computer-based neuropsychological tests . METHODS A computerized neuropsychological battery was administered to a sample of 858 collegiate male athletes . Of this sample , 298 athletes reported a history of concussion . A traditional neuropsychological battery was administered to a separate sample of 479 male collegiate athletes , 187 of whom reported a history of concussion . Finally , both a computerized and a traditional neuropsychological battery were administered to a third distinct sample of 175 male collegiate athletes , 57 of whom reported a history of concussion . Concussion history was assessed via self-report . None of the athletes had been concussed in the 6 months before testing . RESULTS No significant association was found between self-reported concussion history and performance on either  computerized or traditional neuropsychological tests .  CONCLUSION Findings suggest that athletes who report a distant history of concussion have minimal enduring neurocognitive deficits . Given conflicting findings in the literature , prospect i ve studies that attempt to identify moderating factors are necessary to help determine who is at risk for long-term cognitive difficulties after concussion AIM To use the King-Devick ( KD ) test and Sports Concussion Assessment Tool 2 ( SCAT2 ) in amateur rugby union players to identify witnessed and unrecognised episodes of concussion that occurred from match participation . METHODS A prospect i ve observational cohort study was conducted on a premier club level amateur rugby union team during the 2012 competition in New Zeal and . Every player completed a pre-competition question naire on concussion history , a baseline PCSS and two trials of the KD before they participated in any match activities . RESULTS For players reporting a concussion in the previous three years there was an average of 4.0±2.8 concussions per player . There were 22 concussive incidents recorded over the duration of the competition ( 46 per 1000 match hours ) . Five concussive incidents were witnessed ( 11 per 1000 match hours ) and 17 unrecognised concussive incidents were identified with the KD ( 37 per 1000 match hours ) . Witnessed concussions recorded , on average , a longer KD on the day of injury ( 5.5±2.4s ) than unrecognised concussions ( 4.4±0.9s ) when compared with their baseline KD . DISCUSSION The KD was able to identify players that had not shown , or reported , any signs or symptoms of a concussion but who had meaningful head injury . The current rate of concussion reported was a ten-fold increase in previously reported concussion injury rates . This makes the KD suitable for rapid assessment in a limited time frame on the sideline such as a five-minute window to assess and review suspected concussed players in rugby union Objective Three-percent hypertonic saline ( HTS ) is a hyperosmotic therapy used in pediatric traumatic brain injury to treat increased intracranial pressure and cerebral edema . It also promotes plasma volume expansion and cerebral perfusion pressure , immunomodulation , and anti-inflammatory response . We hypothesized that HTS will improve concussive symptoms of mild traumatic brain injury . Methods The study was a prospect i ve , double-blind , r and omized controlled trial . Children , 4 to 7 years of age with a Glasgow Coma Scale score greater than 13 , were enrolled from a pediatric emergency department following closed-head injury upon meeting Acute Concussion Evaluation criteria with head pain . Patients were r and omized to receive 10 mL/kg of HTS or normal saline ( NS ) over 1 hour . Self-reported pain values were obtained using the Wong-Baker FACES Pain Rating Scale initially , immediately following fluids , and at 2 to 3 days of discharge . The primary outcome measure was change in self-reported pain following fluid administration . Secondary outcome measures were a change in pain and postconcussive symptoms within 2 to 3 days of fluid administration . We used an intention-to-treat analysis . Results Forty-four patients , ranging from 7 to 16 years of age with comparable characteristics , were enrolled in the study ; 23 patients ( 52 % ) received HTS , and 21 ( 48 % ) received NS . There was a significant difference ( P < 0.001 ) identified in the self-reported improvement of pain following fluid administration between the HTS group ( mean improvement = 3.5 ) and the NS group ( mean improvement = 1.1 ) . There was a significant difference ( P = 0.01 ) identified in the self-reported improvement of pain at 2 to 3 days after treatment between the HTS group ( mean improvement = 4.6 ) and the NS group ( mean improvement = 3.0 ) . We were unable to determine a difference in other postconcussive symptoms following discharge . Conclusions Three-percent HTS is more effective than NS in acutely reducing concussion pain in children This article summarizes the development and validation of a scale to measure the level of self-efficacy of patients with type 2 diabetes mellitus . Self-efficacy is described as people 's belief in their capability to organize and execute the course of action required to deal with prospect i ve situations . This self-efficacy scale was developed based on the self-care activities these patients have to carry out in order to manage their diabetes . The following psychometric properties of this scale were established : content validity , construct validity , internal consistency and stability . The original scale contained 42 items . A panel of five experts in diabetes and four self-efficacy experts evaluated the original scale two times for relevance and clarity . This content validity procedure result ed in a final scale which consisted of 20 items . Subsequently , patients with type 2 diabetes were asked to complete this 20-item scale and further tests were done with the 94 usable responses . Factor analysis identified four factors , all of which were related to clusters of self-care activities used to manage diabetes which comprised this scale . The internal consistency of the total scale was alpha=0.81 and the test-retest reliability with a 5-week time interval was r=0.79 ( P < 0.001 ) Background Neurocognitive testing has been endorsed as a “ cornerstone ’ of concussion management by recent Vienna and Prague meetings of the Concussion in Sport Group . Neurocognitive testing is important given the potential unreliability of athlete self-report after injury . Relying only on athletes'ormalities after injury . Study Design Case control study ; Level of evidence , 3 . Methods High school and college athletes with a diagnosed concussion were tested 2 days after injury . Postinjury neurocognitive performance ( Immediate Postconcussion Assessment and Cognitive Testing ) and symptom ( postconcussion symptom ) scores were compared with preinjury ( baseline ) scores and with those of an agex and education-matched noninjured athlete control group . “ Abnormal ” test performance was determined statistically with Reliable Change Index scores . Results Sixty-four percent of concussed athletes reported a significant increase in symptoms , as judged by postconcussion symptom scores , compared with preinjury baseline at 2 days after injury . Eighty-three percent of the concussed sample demonstrated significantly poorer neurocognitive test results relative to their own baseline performance . The addition of neurocognitive testing result ed in a net increase in sensitivity of 19 % . Ninety-three percent of the sample had either abnormal neurocognitive test results or a significant increase in symptoms , relative to their own baseline ; 30 % of a control group demonstrated either abnormalities in neurocognitive testing or elevated symptoms , as judged by postconcussion symptom scores . For the concussed group , use of symptom and neurocognitive test results result ed in an increased yield of 29 % overreliance on symptoms alone . In contrast , 0 % of the control group had both symptoms and abnormal neurocognitive testing . Conclusion Reliance on patients ’ self-reported symptoms after concussion is likely to result in underdiagnosis of concussion and may result in premature return to play . Neurocognitive testing increases diagnostic accuracy when used in conjunction with self-reported symptoms OBJECTIVES Health care providers have an important role in acknowledging and supporting patients ' self-management of chronic illnesses such as bipolar disorder . This report describes the development and evaluation of a brief measure for assessing patient perception of providers ' support for self-management of bipolar disorder . METHODS A 10-item measure was developed combining generic items from an existing measure of providers ' autonomy supportive versus controlling style with items specific to the self-management of bipolar disorder . The psychometric properties of the measure and its relation to clinical variables were evaluated in a sample of patients enrolled in an ongoing r and omized intervention trial . RESULTS Data were obtained from 420 patients with a chart diagnosis of bipolar disorder ( mean age=44 , 68 % female , 88 % Caucasian ) . The proportion of missing responses for items ranged from 0 to 3 % . Reliability coefficient alpha for the full scale was 0.94 . Corrected item-total correlations for individual items ranged from 0.70 to 0.83 . Factor analysis identified a single factor accounting for 67 % of total variance . Factor loadings for individual items were all at least 0.75 . The measure showed moderate positive correlations with measures of self-efficacy for managing bipolar disorder ( r=0.34 ; p < 0.001 ) , treatment satisfaction ( r=0.63 ; p < 0.001 ) , small negative correlations with measures of mania symptoms ( r=-0.11 ; p < 0.03 ) and depressive symptoms ( r=-0.09 ; p < 0.10 ) . CONCLUSIONS This measure shows good psychometric properties and good evidence for convergent and discriminant validity . It is promising for assessing an important aspect of care for bipolar disorder Background . Existing measures of self‐reported shoulder function fail to measure effectively the full range of shoulder functioning . The classic approach for improving the reliability of a scale is adding items , but a scale with a substantial number of items imposes a large response burden on participants . A more efficient approach is to use modern psychometric methods to construct an adaptive scale in which patients respond only to items that are targeted at their level of shoulder function . Objectives . We developed a Flexilevel Scale of Shoulder Function ( FLEX‐SF ) . This scale includes three testlets that target low , medium , and high shoulder function . Scores on the testlets were equated to a common mathematical metric . Design and Subjects . We developed an initial pool of 68 items . This pool was administered to 400 patients , and responses were calibrated using a rating scale model . Subsets of items were identified for an easy , medium difficulty , and hard testlet . Properties of the scale were evaluated in a 3‐month longitudinal study of 200 shoulder patients . Results . The FLEX‐SF exhibited high reliability at both the scale level ( intraclass correlation coefficient [ 3,1 ] = 0.90 ) and specific trait levels . The validity of the FLEX‐SF was supported by its internal and external responsiveness ( Guyatt responsiveness index = 1.12 ) and the pattern of its associations with other health status measures . Conclusions . The FLEX‐SF can be used as a primary endpoint in clinical trials even when there are relatively few people in each treatment group . The scale also has excellent properties for use in clinical setting s tracking individual changes over time Background Self-report measures can guide clinical decisions and are useful when evaluating treatment outcomes . However , many clinicians do not use self-report measures systematic ally in their clinical practice . Internet-based question naires could facilitate administration , but the psychometric properties of the online version of an instrument should be explored before implementation . The recommendation from the International Test Commission is to test the psychometric properties of each question naire separately . Objective Our objective was to compare the psychometric properties of paper- and -pencil versions and Internet versions of two question naires measuring depressive symptoms . Methods The 87 participating patients were recruited from primary care and psychiatric care within the public health care system in Sweden . Participants completed the  Beck Depression Inventory ( BDI-II )  and the  Montgomery-Åsberg Depression Rating Scale — Self-rated ( MADRS-S )  , both on paper and on the Internet . The order was r and omized to control for order effects . Symptom severity in the sample ranged from mild to severe depressive symptoms . Results Psychometric properties of the two administration formats were mostly equivalent . The internal consistency was similar for the Internet and paper versions , and significant correlations were found between the formats for both MADRS-S ( r = .84 ) and the BDI-II ( r = .89 ) . Differences between paper and Internet total scores were not statistically significant for either question naire nor for the MADRS-S question dealing with suicidality ( item 9 ) when analyzed separately . The score on the BDI-II question about suicidality ( item 9 ) was significantly lower when administered via the Internet compared with the paper score , but the difference was small ( effect size , Cohen ’s [ d ] = 0.14 ) . There were significant main effects for order of administration on both question naires and significant interaction effects between format and order . This should not , however , pose a problem in clinical use as long as the administration format is not changed when repeated measurements are made . Conclusions The MADRS-S can be transferred to online use without affecting the psychometric properties in a clinical ly meaningful way . The full BDI-II also seems to retain its properties when transferred ; however , the item measuring suicidality in the Internet version needs further investigation since it was associated with a lower score in this study . The use of online question naires offers clinicians a more practical way of measuring depressive symptoms and has the potential to save re sources STUDY DESIGN Prospect i ve cohort . OBJECTIVES To identify the prevalence of neurocognitive and balance deficits in collegiate football players 48 hours following competition . BACKGROUND Neurocognitive testing , balance assessment s , and subjective report of symptoms are a commonly used test battery in examining athletes when concussion is suspected . Previous literature suggests many concussions go unreported . Little research exists examining the prevalence of neurocognitive or balance deficits in athletes who do not report concussion-like symptoms to a health care provider . METHODS Forty-five Division IA collegiate football players participated in this study . Preseason baseline scores using the  Balance Error Scoring System , the Immediate Post-Concussion Assessment and Cognitive Testing , and the Postconcussion Symptom Scale  were compared to posttest results obtained 48 hours following a game . Prevalence of symptoms was analyzed and reported . RESULTS Thirty-two ( 71 % ) of the 45 athletes tested demonstrated at least 1 deficit in either the Postconcussion Symptom Scale , Balance Error Scoring System , or at least 1 composite score of the Immediate Post-Concussion Assessment and Cognitive Testing . Nineteen of the 32 subjects demonstrated a change in 2 or more categories of neurocognitive and balance function . CONCLUSION In a cohort of football players tested 48 hours following their last game of the season , who did not seek medical attention related to a concussion , a significant number demonstrated limitations in neurocognitive and balance performance , suggesting that further research may need to be performed to improve recognition of an athlete 's deficits and to improve the ability to assess concussion . LEVEL OF EVIDENCE Differential diagnosis/symptom prevalence , level 3b The prevalence of alcohol use disorder ( e.g. , alcohol dependence ; AD ) among individuals with posttraumatic stress disorder ( PTSD ) is quite high , with estimates of 52 % for men and 30 % for women ( Kessler , Sonnega , Bromet , Hughes , & Nelson , 1995 ) . There are several interviews and self-report measures of PTSD with good published psychometric properties , and they are routinely used with comorbid AD and PTSD . However , none of these instruments was vali date d with this population . The current study fills this gap by examining the psychometric properties of the  PTSD Symptom Scale-Interview ( PSS-I )  and  the self-report PTSD Diagnostic Scale ( PDS )  in individuals diagnosed with current PTSD and AD . Both scales comprised of 17 items provide diagnostic and symptom severity information according to DSM-IV-TR criteria . Participants were 167 individuals who were diagnosed with AD and chronic PTSD and were enrolled in a r and omized controlled treatment study . Results revealed excellent internal consistency of both the PSS-I and the PDS , good test-retest reliability over a 1-month period , and good convergent validity with the SCID . The specificity of the PSS-I diagnosis of PTSD was better than the PDS diagnosis , the latter exhibiting a greater percentage of false positives . In sum , the results showed that the PSS-I and PDS performed well in this population and can be used with confidence to assess PTSD diagnosis and symptom severity Background : Poor adherence to oral osteoporosis medications is common . Strategies for improving adherence begin with identification of the problem . The 8-item Morisky Medication Adherence Scale for self-reported adherence to antihypertensive medications was modified for assessing adherence to oral osteoporosis medications . An evaluation of the measurement properties of the Osteoporosis-Specific Morisky Medication Adherence Scale  ( OS-MMAS ) was needed . Objective : To examine the psychometric properties of the OS-MMAS in women with postmenopausal osteoporosis . Methods : Five hundred women aged 55 years and older with osteoporosis who were newly prescribed daily or weekly oral bisphosphonates between May 15 , 2010 , and August 15 , 2010 , were r and omly selected from Kaiser Permanente Southern California , a large integrated health care delivery system , and mailed a self-administered survey  that included the 8-item OS-MMAS , Self-Efficacy for Appropriate Medication Use Scale ( SEAMS ) , Beliefs about Medicines Question naire ( BMQ ) , Treatment Satisfaction Question naire for Medication ( TSQM ) , Gastrointestinal Symptom Rating Scale ( GSRS ) , and 12-item Short-Form Health Survey ( SF-12v2 ) . OS-MMAS scores can range from 0 to 8 , with higher scores indicating better medication adherence . Internal consistency reliability was evaluated using Cronbach α coefficient . Test-retest reliability was assessed using intraclass correlation coefficients ( ICCs ) in a subset of 102 participants . Construct validity was assessed using confirmatory ( actor analysis and correlations between OS-MMAS and related measures . Results : Of 197 participants , 150 reported that they were still taking their bisphosphonate at the time of the survey and completed the OS-MMAS . Overall , 30.7 % , 32.7 % , and 36.7 % had tow , medium , and high  OS-MMAS scores ( < 6 , 6 to < 8 , and 8 , respectively ) . Cronbach α was 0.82 and the ICC was 0.77 . Convergent validity was supported by significant correlations with SEAMS , BMQ necessity , and TSQM scores . In confirmatory factor analysis , a single-factor scale was supported . Conclusions : The OS-MMAS showed strong psychometric properties with good reliability and construct validity and may provide a valuable assessment of self-reported medication adherence in women newly prescribed oral osteoporosis medications Background : The relevance of headache to outcome after sports-related concussion is poorly understood . Hypotheses : High school athletes reporting headache approximately 1 week after injury will have significantly more other concussion symptoms and will perform more poorly on neuropsychological tests than athletes not experiencing headache . Study Design : Prospect i ve cohort study . Methods : Study participants included 109 high school athletes who had sustained concussion and who were divided into two groups : those reporting headache 7 days after injury and those reporting no headaches . The two groups were compared regarding on-field markers of concussion severity at the time of injury and symptoms and neurocognitive test results collected via ImPACT , a computerized neuropsychological test battery and postconcussion symptom scale , at a mean of 6.8 days after injury . Results : Athletes reporting posttraumatic headache demonstrated significantly worse performance on reaction time and memory ImPACT neurocognitive composite scores . These athletes also reported significantly more symptoms other than headache and were more likely to have demonstrated on-field antero grade amnesia . Conclusions : Findings suggest that any degree of postconcussion headache in high school athletes 7 days after injury is likely associated with an incomplete recovery after concussion IMPORTANCE Animal models suggest that reduced cerebral blood flow ( CBF ) is one of the most enduring physiological deficits following concussion . Despite this , longitudinal studies documenting serial changes in regional CBF following human concussion have yet to be performed . OBJECTIVE To longitudinally assess the recovery of CBF in a carefully selected sample of collegiate athletes and compare time course of CBF recovery with that of cognitive and behavioral symptoms . DESIGN , SETTING , AND PARTICIPANTS A cohort of collegiate football athletes ( N = 44 ) participated in this mixed longitudinal and cross-sectional study at a private research institute specializing in neuroimaging between March 2012 and December 2013 .  Serial imaging occurred approximately 1 day , 1 week , and 1 month postconcussion for a subset of participants ( n = 17 ) . All athletes reported no premorbid mood disorders , anxiety disorders , substance abuse , or alcohol abuse . MAIN OUTCOMES AND MEASURES  Arterial spin labeling magnetic resonance imaging  was used to collect voxelwise relative CBF at each visit . Neuropsychiatric evaluations and a brief cognitive screen  were also performed at all 3 points . Clinicians trained in sports medicine provided an independent measure of real-world concussion outcome ( ie , number of days withheld from competition ) . RESULTS The results indicated both cognitive ( simple reaction time ) and neuropsychiatric symptoms at 1 day postinjury that resolved at either 1 week ( cognitive ; P < .005 ) or 1 month ( neuropsychiatric ; P < .005 ) postinjury . Imaging data suggested both cross-sectional ( ie , healthy vs concussed athletes ; P < .05 ) and longitudinal ( 1 day and 1 week vs 1 month postinjury ; P < .001 ) evidence of CBF recovery in the right insular and superior temporal cortex . Importantly , CBF in the dorsal midinsular cortex was both decreased at 1 month postconcussion in slower-to-recover athletes ( t11 = 3.45 ; P = .005 ) and was inversely related to the magnitude of initial psychiatric symptoms ( Hamilton Depression Scale : r = -0.64 , P = .02 ; Hamilton Anxiety Scale : r = -0.56 , P = .046 ) , suggesting a potential prognostic indication for CBF as a biomarker . CONCLUSIONS AND RELEVANCE To our knowledge , these results provide the first prospect i ve evidence of reduced CBF in human concussion and subsequent recovery . The resolution of CBF abnormalities closely mirrors previous reports from the animal literature and show real-world validity for predicting outcome following concussion AIM To determine whether the King-Devick ( K-D ) test used as a sideline test in junior rugby league players over 12 matches in a domestic competition season could identify witnessed and incidentally identified episodes of concussion . METHODS A prospect i ve observational cohort study of a club level junior rugby league team ( n=19 ) during the 2014 New Zeal and competition season involved every player completing two pre-competition season baseline trials of the K-D test .  Players removed from match participation , or who reported any signs or symptoms of concussion were assessed on the sideline with the K-D test and referred for further medical assessment . Players with a pre- to post-match K-D test difference > 3s were referred for physician evaluation . RESULTS The baseline test-retest reliability of the K-D test was high ( rs=0.86 ; p<0.0001 ) . Seven concussions were medically identified in six players who recorded pre- to post-match K-D test times greater than 3s ( mean change of 7.4s ) . Post-season testing of players demonstrated improvement of K-D time scores consistent with learning effects of using the K-D test ( 67.7s vs. 62.2s ) . DISCUSSION Although no witnessed concussions occurred during rugby play , six players recorded pre- to post-match changes with a mean delay of 4s result ing in seven concussions being subsequently confirmed post-match by health practitioners . All players were medically managed for a return to sports participation . CONCLUSION The K-D test was quickly and easily administered making it a practical sideline tool as part of the continuum of concussion assessment tools for junior rugby league players Objective : To evaluate a grade d treadmill test for retest reliability ( RTR ) and interrater reliability ( IRR ) in the evaluation of the physiologic effects of symptom exacerbation from concussion . Design : Prospect i ve case series ( RTR ) and blinded rater assessment of 10 actors portraying patients with and without symptom exacerbation ( IRR ) . Setting : University Sports Medicine Concussion Clinic . Participants : For RTR , 21 refractory concussed patients ( 11 athletes and 10 nonathletes ) and 10 healthy subjects ; for IRR , 32 raters representing a variety of health care disciplines . Intervention : For RTR , a Balke protocol treadmill test to symptom exacerbation before and after 2 to 3 weeks . For IRR , video recordings of actors during the treadmill test viewed by raters blinded to condition . Main Outcome Measures : For RTR , agreement of the tests for maximal heart rate ( HR ) , systolic blood pressure , diastolic blood pressure , and rating of perceived exertion . For IRR , presence or absence of symptom exacerbation and the symptom exacerbation HR . Results : Raters achieved a sensitivity of 99 % for identifying actors with symptom exacerbation and a specificity of 89 % for ruling out concussion symptoms and agreed on 304 of 320 observations ( accuracy of 95 % ) . The intraclass correlation coefficient for the symptom exacerbation HR was large at 0.90 ( 95 % confidence interval , 0.78 - 0.98 ) . The treadmill test had good RTR for maximum HR ( intraclass correlation coefficient , 0.79 ) but not for systolic blood pressure , diastolic blood pressure , or rating of perceived exertion . Conclusions : The Balke exercise treadmill protocol has very good IRR and sufficient RTR for identifying patients with symptom exacerbation from concussion The 16-item Quick Inventory of Depressive Symptomatology ( QIDS ) , a new measure of depressive symptom severity derived from the 30-item Inventory of Depressive Symptomatology ( IDS ) , is available in both self-report ( QIDS-SR(16 ) ) and clinician-rated ( QIDS-C(16 ) ) formats . This report evaluates and compares the psychometric properties of the QIDS-SR(16 ) in relation to the IDS-SR(30 ) and the 24-item Hamilton Rating Scale for Depression ( HAM-D(24 ) ) in 596 adult out patients treated for chronic nonpsychotic , major depressive disorder .  Internal consistency was high for the QIDS-SR(16 ) ( Cronbach 's alpha = .86 ) , the IDS-SR(30 ) ( Cronbach 's alpha = .92 ) , and the HAM-D(24 ) ( Cronbach 's alpha = .88 ) .  QIDS-SR(16 ) total scores were highly correlated with IDS-SR(30 ) ( .96 ) and HAM-D(24 ) ( .86 ) total scores . Item-total correlations revealed that several similar items were highly correlated with both QIDS-SR(16 ) and  IDS-SR(30 ) total scores . Roughly 1.3 times the QIDS-SR(16 )  total score is predictive of the HAM-D(17 ) ( 17-item version of the HAM-D ) total score . The QIDS-SR(16 ) was as sensitive to symptom change as the IDS-SR(30 ) and HAM-D(24 ) , indicating high concurrent validity for all three scales . The QIDS-SR(16 ) has highly acceptable psychometric properties , which supports the usefulness of this brief rating of depressive symptom severity in both clinical and research setting PURPOSE We present psychometric properties of 9 health and psychosocial measures in a sample of hospitalized women with cardiovascular disease . This information will be useful to others needing to make choices about selection of health and psychosocial measurements in women smokers . METHODS Psychometric properties were examined using baseline measures from a cross-sectional study , nested within a r and omized clinic trial , Women 's Initiative for Non-Smoking . Women smokers hospitalized with cardiovascular disease were recruited from 10 hospitals in the San Francisco Bay Area . Measures included the  perceived stress scale , a depression screener , self-efficacy , the sense of mastery scale , and measures of health-related quality of life  from the  Medical Outcomes Study  . RESULTS The sample of 277 women smokers ranged in age from 34 to 86 years ( mean = 61 + /- 10.1 ) . Studies of variability , including floor/ceiling effects , skewness , range , mean , and SD , indicated that most measures had sufficient variability to be predictive and detect both positive and negative changes over time . Internal-consistency reliabilities ranged from 0.63 to 0.86 . Preliminary evidence of construct validity was found , with most hypotheses being confirmed . CONCLUSIONS The battery of tests included in the Women 's Initiative for Non-Smoking trial may be useful in identifying women at high risk of relapse and in detecting short-term quality -of-life outcomes . The measures generally performed well and show promise for advancing our underst and ing of the process of successful smoking cessation in this population . SUMMARY Psychometric properties of the  perceived stress scale , a depression screener , self-efficacy for quitting smoking ,  the sense of mastery scale , and  measures of health-related quality of life  from the Medical Outcomes Study in 277 women smokers hospitalized with cardiovascular disease were examined . The measures generally performed well and show promise for advancing our underst and ing of smokers in this population
Six core scales were identified with a broad range of symptom items but with limited information on their psychometric properties .
OBJECTIVE To identify  self-reported sport concussion symptom scales  and to describe the psychometric properties of these identified scales .