bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring well‐being rather than the absence of distress symptoms: a comparison of the SF‐36 Mental Health subscale and the WHO‐Five well‐being scale
Authors: Bech Per , Olsen Lis Raabaek , Kjoller Mette , Rasmussen Niels Kristian
Published: March 2006

The health status questionnaire Short‐Form 36 (SF‐36) includes subscales measuring both physical health and mental health. Psychometrically, the mental health subscale contains a mixture of mental symptoms and psychological well‐being items, among other things, to prevent a ceiling effect when used in general population studies. Three of the mental health well‐being items are also included in the WHO‐Five well‐being scale. In a Danish general population study, the mental health subscale was compared psychometrically with the WHO‐Five in order to evaluate the ceiling effect. Tests for unidimensionality were used in the psychometric analyses, and the sensitivity of the scales in differentiating between changes in self‐reported health over the past year has been tested.

The results of the study on 9,542 respondents showed that, although the WHO‐Five and the mental health subscale were found to be unidimensional, the WHO‐Five had a significantly lower ceiling effect than the mental health subscale. The analysis identified the three depression symptoms in the mental health subscale as responsible for the ceiling effect. The WHO‐Five was also found to be significantly superior to the mental health subscale in terms of its sensitivity in differentiating between those persons whose health had deteriorated over the past year and those whose health had not.

In conclusion, the WHO‐Five, which measures psychological well‐being, reflects aspects other than just the absence of depressive symptoms. Copyright © 2003 Whurr Publishers Ltd.
The construct validity of the client questionnaire of the Wisconsin Quality of Life Index – a cross‐validation study
Authors: Caron Jean , Corbière Marc , Mercier Céline , Diaz Pablo , Ricard Nicole , Lesage Alain
Published: March 2006

The Wisconsin Quality of Life Index (W‐QLI, Becker, Diamond and Sainfort, 1993) consists of eight scales: satisfaction with life domains, occupational activities, symptoms, physical health, social relations/support, finances, psychological wellbeing, and activities of daily living. The W‐QLI has been modified to fit the characteristics of the Canadian population, the universal Canadian health system, and community and social services in Canada and the modified form was named CaW‐QLI (Diaz, Mercier, Hachey, Caron, and Boyer, 1999). This study will verify the empirical basis of these theoretical dimensions by applying a cross‐validation procedure on two samples, most of whose subjects have a serious mental illness. Confirmatory factor analyses and exploratory factor analyses using the principal component extraction technique with varimax rotation were applied. With the exception of the occupational activities domain, the remaining scales were correctly identified by the factor analyses on each sample. The occupational activities scale should be developed by additional items for representing this scale, which is too brief, and two other items should be revised in order to improve the quality of the instrument. Copyright © 2003 Whurr Publishers Ltd.
A modelling strategy for the analysis of clinical trials with partly missing longitudinal data
Authors: White Ian R. , Moodie Erica , Thompson Simon G. , Croudace Tim
Published: March 2006

Standard statistical analyses of randomized controlled trials with partially missing outcome data often exclude valuable information from individuals with incomplete follow‐up. This may lead to biased estimates of the intervention effect and loss of precision. We consider a randomized trial with a repeatedly measured outcome, in which the value of the outcome on the final occasion is of primary interest. We propose a modelling strategy in which the model is successively extended to include baseline values of the outcome, then intermediate values of the outcome, and finally values of other outcome variables. Likelihood‐based estimation of random effects models is used, allowing the incorporation of data from individuals with some missing outcomes. Each estimated intervention effect is free of non‐response bias under a different missing‐at‐random assumption. These assumptions become more plausible as the more complex models are fitted, so we propose using the trend in estimated intervention effects to assess the nature of any non‐response bias. The methods are applied to data from a trial comparing intensive case management with standard case management for severely psychotic patients. All models give similar estimates of the intervention effect and we conclude that non‐response bias is likely to be small. Copyright © 2003 Whurr Publishers Ltd.
Screening for antisocial personality disorder in drug users – a qualitative exploratory study on feasibility
Authors: Fischer Benedikt , Haydon Emma , Kim Gregory , Rehm Jürgen , El‐Guebaly Nady
Published: March 2006

Knowledge about co‐occurring personality disorders in drug users is important for planning therapy and prevention. The objective of this study was to assess whether the SCID‐II (Structured Clinical Interview for DSM‐III‐R) Screen for antisocial personality disorder was feasible and acceptable in a population of opioid users. A qualitative study on veridicality and emotional quality in responses to SCID‐II Screen was carried out by personal interview in a multifunctional addiction centre. The subjects were 10 outpatient participants (six female, four male) in methadone substitution treatment.

The SCID‐II Screen triggered a high level of emotions. Some questions were mainly interpreted from a victim's perspective, even though the intention was the perpetrator's view. Questions were seen as sex‐biased. Provision of support to deal with potential emotional problems should be supplied. Potential revision should be considered to include the female perspective in the screen. Copyright © 2003 Whurr Publishers Ltd.
Validation of the Routine Assessment of Patient Progress (RAPP) in patients with psychosis in South India
Authors: Charles H. , John T. , Chandy S. , Ezhilarasu P. , Antonisamy B. , Jacob K.S.
Published: March 2006

The aim of the study was to validate the Routine Assessment of Patient Progress (RAPP), an instrument for assessment by nurses, among patients with psychosis in South India. One hundred consecutive patients with psychosis admitted to the Department of Psychiatry, Christian Medical College, Vellore, India, were assessed on day five and day 19 using the RAPP, the PANSS, and the CGI scales. The correlation of the RAPP with the other scales, its change over time, the inter‐rater reliability, and factor structure were assessed. The subscales of RAPP correlated significantly with those of the other scales at intake and at follow‐up. The RAPP scores changed significantly after treatment. Its inter‐rater reliability as measured by the intra‐class correlation coefficient was 0.98. The Cronbach's alpha, used to measure the internal consistency of the scale, was 0.87. The split‐half reliability (Spearman‐Brown) was 0.89. Principal component analysis with varimax rotation revealed six factors, which explained 67.4% of the variance. Items related to life skills explained a major proportion of the variance. The good psychometric properties, concurrent validity, high inter‐rater reliability and sensitivity to change make it a useful instrument for nurses to employ to assess patients with psychoses. Copyright © 2003 Whurr Publishers Ltd.
A confirmatory factor analysis of the Brief Psychiatric Rating Scale in a homeless sample
Authors: Burger Gary K. , Yonker Robert D. , Calsyn Robert J. , Morse Gary A. , Klinkenberg W. D.
Published: March 2006

This study used a confirmatory factor analysis procedure, the Oblique Multiple Group Method (OMG), with the Brief Psychiatric Rating Scale (BPRS) on a sample of homeless individuals who had both a severe mental illness and a substance use disorder. The hypothesized five‐factor model of Guy (1976) accounted for 93% of the possible variance, and all the appropriate scales had their highest loading on their respective hypothesized factor. In addition, the Guy model accounted for more variance than did an alternative model. The five factors were labelled: thinking disorder, anergia, anxiety‐depression, hostility‐suspicion, and activity. Copyright © 2003 Whurr Publishers Ltd.
Toward better probing for hypomania of bipolar‐II disorder by using Angst's checklist
Authors: Benazzi Franco
Published: March 2006

The reliability of the diagnosis of bipolar‐II disorder (BP‐II) is still a problem. Semi‐structured interviews by clinicians might partly overcome this problem. The aims of this study were to find the degree of agreement in the diagnosis of BP‐II between the Structured Clinical Interview for DSM‐IV (SCID) and a semi‐structured interview based on Angst's hypomania checklist (Angst et al., 2003), and to assess the priority among hypomanic symptoms for the diagnosis of BP‐II. Remitted depression outpatients (N = 102) were interviewed during a follow‐up visit using the Structured Clinical Interview for DSM‐IV (SCID), and then with Angst's semi‐structured interview, following DSMIV criteria. Bipolar I (BP‐I) patients were excluded. Using the SCID, 29 patients were diagnosed BP‐II, 26 BP‐I, and 47 major depressive disorder (MDD). By the semi‐structured interview 69 patients were diagnosed BP‐II, 33 MDD, and none BP‐I. Agreement for the diagnosis of BP‐II between the two interviews was 53.9% (k = 0.18). Re‐analysis, after deleting the SCID question on the impact on functioning (DSM‐IV unclear boundary between BP‐I and BP‐II), increased agreement to 78.4% (k = 0.55). Elevated mood and overactivity (increased goal‐directed activity) had the lowest agreement (k = 0.46–0.49). For predicting BP‐II, overactivity had the highest sensitivity (94.2%), while elevated mood had a sensitivity of 84.0%. Multivariate analysis for predicting BP‐II (diagnosed by semi‐structured interview), including all DSM‐IV hypomanic symptoms, found that mood change and overactivity were the only independent predictors. Overactivity plus at least three symptoms (as suggested by Angst and Gamma, 2002) were present in 71 patients, of whom 91.5% also met DSM‐IV criteria for hypomania. Overactivity and elevated mood were strongly associated (but not overactivity and irritability). Findings may support a diagnosis of BP‐II based on Angst's semi‐structured interview versus the fully structured SCID interview. While DSM‐IV always requires mood change for the diagnosis of hypomania, the present findings may suggest that overactivity could have the same priority, as suggested by Angst et al. (2003) and by Akiskal et al. (1977, 2001, 2003). Copyright © 2004 Whurr Publishers Ltd.
Screening for personality disorder: a comparison of personality disorder assessment by patients and informants
Authors: Walters Paul , Moran Paul , Choudhury Partha , Lee Tennyson , Mann Anthony
Published: March 2006

The Structured Clinical Interview for DSM‐IV Personality Disorders (SCID‐II Version 2.0) is becoming the most favoured instrument to measure personality disorder but takes up to an hour to complete. The Standardized Assessment of Personality (SAP), an informant‐based measure, takes 10 to 15 minutes to complete. Both instruments have been validated independently. This study aimed to determine whether the SAP is a suitable screening instrument for personality disorder as measured by the SCID‐II.

Fifty‐seven psychiatric patients were assessed for personality disorder using both the SAP and the SCID‐II. The SAP assessments were conducted blind to the results of the SCID‐II assessments.

Agreement between the two instruments in this population was low (kappa = 0.3). The level of agreement differed between personality disorder categories, ranging from kappa = 0.4 (antisocial) to −0.1 (narcissistic).

In this population of patients, the SAP proved to be a poor screen for the SCID‐II. The study highlights the discrepancy between informant and self‐report assessments for personality disorder. Copyright © 2004 Whurr Publishers Ltd.
The US National Comorbidity Survey Replication (NCS‐R): design and field procedures
Authors: Kessler Ronald C. , Berglund Patricia , Chiu Wai Tat , Demler Olga , Heeringa Steven , Hiripi Eva , Jin Robert , Pennell Beth‐Ellen , Walters Ellen E. , Zaslavsky Alan , Zheng Hui
Published: March 2006

The National Comorbidity Survey Replication (NCS‐R) is a survey of the prevalence and correlates of mental disorders in the US that was carried out between February 2001 and April 2003. Interviews were administered face‐to‐face in the homes of respondents, who were selected from a nationally representative multi‐stage clustered area probability sample of households. A total of 9,282 interviews were completed in the main survey and an additional 554 short non‐response interviews were completed with initial non‐respondents. This paper describes the main features of the NCS‐R design and field procedures, including information on fieldwork organization and procedures, sample design, weighting and considerations in the use of design‐based versus model‐based estimation. Empirical information is presented on non‐response bias, design effect, and the trade‐off between bias and efficiency in minimizing total mean‐squared error of estimates by trimming weights. Copyright © 2004 Whurr Publishers Ltd.
Clinical calibration of DSM‐IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH‐CIDI)
Authors: Kessler Ronald C. , Abelson Jamie , Demler Olga , Escobar Javier I. , Gibbon Miriam , Guyer Margaret E. , Howes Mary J. , Jin Robert , Vega William A. , Walters Ellen E. , Wang Philip , Zaslavsky Alan , Zheng Hui
Published: March 2006

An overview is presented of the rationale, design, and analysis plan for the WMH‐CIDI clinical calibration studies. As no clinical gold standard assessment is available for the DSM‐IV disorders assessed in the WMH‐CIDI, we adopted the goal of calibration rather than validation; that is, we asked whether WMH‐CIDI diagnoses are ‘consistent’ with diagnoses based on a state‐of‐the‐art clinical research diagnostic interview (SCID; Structured Clinical Interview for DSM‐IV) rather than whether they are ‘correct’. Consistency is evaluated both at the aggregate level (consistency of WMH‐CIDI and SCID prevalence estimates) and at the individual level (consistency of WMH‐CIDI and SCID diagnostic classifications). Although conventional statistics (sensitivity, specificity, Cohen's κ) are used to describe diagnostic consistency, an argument is made for considering the area under the receiver operator curve (AUC) to be a more useful general‐purpose measure of consistency. In addition, more detailed analyses are used to evaluate consistency on a substantive level. These analyses begin by estimating prediction equations in a clinical calibration subsample, with WMH‐CIDI symptom‐level data used to predict SCID diagnoses, and using the coefficients from these equations to assign predicted probabilities of SCID diagnoses to each respondent in the remainder of the sample. Substantive analyses then investigate whether estimates of prevalence and associations when based on WMH‐CIDI diagnoses are consistent with those based on predicted SCID diagnoses. Multiple imputation is used to adjust estimated standard errors for the imprecision introduced by SCID diagnoses being imputed under a model rather than measured directly. A brief illustration of this approach is presented in comparing the precision of SCID and predicted SCID estimates of prevalence and correlates under varying sample designs. Copyright © 2004 Whurr Publishers Ltd.
Multilevel investigation of variation in HoNOS ratings by mental health professionals: a naturalistic study of consecutive referrals
Authors: Ecob R. , Croudace T.J. , White I. R. , Evans J. E. , Harrison G. L. , Sharp D. , Jones P. B.
Published: March 2006

Episodes of mental healthcare in specialist psychiatric services often begin with the assessment of clinical and psychosocial needs of patients by healthcare professionals. Particularly for patients with complex needs or severe problems, ratings of clinical and social functioning at the start of each episode of care may serve as a baseline against which subsequent measures can be compared. Currently, little is known about service variations in such assessments on referrals from primary care. We set out to quantify variability in initial assessments performed by healthcare professionals in three CMHTs in Bristol (UK) using the Health of the Nation Outcome Scales (HoNOS). We tested the hypothesis that variations in HoNOS total and sub‐scale scores are related to referral source (general practices), healthcare assessor (in CMHTs) and the assessor's professional group. Statistical analysis was performed using multilevel variance components models with cross‐classified random effects. We found that variation due to assessor substantially exceeded that due to referral source (general practices). Furthermore, patient variance differed by assessor profession for the HoNOS – Impairment scores. Assessor variance differed by assessor profession for the HoNOS – Social scores. As HoNOS total and subscale scores show much larger variation by assessor than by referral source, investigations of HoNOS scores must take assessors into account. Services should implement and evaluate interdisciplinary training to improve consistency in use of rating thresholds; such initiatives could be evaluated using these extensions of multilevel models. Future research should aim to integrate routine diagnostic data with continuous outcomes to address selection effects (of patients to assessors) better. Copyright © 2004 Whurr Publishers Ltd.
Continuation and long‐term maintenance treatment with Hypericum extract WS® 5570 after successful acute treatment of mild to moderate depression – rationale and study design
Authors: Kasper S. , Dienel A. , Kieser M.
Published: March 2006

Unipolar major depression is often a chronic disease that may require lifelong prophylaxis. Recovery from an acute episode is followed by 4‐6 months of relapse prevention. After that, long‐term maintenance treatment is administered to avoid recurrence.

We present the rationale and design of an ongoing double‐blind, randomized, placebo‐controlled trial investigating the efficacy of Hypericum extract WS® 5570 in relapse prevention in recurrent unipolar depression. An estimated sample of 425 adults with recurrent, mild to moderate major depression (ICD‐10 and DSM‐IV criteria), ≥3 previous episodes (last 5 years) and a total score ≥20 points on the 17‐item Hamilton Rating Scale for Depression (HAMD) will be included. After a one‐week wash out patients receive 3 × 300 mg/day WS® 5570 single‐blind for 6 weeks. Responders are randomized to 26 weeks of double‐blind continuation treatment with 3 × 300 mg/day WS® 5570 or placebo. Patients completing continuation treatment without relapse enter 52 weeks of double‐blind maintenance treatment, where those treated with WS® 5570 are re‐randomized to 3 × 300 mg/day WS® 5570 or placebo. The primary outcome measure is the time to relapse during continuation treatment (HAMD ≥16, clinical diagnosis of depression, or premature treatment termination for inefficacy).

Hypericum extract, with its favourable tolerability profile, could be an interesting option for long‐term prophylaxis. The trial was designed according to current consensus and guidance. Notably, it includes long‐term prophylactic treatment with the same drug and the same therapeutic dose applied during acute treatment, uses well‐defined outcome measures and provides a clear distinction between relapse and recurrence. Copyright © 2004 Whurr Publishers Ltd.
Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES)
Authors: Heeringa Steven G. , Wagner James , Torres Myriam , Duan Naihua , Adams Terry , Berglund Patricia
Published: March 2006

This paper provides an overview of the probability sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES): the National Comorbidity Survey Replication (NCS‐R), the National Study of American Life (NSAL) and the National Latino and Asian American Study of Mental Health (NLAAS). The multi‐stage sample design and respondent selection procedures used in these three studies are based on the University of Michigan Survey Research Center's National Sample designs and operations. The paper begins with a general overview of these designs and procedures and then turns to a more detailed discussion of the adaptation of these general methods to the three specific study designs. The detailed discussions of the individual study samples focus on design characteristics and outcomes that are important to analysts of the CPES data sets and to researchers and statisticians who are planning future studies. The paper describes how the expected survey cost and error structure for each of these surveys influenced the original design of the samples and how actual field experience led to changes and adaptations to arrive at the final samples of each survey population. Copyright © 2004 Whurr Publishers Ltd.
Methodological innovations in the National Survey of American Life
Authors: Jackson James S. , Neighbors Harold W. , Nesse Randolph M. , Trierweiler Steven J. , Torres Myriam
Published: March 2006

This paper provides an overview of the conceptualization and methods used in the National Survey of American Life (NSAL). The objectives of the NSAL are to investigate the nature, severity, and impairment of mental disorders among national samples of the black and non‐Hispanic white (n = 1,006) populations in the US, including African American (N = 3,570), and Afro‐Caribbean (N = 1,623) immigrant and second and older generation, populations. National multi‐stage probability methods were used in generating the samples and race/ethnic matching of interviewers and respondents were employed in the largely face‐to‐face interview, lasting on average 2 hours and 20 minutes. Two methodological approaches are described for addressing sampling coverage of individuals attached to, but not residing in, selected households at the time of the study. The paper also describes two approaches used to address concerns about the interpretations of standard symptom probe information in assessing serious mental disorders. This included a clinical reappraisal study designed to ascertain differences in symptom responding and ascertainment of cases (N = 677) in a subset of the same NSAL respondents. Finally, an abbreviated, novel method for estimating the prevalence of mental disorders in first‐degree family members is described and the preliminary results from this new approach are reported. Copyright © 2004 Whurr Publishers Ltd.
Instrumental variable methods for effectiveness research
Authors: Sturm Roland
Published: March 2006

Many research questions, such as quality of specific providers or guideline‐concordant care in typical practices, are commonly studied in an observational setting. These analyses face the risk that covariates related to both an outcome of interest and the probability of treatment are unobserved or uncontrolled. The resulting biases can easily overwhelm true effects or create apparent effects, and small changes in the analytic approach can yield contradictory results, which is demonstrated for antidepressant medication and counselling.

An econometric method, instrumental variable estimation (IV), provides a possible solution and permits causal inferences under certain conditions. The central element of IV is the observation that some variables are related to outcomes only through their effect on treatment and have no independent direct effect. The main difficulty of using IV is to identify appropriate instrumental variables and to assure that the sample size is sufficiently large to provide acceptable statistical power, which is substantially lower in IV than in standard regression models. These issues are discussed in the context of determining the effectiveness of depression treatment and illustrated using data from the depression panel of the medical outcomes study. Copyright © 1998 Whurr Publishers Ltd.
Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US national comorbidity survey (NCS)
Authors: Kessler Ronald C. , Wittchen Hans‐Ulrich , Abelson Jamie M. , Mcgonagle Katherine , Schwarz Norbert , Kendler Kenneth S. , Knäuper Bärbel , Zhao Shanyang
Published: March 2006

This paper reports the results of methodological studies carried out in conjunction with the US National Comorbidity Survey (NCS) to evaluate Version 1.0 of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). These studies relied on recent survey data collection methodology literature to investigate problems regarding question comprehension, instruction comprehension, respondent motivation to report accurately, and regarding the limits of respondent ability to report accurately. Insights and strategies developed by survey methodologists were used to modify the CIDI in an effort to address these problems. The paper describes these strategies and methodological studies that evaluated their effects, including a clinical reappraisal study and a field experiment that evaluated the impact of question modifications on prevalence estimates. The paper closes with a discussion of remaining methodological problems with the CIDI and potentially useful future studies that might be able to develop solutions to these problems. Copyright © 1998 Whurr Publishers Ltd.
The International Personality Disorder Examination Questionnaire (IPDEQ): preliminary data on its utility as a screener for anxious personality disorder
Authors: Slade Tim , Peters Lorna , Schneiden Vivienne , Andrews Gavin
Published: March 2006

The present study assessed the utility of the International Personality Disorder Examination Questionnaire (IPDEQ) as a screener for ICD‐10 personality disorders in a sample of 76 subjects attending treatment for an anxiety disorder. The performance of the IPDEQ at different cut‐off points was compared to IPDE diagnoses of personality disorder using receiver operating characteristic analysis. As the majority of positive diagnoses were of ICD‐10 anxious (DSM‐IV avoidant) personality disorder the six IPDEQ items relating to anxious personality disorder were analysed. Sensitivities were very high and specificities were moderate indicating that the IPDEQ items relating to anxious personality disorder are good at discriminating between those with and those without anxious personality disorder. Furthermore, a cut‐off point of four or more anxious personality disorder items yielded the highest specificity given maximum sensitivity, a condition necessary for a screening instrument to be effective. Thus, at a cut‐off point of four or more screening items the IPDEQ appears to be a valid screening instrument for the detection of anxious personality disorder. The limitations of the study, including the generalizability of the results to other personality disorders and/or other samples, are discussed. Copyright © 1998 Whurr Publishers Ltd.
Depression, dysthymia and substance use disorders: sources of dissonance between ICD‐10 and DSM‐IV
Authors: Andrews Gavin , Slade Tim
Published: March 2006

The present study examined the diagnostic concordance between ICD‐10 and DSM‐IV in the depressive disorders, dysthymic disorder and substance dependence and substance harmful use/abuse disorder. The Composite International Diagnostic Interview (CIDI) was administered to 1504 people, in a sample derived from community and clinic cases, and discrepant diagnoses were identified for ICD‐10 and DSM‐IV. The diagnostic concordance for the depressive disorders, dysthymic disorder and substance dependence disorder was excellent (kappa = 0.89, 0.93, and 0.86, respectively). Diagnostic agreement in the substance harmful use/abuse disorder category was considerably lower (Kappa = 0.44). The small number of discrepancies in diagnoses of the depressive disorders, dysthymic disorder and substance dependence disorder are a reflection of minor but real differences in the diagnostic criteria. Discrepancies in the diagnosis of substance harmful use/abuse disorder are explained by different concepts proposed to define each disorder. Copyright © 1998 Whurr Publishers Ltd.
Post‐traumatic stress disorder assessment with a structured interview: reliability and concordance with a standardized clinical interview
Authors: Breslau Naomi , Kessler Ronald , Peterson Edward L
Published: March 2006

Epidemiologic studies of post‐traumatic stress disorder (PTSD) have used the PTSD module of the NIMH Diagnostic Interview (DIS) in its various editions and modifications. Although the diagnoses of numerous disorders made by the DIS or the WHO – Composite International Diagnostic Interview (CIDI), which is modelled on the DIS, have been compared to clinical diagnoses, little is known about the performance of these instruments in diagnosing PTSD. In this study, we examine the test–retest reliability of a modified version of the PTSD section of the DIS‐IV and the CIDI 2.1 and compare it with an independently conducted clinical interview in the 1996 Detroit Area Survey of Trauma, an epidemio‐logical study of a representative sample of 2181 persons. A blind readministration of the structured interview was conducted by a lay interviewer 12–18 months after the initial interview, on 32 respondents classified as PTSD cases in the initial interview and on 23 non‐cases who reported exposure to trauma. The clinical reappraisal was conducted blindly by two psychiatric social workers, using the Clinician Administered PTSD Scale for DSM‐IV (CAPS‐DX). The data were weighted to adjust for the oversampling of cases and the differential probabilities of selection of traumatic events across respondents with different numbers of events. The test–retest consistency of the structured interview was a kappa of 0.62 and an odds ratio of 42.5. The comparison of the structured interview with the clinical reappraisal showed agreement in 81% of the assessed sample. Positive predicted value was 0.75, negative predictive value was 0.97, and the odds ratio was 94.8 (all weighted values). Discrepant cases were mostly ‘false positives’ and, of these, the majority were subthreshold cases missing only one symptom in the CAPS‐DX. Copyright © 1998 Whurr Publishers Ltd.
Validation of the Impulsivity Rating Scale and relationship with anxiety in healthy French adolescents
Authors: Caci Hervé , Askenazy Florence , Frequelin Nathalie , Nadalet Liliane , Myquel Martine , Staccini Pascal , Cherick Faredj , Boyer Patrice
Published: March 2006

Impulsivity is common among adolescents and adults, and can be assessed by specific or personality questionnaires. The clinical evaluation of impulsivity is not easy. The authors report the psychometric characteristics of a recently developed specific seven‐item hetero‐assessment instrument: the Impulsivity Rating Scale (IRS). Ninety‐one 14–16‐year‐old non‐depressed and non‐anxious adolescents were interviewed in high schools. While females score higher than males, the total score is independent of Spielberger's Trait‐Anxiety. The scale has a good reliability (a = 0.766), and PCA reveals a clear two‐factor solution: ‘Lack of control’ and ‘Lack of planification’. There is a moderate convergent validity with the Impulsivity subscale of the EPI. The IRS is a reliable easy‐to‐use instrument for assessing impulsivity in our sample. Nevertheless, more work is needed to generalize these results to the adolescent population. Copyright © 1998 Whurr Publishers Ltd.
An index of validity that corrects for chance agreement
Authors: Newman Stephen C.
Published: March 2006

Cohen's (1960) kappa coefficient, κ, is a well‐known index of reliability that corrects for chance agreement. The maximum and minimum values of kappa are examined. Using kappa as a theoretical framework, an index of validity is derived for the case of binary outcomes that summarizes sensitivity and specificity. This index is shown to be identical to the coefficient derived by Youden (1950). Copyright © 1998 Whurr Publishers Ltd.
Analysing violent incidents and other events
Authors: Rabe‐Hesketh S.
Published: March 2006

The paper discusses the analysis of recurrent events such as violent incidents in psychiatric hospitals. Many methods used to analyse such data fail to take account of length of follow‐up, individual differences between patients and correlations between events linked to the same patient. Random effects Poisson models and other methods that may be used to address these issues are described. All proposed methods are illustrated by applying them to a previously published dataset. Copyright © 1998 Whurr Publishers Ltd.
The measurement properties of a French language adaptation of the National Adult Reading Test
Authors: Mackinnon A. , Ritchie K. , Mulligan R.
Published: March 2006

An item response theory model was used to investigate the measurement properties of a French‐language adaptation of the National Adult Reading Test (fNART) in a sample of 388 community‐dwelling and institutionalized elderly persons. The test was found to be essentially unidimensional and to discriminate over a range of ability. A number of items were found to have poor discriminatory power or other undesirable measurement characteristics and were eliminated from the item pool to form a 33‐item test. Although a large sample calibration of the test against the Wechsler Adult Intelligence Scales is desirable, the fNART shows considerable promise as a means of estimating ability premorbid to cognitive decline in French‐speaking individuals. Copyright © 1999 Whurr Publishers, Ltd.
Improving accuracy of major depression age‐of‐onset reports in the US National Comorbidity Survey
Authors: Knäuper Bärbel , Cannell Charles F. , Schwarz Norbert , Bruce Martha L. , Kessler Ronald C.
Published: March 2006

This paper describes a series of questions designed to improve the accuracy of age‐of‐onset reports in the US National Comorbidity Survey (NCS) and empirically evaluates the impact of these questions on reports about age of onset of major depressive episodes. The logic underlying the series of question is traced to cognitive psychological research on autobiographical memory. Data are presented showing that the new question series yielded more substantively plausible age‐of‐onset reports than those obtained a decade earlier in the Epidemiologic Catchment Area (ECA) Study. The test–retest consistency of age‐of‐onset reports was also higher in the NCS than the ECA. Despite these improvements, considerable inconsistency in age‐of‐onset reports remains in the NCS test‐retest data. The paper closes with a discussion of potentially promising future directions to improve retrospective age‐of‐onset reports in new psychiatric epidemiological surveys. Copyright © 1999 Whurr Publishers, Ltd.
Validity and reliability of a new instrument for assessing mood symptomatology: the Structured Clinical Interview for Mood Spectrum (SCI‐MOODS)
Authors: Fagiolini Andrea , Dell'osso Liliana , Pini Stefano , Armani Antonella , Bouanani Siham , Rucci Paola , Cassano Giovanni B. , Endicott Jean , Maser Jack D. , Katherine Shear M. , Grochocinski Victoria J. , Frank Ellen
Published: March 2006

We evaluated the internal consistency, discriminant validity, inter‐rater reliability and test–retest reliability of a new instrument for the assessment of lifetime symptoms related to mood spectrum disorders: the Structured Clinical Interview for Mood Spectrum (SCI‐MOODS). We report on results obtained from 491 subjects assessed across eight psychiatric centres in Italy who were given the SCI‐MOODS and the Mini International Neuropsychiatric Interview (MINI). The study sample consisted of four groups: 141 students, 116 gastrointestinal (GI) patients, 112 bipolar patients and 122 patients with recurrent depression. To evaluate the inter‐rater reliability and the test–retest reliability, an additional group of 30 subjects (10 non‐psychiatric patients enrolled in an orthopaedic clinic, 10 unipolar patients and 10 bipolar patients) was given the SCI‐MOODS at a baseline assessment and six to eight days later. At the baseline assessment, these subjects were also interviewed using the Structural Clinical Interview for DSM‐IV (SCID IV) and were rated for the severity of symptomatology using the Clinical Global Impression Scale (CGI). The internal consistency of the four domains and six subdomains of the interview, expressed in terms of the Kuder–Richardson coefficient, was high, ranging from 0.79 to 0.92. Correlations of each of the domains with the others ranged from 0.63 to 0.85, indicating a strong interrelationship among the domains. Moreover, the correlations of each of the three manic subdomains with the others and each of the three depressive subdomains with the others were consistently higher than those between manic and depressive subdomains. The SCI‐MOODS was found to discriminate between patients with mood disorders and subjects belonging to two control groups as well as between bipolar and unipolar patients. The inter‐rater reliability for the four domains and the six subdomains was excellent, with the intra‐class correlation coefficient being close to unity for each of them. Test–retest reliability was also excellent, ranging from 0.93 to 0.94 for the four domains. Test–retest reliability was slightly lower in the manic (0.86 to 0.89) than in the depressive subdomains (0.95 to 0.96), but well within the acceptable range. These findings provide strong support for the internal consistency, the discriminant validity and the reliability of the SCI‐MOODS. Copyright © 1999 Whurr Publishers Ltd.
On the development and psychometric testing of the WHO screening instrument to assess disablement in the general population
Authors: Rehm Jürgen , Üstün T. Bedirhan , Saxena Shekhar , Nelson Christopher B. , Chatterji Somnath , Ivis Frank , Adlaf ED
Published: March 2006

The development and psychometric testing of the new World Health Organization (WHO) disablement screening instrument for the general population is described. Two samples were used for the empirical tests: the cross‐cultural sample of the WHO Disablement Assessment Schedule (WHO‐DAS II) field tests in 19 countries (N = 1323), and an Ontario (Canada) general population sample (N = 802). Psychometric tests included procedures from classical test theory as well as analyses based on item response theory (IRT), both parametric and non‐parametric. Results showed that the disablement screener had good properties with respect to classical test theory, but lacked compatibility with respect to IRT criteria. This lack of compatibility with IRT criteria generally leads to a test that must be redefined for each new sample and each time it is administered. Hence, the results reported in this paper suggest that the WHO disablement screener needs revision, if it is to serve as an international cross‐cultural instrument. Copyright © 1999 Whurr Publishers Ltd.
The Computer Body Image Test: a procedure for the assessment of body image perception
Authors: Hennighausen Klaus , Remschmidt Helmut
Published: March 2006

The aim of our study was to develop a procedure that combines the capabilities of body‐part estimation procedures and image distortion techniques. Distorted computerized images of the subjects are presented on a computer monitor. The whole body and body parts can be manipulated interactively. Reliability, stability and validity of the perceived and ideal body image were obtained in a sample of 36 inpatients suffering from anorexia nervosa. The procedure yielded a very high reliability. Perceived and ideal body images are stable after a mean time interval of 60 days. Significant correlations with the Body Shape Questionnaire and subscales of the Eating Disorder Inventory indicate the validity of the procedure. The procedure adds a significant improvement to common image distortion techniques by adding the possibilities of body part distortions. Copyright © 1999 Whurr Publishers Ltd.
The unidimensionality of a psychiatric scale: a statistical point of view
Authors: Falissard Bruno
Published: March 2006

In quantitative psychopathology, one of the most crucial questions is whether a set of items measure just one thing in common. This property may be defined as unidimensionality. After a formal definition of unidimensionality, this paper discusses the use of the different tools traditionally related to this area. For quantitative measurements, factor analysis remains a good approach, goodness‐of‐fit tests, however, are of questionable value. Cronbach's alpha coefficient is more related to reliability than unidimensionality. The scree plot and the proportion of variance accounted for by the first principal component are, in practice, interesting tools. Item response theory leads to models that require unidimensionality to obtain efficient estimates of latent attributes; these methods, however, are not really adapted for assessing the unidimensionality of a set of items. Finally, even if unidimensionality is a fundamental psychometric property, there is a need for general multidimensional instruments that reflect the heterogeneity of psychiatric disorders. Copyright © 1999 Whurr Publishers Ltd.
How specific is the association of two disorders with respect to the association with a third disorder?
Authors: Höfler Michael
Published: March 2006

A common problem in psychiatric epidemiology is that of finding appropriate statistical methods to determine the specificity of an association of two disorders (A and B), when disorder A is also associated with a third disorder C. This paper discusses this problem, which is particularly frequent in mental disorders due to substantial comorbidity between disorders. It is suggested that a measure of specificity of association (MSA) can be applied to address this problem. By building on mutually exclusive categories, classes, this measure indicates a high specificity of association A–B whenever two conditions are fulfilled: (a) there is a considerable difference in strength of association of A with pure B (not C) on the one hand and A with pure C (not B) on the other hand, and (b) the association of A with comorbid cases (cases that have both disorders B and C) is at least not stronger than the association of A with pure B cases. The measure is based on a logistic regression model with the probability of having disorder A as the outcome and mutually exclusive categories of B and C as explanatories as well as possibly other confounding variables.

Statistical inference in MSA is based on a bias‐corrected bootstrap confidence interval. This paper exemplifies the use of this measure with an example from a longitudinal prospective study on the relationship of nicotine dependence with ‘affective’ and ‘anxiety’ disorders. Copyright © 1999 Whurr Publishers Ltd.
Are importance ratings useful in the assessment of subjective quality of life in schizophrenic patients?
Authors: Franz Michael , Meyer Thorsten , Gallhofer Bernd
Published: March 2006

Subjective quality of life (QOL) is predominantly measured as satisfaction in various life domains. However, this approach has often been criticized for not taking individual preferences into account. A combination of importance and satisfaction ratings allows for the different weights that different life domains have in a person's QOL. The present study aimed to investigate empirically the usefulness of combined satisfaction and importance ratings in the assessment of schizophrenic patients. In a cross‐sectional study, 149 schizophrenic patients and 106 healthy controls rated their satisfaction with and the importance of 19 different life domains. Results of multidimensional scaling suggested that satisfaction and importance ratings tap different concepts in mentally healthy controls and schizophrenic patients. However, as compared with satisfaction ratings, importance ratings were even more shifted towards the positive pole of the scale and showed less variance. Very high correlations were found between the pure and the weighted satisfaction scores. No additional variance could be accounted for with regard to psychopathology, age or sex. Although a combination of satisfaction and importance ratings fits better with the subjective concept of QOL on a theoretical level, the results of this study do not support the application of this model in QOL assessment in schizophrenic patients. Copyright © 1999 Whurr Publishers Ltd.
The Asian Cultural Identity Schedule: an investigation of culture and deliberate self‐harm
Authors: Bhugra Dinesh , Bhui Kamaldeep , Desai Manisha , Singh Jayshree , Baldwin David
Published: March 2006

Acculturation as a process, during which cultural identity is challenged, plays an important role in the psychological wellbeing of minority ethnic groups. This paper introduces the Asian Cultural Identity Schedule, and demonstrates its use in an investigation of acculturation and deliberate self‐harm. The Asian Cultural Identity Schedule (ACIS) consists of 106 questions, from which 12 scores represent acculturation on specific domains. The schedule was used as an interview in two research studies of deliberate self‐harm among Asian adolescents and Asian women. Asian adolescents (N = 22), their parents (N = 22) and a sample of Asian women (N = 54) were interviewed. A half of the subjects in each of these three groups were cases; the rest were controls. The acculturation items are compared among each of three groups of cases and controls, and then between subgroups. The results showed that adolescents were less traditional than their parents on the following items: language, leisure, decision making, food shopping and living with a white person. In the absence of any discordance among control group adolescents and their parents, there are less traditional attitudes to work and marriage held by adolescents who attempted deliberate self‐harm in comparison to their parents. Adolescents who attempt deliberate self‐harm show as untraditional aspirations as their parents, and as control group adolescents. The parents of control group adolescents are more traditional, reflecting a protective effective of traditionalism. Women who attempted deliberate self‐harm show less traditional attitudes to social contact and aspirations than control women. In comparison with control parents, women who attempt self‐harm have less traditional attitudes to food shopping, work and living with a white person, whilst showing more traditional attitudes to religion. It may be concluded that acculturation on specific domains is associated with deliberate self‐harm. Copyright © 1999 Whurr Publishers Ltd.
Expressed Emotion about children: reliability and validity of a Camberwell Family Interview for Childhood (CFI‐C)
Authors: Scott Stephen , Campbell Caroline
Published: March 2006

A Camberwell Family Interview for Childhood (CFI‐C) was developed by adding questions about the family impact of the child's problems to a semi‐structured interview on child psychiatric symptoms. The whole CFI‐C took under an hour to administer; the questions about family impact added 15–20 minutes. The inter‐rater reliability was good (kappa 0.64–1.0). Mothers of 25 boys aged four to nine years referred with disruptive behaviour, and 25 matched controls were interviewed twice in five months. Test‐retest stability was fair to good (kappa 0.36–1.0). Discriminant validity between referred and control samples was strong for critical comments, positive comments and warmth, but not significant for emotional overinvolvement or hostility. The same three scales showed strong discriminant validity between child symptom domains, being strongly correlated with conduct symptoms (kappa = 0.49–0.71) but not emotional symptoms (kappa = 0.10–0.17). Sensitivity to change with treatment was shown by a reduction in the mean number of critical comments from 4.7 to 2.9, an increase in positive comments from 2.3 to 3.9, and an increased score on the warmth scale from 2.1 to 2.6. The CFI‐C is a useful instrument for the study of the relationship between parenting style and child psychiatric symptoms. Copyright © 2000 Whurr Publishers Ltd.