Rating Scales

Question 1

All of the following are projective tests except

Select one:
1. Rorschach test
2. Sentence Completion Test
3. HAMD
4. Draw A Person Test
5. Thematic Apperception Test

Answer 1

HAMD

TAT, Draw-A-Person test, Rorschach test, and Sentence Completion Test are all projective test. HAMD is a test for depression - it is not a projective test.

Question 2

Which of the following rating scales retain the aspects of a clinical examination during consultation?

Select one:
1. HoNOS
2. CATEGO
3. SANS
4. PSE
5. BPRS

Answer 2

PSE

PSE retains the aspects of a mental state examination.

Question 3

Which of the following scales can be used by primary care physicians, general medical professionals and also in community studies?

Select one:
Signs and Symptoms in Psychotic Illness
Scale of Assessment of Positive Symptoms
General Health Questionnaire
Simpson-Angus Scale
Brief Psychiatric Rating Scale

Answer 3

General Health Questionnaire

The original General Health Questionnaire (GHQ) comprised 60 items and versions with fewer items have been developed from this, e.g. the GHQ - 30, GHQ - 28 and GHQ- 12. The GHQ -12 is a brief, well-validated instrument that has been widely used in studies such as the British Household Panel Survey (BHPS) to detect ‘caseness’. Health and Quality of Life Outcomes 2010, 8:45.

Question 4

Brief Psychiatric Rating Scale is a clinician-rated scale used to measure the severity of clinical symptoms based on observation. It is most commonly used in patients with a diagnosis of

Select one:
1. Alcohol use disorder
2. Personality disorders
3. Schizophrenia
4. Bipolar disorder
5. Somatisation

Answer 4

Schizophrenia

Brief Psychiatric Rating Scale (BPRS) measures major psychotic and non-psychotic symptoms, primarily used for schizophrenia patients. Clinician-rated based on observation.

Question 5

Which of the following is the most important aspect of construct validity for a test of cognitive impairment in dementia?

Select one:
1. The scores depend on educational attainment of the subjects
2. It predicts the likelihood of progression to end stage dementia
3. It includes most of the components of cognition that is commonly affected by dementia
4. Scores are not affected by taking medications
5. Experts agree with the choice of sub items for the global scale

Answer 5

It includes most of the components of cognition that is commonly affected by
dementia

Construct validity refers to the degree to which inferences can legitimately be made from the items in your scale to the theoretical constructs on which the measurement based. When we measure cognitive impairment using a scale for ‘cognition’ programme, is our label an accurate one? When you measure what
you term ‘self-esteem’ is that what you were really measuring? If our scale includes most of the components of cognition that is commonly affected by dementia, we can be assured of a good degree of construct
validity.

Question 6

Which of the following is a gold standard test for intelligence?

Select one:
1. Auditory Verbal Learning Test
2. National Adult Reading Test
3. Quick Test
4. Wechsler Adult Intelligence Scale
5. Wisconsin Card Sorting Test

Answer 6

Wechsler Adult Intelligence Scale

WAIS is the gold standard intelligence measurement scale that can be used from ages 16 to 89.

Question 7

Which of the following is true concerning Brief Psychiatric Rating Scale (BPRS)?

Select one:
1. Useful for global psychiatric symptom ratings
2. Cannot be used to detect treatment response
3. It requires no clinical training to administer
4. It has 20 items
5. It has 8 items

Answer 7

Useful for global psychiatric symptom ratings

The BPRS assesses the level of 18 (or 24 in the full version) symptom constructs across positive, and to some extent negative domain as well as general psychopathology. It is particularly useful in gauging the efficacy of treatment in patients who have moderate to severe psychoses. It is based on the clinician’s
interview with the patient and observations of the patient’s behaviours over the previous 2-3 days. The patient’s family can also provide the behaviour report. Score for each symptom construct ranges from 1 (not present) to 7 (extremely severe).

Question 8

Concurrent validity is also known as
1. Select one:
2. Face validity
3. Construct validity
4. Incremental validity
5. Criterion validity
6. Predictive validity

Answer 8

Criterion validity

In criterion-related validity, we examine whether the operationalised criteria used in a scale is aligned to the theory behind a construct that is being tested.

Question 9

Which of the following scales is used for measuring drug-induced movement abnormalities in general and tardive dyskinesia in particular?

Select one:
1. AIMS scale
2. Barnes Akathisia scale
3. Simpson Angus scale
4. Lane scale
5. LUNSERS scale

Answer 9

AIMS scale

Abnormal involuntary movements scale is used to examine for TD. Though it includes Parkinsonian symptoms to some extent, dystonias are not picked up noticeably by AIMS.

Question 10

Which one among the following rating scales is a self-administered instrument?

Select one:
1. Abbreviated Mental Test
2. Glasgow Coma Scale
3. Hamilton Depression Scale
4. Beck’s depression inventory
5. Clinical global improvement scale

Answer 10

Beck’s depression inventory

Beck depression inventory is a self-rating scale with 21 items measuring the severity of depression. All others on this list, Brief psychotic rating scale, clinical global improvement scale, Hamilton rating scale for depression and GCS are all administered by clinician

Question 11

Which of the following is not a rating scale for mood disorders?

Select one:
1. Beck’s inventory
2. Hamilton Rating scale
3. Montgomery-Asberg rating scale
4. Simpson-Angus scale
5. Young’s rating scale

Answer 11

Simpson-Angus scale

Simpson Angus Rating scale is used to measure extrapyramidal symptoms.

Question 12

Which one of the following scales is used for monitoring clinical recovery?

Select one:
1. PSE
2. CAGE
3. MMPI
4. AUDIT
5. HoNOS

Answer 12

HoNOS

Health of the Nation Outcome Scales (HoNoS)was specifically designed as an outcome indicator for monitoring clinical change.

Question 13

Mr X is a 56-year-old gentleman assessed in the outpatient clinic. He is presenting with features of alcohol withdrawal. The patient is asked to complete (SAWS) Short Alcohol Withdrawal Scale. The nurse wants to know the total scores, above which he might require pharmacotherapy for withdrawal. Choose the correct answer from the following options.

Select one:
1. 8
2. 10
3. 15
4. 12
5. 6

Answer 13

12

SAWS) short alcohol withdrawal scale is a self-completion questionnaire. Symptoms cover the previous 24 hour period. Total scores above 12 require pharmacotherapy. The symptoms assessed include anxiety,
sleep disturbance, problems with memory, nausea, restless, tremor, feeling confused, sweating, and miserable, heart pounding and each rated from 0 to 4 based on the severity.

Question 14

Which of the following is a useful screening tool for early detection of an eating disorder?

Select one:
1. Prochaska questionnaire
2. AUDIT
3. CAMCOG questionnaire
4. SCOFF questionnaire
5. CAGE questionnaire

Answer 14

SCOFF questionnaire

In terms of screening patients with eating disorder, Not all patients will volunteer their symptoms or regard themselves as ill. However, early detection of an eating disorder in patients with unexplained weight loss improves prognosis. The SCOFF questionnaire (Morgan 1999b) is a useful screening tool, which uses five simple questions, with two or more positive answers prompting the need to take a more detailed history. Although it is perhaps more commonly used in primary care, it has also been validated in secondary care (Luck 2002) and can serve as a helpful aide-memoire during the assessment process.

Question 15

You have designed a study questionnaire and would like to measure the construct validity. Which of the following will you be testing?

Select one:
1. The questionnaire predicts what will happen in the future
2. Constituent parts of the questionnaire are suitable and related to the phenomenon being tested
3. The questionnaire covers most symptoms related to the phenomenon being measured
4. The questionnaire gives same results when tested on the same patient twice by a
single rater
5. questionnaire gives same results when used by two different raters on the same
patient twice

Answer 15

Constituent parts of the questionnaire are suitable and related to the phenomenon
being tested

Construct validity has traditionally been defined as the experimental demonstration that a test is measuring the construct it claims to be measuring. Regardless of how construct validity is defined, there is no single best way to study it. In most cases, construct validity should be demonstrated from a number of perspectives. Hence, the more strategies used to demonstrate the validity of a test, the more confidence
test users have in the construct validity of that test, but only if the evidence provided by those strategies is convincing.

Question 16

Which of the following is correct concerning the SCID?

Select one:
1. Based on a dimensional diagnostic scheme
2. Used in conjunction with ICD-10 classification
3. Provides the Axis V diagnosis in DSM-IV.
4. Useful for untrained lay interviewers
5. Primarily used in research

Answer 16

Primarily used in research

Structured Clinical Interview for DSM (SCID) is a clinician-administered semi-structured clinical interview for use with patients in whom a psychiatric diagnosis is suspected. It is primarily used in research with trained
interviewers to inform the operationalized diagnosis psychiatric disorders.
The correct answer is:

Question 17

A 22-year-old man is admitted with troublesome voices discussing his sexuality. He also believes they influence his actions and control his thoughts. Which of the following instrument can be used to monitor his symptoms?

Select one:
1. Schedule for Assessment of Negative symptoms
2. Brief Psychiatric Rating Scale
3. Bristol Assessment Scale
4. Thought Language Index
5. General Health Questionnaire

Answer 17

Brief Psychiatric Rating Scale

BPRS is useful to monitor changes in positive psychotic symptoms.

Question 18

Which of the following technique is best utilised minimally if possible in those with high suggestibility?

Select one:
1. Open questions
2. Structured questionnaire
3. Validation
4. Summarising techniques
5. Facilitating comments

Answer 18

Structured questionnaire

Structured interviews have demonstrated a high degree of reliability, validity, and legal defensibility. But in highly suggestible patients, rigid interview questions are bound to induce responses that are in agreement with the tone of the question, leading to inaccurate answers.

Question 19

Which of the following scales is NOT used for measuring drug-induced movement abnormalities?

Select one:
1. LUNSERS scale
2. Lane scale
3. Barnes Akathisia scale
4. Simpson Angus scale
5. AIMS scale

Answer 19

Lane scale

Lane scale is used for minor physical anomalies.

Question 20

In psychometry internal consistency refers to

Select one:
1. Degree of correlation between one test item with other items
2. Degree of agreement between two raters
3. Degree of agreement between results obtained in two different occasions
4. Degree of correlation between two different versions of the scale
5. Degree of agreement between two similar scales

Answer 20

Degree of correlation between one test item with other items

In internal consistency, which is a type of reliability estimation, we measure how well the items that reflect the same construct yield similar results. This can be done using average Inter-item correlation, split half
reliability, average item-total correlations or as it is often the case, using Cronbach’s alpha.

Question 21

Which of the following scales of depression is most sensitive to change?

Select one:
1. Visual analogue scale
2. Beck depression inventory
3. Zung self-rating scale
4. Montgomery-Asberg depression rating scale
5. Hospital anxiety and depression scale

Answer 21

Montgomery-Asberg depression rating scale

Montgomery-Asberg depression rating scale is most sensitive to change. It has a ten items version, which requires a clinical interview like Hamilton depression rating scale.

Question 22

Mr. Y is a 30-year-old man who presented to the A and E after an overdose. He believes that there are cameras spying on his movements. He has stopped going out and no longer socialises with friends. He has been hearing voices discussing his sexuality in an unpleasant way. Which of the following tools would be helpful to assess and monitor his psychopathology?

Select one:
1. MADRS
2. PANSS
3. MMSE
4. HAS
5. GHQ

Answer 22

PANSS

Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative
symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes
four scales measuring positive and negative syndromes, their differential, and the general severity of illness.

Question 23

Choose the correct statement about Brief Psychiatric Rating Scale?

Select one:
1. It is an assessment of global psychiatric symptomatology
2. Each item is rated on a 6-point scale
3. It focuses on negative symptoms
4. It is a 30-item scale
5. It is self administered

Answer 23

It is an assessment of global psychiatric symptomatology

The Brief Psychiatric Rating Scale (BPRS) is a rating scale used for quantifying various psychiatric symptoms (depression, anxiety, hallucinations and unusual behaviour). Each symptom is rated 1-7 and depending on the version between a total of 18-24 symptoms are scored.

Question 24

Which of the following refers to the extent to which performance on a test fits with theoretical schema about the test attributes?

Select one:
1. Criterion validity
2. Convergent validity
3. Construct validity
4. Face validity
5. Concurrent validity

Answer 24

Construct validity

Construct validity refers to the degree to which inferences can legitimately be made from the operationalizations in a study to the theoretical constructs on which those operationalizations were based.

Question 25

The term test-retest reliability refers to

Select one:
1. The correlation between the 1st and 2nd test of a number of subjects.
2. The correlation between the 1st and 2nd test in the same subject
3. The correlation between the 1st and 2nd test carried out by different raters.
4. The agreement between 2 raters.
5. The correlation between ratings before and after treatment.

Answer 25

The correlation between the 1st and 2nd test in the same subject

Test-Retest Reliability: A measure of the ability of a psychological testing instrument to yield the same result for a single subject at 2 different test periods, which are closely spaced so that any variation detected
reflects reliability of the instrument rather than changes in the subject’s status.

Question 26

The SF-36 scale measures which of the following?

Select one:
1. Occupational Functioning
2. Stress Level at Work
3. Developmental psychopathology
4. Health Related Quality of Life
5. Social Readjustment

Answer 26

Health Related Quality of Life

Health-related quality of life (HRQOL) refers to functioning and well-being in physical, mental and social dimensions of life. The SF-36 is a frequently used multi-item HRQOL instrument. The SF-36 Health Survey (36 item short form health survey) is a generic outcome measure designed to examine a person’s perceived health status. Outcome studies using the SF-36 can be done at outpatient clinics, via postal survey or telephone interview. The SF-36 can also be used in a computerised format. It assesses physical, social and mental well-being.

Question 27

The maximum possible score from General Health Questionnaire (28 items version) is

Select one:
1. 84
2. 28
3. 12
4. 42
5. 72

Answer 27

84

GHQ was developed as a screening tool to detect those likely to have or be at risk of developing psychiatric disorders. It is available in a variety of versions using 12, 28, 30 or 60 items, the 28-item version is used most widely. Each item is scored as a 4 point Likert (0-3) allowing a total possible score on the GHQ 28 of 0 to 84.

Question 28

The Clifton Assessment Procedure is used in which of the following situations?

Select one:
1. Residential care for the elderly
2. Schizophrenia rehabilitation units
3. Children in foster care
4. Care homes for the learning disabled
5. Prisons with high mental health burden

Answer 28

Residential care for the elderly

CAPE (Pattie and Gilleard, 1979) is intended to assess level of disability and estimate need for care. It consists of a short cognitive scale and a behavioural rating scale. The latter has four sub-scales: physical disability, apathy, communication difficulties and social disturbance. It is quick and easy to administer, and is
widely used by professional staff and care workers especially at elderly residential care settings.

Question 29

Which of the following is not a type of validity?

Select one:
1. Face validity
2. Construct validity
3. Ecological validity
4. Interrater validity
5. Content validity

Answer 29

Interrater validity

Inter-rater reliability is different from validity.

Question 30

A tool designed to test cognitive functions has subtests that measure cognitive abilities well. This test can be said to have

Select one:
1. Good concurrent validity
2. Good construct validity
3. Good predictive validity
4. Good face validity
5. Good incremental validity

Answer 30

Good construct validity

Construct validity seeks agreement between a theoretical concept and a specific measuring device or
procedure.

Question 31

You want to screen for depression in adolescents of age between 14 and 18-years. Which is the best screening tool?

Select one:
1. Hamilton depression rating scale
2. Child behavioural checklist
3. Child and adolescent functional assessment scale
4. Beck’s depression inventory
5. SCID (Structured clinical interview for DSM-IV)

Answer 31

Beck’s depression inventory

BDI can be used to screen depression above 14 years age. Other tools mentioned are not depression specific (CBCL and functioning assessment scales). HAMD is not used as screening but to assess severity after a diagnosis is established. It is not popularly used for adolescents. SCID is not a screening tool; it has been used to assess current or lifetime psychiatric diagnoses in accordance with DSM criteria in any English-speaking person who can participate in the interview. The majority of studies have used the SCID on adults though it has been successfully administered to adolescents.

Question 32

Which of the following is a self-rated questionnaire used as a screening instrument for the presence of
psychiatric illness?

Select one:
1. Global Assessment of Functioning Scale
2. Quality of Life Interview
3. Structured Clinical Interview
4. General Health Questionnaire
5. Diagnostic Interview Schedule

Answer 32

General Health Questionnaire

General Health Questionnaire (GHQ) is a self-rated questionnaire used as a screening instrument for the presence of psychiatric illness. The patient is asked to report the presence of a list of symptoms in the preceding weeks.

Question 33

Which one of the following questionnaires can be used to identify psychiatric ‘caseness’ in the general population?

Select one:
1. BDI Beck’s depression inventory
2. HAM-D
3. Structured clinical interview DSM-IV
4. GHQ General Health Questionnaire
5. PSE Present state examination

Answer 33

GHQ General Health Questionnaire

Goldberg introduced the General Health Questionnaire (GHQ). GHQ was developed as a screening tool to detect those likely to have or be at risk of developing psychiatric disorders.

Question 34

Which of the following rating scales for depression used in adults is well validated in children aged 14 and older?

1. Select one:
2. Clifton Assessment Procedure
3. Beck Depression Inventory
4. Cornell Depression Scale
5. Weschler assessment scale
6. Edinburgh Depression Scale

Answer 34

Beck Depression Inventory

Reynolds Child Depression Scale and the Children’s Depression Inventory were developed specifically for children and are written at lower reading levels. In addition, BDI is validated for use in those who are above 14 years of age.

Question 35

Which of the following is not an alcohol assessment tool?

Select one:
1. MAST
2. AUDIT
3. CAGE
4. SCOFF
5. CIWA

Answer 35

SCOFF

SCOFF is an eating disorders questionnaire, devised by researchers at St George’s Hospital Medical School. The questions focus on some key symptoms of anorexia and bulimia.

Question 36

Which of the following rating scale for depression has more cognitive items than the others?

Select one:
1. Young’s rating scale
2. Hamilton Rating Scale
3. Beck’s depression inventory
4. General Health Questionnaire
5. Montgomery Asberg scale

Answer 36

Beck’s depression inventory

The Beck Depression Inventory (BDI - II) is a 21-item measure designed to assess the cognitive, behavioural, affective and somatic symptoms of depression. It gives a relatively higher emphasis on cognitive items that other scales for measuring clinical depression.

Question 37

You have designed a study questionnaire and would like to measure the inter-rater reliability. Which of the following will you be testing?

Select one:
1. The questionnaire is valid when it gives same results if assessed on two different
occasions by same rater
2. The scores given by one rater are well concealed and cannot be copied by another rater
3. The questionnaire gives same results when used by two different raters on the same patient
4. Self-rating and clinician rating gives the same score from the questionnaire
5. The questionnaire is valid when it gives same results if assessed by two different
assessors on two different patients

Answer 37

The questionnaire gives same results when used by two different raters on the same
patient

Inter-rater reliability refers to the consistency among the different raters using a scale or an instrument. To test inter-rater reliability, each rater is asked to assign a score to each test item. The correlation between the two (or more) ratings is then computed to determine the level of inter-rater reliability.

Question 38

Which is the most commonly used screening tool to diagnose dementia in older people?

Select one:
1. CAMDEX
2. Addenbrooke’s cognitive examination
3. Abbreviated mental test score
4. Mini-mental state examination
5. Mini-COG

Answer 38

Mini-mental state examination

MMSE: Cut off 24/30, takes 5-10 minutes to complete and is a standard baseline test. It is the most widely used cognitive test in old age psychiatry and has been validated in a variety of populations. It is good for screening global cognitive dysfunctions as opposed to focal cognitive dysfunctions. It covers the following areas of cognition such as orientation, memory, concentration, language, praxis and Gnosis

Question 39

The assessment tool useful in measuring the severity and change in psychotic symptoms is

Select one:
1. Neuropsychiatric inventory
2. CATEGO
3. Young mania rating scale
4. Brief psychiatric rating scale
5. Present state examination

Answer 39

Brief psychiatric rating scale

BPRS was designed to assess psychopathology (including positive, negative, and affective psychopathology) in patients with, or suspected of having, schizophrenia or other psychotic illnesses.

Question 40

Considering Beck’s Depression Inventory, which of the following is true?

Select one:
1. Refers to symptoms over the last five days.
2. It has 21 items
3. Maximum score is 42
4. Has no item on suicidal ideas
5. Strictly clinician-rated scale

Answer 40

It has 21 items

Beck Depression Inventory was created by Dr. Aaron T. Beck. It is a 21-question multiple-choice self-report inventory.
The correct answer is: It has 21 items

Question 41

What is the most reliable instrument to make clinical diagnosis according to DSM criteria

Select one:
1. AIMS
2. SCID
3. SCAN
4. HAMD
5. MMPI

Answer 41

SCID

The structured clinical interview for the DSM (SCID) is a semi-structured interview that is arguably the most reliable instrument for psychiatric diagnoses.

Question 42

With respect to Young Mania Rating Scale, which of the following is least likely to be correct?

Select one:
1. It is sensitive to change
2. It does not have items on suicidality
3. Psychotic symptoms are not included in the scale
4. It has 11 items
5. It is self-rated

Answer 42

It is self-rated

Young Mania Rating Scale is the most often used for mania. It does not rate depression or psychotic symptoms. For studies in which both mania and depression are investigated the Bech-Rafaelsen scales for
both mania and melancholia, (Bech et al., 1986) may be most appropriate.

Question 43

Which of the following interview schedules have replaced the Present Status Examination in contemporary epidemiological studies?

Select one:
1. SCAN
2. PANSS
3. SSPI
4. CASH
5. SANS

Answer 43

SCAN

PSE is now being replaced by SCAN, which incorporates much of the old PSE. SCAN stands for Schedules for Clinical Assessment in Neuropsychiatry