Rating Scales Flashcards
1
Q
Is Beck’s Depression Inventory self-rated?
A
Yes
2
Q
Is GHQ self-rated?
A
Yes
3
Q
Is the Edinburgh postnatal depression scale clinician-rated?
A
No - self-rated
4
Q
What are schedules?
A
Based on clinical expectations
Deal with categories of disorders based on known classification systems
5
Q
What are the types of procedures used to select items for scales?
A
Based on previous clinical literature
Based on calibration
6
Q
What needs to be considered when selecting a screening measure for a study?
A
Characteristics of population to be screened
Psychometric properties of the instrument
Time required to complete
Ease of use
Cost of obtaining measure
7
Q
What is GHQ used for?
A
First-level assessment in epidemiological studies before detailed schedules employed
8
Q
Who introduced the GHQ?
A
Goldberg
9
Q
What is the purpose of GHQ?
A
Screening tool to detect those likely to have or be at risk of developing a psychiatric disorder
10
Q
How many items does the GHQ have?
A
28
11
Q
Scoring of GHQ
A
Each item is a 5 point Likert, allowing total of 84
12
Q
Name the clinician-administered diagnostic schedules
A
Clinical interview schedule
Composire International Diagnostic Interview
Present State Examination
Schedule for Affective Disorders and Schizophrenia
Schedule for assessment in neuropsychiatry
Structured clinical interview for DSM IV
13
Q
Which diagnostic schedules can be used by trained primary care workers?
A
Hopkins Symptom Check List
14
Q
Which diagnostic schedules are self-report?
A
Diagnostic Interview Schedule
Patient Health Questionnaire
15
Q
What is the aim of the Clinical Interview Schedule?
A
Identify common disorders in primary care and community 0 focus on neurosis
16
Q
Who developed the Composite International Diagnostic Interview?
A
WHO
17
Q
Which diagnostic schedule uses both ICD and DSM?
A
Composite International Diagnostic Interview
18
Q
What does Diagnostic Interview Schedule study?
A
Lifetime DSM diagnosis initially, then current diagnosis
19
Q
How many items in the Hopkins Symptoms Check list?
A
58
20
Q
What does Hopkins symptoms check list measure?
A
Neurotic symptom distress in OP
21
Q
Who developed the PHQ?
A
Spitzer
22
Q
Aim of PHQ 9?
A
Diagnose common neurotic conditions in primary care
23
Q
What does present state examination do?
A
Provides clinical diagnosis in line with ICD
24
Q
Aim of Schedule for Affective disorders and schizophrenia?
A
Covers all major mental illness.
25
Which diagnostic schedule has a kids version?
Schedule for affective disorders and schizophrenia - Kiddie-SADs
26
Which diagnostic schedule has replaced the present state examination?
Schedule for assessment in neuropsychiatry
27
Items in total in schedule for assessment in neuropsychiatry?
1872
28
Which patients is the structured clinical interview for DSM IV used for
Patients in whom a psych diagnosis is suspected
29
Name some clinician-rated depression rating scales
Hamilton depression scale
| Montgomery-Asberg depression rating scale
30
Name some self-rated depression rating scales
2 question scale/PHQ-2
Beck depression inventory
Zung depression inventory
Visual analogue scale
31
Easiest scale to quantify depression severity?
Visual analogue scale
32
What happens in the Visual Analogue scale?
10cm line where patient indicates state of mood
33
How many items in Hamilton depression rating scale?
17-21
34
What duration of symptoms does Hamiltion depression rating scale refer to?
Last 1-2 weeks
35
Which depression rating scale is a reference standard?
Hamilton
36
How many items in the Montgomery-Asberg depression rating scale?
10
37
Which depression rating scale is most sensitive to change?
Montgomery-Asberg Depression rating scale
38
How many items in Beck depression inventory?
21
39
Max score in Beck depression inventory?
63
40
Duration of symptoms tested in Beck depression inventory?
Last 2 weeks
41
Scoring in Beck depression inventory
0-13 - minimal
14-19 - mild
20-28 - moderate
>28 severe
42
Disadvantages of Beck Depression Inventory
Lacks discriminatory power among severely ill
43
How many items in Zung Depression inventory?
20
44
Advantage of Zung Depression Inventory
Avoids imbalance towards psychological factors such as Becks
45
Disadvantages of Zung Depression Inventory
Insensitive to change
| Poor correlation with observer rating
46
When is depression rating scale appropriate for children?
At least 7 years of age
47
Name two depression rating scales for children
Reynolds Child Depression Scale
| Children's Depression Inventory
48
Number of items in Childrens Depression Inventory
27 - full version
| 10 - screening
49
At what age can Becks Depression Inventory be used?
14+
50
Which depression rating scale is NICE approved and has a parent version?
Mood and Feelings Questionnaire
51
Perinatal depression rating scales
Becks Depression Inventory
Edinburgh Postnatal depression scale
Center for Epidemiological Studies - depression scale
52
Duration of symptoms in Edinburgh postnatal depression scale?
Last 7 days
53
How many items are there in Edinburgh postnatal depression scale?
10
54
Characteristics of Geriatric depression scale?
Fewer somatic symptoms
Symptoms in past week
Yes/no answers
55
Depression rating scales for patients with cognitive deficits
Cornell Scale for Depression in Dementia - for caregiver
| Hamilton Rating Scale for Depression
56
Which depression rating scale is for use in hospital?
Brief Assessment Schedule Depression cards - avoids patients being overhead - choose from a deck of 19 cards
57
Depression rating scale for those with schizophrenia?
Calgary Depression Scale for Schizophrenia
58
Name some Alcohol rating scales
CAGE
AUDIT
MAST
CIWA
59
Score to suggest alcohol misuse in CAGE?
2
60
How many items in AUDIT?
10
61
Score suggestive of alcohol misuse in AUDIT
8 or more
62
Score suggestive of dependence drinking in women and men in AUDIT?
13 - women
| 15 - men
63
Which alcohol questionnaire is recommended by WHO for primary care use?
AUDIT
64
How many items in MAST?
25, self-report
65
Scoring system of MAST
3-5 - early indicator of problems
| 6 or more - problem drinker
66
How many items does CIWA consist of?
10
67
Total score in CIWA?
67
68
Name some scales used in child psychiatry
Child and Adolescent Functional Assessment Scale
Child behaviour checklist
Diagnostic interview schedule for children
Conners rating scale
69
Is the Child and Adolescent Functional assessment scale self-reported?
No
70
When is Child and Adolescent Functional Assessment scale used?
Assessing outcome over time and directing case management activities
71
What does Child and Adolescent functional assessment scale measure?
Aggression and conduct problems between 7-17 years
72
How many items in the Child Behaviour Checklist?
113
73
What does Child Behaviour Checklist measure?
Behavioural problems and competencies of children 4-16 as reported by parents/teachers
74
Scores of Child Behaviour Checklist
Total score
Internalizing behaviours score
Externalizing behaviours score
75
Which scale is used for DSM-based diagnosis in children?
Diagnostic interview schedule for children
76
Which rating scale is commonly used to assess ADHD?
Conners Rating Scale
77
Name some scales used in Old Age Psychiatry
```
Geriatric Mental state schedule
MMSE
AMTS
Alzheimers Disease Assessment Scale
BEHAVE-AD
Neuropsychiatry Inventory
MOUSEPAD
Clifton assessment procedure for the elderly
Bristol Activities of Daily Living
```
78
Cut off in MMSE suggestive of cognitive impairment?
23
79
What does MMSE not pick up?
Frontal lobe deficits
80
Cut off for cognitive impairment in MMSE?
10
81
Which rating scale is used to assess changes in cognitive function in anti-dementia drug trials?
Alzheimers Disease Assessment scale
82
Is BEHAVE-AD scale self-report?
No
83
What does BEHAVE-AD measure?
Behavioural symptoms in patients with Alzheimers
84
What does Neuropsychiatric Inventory measure?
Records severity of associated behavioural symptoms in dementia over ten domains
85
Scoring in Neuropsychiatry Inventory
1-144
86
What does MOUSEPAD stand for?
Manchester and Oxford Universities Scale for the Psychopathological Assessment of Dementia
87
Who is MOUSEPAD administered to?
To carers by clinicians
88
What does MOUSEPAD measure?
Behavioural and psychiatric symptoms of dementia
89
What does Clifton assessment procedure for the elderly measure?
Level of disability and estimate need for care
90
Structure of Clifton assessment procedure for elderly
Short cognitive scale
Behavioural rating scale, divided into four sub-scales; physical disability, apathy, communication difficulties and social disturbance
91
What does Bristol Activities of Daily Living Scale assess?
20 daily living abilities in patients with dementia
92
Who is the Bristol Activities of Daily Living scale tested on?
Caregivers by trained HCPs
93
How many items in Positive and Negative Symptoms Scale?
30
94
Is the Positive and Negative Symptom scale self-reported?
No
95
Who is the Yale-Brown Obsessive-Compulsive scale used on?
Severity in those already with OCD
| Clinician-administered
96
Which eating disorder scale has high sensitivity
SCOFF
97
Is MMPI a projective test?
No
98
Is MMPI self-report?
Yes
99
How many items in MMPI?
567:
8 psychopathology
2 of personality type
3 scales of truthfulness
100
Is IPDE self-report
No
101
What is IPDE based on?
ICD 10
102
What does IPDE consist of?
67 questions
| 57 for screening
103
Is Clinical Global Improvement scale self-report?
No
104
Structure of Clinical Global Improvement scale
Two-item - severity (current condition on 1-7)
| Extent of improvement (1-7)
105
Where is Clinical Global Improvement Scale used?
For any psych disorder on ward or clinic
106
Is Brief Psychiatric Rating scale self-report?
No
107
Results of Brief Psychiatric Rating Scale?
```
Hostility-suspiciousness
withdrawl-retardation
Thinking disturbance
Depression-anxiety
Activation
```
108
What is the Scale for assessment of positive/negative symptoms used for?
Not for diagnosis
| Used in studies of neurobiological correlates of symptom grouping
109
Structure of Scale for assessment of positive/negative symptoms
Clinician-reported
Positive symptoms- 34
Negative - 25
110
Is PDQ-4 self-report?
Yes
111
Which classification does PDQ-4 use?
DSM IV
112
What is used with PDQ-4?
Clinical significance scale as follow-up to estimate if trait is enduring, present in absence of other disorders and leads to distress/impairment
113
Which scale is available as an appendix in DSM IV?
Global assessment of function scale
| Social and Occupational Functioning Assessment Scales
114
How many items in the Global Assessment of Functioning scale?
10 -item (100 points)
115
What is Global Assessment of Functioning scale based on?
Self-report and info from interview
| Combines symptomatic severity, functional impairment and clinicians appraisal of functional limitation
116
Structure of Social and Occupational Functioning Assessment Scale?
Clinician-rated
| 100-oint scale
117
Who can administer the Short form health survey-26?
Self-administered by those 14+ years of age
118
What does SF-36 assess?
```
Limitations on physical activities due to illness
Limitations in social activities
Limitations in role performance
Bodily pain
General mental distress and well-being
Limitations in role performance due to emotional problems
Vitality
General health perceptions
```
119
What is the most widely used psych rating scale in the NHS?
Health of the Nation Outcome scale
120
Who developed the Health of the Nation Outcome scale?
RCPsych in 1993
121
Items in Health of the nation Outcome scale?
12 measuring behaviour, impairment, symptoms and social functioning
122
What does the Health and Nation Outcome Scale base its measurement on?
Routine clinical assessment
123
What measures the internal consistency of a test?
Cronbach's alpha
124
What does Cronbach's alpha do?
Correlates each item of a test with the total score and averages the correlation coefficient
125
Cut-off of Cronbach's alpha for test to be considered internally consistent?
0.7 and above
126
What is intraclass correlation coefficient used for?
for continuous variables
127
Scores of intraclass correlation coefficient
0 (unreliable) - 1 (reliable)
128
What is used to measure reliability in a test with nominal data of more than two categories?
Kappa or weighted kappa
129
What is face validity?
Subjective measure of deciding whether the test measures the construct of interest on its face value
130
What is construct validity?
Measures whether a test really measures the construct of interest or something else
131
What is unified construct validity
Both content and criterion validity
132
What is content validity?
Whether the contents e.g. items of the test, are in line with the objectives the test was designed to measure.
Looks for coverage across all domains thought to be related.
133
How can content validity be measured?
Cannot be statistically tested
| Experts called to comment
134
What is criterion validity?
Performance against an external criterion such as another instrument (concurrent) or future diagnostic possibility (predictive)
135
What is concurrent validity?
Ability of a test to distinguish between subjects who differ concurrently in other measures (other instruments)
136
What is predictive validity?
Ability of a test to predict future group differences according to current group differences in score
137
What is incremental validity?
Ability of a measure to predict or explain variance over and above other measures
138
How can construct validity be classified?
Content & criterion validity
or
Convergent, discriminant and experimental validity
139
What is convergent validity?
Agreement between instruments that measure some construct e.g. BDI and Hamilton for depression.
This agreement can be tested in contrast groups e.g. depressed and non-depressed
140
What is discriminant validity?
Degree of disagreement between two scales measuring different constructs
141
What is experimental validity?
Refers to sensitivity to change. An instrument must show the difference in results when an intervention is carried out to modify the measured domain.
142
What is factorial validity?
Form of construct validity established via factor analysis of items in scale
143
What is precision?
Degree to which a calculated central value (e.g. mean) varies with repeated sampling
144
What leads to imprecision?
Random errors
145
What does a narrow variation mean?
More precise the value
146
What factors reduce precision?
Wide limits of the interval
| 2. Expecting higher confidence interval
147
What is accuracy?
Correctness of the mean value i.e. how close it is to the true population value
148
Name the three problems with predicting risk
Low base rate
Multifactorial
Unknown interactions
149
what is low base rate?
Events of interest being rare, therefore predictive value will be low, leading in false positive rate.
150
What is the multifactorial difficulty of risk assessment?
Risk is dependent on multiple factors which change over time
151
What are the unknown interactions in risk assessment?
Risk evaluations are time-consuming and often the degree and nature of interactions are unknown
152
What are stable risk factors?
Long term and enduring issues but modifiable to some extent
153
What is the clinical approach to risk assessment?
Clinicians subjective, intuitive judgement informed by experience and knowledge is used to estimate risk and decide treatment
154
How many clinical judgements on risk have been fond to be correct?
33%
155
What does actuarial risk approach not tell you?
Does not inform clinician about risk factors requiring targeting to minimise risk
156
Problems of actuarial tools?
Historical aspects given more importance
High false positive rates
Generalisation to another setting is difficult
Focused on static and stable factors rather than dynamic and modifiable
157
What is the structured professional judgement to risk?
Combines evidence base for risk factors with individual clinical assessment to complement psychiatric opinion
158
What is used in structured professional judgement of risk?
Structured, scales-based assessment
159
Who created the stages of risk assessment and management?
Bouch and Marshall
160
What are the stages in risk assessment?
Identifying need for assessment
Assessing static, stable, dynamic and future risk factors and protective factors
Individual formulation of risk applied to current presentation
Considering possible interventions/support
Anticipating impact of interventions
Developing management plan with short and long term implementations
Reviewing and revising plan with variations in risk factors
161
Who created the HCR-20?
Webster
162
What does HCR stand for?
Historical, Clinical Risk
163
Advantage of HCR-20?
Good inter-rater reliability
164
What does HCR-20 consist of?
10 historical items
5 Clinical
5 Risk management
165
Historical items in HCR-20
```
Previous violence
Young age at first incident
Unstable relationships
Major MI
Substance Use
Psychopathy
Employment issues
PD
Early maladjustment
Previous supervision failure
```
166
What are the clinical items in HCR 20?
```
Negative attitudes to health services
Active symptoms
Impulsivity
Treatment unresponsiveness
Lack of insight
```
167
What are the risk items in HCR-20?
```
Management plan lacks feasibility
Exposure to destabilisers (e.g. alcohol)
Non-compliance
Stress
Lack of personal support
```
168
What is SARA?
Spousal Assault Risk Assessment
169
How many items in SARA?
20
170
What is SVR-20?
20-item scale for sexual violence risk
171
What is SAD PERSONS Score?
10 major demographic risk factors used to assess immediate suicidal risk in general hospital.
172
Name the items in SAD PERSONS SCORE
```
Sex - 1 if male, 0 if female
A - Age, 1 if <20 or >44
D - Depression (1)
P - Previous attempt (1)
E - Ethanol abuse (1)
R - Rational thinking loss (1)
Social supports lacking (1)
Organized plan (1) if lethal
No spouse (1)
Sickness (1) if chronic, debilitating and severe
```
173
What does Becks Hopelessness Scale consist of?
20 True/false statements focused on pessimism and about the future
174
Score analysis of Becks Hopelessness Scale?
0-3 - minimal suicide risk
4-8 mild
9-14 moderate
15-20 severe
175
How many items in Beck Scale for Suicidal Ideation?
24 self-report
176
How are actuarial instruments formed?
Group data obtained from high risk individuals and then applied to patient. Gives group risk
177
Who created CRAG?
Quinsley - 1995
178
What does VRAG stand for?
Violence Risk Appraisal Guide
179
What is VRAG based on?
Historical factors
180
How many items in VRAG?
12
181
Structure of Violence Risk scale?
23 dynamic and 6 static variables
182
Purpose of PCL-R (Hare)?
Diagnose psychopathy, inform risk assessment and treatment decisions.
183
How many items and score range in PCL-R?
20 items
| 0-40 score range
184
Cut off for diagnosis of psychopathy in PCL-R?
25
185
Who created Static 99?
Hanson and Thornton
186
Number of items in Static 99?
Ten item actuarial assessment
187
Who is Static 99 used in?
Male adult sex offenders at least 18 years of age at time of release into community
188
What does SORA stand for?
Sexual risk offender appraisal guide
189
What does SORA consist of?
14 item actuarial instrument that incorporates PCL_R
190
What is Manchester Self Harm Rule?
Actuarial instrument for self-harm risk assessment
191
Advantage of Manchester Self Harm Rule?
High sensitivity
192
Disadvantage of Manchester Self Harm Rule?
Low specificity
