Psychometric evaluation of the symptom checklist (SCL-90) in psychiatric inpatients

The factorial validity, temporal stability and discriminatory power of the Symptom Checklist (SCL-90) were investigated in a heterogeneous sample of short-stay psychiatric inpatients (n=437). Results from a confirmatory factorial approach suggested a reduced dimensionality for the SCL-90 rather than supporting the 10 or 9 a priori symptom dimensions. From exploratory factor analyses 4 clinically interpretable and moderately intercorrelated dimensions emerged: depression, hostile-suspiciousness, somatization and phobic anxiety. Internal consistency and temporal stability coefficients of these 4 subscales and of the global scale were satisfactory. SCL-90 discriminated poorly between different clinical groups. However, the scale quite successfully discriminated patients from healthy subjects from the general population. It is concluded that SCL-90 might be a valuable instrument for the detection of potential psychiatric cases in the general population.     

Discriminant and convergent validity of the SCL-90 in psychiatric inpatients

Examined the convergent and discriminant validity of the SCL-90 in a group of 113 psychiatric inpatients and determined the degree of reactivity to several common response sets. The nine SCL-90 dimensions were found to correlate with analogous measures from other tests, and thus showed convergent validity, but were also found to correlate with nonanalogous measures, an indication of low discriminant validity. In addition, the dimensions correlated with the three MMPI validity scales, suggesting their reactivity to response bias. These findings were interpreted as indicating that the SCL-90 has limited use with psychiatric inpatients at present, although it may be useful as a brief screening device for disposition and referral.     

Double Depression in Men: Does It Exist?

Differences between male veterans diagnosed with major depression alone and male veterans diagnosed with both major depression and dysthymia (double depression) were investigated. Assessment instruments included the Structured Clinical Interview for DSM-III-R, the Beck Depression Inventory (BDI), and the Symptom Checklist-90-R (SCL-90-R). Consistent with prior literature, it was hypothesized that male veterans diagnosed with both major depression and dysthymia display more severe depressive symptomatology and other forms of psychopathology than male veterans diagnosed with major depression alone. Results did not corroborate these hypotheses. Patients with double depression (n = 17) yielded BDI and SCL-90-R scores which did not differ significantly from those of patients with major depression alone (n = 14). Our results call into question the existence of double depression among men, a disorder whose existence has been demonstrated primarily among women.     

Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.     

大学生心理健康变迁的横断历史研究

自恢复高考至今, 中国的高等教育取得了巨大进步, 这一历史时期大学生整体的心理健康水平如何变化呢？本研究对1986至2010年间237项采用90项症状自评量表(SCL-90)的研究报告进行了横断历史的元分析, 以考察这些研究(被试为30多万名大学生)所测心理问题的9个因子得分随年代的变化趋势。结果表明：(1)SCL-90各因子均值与年代之间均呈负相关, 年代可以解释9个因子4%至36%的变异; 25年来9个因子均值分别下降了1%至13%, 其中偏执、人际关系、抑郁、敌对因子变化较明显。这说明25年来大学生的心理问题逐渐减少, 即大学生心理健康的整体水平逐步提高。(2)25年来大学生心理健康水平的提高, 主要体现在大学一年级以上的学生上, 而且重点大学学生(较之非重点大学)、城市生源学生(较之农村)、男生(较之女生)的心理健康改善更快。     

On the determination of appropriate dimensionality in data with error

The study deals with the problem of determining true dimensionality of data-with-error scaled by Kruskal's multidimensional scaling technique. Artificial data was constructed for 6, 8, 12, 16, and 30 point configurations of 1, 2, or 3 true dimensions by adding varying amounts of error to the true distances. Results show how stress is affected by error, number of points, and number of dimensions, and indicate that stress and the elbow criterion are inadequate for purposes of identifying true dimensionality when there is error in the data. The Wagenaar-Padmos procedure for identifying true dimensionality and error level is discussed. A simplified technique, involving a measure calledConstraint, is suggested.The authors wish to thank Dr. J. B. Kruskal for his valuable help and suggestions.Computer time for this research was supplied by the Instruction and Research Computer Center, The Ohio State University.     

Standardized Web-Based Cognitive Behavioural Therapy of Mild to Moderate Depression: A Randomized Controlled Trial with a Long-Term Follow-Up

Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment (web-CBT) of mild to moderate depression. Fifty-four individuals with chronic, moderate depression participated in a randomized wait-list controlled trial, with an 18-month follow-up (immediate treatment: n = 36, wait-list control: n = 18). Primary outcome measures were the Beck Depression Inventory (BDI-IA) and the Depression scale of the Symptom Checklist-90-Revised (SCL-90-R. DEP). Secondary outcome measures were the Depression Anxiety Stress Scales and the Well-Being Questionnaire. Five participants (9%) dropped out. Intention-to-treat analyses of covariance revealed that participants in the treatment condition improved significantly more than those in the wait-list control condition (.011 < p < .015). With regard to the primary measures, between-group effects (d) were 0.7 for the BDI-IA and 1.1 for the SCL-90-R DEP. Posttest SCL-90- R DEP scores indicated recovery of 49% of the participants in the treatment group compared with 6% in the control group (odds ratio = 14.5; p < .004). On average, the effects were stable up to 18 months (n = 39), although medication was a strong predictor of relapse. The results demonstrate the efficacy of web-CBT for mild to moderate depression and the importance of therapist guidance in psychological interventions.     

Deconstructing therapy outcome measurement with Rasch analysis of a measure of general clinical distress: the Symptom Checklist-90-Revised

Rasch analysis was used to illustrate the usefulness of item-level analyses for evaluating a common therapy outcome measure of general clinical distress, the Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1994). Using complementary therapy research samples, the instrument's 5-point rating scale was found to exceed clients' ability to make reliable discriminations and could be improved by collapsing it into a 3-point version (combining scale points 1 with 2 and 3 with 4). This revision, in addition to removing 3 misfitting items, increased person separation from 4.90 to 5.07 and item separation from 7.76 to 8.52 (resulting in alphas of .96 and .99, respectively). Some SCL-90-R subscales had low internal consistency reliabilities; SCL-90-R items can be used to define one factor of general clinical distress that is generally stable across both samples, with two small residual factors.     

抗震救灾官兵心理健康状况及相关因素分析

了解参加抗震救援官兵的心理健康状况及相关因素,为进行心理危机干预提供科学依据。方法 采用症状自评量表（SCL-90）、简易应对方式问卷（SCSQ）、艾森克人格问卷简式量表中国版（EPQ-RSC）及军事应激症状核查表（PCL-M）,对空军某部抗震救援官兵进行心理测评。结果 消极应对和PCL-M总分与SCL-90总分及各因子分呈正相关（p＜0.01）;积极应对方式与PCL-M总分、SCL-90总分及4项因子分呈低相关（p＜0.01）;不同气质类型PCL-M总分及SCL-90各项统计指标之间均有显著性差异（p＜0.01）。结论 气质类型与应对方式对心理健康状况有很大影响,个别官兵应及时给予心理疏导     

Personality diagnostic questionnaire-revised (PDQ-R) personality disorder scores and negative life events independently predict changes in hopkins symptom checklist (SCL-90) Psychopathology Scores

The present study employed a prospective design to investigate whether Personality Diagnostic Questionnaire—Revised (PDQ-R) scores and/or Hassles Scale—Revised (HS-R) scores predict changes in Axis I psychopathology levels over 1 month, in a nonclinical sample of young adults. The PDQ-R, HS-R, and Hopkins Symptom Checklist (SCL-90) were administered to a mixed-sex sample of 100 undergraduate students on two occasions separated by 1 month. Hierarchical multiple regression analyses indicated that (1) time 1 PDQ-R composite scores predicted changes in scores on 11 SLC-90 scales; (2) time 1 PDQ-R impairment/distress index scores predicted changes in SCL-90 general symptom index scores; (3) only one of the individual PDQ-R personality disorder subscales—the schizotypal personality disorder subscale—predicted changes in SCL-90 general symptom index scores; (4) HS-R scores predicted changes in scores on 9 SCL-90 scales; and (5) in only 3 of the 27 analyses conducted did the statistical interaction between PDQ-R and HS-R scores predict changes in SCL-90 scores. These findings indicate that personality disorder symptomatology and negative life events may independently predict changes in Axis I psychopathology levels and, thus, support the continued inclusion of Axis II and Axis IV in future versions of the Diagnostic and Statistical Manual of Mental Disorders.     

SCL-90-R symptom patterns for adolescent psychiatric inpatients

We collected Symptom Check List-90-Revised (SCL-90-R) symptom pattern and severity data from a sample of 486 adolescent psychiatric inpatients. Preliminary comparison of these data with previously published data for adolescent nonpatients suggested no meaningful differences in overall symptom severity, although the data suggested higher Positive Symptom Distress Index (PSDI) scores for inpatients, less severe somatization and psychoticism symptoms for inpatient males compared to nonpatient males, and more severe depressive symptoms for inpatient females compared to nonpatient females. Future studies should be directed toward further analyses of such data and the development of representative and generalizable adolescent inpatient norms for the SCL-90-R.     

SCL--90--R Symptom Patterns for Adolescent Psychiatric Inpatients

We collected Symptom Check List-90-Revised (SCL-90-R) symptom pattern and severity data from a sample of 486 adolescent psychiatric inpatients. Preliminary comparison of these data with previously published data for adolescent nonpatients suggested no meaningful differences in overall symptom severity, although the data suggested higher Positive Symptom Distress index (PSDI) scores for inpatients, less severe somatization and psychoticism symptoms for inpatient males compared to nonpatient males, and more severe depressive symptoms for inpatient females compared to nonpatient females. Future studies should be directed toward farther analyses of such data and the development of representative and generalizable adolescent inpatient norms for the SCL-90-R.     

The SCL-90-R as a screening instrument for severe personality disturbance among outpatients with mood and anxiety disorders

Our objective was to examine whether the SCL-90-R, a widely used self-report measure of distress and psychopathology, could screen for personality disorders in general and for severe personality disturbance (SPD) in particular, at the time when patients seek treatment for a state (mood or anxiety) disorder. The SCL-90-R was administered to 112 consecutive outpatients with various mood and anxiety disorders. The personality severity index (PSI) score, defined as the mean value of the scores on the SCL-90-R subscales of interpersonal sensitivity, hostility, and paranoid ideation, was compared with the current symptom index (CSI) score, defined as the mean value of the scores on the remaining six SCL-90-R subscales. A positive screen was considered if PSI > CSI. SPD was defined as the presence of any DSM-III-R Cluster A and/or Cluster B personality disorder. The accuracy of the screen was verified by means of the Structured Clinical Interview for DSM-III-R Personality Disorders. The sensitivity of the PSI > CSI criterion to screen for SPD was 89.4%, while its sensitivity to screen for any DSM-III-R personality disorder was 72.9%. The SCL-90-R subscales that contributed the most to the screening discriminability of this SCL-90-R-derived screening measure were hostility, paranoid ideation, somatization, and obsessive-compulsive behavior. The SCL-90-R may be used to screen for SPD in routine work with outpatients with mood and anxiety disorders, but the results of the screening need to be verified because of the possibility of false negatives and false positives, although that possibility is apparently low. These findings may have important prognostic and treatment implications.     

The Dutch Identity: A new tool for the study of item response models

The Dutch Identity is a useful way to reexpress the basic equations of item response models that relate the manifest probabilities to the item response functions (IRFs) and the latent trait distribution. The identity may be exploited in several ways. For example: (a) to suggest how item response models behave for large numbers of items—they are approximate submodels of second-order loglinear models for 2 ^J tables; (b) to suggest new ways to assess the dimensionality of the latent trait—principle components analysis of matrices composed of second-order interactions from loglinear models; (c) to give insight into the structure of latent class models; and (d) to illuminate the problem of identifying the IRFs and the latent trait distribution from sample data.This research was supported in part by contract number N00014-87-K-0730 from the Cognitive Science Program of the Office of Naval Research. I realized the usefulness of the identity in Theorem 1 while lecturing in the Netherlands during October, 1986. Because this was in no small part due to the stimulating psychometric atmosphere there, I call the result the Dutch Identity.     

Strength Recovery Patterns Following Isometric and Isotonic Exercise

In 3 experiments, the author tested the hypothesis that coordination dynamics is the content of a generalized motor program (GMP) for rhythmic interlimb coordination. In Experiment 1, learners (N = 14) practiced a ?90° movement with either identically timed or differently timed limbs. Both acquisition and transfer to novel (effector and pattern) timings were unaffected by the learning condition and were suggestive of the intrinsic dynamics for in-phase and antiphase. In Experiment 2, learners' (N = 13) acquisition of 2 different phase relations (?90° and ?45°) was qualitatively identical. Attractor reconstruction revealed an increase in the predictability of individual movement trajectories and a decrease in attractor dimensionality over learning. Transfer for both ?90° and ?45° was again suggestive of the intrinsic dynamics. In Experiment 3, learning altered participants' (N = 8) performance of in-phase and antiphase relations. Together, the results suggested a single continuum of phase relations, called an attractor landscape, that produces similar patterns of CE and VE for both previously stable and learned coordinations.     

Ideal Point Discriminant Analysis Revisited with a Special Emphasis on Visualization

Ideal point discriminant analysis is a classification tool which uses highly intuitive multidimensional scaling procedures. However, in the last paper, Takane wrote about it. He concludes that the interpretation is rather intricate and calls that a weakness of the model. We summarize the conditions that provide an easy interpretation and show that in maximum dimensionality they can be obtained without any loss. For reduced dimensionality, it is conjectured that loss is minor which is examined using several data sets. This research was conducted while the author was sponsored by the Netherlands Organisation for Scientific Research (NWO), Innovational Grant, no. 452-06-002.     

Psychological profile of Greek doctors: differences among five specialties

The aim of the present study was to explore the differences in the psychological profiles between genders and different specialties among Greek doctors. Five-thirty nine doctors in five different specialties, namely 115 general practitioners, 168 internists, 81 surgeons, 108 microbiologists and 67 anesthesiologists, participated in the study. 253 participants were specialized doctors and 286 participants were medical residents. The sample consisted of 280 women and 259 men. The mean age of the sample was 38.75(±7.98) years. A cross sectional survey study was conducted. Symptom Check List 90-Revised (SCL-90-R) was used to collect the data. Multivariate Analysis of Variance indicated the significant effect of specialty (Wilks’ Lambda = .20, p = .000), the effect of gender (Wilks’ Lambda = .90, p = .000) as well as their interaction (Wilks’ Lambda = .68, p = .000) on participants’ scores in SCL-90-R subscales. Internists reported high scores in 8 out of 9 subscales of SCL-90-R. Surgeons scored significantly higher compared to all other specialties in hostility(HS) subscale. Women reported statistically higher scores in almost all subscales of the SCL-90-R test compared to men, apart from HS (p = .191). Gender and specialty choice play role in the psychological profile of Greek doctors. Women and internists seem to be more prone to psychopathology. These findings should be taken into account in future studies and interventions.     

1996至2016年中国老年人心理健康变迁的横断历史研究

为探究中国老年人心理健康水平随年代的变迁,运用横断历史研究方法对1996至2016年间160篇采用90项症状自评量表（SCL-90）的研究报告进行元分析。研究发现：（1）SCL-90各因子与年代均呈显著正相关,说明我国老年人心理健康水平在逐年下降。（2）SCL-90各因子与3项社会指标（离婚率、死亡率和犯罪率）有显著正相关。（3）不同性别老年人的心理健康水平均呈逐年下降趋势,但心理健康水平得分的性别差异并不显著。（4）城市老年人的心理健康水平呈逐年下降的趋势,而农村老年人的心理健康水平则呈逐年上升趋势。     

1996至2016年中国老年人心理健康变迁的横断历史研究

为探究中国老年人心理健康水平随年代的变迁,运用横断历史研究方法对1996至2016年间160篇采用90项症状自评量表（SCL-90）的研究报告进行元分析。研究发现：（1）SCL-90各因子与年代均呈显著正相关,说明我国老年人心理健康水平在逐年下降。（2）SCL-90各因子与3项社会指标（离婚率、死亡率和犯罪率）有显著正相关。（3）不同性别老年人的心理健康水平均呈逐年下降趋势,但心理健康水平得分的性别差异并不显著。（4）城市老年人的心理健康水平呈逐年下降的趋势,而农村老年人的心理健康水平则呈逐年上升趋势。