Validity of the Brief Psychiatric Rating Scale Within a Forensic Inpatient Hospital

Although the Brief Psychiatric Rating Scale(BPRS) has been utilized across several clinical settings, its potential utility within forensic psychiatric hospitals has not yet been investigated. Given the diversity of training and background among correctional mental health workers (i.e., psychiatrists, psychiatric nurses, occupational therapists, recreation therapists, psychologists, social workers,etc.) it is possible that the uniform use of the BPRS among the correctional staff would require extensive training and that substantial “refresher” training may be required to maintain the integrity of rater practices. The present study examined the ability of previously trained forensic mental health professionals to accurately assess psychopathology using the BPRS. Overall,experienced raters demonstrated relatively high concordance rates with “gold standard” ratings across three BPRS training videos (Case 1, Case2 and Case 3). No overall “rater drift” was apparent. However, raters were found to make significantly more errors when rating behavioral observation ratings than for ratings based on self-report patient statements. Findings suggest that ratings done by forensic mental health workers are relatively accurate when compared to “gold standard” ratings established for assessment of community and forensic psychiatric patients. This revised version was published online in July 2006 with corrections to the Cover Date.     

Factor structure and differential validity of the expanded Brief Psychiatric Rating Scale

The Brief Psychiatric Rating Scale (BPRS) is one of the most widely used measures in psychiatric outcome and clinical psychopharmacology research. To date, however; research on the psychometric properties of the expanded version of the BPRS (BPRS-E) has been limited. An exploratory factor analysis (n = 360) using maximum likelihood extraction with oblimin rotation found a four-factor solution (Thought Disturbance, Animation, Mood Disturbance, Apathy) to underlie the BPRS-E. Furthermore, these factors were logical in nature and estimates of internal consistency were acceptable. A confirmatory factor analysis conducted on a second, independent sample (n = 280)found that for the five models currently available in the literature, the model developed herein provided the best fit to the data. Again, estimates of internal consistency were found acceptable. Finally, the four factors demonstrated appropriate differential validity with regards to both demographic variables and various psychiatric diagnoses.     

Factor structure of the Brief Psychiatric Rating Scale for Children (BPRS-C) among Hospital Patients and Community Clients

The factor structure, reliability and concurrent validity of the Brief Psychiatric Rating Scale for Children (BPRS-C) was examined. The BPRS-C was designed to measure child psychopathology with seven scales consisting of three items each. Two large samples of intake assessments at admission to the public mental health system of state psychiatric hospitals (n = 6712) and community mental health centers (n = 21,459) for children aged 3–17 were examined. In both samples exploratory and confirmatory factor analysis found seven factors that generally supported the BPRS-C seven scale structure. Reliability as measured by internal consistency was acceptable with an average alpha of .72 (SD = .09). Mean scale scores across diagnoses and concurrent correlations with the Child Behavior Checklist (CBCL) were consistent with expectations.     

Assessing Psychiatric Symptoms in Youth Affected by HIV: Comparing a Brief Self-Administered Rating Scale with a Structured Diagnostic Interview

Brief psychiatric assessment tools are needed for evaluating children affected by HIV for emotional and behavioral problems. We compared a self-administered symptom rating scale (CASI-4R) to a semi-structured diagnostic interview (DICA-P) in 136 U.S. children affected by HIV. Agreement and performance measures for the two instruments were computed for attention deficit hyperactivity disorder, depression, anxiety, and disruptive behavior. Correlations and regression analyses were conducted to compare the two instruments, and to evaluate their associations with social, academic, and global function. Higher CASI-4R symptom severity scores were associated with DICA diagnoses (p?<?0.02 for all disorders). Agreement (κ) between DICA diagnoses and CASI-4R Clinical Cutoffs (which incorporated symptoms and impairment) was low to moderate (0.19–0.40 for all disorders). Thirty-two percent of cases with a DICA diagnosis were identified by the CASI-4R Clinical Cutoff (sensitivity), yet over 90% of DICA-negative cases were negative by the CASI-4R (specificity). Sensitivity was higher using CASI-4R Severity Score thresholds based on median scores compared to the DICA diagnoses. The presence and severity of psychiatric symptoms and impairment were associated with poorer academic, social, and global function. The CASI-4R symptom checklist can be used to inexpensively screen youth affected by HIV for emotional and behavioral problems, although it is important that there be appropriate mental health evaluation follow-up.     

A Brief Parent Rating Scale for Assessing Young Children's Adjustment

This report describes the development of the Parent Rating Scale (PRS), a 20-item scale for use by parents in rating the adjustment of young normal children. Based on the responses of 416 parents of urban and suburban 2nd and 3rd grade children, a principal components factor analysis with varimax rotation yielded a 4-factor solution accounting for 48.3% in total variance. Low to moderate relationshps were found between PRS scores and teacher, self, and sociometric ratings fo children. PRS total and factor and total scores discriminated clearly between referred and nonreferred children. Suburban children had higher PRS scores than urban children and girls had higher scores than boys.     

New subscales for an anchored version of the Brief Psychiatric Rating Scale: construction, reliability, and validity in acute psychiatric admissions

Attending psychiatrists completed an anchored version of the 18-item Brief Psychiatric Rating Scale (BPRS-A) based on admission and evaluation information on a total of 2,921 adult patients treated at 1 public sector acute psychiatric teaching hospital. Exploratory factor analysis was applied to a 6-month sample to construct 4 nonoverlapping subscales: Resistance, Positive Symptoms, Negative Symptoms, and Psychological Discomfort. Confirmatory factor analysis compared these new subscales to 3 other published subscale models using a second 6-month sample. Internal consistency, rater influence, and interrater agreement were estimated in separate studies. Discriminant validity was explored by comparison of diagnosis-based samples. Application of the BPRS-A as a debriefing instrument in the study of symptomatic change and the multiple challenges inherent in psychometric study of such a rating scale in realistic hospital practice are discussed.     

Psychometric Evaluation of the Rage Outbursts and Anger Rating Scale in an Outpatient Psychiatric Sample

The primary objective of this study was to examine the psychometric properties of a measure of anger/rage attacks—the Rage Outburst and Anger Rating Scale (ROARS)—in a sample of youth (n = 81, ages 7–17 years, 72.8 % male) receiving treatment at an outpatient pediatric psychiatric clinic. A trained rater completed the ROARS and Clinical Global Impression-Rage (CGI-Rage). Children completed the Spence Children’s Anxiety Scale for Children and Center for Epidemiological Studies Depression Scale. Parents completed the Spence Children’s Anxiety Scale for Parents. Internal consistency (α = .89), inter-rater reliability (κ = .94) and 1-week test–retest reliability (r = .72) were calculated for the ROARS. The ROARS was correlated with CGI-Rage (r = .68, ρ < .001), although not with parent- and child-rated anxiety symptoms or with child-rated depressive symptoms. Implications regarding clinical utility of the ROARS and directions for future research are discussed.     

基于灰色统计的心理评定量表研究述略

本文提出运用灰色统计对心理评定量表进行分析处理的方法。灰色系统的理论和方法能够处理信息不完全的数据,很适合运用于心理学研究的数据分析。文章在介绍该方法的同时,还以问题解决能力评定量表的测量数据为例,进行了灰色统计实例分析。     

Relationships between the Beck Depression Inventory and the Hamilton Psychiatric Rating Scale for Depression in depressed outpatients

The Beck Depression Inventory (BDI) and the Hamilton Psychiatric Rating Scale for Depression (HRSD) were used with 300 outpatients diagnosed with DSM-III major depression disorders. A principal-components analysis was performed on the intercorrelations among the 21 BDI and 24 HRSD symptoms. Three orthogonal components were found and interpreted as reflecting differences in self-report and clinical rating methods for measuring the severity of depression. The importance of using both self-reports and clinical ratings for evaluating depression in psychiatric outpatients was discussed.     

结构化面试中评分量表对评分准确性的影响

采用2(组内变量:量尺大小(25分和9分))×2(组间变量:评分方法(相对和绝对))的混合实验设计探讨评分量表对115名大学生新手评委评分准确性的影响。对于评分准确性,采用Cronbach1955年提出的四个指标,Elevation(EL)、Differential elevation(DE)、Stereotype accuracy(SA)、Differential Accuracy(DA)。结果发现,评分方法只在SA上主效应显著,量尺大小在只在DA上主效应边缘显著,评分方法和量尺大小在DE、SA和DA三个指标上均有交互作用。总体上看,在结构化面试评分中,对于评分准确性,相对评分量表优于绝对评分量表,小量尺量表优于大量尺量表。     

Treatment Sensitivity of a Brief Rating Scale for Attention-Deficit Hyperactivity Disorder (ADHD) Symptoms

This study examined the treatment sensitivity of the ADHD Questionnaire (ADHD-Q), which is a brief rating scale for measuring symptoms of inattention, hyperactivity, and impulsivity in children. Parent, teacher, and child self-report data of the ADHD-Q were obtained for 17 clinically referred children with ADHD on the three occasions: (1) during the regular intake assessment, (2) just before the start of the stimulant medication (i.e., methylphenidate) intervention, and (3) four weeks after the start of the medication intervention. Results showed that ADHD-Q scores remained fairly stable in the period prior to the intervention, but then showed a substantial decline after the stimulant medication had been administered. Clearly, this finding supports the treatment sensitivity of the ADHD-Q.     

Structural Validation of the Hamilton Depression Rating Scale

Despite the prolific use of the Hamilton Depression Rating Scale (HDRS), there have been no prior studies using confirmatory factor analysis (CFA) to compare competing HDRS latent structures. The current study undertakes this task, examining CFAs on 397 older adults on the most stable latent models previously posited and a new rationally derived model by Cole and Motivala. CFAs were evaluated in their original first-order structure and in hierarchically related counterparts. All hierarchical models performed significantly better than their first-order counterparts. Moreover, the hierarchical Cole and Motivala model was significantly better on all comparative criteria than any of the other models. However, none of the tested models obtained sufficient fit with the data suggesting psychometric, scoring, or content limitations of the scale.     

Development of the Family Therapy Enactment Rating Scale

This report describes the development of a new scale designed to establish how therapists intervene and clients respond during effective enactments in family therapy sessions. The Family Therapy Enactment Rating Scale (FTERS) was developed by clinically trained investigators who observed 27 videotaped family therapy sessions and listed therapist interventions and client responses during four phases of enactments: pre-enactment preparation, initiation, facilitation, and closing commentary. Interrater reliabilities for the FTERS were calculated by training 6 undergraduate volunteers to rate independently a sample of 12 enactments. When reliabilities were found to be relatively low, a second study was conducted in which the FTERS was revised and reliabilities were calculated with a different sample of 21 videotaped enactments and a new group of 6 undergraduate raters. Reliability for the FTERS was found to be sufficiently robust to make this measure of therapist interventions and client responses a useful instrument for evaluating what takes place during enactments. Findings on the FTERS were used to offer tentative guidelines for effective initiation and facilitation of enactments in family therapy sessions.