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.     

Utility of the SCL-90-R With Depressed and Conduct-Disordered Adolescent Inpatients

We assessed the ciiagnosric utility of the Symptom Checklist-90-Revised (SCL-9O-R) in a sample of adolescent inpatients. In Part 1 (n = 73), convergent and discriminant validity were demonstrated for SCL-90-R scales measuring depression and paranoid ideation, Canonical correlation showed that SCL-90-R scales tapped two dimensions of adolescent psychopathology, a primary dimension of dysphoria and a secondary dimension of anger and mistrust. In Part 2 (n = 50), adolescents diagnosed as having major depression showed significant elevations on scales measuring depression, anxiety, an obsessive-compulsive features. Although several scales had high diagnostic specificity for major depression and conduct dsorder, sensitivity was low.     

Utility of the SCL-90-R with depressed and conduct-disordered adolescent inpatients.

We assessed the diagnostic utility of the Symptom Checklist-90-Revised (SCL-90-R) in a sample of adolescent inpatients. In Part 1 (n = 79), convergent and discriminant validity were demonstrated for SCL-90-R scales measuring depression and paranoid ideation. Canonical correlation showed that SCL-90-R scales tapped two dimensions of adolescent psychopathology, a primary dimension of dysphoria and a secondary dimension of anger and mistrust. In Part 2 (n = 50), adolescents diagnosed as having major depression showed significant elevations on scales measuring depression, anxiety, and obsessive-compulsive features. Although several scales had high diagnostic specificity for major depression and conduct disorder, sensitivity was low.     

Comparison of Eleven Short Versions of the Symptom Checklist 90-Revised (SCL-90-R) for Use in the Assessment of General Psychopathology

Eleven short versions of the Symptom Checklist (SCL-90-R) assessing general psychopathology, containing 5 to 53 items, were compared on the basis of data from a sample of one hundred mothers of 0-to-6-year-old children referred for treatment at a Child Psychiatric Family Day Hospital in Münster, Germany. The SCL short versions were compared with regard to internal consistency, sensitivity and specificity, ability to distinguish between subjects by a new test index (PDTS), and association with indicators of validity (SCL-90-R Global Severity Index, BDI scores). All short versions showed almost equally high internal consistency, sensitivity and specificity, and high correlations with validity indices. The PDTS test index describes a ‘good’ ability of the original SCL-90-R to differentiate between subjects, a ‘moderate’ performance for the BSI, the HSCL-25 and the SCL-27, and a ‘poor’ performance of the very short forms—according to the standards of interpreting PDTS scores. The SCL-10S is recommended for screening purposes because this scale represented the best compromise between economy and accuracy. However, for other research and clinical purposes, the use of one of the longer short versions (BSI, HSCL-25, or SCL-27) is recommended because of their superior discriminative ability.     

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.     

SA-45: a brief form of the SCL-90

The Symptom Assessment-45 Questionnaire (SA-45) is a 45-item self-report instrument of psychiatric symptomatology derived from the original SCL-90. The SA-45 consists of nine 5-item scales assessing each of the same symptom domains as its parent instrument with no item overlap across domains. This paper provides preliminary validation of the Spanish version of the questionnaire in an undergraduate sample. Exploratory and confirmatory factor analyses supported a 9-factor structure, which corresponds to the nine proposed scales. Normative data, reliability (internal consistency) and validity were also examined, finding support for sound psychometric properties.     

Assessing clinically significant religious impairment in clients: Applications from measures in the psychology of religion and spirituality

This article reviews measures in the psychological study of religion and spirituality (RS) in terms of Hathaway's (1999) conceptualization of clinically significant religious impairment (CSRI). It is maintained that RS can be regarded as an endogenous variable impaired by psychopathology. Specific RS measures are discussed in terms of how they may be used to assess RS impairment in clients in terms of performing RS activities, achieving RS goals, and experiencing desired RS states.     

Establishing clinically significant change: increment of precision and the distinction between individual and group level of analysis

Some essential adaptations to the method for determining clinically significant change originally introduced by Jacobson, Follette and Revenstorf [Jacobson, N. S., Follette, W. C. & Revenstorf, D. (1984a). Psychotherapy outcome research: methods for reporting variability and evaluating clinical significance. Behavior Therapy, 15, 336-352.] are presented. One adaptation deals with the failure in the original method to distinguish between analysis at the individual versus analysis at the group level. A second adaptation entails the provision of a closer approximation of the underlying true scores. This refinement represents an enhancement in precision. Specific aspects of this refinement may be understood in terms of a correction for error-based regression to the mean. Taking into account these adaptations, new procedures are described for determining (clinically significant) change. Some guidelines for the publication of outcome findings are also presented.     

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.     

幼儿园教师的心理健康:对基于SCL-90量表研究的元分析

症状自评量表(SCL-90)在过去15年里广泛用于幼儿园教师心理健康状况调查,然而调查结论却很不一致。为了综合这些相互矛盾的调查结果,分析其原因,37项原始研究(含42个独立样本)进入了元分析。结果显示:(1)幼儿园教师的SCL-90得分与常模没有显著差别,明显低于中小学教师;(2)城镇教师和农村教师、公办教师与民办教师的得分可能有差异;(3)离婚率、教育经费投入,以及出生死亡率与幼儿园教师的SCL-90得分有显著相关。幼儿园教师在心理健康积极端的表现,以及压力–资源–心理健康之间的因果关系在未来研究中需要更多关注。     

Evaluation of counseling outcomes at a university counseling center: the impact of clinically significant change on problem resolution and academic functioning

The main purpose of this study was to investigate how receiving personal counseling at a university counseling center helps students deal with their personal problems and facilitates academic functioning. To that end, this study used both clinical and academic outcome measures that are relevant to the practice of counseling provided at a counseling center and its unique function in an institution of higher education. In addition, this study used the clinical significance methodology (N. S. Jacobson & P. Truax, 1991) that takes into account clients' differences in making clinically reliable and significant change. Pre-intake and post-termination surveys, including the Outcome Questionnaire (M. J. Lambert, K. Lunnen, V. Umphress, N. Hansen, & G. Burlingame, 1994), were completed by 78 clients, and the responses were analyzed using clinical significance methodology. The results revealed that those who made clinically reliable and significant change (i.e., the recovered group) reported the highest level of improvement in academic commitment to their educational goals and problem resolution, compared with those who did not make clinically significant change. The implications of the findings on practice for counseling at university counseling centers and for administrators in higher education institutions are discussed.     

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.     

Psychopathology and response styles in the SCL-90 responses of acutely distressed persons

Using the responses of 197 suicidal and nonsuicidal patients of a crisis and short-term intervention unit, the item factor structure of the SCL-90 was examined. Results suggested a reduced dimensionality for the checklist rather than supporting the nine scales associated with the instrument's scoring key. The influence of various response styles on the SCL-90's dimensionality was also explored. Although a social desirability response style was strongly related to all SCL-90 subscales and factors, it did not offer a complete explanation for the checklist's apparent unidimensionality. Other explanations relating to methods of test construction and to patients' inability to differentiate symptoms were also preferred. Finally, although subscale scores may facilitate clinical interpretation, it was suggested that the SCL-90 might best be scored as a single index of general symptomatology.We wish to thank G. C. Fekken and R. N. MacLennan for their assistance with this project.This work was supported in part by Social Sciences and Humanities Research Council of Canada Grant 410-85-1043 and by an Ontario Ministry of Health Research Personnel Award.     

On the identification of clinically significant client changes: Reinterpretation of Jacobson's cut scores

Cut points or cut scores play a central role in Jacobson's popular method of identifying clinically significant changes in psychotherapy. When pre- and posttherapy scores of a client are on different sides of one of these cut scores, the change is considered clinically significant, provided that it is also reliable (i.e., not due to measurement errors). This article critically examines the meanings and implications of these cut scores. Contrary to popular beliefs, they are generallynot the test scores for which the probability of belonging to the Functional population is equal to the probability of belonging to the Dysfunctional population. When the Functional population distribution is above that of the Dysfunctional population, persons scoring above these cut scores can, in fact, have much greater probabilities of belonging to the Dysfunctional than to the Functional population. Goals of Jacobson's method can be attained only with Bayesian methods. Bayesian modifications of Jacobson's cut scores are proposed, although their use is limited by the availability of relevant base rates. Bayesian methods (a) can provide information about the probability that an individual belongs to each population, given his (her) score, and (b) are expected to yield total misdiagnosis rates that are many times lower than those of Jacobson's method. Users of Jacobson's method are cautioned against interpreting ratios of likelihoods as if they were ratios of posterior probabilities.     

Defining clinically significant changes in the treatment of child stutterers.

This study established a clinically significant criterion to evaluate outcomes of children's stuttering therapy. 30 stutterers, ages 6 to 15 years, and 30 non-stutterers served as subjects. Speech samples were recorded and the percentage of stuttered syllables and rate of speech analyzed. According to Jacobson and Revenstorf's procedure, 3% of stuttered syllables and 160 syllables per minute should become the target behaviors in the treatment of children's stuttering.     

Assessing the impact of dispositional resistance to change on organizational attraction

In recent years there has been an increasing interest among researchers and practitioners to analyze what makes a firm attractive in the eyes of university students, and if individual differences such as personality traits have an impact on this general affect towards a particular organization. The main goal of the present research is to demonstrate that a recently conceptualized narrow trait of personality named dispositional resistance to change (RTC), that is, the inherent tendency of individuals to avoid and oppose changes (Oreg, 2003), can predict organizational attraction of university students to firms that are perceived as innovative or conservative. Three complementary studies were carried out using a total sample of 443 college students from Mexico. In addition to validating the hypotheses, our findings suggest that as the formation of the images of organizations in students' minds is done through social cognitions, simple stimuli such as physical artifacts, when used in an isolated manner, do not have a significant impact on organizational attraction.     

A practice-based exploration of therapeutic change in a charitable,community-based person-centred counselling service using routine outcome measures of anxiety and depression. I: Statistical and clinically significant change

Background

Establishing the value of differing treatments for depression and anxiety is crucial in a climate of delimited spending and increased demand. Drawing from a well-founded, diverse evidence base is salient to constructive evaluation and any subsequent recommendations being fit for purpose.

Design

This study employed a practice-based quantitative design to explore therapeutic gains in adult counselling clients attending person-centred therapy (n = 301), delivered in a charitable, community-based UK service.

Measures

Outcome measures PHQ-9 and GAD-7 were used from three time points: initial assessment (IA), first ongoing session and last or 6th ongoing appointment (whichever occurred first; T1, T2 and T3).

Analysis

Repeated measures ANOVA, CSI, RI and RCSI calculations were used to consider significant change in clients.

Findings

Reductions in PHQ-9 and GAD-7 outcome measures were observed over time (between T2 & T3 and T1 & T3) and were all statistically significant (p = <0.001). By T3: CSI was achieved by 48.1% of clients on PHQ-9 and 50.8% of clients on GAD-7, RI was achieved by 47.8% of clients on PHQ-9 and 60.5% of clients on GAD-7, and RCSI was achieved by 32.6% of clients on PHQ-9 and 41.2% of clients on GAD-7.

Conclusions

The treatment observed resulted in effective outcomes equivalent to other therapies reviewed in the literature for clients' symptoms of anxiety and depression as measured by GAD-7 and PHQ-9.