Can I add an assessment to NovoPsych?

Can I add an assessment to NovoPsych?

You are welcome to email us a suggestion for adding an assessment. Assessments are uploaded and programmed into NovoPsych according to demand from our users as well as copyright permission. There is an option of having some assessments fast-tracked if they are integral to your practice. Each assessment cost $500 (plus GST) with an approximate two week turnaround.

How do I graph results over time?

How do I graph results over time?

Any assessments designed to monitor psychological symptoms of clients will automatically graph results over time. If you administer the assessment to the same client more than once it will graph the results over time.

What is a Practice Plan?

What is a Practice Plan?

A Practice Plan Connects multiple users with different levels of user access (ie. Account Manager, Supervisor, Practitioner) under one umbrella account. Clients can be shared within the practice, where you can adjust the visibility of clients depending on user access levels.

  1. Account Manager (central account)- can add, assign, and view all clients and assessments within the practice & manage the payment of NovoPsych.
  2. Supervisor can add, assign, and view all clients and assessments within the practice
  3. Practitioner(s) can view clients that have been assigned to them

How to share an assessment URL?

How to share an assessment URL?

1. From the NovoPsych platform you can press email assessment from the home screen.

2. Select a Client
3. Choose the assessments you would like to send
4. Press “Copy URL”. The link to the assessment will be ready for you to paste into an email or messaging service (e.g. Skype, Zoom, SMS).

How to email an assessment from the Assessments tab

How to email an assessment from the Assessments tab

1. Click on Assessments
2. Select your preferred Assessment
3. Select Email

4. Select your client
5. From here you have the option to select additional assessments under Select Assessment(s).
6. You can also Customise Email
7. Select Send at bottom right-hand corner.

How to email an assessment from the Clients tab

How to email an assessment from the Clients tab

1. Click on Clients
2. Select your Client
3. Select Email

4. Choose your Assessment(s) under Select Assessment(s).
5. You can also Customise Email
6. Select Send at bottom right-hand corner.

How to email an assessment from the Homepage

How to email an assessment from the Homepage

1. From the homepage view, click on Email Assessment.

2. Select your client

3. Choose your Assessment(s)
4. Select Send at bottom right-hand corner.

Flourishing Scale (FS)

Dr Ben Buchanan

The Flourishing Scale is a brief 8-item summary measure of the respondent’s self-perceived success in important areas such as relationships, self-esteem, purpose, and optimism. The scale provides a single psychological well-being score and can be used to provide useful feedback for how to improve one’s life and provides useful stimulus for self-reflection. The Flourishing Scale is best used with individuals without clinic disorders, but rather with individuals seeking to enhance an already relatively adaptive lifestyle.

Validity

The scale was evaluated in a sample of 689 college students from six locations (in the USA and Singapore) and found to accurately measure subjective wellbeing. A number of well-being measures were administered in order to determine the convergence of the new scales with established measures, including the Satisfaction with Life Scale (Diener et al., 1985), Lyubomirsky and Lepper’s (1999) 4-item scale of happiness, and Watson et al.’s (1988) Positive and Negative Affect Schedule (PANAS). See reference for convergence correlations. Additionally, a principal axis factor analysis of the Flourishing Scale revealed one strong factor with an eigenvalue of 4.24, accounting for 53 percent of the variance in the items, and no other eigenvalue above 1.0. The factor loadings ranged from .61 to .77. The test has a Cronbach’s alpha of .87 and a temporal stability over one month of .71.

Interpretation

Results consist of a single psychological well-being score, and a percentile derived from a student sample. The possible range of scores is from 8 to 56, where higher scores represented a higher level of reported psychological well-being, resources and strengths. Among the sample of college students used to derive percentiles, the mean score was 44.97 (SD = 6.56). The scores can be used to provide useful feedback for how to improve one’s life and provides stimulus for self-reflection.

Developer

Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi. D., Oishi, S., & Biswas-Diener, R. (2009).
New measures of well-being: Flourishing and positive and negative feelings. Social Indicators Research, 39, 247-266
Please visit: http://internal.psychology.illinois.edu/~ediener/FS.html

Experience in Close Relationship Scale – Short Form (ECR-S)

Dr Ben Buchanan

The Close Relationship Scale is a 12 item self-report adult attachment style questionnaire. Based on Ainsworth’s infant attachment styles literature, this scale measures maladaptive attachment in adulthoods who are in a romantic relationship. The ECR-S gives scores on the two factors important in adult attachment; anxiety and avoidance. The scale is designed to assess a general “trait” pattern of adult attachment as independently as possible from respondents’ current circumstances, and may be helpful in conceptualizing with clients how they approach close relationships.

Validity

Anxiety and Avoidance subscales were r = .19, which indicated that these two measures reflected distinct dimensions of attachment. Consistent with the attachment theory predictions, the construct validity of the ECR-S was supported by the positive association of attachment anxiety with emotional reactivity and the positive association of attachment avoidance with emotional cutoff (Wei et al. 2007). Convergent validity was established through correlation analyses with various tests (Wei et al. 2007): Excessive reassurance seeking was significantly associated with attachment anxiety but not with attachment avoidance. Depression was significantly associated with both attachment anxiety and avoidance. In summary, the ECR-S possess a stable factor structure and acceptable internal consistency, test-retest reliability, and construct validity. Results consist of two scores for the two separate factors; attachment anxiety and attachment avoidance. The minimum score for each scale is 7 and a maximum score of 42. In addition, scores are represented in terms of percentile ranks in accordance to Wei et al.’s (1998) undergraduate sample, where higher percentiles represent more difficulties with adult attachment compared to peers. – Attachment avoidance is defined as involving fear of dependence and interpersonal intimacy, an excessive need for self-reliance, and reluctance to self-disclose. – Attachment anxiety is defined as involving a fear of interpersonal rejection or abandonment, an excessive need for approval from others, and distress when one’s partner is unavailable or unresponsive.

Interpretation

People who score high on either or both of these dimensions are assumed to have an insecure adult attachment orientation. By contrast, people with low levels of attachment anxiety and avoidance can be viewed as having a secure adult attachment orientation (Brennan et al., 1998). In addition, higher scores are significantly and positively related to depression, anxiety, interpersonal distress, or loneliness.

Developer

Wei, M., Russell, D. W., Mallinckrodt, B., & Vogel, D. L. (2007). The experiences in Close Relationship Scale (ECR)-Short Form: Reliability, validity, and factor structure. Journal of Personality Assessment, 88, 187-204. http://wei.public.iastate.edu/

Generalised Anxiety Disorder Assessment (GAD-7)

Dr Ben Buchanan

The GAD-7 is a brief measure of symptoms of anxiety, based on the generalised anxiety disorder diagnostic criteria described in DSM-IV. This assessment asks patients to evaluate their level of symptoms over the last two weeks, and can be used to track treatment progress over time. Given the simple language used in the assessment it is appropriate for individuals as young as 14 years. When used as a screening tool, further evaluation is recommended when the score is 10 or greater. Using the threshold score of 10, the GAD-7 has a sensitivity of 89% and a specificity of 82% for generalised anxiety disorder. It is moderately good at screening three other common anxiety disorders – panic disorder (sensitivity 74%, specificity 81%), social anxiety disorder (sensitivity 72%, specificity 80%), and post-traumatic stress disorder (sensitivity 66%, specificity 81%) (Kroenke, et al. 2007).

Validity

Lowe et al. (2008) investigated the validity and reliability of the GAD-7. Confirmatory factor analyses substantiated the 1-dimensional structure of the GAD-7. Internal consistency was identical across all subgroups (alpha = 0.89). Intercorrelations with the PHQ-2 and the Rosenberg Self-Esteem Scale were r = 0.64 (P < 0.001) and r = -0.43 (P < 0.001), respectively. As expected, women had significantly higher mean (SD) GAD-7 anxiety scores compared with men [3.2 (3.5) vs. 2.7 (3.2); P < 0.001]. Approximately 5% of subjects had GAD-7 scores of 10 or greater, and 1% had GAD-7 scores of 15 or greater. Norms were developed by Lowe et al. (2008) with a German sample of 5030 subjects (53.6% female) with a mean age (SD) of 48.4 (18.0) years. Interpretation A raw score (from 0 to 21) is presented as well as a percentile rank based on the Lowe et al. (2008) community sample. Given that females score slightly higher than males, a percentile for each gender is presented – the appropriate gender percentile should be selected for interpretation.

Interpretation

Developer

Pain Self-Efficacy Questionnaire (PSEQ)

Dr Ben Buchanan

The Pain Self-Efficacy Questionnaire (PSEQ) is a 10-item questionnaire, developed to assess the confidence people with ongoing pain have in performing activities while in pain. The PSEQ is applicable to all persisting pain presentation. It covers a range of functions, including household chores, socialising, work, as well as coping with pain without medication. It takes two minutes to complete.

Validity

Internal consistency is high (0.92 Cronbach’s alpha) and test-retest reliability is high of a 3-month period. Validity is reflected in high correlations with measures of pain-related disability, different coping strategies, and another more activity-specific measure of self-efficacy beliefs, the Self-Efficacy Scale. The evidence of the PSEQ’s sensitivity to change provides support for its construct validity. Vong et., (2009) conducted a validation study using a Chinese sample with a mean age of the 120 participants (39 men, 81 women) was 41.9 years. The mean duration of pain was 31 months. The pain locations included the lower back (n=47, 38.3%), neck (n=11, 9.2%), shoulder (n=10, 8.3%), knee (n=8, 6.7%), foot (n=8, 6.7%), wrist (n=3, 2.5%), and other areas (n=14, 11.6%). Among the participants, the mean of total Chinese Pain Self- Efficacy Questionnaire score was 40.1 (SD 11.0). It demonstrated good internal consistency reliability and construct-related validity.

Interpretation

Scores can range from 0 – 60 and is done by simple addition. High PSEQ scores are strongly associated with clinically-significant functional levels and provide a useful gauge for evaluating outcomes in chronic pain patients. Scores around 40, as found in injured workers who returned to work (Cohen et al, 2000; Adams and Williams, 2003) are associated with return to work and maintenance of functional gains, whilst lower scores after treatment (e.g., 30) tend to predict less sustainable gains (Couglan et al, 1995). Results consist of the total raw score and a percentile score derived from a chronic pain sample by Vong et al., (2009), where the mean score was 40.1 (SD=11.0). Higher scores (and a higher percentile) represent lower confidence to function with pain.

Developer

Nicholas, M. K. (2007). The pain self-efficacy questionnaire: Taking pain into account. European Journal of Pain, 11(2), 153-163.

Appearance Anxiety Inventory (AAI)

Dr Ben Buchanan

The Appearance Anxiety Inventory is a 10 question self-report scale that measures the cognitive and behavioural aspects of body image anxiety in general, and body dysmorphic disorder (BDD) in particular. This scale is useful as part of a diagnostic procedure for BDD as well as symptom monitoring during treatment.

Validity and Reliability

The AAI was developed by Veale et al (2014). They examined the psychometric properties in a clinical BDD sample and non-clinical community sample in the UK. The AAI was found to have good convergent validity, with correlations of .55 with the clinician rated YBOCS-BDD and .58 with the PHQ9. Internal consistency was high, with a Cronbachs Alpha of .86. Two subscales were found using factor analysis; Avoidance and Threat Monitoring.

The BDD validation sample (n = 139) had a median age of 28 and was 51.8% female. A subgroup of 12 participants had a median AAI score of 26 at diagnosis and 10.50 after CBT treatment.

The non-clinical community sample (n = 108) was used to establish the normal levels of appearance anxiety among relatively healthy individuals. The group had a median age of 28.5 and 75.9% were female. The mean score was 15.45 (SD = 8.68).

Interpretation and Scoring

Scores consistent of a total raw score derived by summing each item as well as two subscales.

– Avoidance (items 1, 3, 4, 7, 9 and 10)
– Threat Monitoring (items 2, 4, 6 and 8)

Two percentiles are presented to indicate how AAI scores compare to a body dysmorphic disorder group and a community sample. A BDD percentile of 50 indicates average symptoms for someone with a BDD diagnosis before treatment, while the community percentile represents scores in comparison to a normal population.

Veale et al. (2014) did not define a cut-off score for BDD diagnosis but Mastro et al. (2016) suggested a cutoff score of 20 as being indicative of high risk of clinical problems.

Developer:

Veale, D., Eshkevaria, E., Kanakama, N., Ellisona, N., Costa, A., and Werner, T. (2014). The Appearance Anxiety Inventory: Validation of a Process Measure in the Treatment of Body Dysmorphic Disorder. Behavioural and Cognitive Psychotherapy, 42, 605-616.

References:

Mastro, S., Zimmer-Gembeck, M. J., Webb, H. J., Farrell, L., & Waters, A. (2016). Young adolescents’ appearance anxiety and body dysmorphic symptoms: Social problems, self-perceptions and comorbidities. Journal of Obsessive-Compulsive and Related Disorders, 8, 50-55.

Alcohol Use Disorders Identification Test (AUDIT)

Dr Ben Buchanan

The AUDIT is a 10 question self-report screening questionnaire designed to measure harmful alcohol use. It is widely used and useful for routine screening in community health settings and was developed in conjunction with the World Health Organization. It is sensitive to three factors of problematic alcohol use:

– Hazardous heath impacts

– Dependence symptoms

– Behavioral or social problems of use

The AUDIT differs from other self-report screening tests in that it was based on data collected from a large multinational sample, used a statistical rationale for item selection, emphasizes identification of hazardous drinking rather than long-term dependence and adverse drinking consequences, and focuses primarily on symptoms occurring during the recent past rather than “ever”.

Validity

In the test development sample (Saunders et al, 1993), a cut-off value of 8 yielded sensitivities for various indices of problematic drinking that were in the mid 0.90s.

Subsequent research has evaluated the AUDIT against other measures of alcohol problems including data from comprehensive interviews. One such study (Bush, et al, 1998) found that among 477 participants who completed the AUDIT and were interviewed to determine significant alcohol related problems, a cutoff score of 8 had a sensitively (false negative) of 59% and a specificity (false positive) of 91%. That is, a score of 8 or more will only be sensitive to 59% of individuals who actually have drinking problems, and one can be 91% sure it is not a false positive.

Hays and Merz (1995) gave 832 individuals who were enrolled in drink driving treatment program in California the AUDIT and found that the average score was 8.6 (SD 6.9). This data is used to compute percentiles but given the positive skew should be interpreted with caution.

Interpretation

Total scores range from 0 to 40, with higher scores indicating greater likelihood of hazardous and harmful drinking. Scores are also presented as a percentile compared to a sample of individuals enrolled in a drink driving treatment program (Hays & Merz, 1995). A percentile of 50 indicates a typical score for someone with serious drinking related driving offences, with higher percentiles indicate higher severity. Percentiles below 30 likely indicate no drinking problem.

Scoring was computed by adding scores (0 – 4) on questions 1 to 8, and questions 9 and 10 scored 0, 2, or 4 points.

Total scores of 8 or more are recommended as indicators of hazardous and harmful alcohol use, as well as possible alcohol dependence. However, a score of 8 or more will only be sensitive to 59% of individuals who actually have drinking problems, (Bush et al, 1998). Therefore, scores should only be used as an indication of alcohol problems and not to definitively rule it out.

When looking at individual responses the questions can be conceptualized using the following three categories.

– Likelihood of hazardous heath impacts (questions 1, 2 & 3)

– Dependence symptoms (questions 4, 5 & 6)

– Behavioural or social problems of use (questions 7, 8, 9 & 10)

Developer:

Saunders, J.B., Aasland, O.G., Babor, T.F., de la Fuente, J.R. and Grant, M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. II. Addiction, 88, 791-804,
1993.

Saunders, J.B., Aasland, O.G., Amundsen, A. and Grant, M. Alcohol consumption and related problems among primary health care patients: WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption I. Addiction, 88, 349-362, 1993.

References:

Miller, W.R., Zweben, A., DiClemente, C.C. and Rychtarik, R.G. Motivational enhancement therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence. Project MATCH Monograph Series, Vol. 2. Rockville MD: NIAAA, 1992.

Bush, K., Kivlahan, D., Mcdonell, M., Pihn, S., Bradley, K., The AUDIT Alcohol Consumption Questions (AUDIT-C): An Effective Brief Screening Test for Problem Drinking, Arch Intern Med, 1998;158(16):1789-1795

Hays, R., Merz, J., Response burden, reliability, and validity of the Cage, Short MAST, and AUDIT alcohol screening measures, Behavior Research Methods, Instruments, & Computers, 1995, 27 (2), 277-280.

Clinical Outcomes in Routine Evaluation (CORE-OM)

Dr Ben Buchanan

The CORE Outcome Measure (CORE-OM) is a self-report measure of psychological distress designed to be administered during a course of treatment to determine treatment response. The broad spectrum nature of the measure means it captures a wide variety of problems associated with mental health difficulties, beyond typical symptom measures. 

The client is asked to respond to 34 questions about how they have been feeling over the last week, using a 5-point scale.  The scale covers four dimensions:

  • Subjective well-being
  • Problems/symptoms
  • Life functioning
  • Risk/harm

When the questionnaire is administered periodically comparison of the pre-and post-therapy scores offers a robust measure of ‘outcome’ (i.e. whether or not the client’s level of distress has changed, and by how much).

Validity and Reliability

Since its development the CORE-OM has been validated with samples from the general population, NHS primary and secondary care, and in older adults.

Clinical normative data came from 21 sites from England, predominately within the NHS. The clinical population comprising users waiting for or receiving a wide variety of psychological interventions in a wide variety of settings (total n = 890). This normative data is reported in the CORE SYSTEM USER MANUAL and is used to compute percentile ranks.

Scoring and Interpretation

Scores are presented as a total raw score (range 0-136) and a client average response from 0 – 4, which represents that average response on the likert scale and allows for standardised comparison across subscales.  Higher scores represent poorer overall functioning.

In addition, scores are presented as a percentile compared to a clinical normative sample, where a percentile of 50 represents the average psychological distress of someone seeking psychological intervention.

Scores are presented for the 4 subscales. 

  • Subjective well-being deficits (items 4, 14, 17, 31)
  • Problems/symptoms (items 2, 5, 8, 11, 13, 15, 18, 20, 23, 27, 28, 30)
  • Life functioning difficulties (1, 3, 7, 12, 10, 19, 21, 25, 26, 29, 32, 33)
  • Risk/harm (9, 6, 16, 22, 24, 34)

When administered more than once two graphs are produced. The first shows the total clinical percentile over time, which compares respondents total score to other people seeking mental health support. The second graph represents subscale percentiles over time and is helpful for understanding the areas of improvement or deterioration and therefore targets for treatment.  Both graphs can be useful in providing feedback to clients and assessing treatment response. 

Developer

Evans C, Connell J, Barkham M, Margison F, McGrath G, Mellor-Clark J, Audin K. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. Br J Psychiatry. 2002 Jan;180:51-60.

References

Evans C, Connell J, Barkham M, Margison F, McGrath G, Mellor-Clark J, Audin K. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. Br J Psychiatry. 2002 Jan;180:51-60.

Center for Epidemiologic Studies Depression Scale – Revised (CESD-R)

Dr Ben Buchanan

The Center for Epidemiologic Studies Depression Scale (CESD-R) is a 20 item self-report questionnaire used to measure symptoms of depression, and is particularly useful for tracking symptoms over time. It taps into nine different symptom groups of Major Depressive Disorder as defined by the American Psychiatric Association Diagnostic and Statistical Manual, fifth edition (DSM-V). These symptom groups are:

  1. Sadness (dysphoria)
  2. Loss of Interest (anhedonia)
  3. Appetite
  4. Sleep
  5. Thinking / concentration
  6. Guilt (worthlessness)
  7. Tired (fatigue)
  8. Movement (agitation)
  9. Suicidal ideation

When used in conjunction with DSM-V criteria and clinical judgment this scale is useful for diagnosis of Major Depressive Disorder.

Validity and Reliability

Van Dam and Earleywine (2011) validated the CESD-R on a large community same (N = 7389, mean age = 30.2, SD = 12.1). Factor analysis showed one factor and that the scale had good internal consistency and psychometric properties. In their community sample total score range of 0 to 77 (M = 10.3, S.D. = 11.7). The distribution of CESD-R scores had a large positive skew, meaning that percentiles derived from this data should be treated with caution. They also evaluated the scale with an undergraduate student sample (mean age 19.5 (SD=1.8), showing a higher mean of 16.4 (SD = 13.5).

Scoring and Interpretation

Scores are presented as total raw scores as well and two percentiles, one based on a community sample of adults and the other based on a student sample (mean age = 19.5). High scores indicate more symptoms of depression.

Further interpretation of individual responses can be done in light of the symptoms clusters of Major Depressive Disorder.

1 – Sadness (Dysphoria): Questions 2, 4, 6
2 – Loss of Interest (Anhedonia): Questions 8, 10
3 – Appetite: Questions 1, 18
4 – Sleep: Questions 5, 11, 19
5 – Thinking / concentration: Questions 3, 20
6 – Guilt (Worthlessness): Questions 9, 17
7 – Tired (fatigue): Questions 7, 16
8 – Movement (Agitation): Questions 12, 13
9 – Suicidal ideation: Questions 14, 15

According to the DSM-5 criteria, diagnosis of Major Depressive disorder can be made if five (or more) of the above symptoms clusters are endorsed and at least one of the symptom is either (1) depressed mood or (2) loss of interest in pleasure.

Developer:

Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1:385-401.

Eaton WW, Muntaner C, Smith C, Tien A, Ybarra M. Center for Epidemiologic Studies Depression Scale: Review and revision (CESD and CESD-R). In: Maruish ME, ed. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. 3rd ed. Mahwah, NJ: Lawrence Erlbaum; 2004:363-377.

References:

Van Dam, N. T., & Earleywine, M. (2011). Validation of the Center for Epidemiologic Studies Depression Scale—Revised (CESD-R): Pragmatic depression assessment in the general population. Psychiatry Research, 186(1), 128-132.

The Kessler Psychological Distress Scale (K10)

Dr Ben Buchanan

The K10 is a psychological screening tool designed to identify adults with significant levels of psychological distress. It is widely used in Australia and often used in primary care settings to identify people with clinically significant psychological distress. The K10 is often interpreted using a single total score. In addition the scale can be used to delineate between Depression and Anxiety symptoms. The K10 is a useful measure to track symptom progression during the course of treatment.

Validity

The K10 has been extensively validated, and scores have strong association between CIDI (WHO Composite International Diagnostic Interview) diagnosis of anxiety and affective disorders. There is a lesser but significant association between the K10 and other mental disorder categories and with the presence of any current mental disorder (Andrews & Slade, 2001). Sensitivity and specificity data analysis also supports the K10 as an appropriate screening instrument to identify likely cases of anxiety and depression in the community and to monitor treatment outcomes. Normative data in an Australian sample was collected showing a mean score of 14.5 among a non-clinical community population (Slade, Gove & Burgess, 2010). While the total score of the K10 has been the conventional method for scoring, factor analysis has found four district clusters of symptoms, with two second order factors (Brooks, Beard & Steel, 2006): – Anxiety (Nervous and Agitated) – Depression (Fatigue and Negative Affect) Data compiled by NovoPsych (n = 25,171) shows the average score for someone seeking psychological treatment in Australia is 27.1 (SD= 9.1), with a Depression subscale mean of 16.6 (SD = 6.2) and Anxiety mean of 10.5 (SD = 3.8). This data is used to generate Clinical Percentiles.

Interpretation

Scores range from 10 to 50 with higher scores indicating a higher severity of psychological distress. Percentiles are also presented, comparing scores against clinical and normative samples. A Clinical Percentile of around 50 is indicative of typical symptoms for those presenting for psychological treatment, and corresponds to a percentile of 95 on the normative sample. Total scores can be split into four levels of severity: – Raw scores 19 and under are likely to be psychologically well. This corresponds to a Clinical Percentile of 18.7, and Normative Percentile of 82.5. – 20-24 indicates mild psychological distress – 25-29 indicates moderate psychological distress – 30 and over indicates severe psychological distress. This corresponds to a Clinical Percentile of 62.5 and a Normative Percentile of 97.5. The two main subscale scores are also presented: – Depression (Items 1, 4, 7, 8, 9, 10) – Anxiety (Items 2, 3, 5, 6). In addition, scores and clinical percentiles are also presented for four first order factors, showing the specific makeup of a patient’s psychological distress. – Nervous (Items 2 & 3) – Agitated (Items 5 & 6) – Fatigue (Items 1 & 8) – Negative Affect (Items 4, 7, 9, 10) When administered on multiple occasions scores are graphed over time against Clinical Percentiles. The Y axis is from 0 to 100, and represent the percentile rank compared to other individuals seeking psychological intervention. For example, a percentile of 50 would represent the typical score for someone seeing a psychologist. Any scores above the dotted line at the 19th percentile indicate scores in the “clinical range”, while those below indicate no or minimal distress.

Developer

Kessler, R.C., Andrews, G., Colpe, .et al (2002) Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32, 959-956.

Brief-COPE

Dr Ben Buchanan

The Brief-COPE is a 28 item self-report questionnaire designed to measure effective and ineffective ways to cope with a stressful life event. “Coping” is defined broadly as an effort used to minimize distress associated with negative life experiences. The scale is often used in health-care settings to ascertain how patients are responding to a serious diagnosis. It can be been used to measure how someone is coping with a wide range of adversity, including a cancer diagnosis, heart failure, injuries, assaults, natural disasters and financial stress. The scale can determine someone’s primary coping styles as either Approach Coping, or Avoidant Coping. In addition, The following subscales are reported: Self-distraction, Active coping, Denial, Substance use, Use of emotional support, Use of instrumental support, Behavioral disengagement, Venting, Positive reframing, Planning, Humor, Acceptance, Religion, & Self-blame.

Validity

The Brief-Cope was developed as a short version of the original 60-item COPE scale (Carver et al., 1989), which was theoretically derived based on various models of coping. The Breif-Cope was initially validated on a 168 participant community sample whom had been impacted by a hurricane (Carver, 1997), and shown to have adequate factor structure. Subsequent factor-analysis (Eisenberg et al., 2012) with heart failure patients indicated two major factors: 1. Avoidant Coping. 2. Approach Coping. Homur and Religion subscales did not exclusively load on either of the above factors and are therefore not included in either.

Interpretation

Scores are presented for the two overarching coping styles: 1. Avoidant Coping, which is characterised by the subscales of denial, substance use, venting, behavioural disengagement, self-distraction and self-blame. Avoidant Coping is associated with poorer physical health among those with medical conditions. Compared to Approach Coping, Avoidant Coping is shown to be a less effective at managing anxiety. 2. Approach Coping is characterised by the subscales of active coping, positive reframing, planning, acceptance, seeking emotional support, and seeking informational support. Approach Coping is associated with more helpful responses to adversity, including adaptive practical adjustment, better physical health outcomes and more stable emotional responding. As well as raw scored being presented for Avoidant and Approach Coping, percentile ranks are presented using normative data from a heart-failure sample (Eisenberg et al., 2012) to indicate the relative preference to coping compared to others experiencing adversity. Scores are also presented for each of the following subscales. – Self-distraction, items 1 and 19 (Avoidant) – Active coping, items 2 and 7 (Approach) – Denial, items 3 and 8 (Avoidant) – Substance use, items 4 and 11 (Avoidant) – Emotional support, items 5 and 15 (Approach) – Use of informational support, items 10 and 23 (Approach) – Behavioral disengagement, items 6 and 16 (Avoidant) – Venting, items 9 and 21 (Avoidant) – Positive reframing, items 12 and 17 (Approach) – Planning, items 14 and 25 (Approach) – Humor, items 18 and 28 * – Acceptance, items 20 and 24 (Approach) – Religion, items 22 and 27 * – Self-blame, items 13 and 26 (Avoidant) *Humor and Religion are neither Approach or Avoidance coping

Developer

Carver, C. S. (1997). You want to measure coping but your protocol’too long: Consider the brief cope. International journal of behavioral medicine, 4(1), 92-100. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: a theoretically based approach. Journal of personality and social psychology, 56(2), 267. Eisenberg, S. A., Shen, B. J., Schwarz, E. R., & Mallon, S. (2012). Avoidant coping moderates the association between anxiety and patient-rated physical functioning in heart failure patients. Journal of behavioral medicine, 35(3), 253-261.

Center for Epidemiological Studies Depression Scale for Children (CES-DC)

Dr Ben Buchanan

The Center for Epidemiological Studies Depression Scale for Children (CES-DC) is a 20 item self-report questionnaire for young people between the ages of 6 and 17. It asks young people to rate how many depressive symptoms they have experienced in the last week. This measure is useful for tracking depressive symptoms over time.

Validity and Reliability

Psychometric characteristics of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) were evaluated with 148 child and adolescent psychiatric inpatients (Faulstich et al., 1986). The sample were diagnosed with major depression, dysthymic disorder or another serious mental disorder requiring an inpatient admission. Psychometric properties were adequate, with an internal consistency of α  =  .89, and sensitivity was 80% with a cutoff score of 15, however the scale was not able to differentiate between inpatients admitted for depression or another mental illness.

Scoring and Interpretation

Scores are presented as a total raw score (0 to 60) and two percentiles. Higher scores represent higher levels of symptoms. As defined by Weissman et al. (1980), a score of 15 or above is considered to be indicative of clinically significant depressive symptoms.

The Clinical Percentile represents the respondents score compared to children independently diagnosed with Major Depression or Dysthymia (Faulstich et al., 1990), where a percentile rank of 50 represents a typical score for a depressed young person.

The Healthy Percentile represents the respondents scores compared to a sample of children with no identified mental health diagnosis (Faulstich et al., 1990). A percentile of 50 on the Healthy Percentile scale presents a typical score for a healthy young person.

Developer:

Weissman, M. M., Orvaschel, H., & Padian, N. (1980). Children’s Symptom and Social Functioning Self-Report Scales Comparison of Mothers’ and Children’s Reports. The Journal of nervous and mental disease, 168(12), 736-740.

References:

Faulstich, M. E., Carey, M. P., Ruggiero, L., Enyart, P., & Gresham, F. (1986). Assessment of depression in childhood and adolescence: An evaluation of the Center for Epidemiological Studies Depression Scale for Children (CES-DC). The American journal of psychiatry.

Fendrich, M., Weissman, M. M., & Warner, V. (1990). Screening for depressive disorder in children and adolescents: validating the center for epidemiologic studees depression scale for children. American Journal of Epidemiology, 131(3), 538-551.

The Impact of Event Scale – Revised (IES-R)

Dr Ben Buchanan

The IES-R was designed as a measure of post-traumatic stress disorder (PTSD) symptoms, and is a short, easily administered self-report questionnaire. It can be used for repeated measurements over time to monitor progress. It is best used for recent and specific traumatic events. It has 22 questions, 5 of which were added to the original Horowitz (IES) to better capture the DSM-IV criteria for PTSD (Weiss & Marmar, 1997). It is an appropriate instrument to measure the subjective response to a specific traumatic event in an adult or senior population. There are three subscales: intrusion (intrusive thoughts, nightmares, intrusive feelings and imagery, dissociative-like re-experiencing), avoidance (numbing of responsiveness, avoidance of feelings, situations, and ideas), and hyperarousal (anger, irritability, hypervigilance, difficulty concentrating, heightened startle), as well as a total subjective stress IES-R score.

Validity

The IES-R was designed and validated using a specific traumatic event as a reference in the directions to the patient while administering the tool and while using a specific time frame of the past seven days. The scale discriminates between a variety of traumatized groups from non-traumatized groups in general population studies. The subscales of avoidance and intrusion show good internal consistency. While related, the subscales measure different dimensions of stress response. African-Americans have been shown to score higher than European-Americans on the IES in general population studies, an effect that diminished with increasing relative violence. This finding should be taken into account during interpretation. The hyperarousal subscale added by Weiss and Marmar has good predictive validity with regard to trauma (Briere, 1997), while the intrusion and avoidance subscales detect relevant differences in the clinical response to traumatic events of varying severity. Sundin and Horomitz (2002) showed that the IES’s two-factor structure is stable over different types of events, that it can discriminate between stress reactions at different times after the event, and that it has convergent validity with observer-diagnosed post-traumatic stress disorder.

Interpretation

Results consist of a total raw score, and raw scores for three subscales: The Avoidance Scale, Intrusion Scale, and the Hyperarousal Scale. Additionally the mean rating for the total score and each subscale is presented, which gives an indication of the level of impairment from post traumatic stress, where: 0 = No symptoms 1 = Few symptoms 2 = Moderate symptoms 3 = A High level of symptoms 4 = An Extremely high level of symptoms

Developer

Weiss, D.S., & Marmar, C.R. (1997). The Impact of Event Scale-Revised. In J.P. Wilson, & T.M. Keane (Eds.), Assessing Psychological Trauma and PTSD: A Practitioner’s Handbook (pp. 399-411). New York: Guilford Press.The original Impact of events Scale (IES) was developed in the 1980s

Rosenberg Self-Esteem Scale (RSES)

Dr Ben Buchanan

Description

The RSES measures self-esteem using ten items answered on a four-point Likert-type scale — from strongly agree to strongly disagree. The RSES is one of the most widely used measures of self-esteem (Sinclair et al., 2010). Self-esteem is not a unitary construct and has been divided equally to measure two 5-item facets; self-competence and self-liking. – Self-competence (SC) is understood as one’s instrumental value. Schmitt and Allik (2005) defined self-competence as ”feeling you are confident, capable and efficacious”(p. 625). – Self-liking (SL) is defined as one’s sense of intrinsic self value (Sinclair et al., 2010). Schmitt and Allik (2005) defined self-liking as ”feeling you are good and socially relevant” (p. 625). A central assumption in psychology has been that high self-esteem is beneficial and low self-esteem is detrimental (Crocker & Park, 2004). However, a more nuanced view of self-esteem is emerging, suggesting the benefits of high trait self-esteem are restricted to enhanced initiative and happiness (Baumiester, Campbell, Krueger, & Vohs, 2003). Crocker and Park (2004) point out that self-esteem is associated with self-focus interpersonal and achievement goals, and high self-esteem can produce costs in terms of loss of relatedness, increased competitiveness and lower concern for group wellbeing. These researchers argue psychologists should be less concerned in fostering the amount of self-esteem and more concerned with the processes by which individuals pursue it.

Validity

The scale has good predictive validity, as well as internal consistency and test–retest reliability (Schmitt & Allik, 2005; Torrey, Mueser, McHugo, & Drake, 2000). Cronbach coefficient has been shown to be high (M = 0.81) supporting the internal coherence of the scale. Sinclair et al. (2010) suggest that self-esteem scores are highly dependent on temporal affect, and therefore the scale may not capture trait based self-esteem adequately. Despite this, test-retest reliability over a period of 2 weeks reveals correlations of .85 and .88, indicating excellent stability. The RSES demonstrates a Guttman scale coefficient of reproducibility of .92, indicating excellent internal consistency.

Interpretation

The minimum total score is 0 and the maximum is 30, with higher scores representing higher self-esteem. Results consist of four raw scores and four percentiles: Total self-esteem, self-competence (sum of first five items), self-liking (sum of second five items) and self-competence minus self liking (SC-SL). Percentiles indicate how the client’s self-esteem compares to Sinclair’s adult sample. Sinclair et al. (2010) found that among a sample of 503 adults (M = 44.7 years, SD = 16.3) the average self-esteem score was 22.62 (SD = 5.8). The self-competence subscale had a mean of 12.01 (SD=2.82). The mean for self-liking was 10.62 (SD = 3.35). Additionally, when the raw self-liking score was taken away from the raw self-competence score (SC-SL), the average difference was 1.39 (SD=2.15). Despite higher self-esteem not always being more adaptive, evidence shows that self-esteem is negatively and linearly related to disorders of mood and anxiety (Greenberg et al., 1992; Lightsey et al., 2006; Neustadt et al., 2006; Torrey et al., 2000), so higher self-esteem has been shown to be protective against some mental disorders.

Developer

Rosenberg, M. (1965). Rosenberg self-esteem scale (RSE). Acceptance and Commitment Therapy. Measures Package, 61. Sinclair SJ; Blais MA; Gansler DA; Sandberg E; Bistis K; LoCicero A. Psychometric properties of the Rosenberg Self-Esteem Scale: overall and across demographic groups living within the United States. Eval Health Prof;33(1):56-80, 2010 Schmitt, D. P., & Allik, J. (2005). Simultaneous administration of the Rosenberg Self-Esteem Scale in 53 nations: exploring the universal and culture-specific features of global self-esteem. Journal of personality and social psychology, 89(4), 623. Crocker, J., & Park, L. E. (2004). The costly pursuit of self-esteem. Psychological Bulletin; Psychological Bulletin, 130(3), 392. Baumeister, R. F., Campbell, J. D., Krueger, J. I., & Vohs, K. D. (2003). Does high self-esteem cause better performance, interpersonal success, happiness, or healthier lifestyles? Psychological science in the public interest, 4(1), 1-44.

Clinical Outcomes in Routine Evaluation 10 (CORE-10)

Dr Ben Buchanan

The CORE-10 is a short 10 item easy-to-use assessment measure for common presentations of psychological distress, designed to be used for screening as well as over the course of treatment to track progress. The measure is a shortened version of the 34 item CORE-OM, both of which ask respondents to self-report symptoms over the past week.

Validity and Reliability

Barkham et al. (2013) validated the CORE-10 in primary care patients as well as the general population, finding it had an internal reliability (alpha) of .9. Based on their analysis it was determined that scores of 11 or above were indicative of clinically significant psychological distress, and scores above 13 likely indicated depression, with a sensitivity and specificity of .92 and .72 respectively.

The CORE-10 manual (2007) reports normative data for validation samples, including the General Population (n=535, M=4.7 SD=4.8) and Primary Care Counseling (n=1835, M=19.7, SD=7.7). The clinical sample comprised people that were voluntarily receiving counselling in the UK, the majority of clients presented with anxiety (71%) and/or depression (65%). Half of the sample reported experiencing interpersonal problems (50.9%).

Scoring and Interpretation

Scores are presented as a total score (0 to 40) as well as a mean score (between 0 – 4). Higher scores indicate higher levels of general psychological distress, where a total score of 11 or above is within the clinically significant range.

Two percentile ranks are also presented, allowing comparison of scores with a Clinical Sample and the General Population. Higher percentiles represent higher levels of distress compared to the comparison group. A percentile of 50 for the Clinical Sample is typical of those receiving psychological treatment (approx. total score of 20), with the same score being above the 99th percentile compared to the General Population.

Scores can be put into the following categories:

  • Less than 10 – non-clinical range
  • 11 to 14 – mild psychological distress
  • 15 to 19 – moderate psychological distress
  • 20 to 24 – moderate-to-severe psychological distress
  • 25 or above – severe psychological distress

Developer

Barkham, M., Bewick, B., Mullin, T., Gilbody, S., Connell, J., Cahill, J., … & Evans, C. (2013). The CORE-10: A short measure of psychological distress for routine use in the psychological therapies. Counselling and Psychotherapy Research, 13(1), 3-13.

References

Barkham, M., Bewick, B., Mullin, T., Gilbody, S., Connell, J., Cahill, J., … & Evans, C. (2013). The CORE-10: A short measure of psychological distress for routine use in the psychological therapies. Counselling and Psychotherapy Research, 13(1), 3-13.

CORE-10 Manual (2019). https://www.corc.uk.net/media/2311/perinatal-roms-manual-a4-final-print-december-2019.pdf

Agnew Relationship Measure – 5 (ARM-5)

Dr Ben Buchanan

The ARM-5 is widely used by clinicians engaging in Feedback Informed Treatment  and is designed to be used used close to the end of a therapy session at regular intervals (either every session, 2nd session or every 3rd session).

The scale is the 5-item version of the Agnew Relationship Measure (ARM; Agnew, Davies, Stiles, Hardy, Barkham, & Shapiro, 1998), and is a self-report measure designed to assess the client-therapist alliance.

Given that therapeutic alliance is among the best predictors of treatment success, this tool can help clinicians identify risk of dropout as well as track any ruptures/repairs in the alliance. The ARM-5 has been shown to be equivalent to other scales such as the Session Rating Scale (SRS) in terms of predicting client outcomes (Bouchard, 2018).

The ARM-5 has been shown to be equivalent to other scales such as the Session Rating Scale (SRS) in terms of predicting client outcomes (Bouchard, 2018). The ARM-5 assesses three dimensions of alliance known to be important for treatment efficacy:

  1. Bond
  2. Partnership
  3. Confidence in therapy

Validity

Cahil et al. (2011) evaluated the ARM-5’s psychometric properties against the full 28-item Agnew Relationship Measure, and found it to have acceptable levels of internal consistency and alternative forms reliability. The ARM-5 was psychometrically approximate to the Core Alliance indexes on the longer form. 

Used consistently as part of CBT for depression, the ARM-5 was shown to be predictive of client outcomes, where higher levels of alliance predicted later treatment gains/symptom reduction. 

The Cahil et al. (2011) Cheffield Psychotherapy Project sample (n=1073) had a mean rating of 5.76 with a standard deviation of 0.91. Cahil et al. (2011) also was found the clients often rate therapists very highly, and the ARM-5 therefore suffers from ceiling effects.

Scoring and Interpretation

A total raw score ranging from 5 to 35 indicates the overall level of therapeutic alliance. In addition, scores are presented as “mean scores”, indicating the average responses (from 1 to 7). A percentile rank is presented using the mean and standard deviation from the Cahil et al. (2011) sample, indicating the level of alliance compared to a normative sample. The percentile should be interpreted with caution, however, given the data is significantly skewed with evident ceiling effects (max percentile = 91.4).

Research shows there is minimal psychometrically significant distinction between the three subscales (Bond, Partnership and Confidence). Therefore clinicians are encouraged to use the total alliance score, which is the most reliable and useful measure. 

  1. Bond (item 1) is the measure that encompasses the classic dimensions of client-therapist bond and feelings of therapist supportiveness. 
  2. Partnership (items 2 and 3) measures agreement on tasks, and agreement on goals. 
  3. Confidence (items 4 and 5) measures the client’s confidence in the treatment approach, as well as the perceived confidence the therapist has in their own techniques. Confidence has been identified as the strongest predictor of positive outcome, reflecting the therapist’s and client’s joint sense of progress and investment.

Developer:

Jane Cahill , William B. Stiles , Michael Barkham , Gillian E. Hardy , Gregory Stone , Roxane Agnew-Davies & Gisela Unsworth (2012) Two short forms of the Agnew Relationship Measure: The ARM-5 and ARM-12, Psychotherapy Research, 22:3, 241-255, DOI: 10.1080/10503307.2011.643253

References:

Agnew‐Davies, R., Stiles, W. B., Hardy, G. E., Barkham, M., & Shapiro, D. A. (1998). Alliance structure assessed by the Agnew Relationship Measure (ARM). British Journal of Clinical Psychology, 37(2), 155-172.

Bouchard, D, Assessment of the Therapeutic Alliance Scales: A Reliability and Validity Evaluation, School of Psychology, University of Ottawa. 2018.

Jane Cahill , William B. Stiles , Michael Barkham , Gillian E. Hardy , Gregory Stone , Roxane Agnew-Davies & Gisela Unsworth (2012) Two short forms of the Agnew Relationship Measure: The ARM-5 and ARM-12, Psychotherapy Research, 22:3, 241-255, DOI: 10.1080/10503307.2011.643253

NovoPsych blog post by Dr Ben Buchanan (25 May 2020). Feedback Informed Treatment: Why Measure Therapeutic Alliance.

Valuing Questionnaire (VQ)

Dr Ben Buchanan

The Valuing Questionnaire (VQ: Smout et al. 2014) is a 10-item self-report scale designed to measure how consistently an individual has been living with their self-determined values and is particularly helpful when administered during a course of ACT. Values are personal principles someone has chosen to guide their behaviour. Articulation of self-defined values is a core component of ACT-like therapies, and this scale is best used in conjunction with and subsequent to this process in therapy. The VQ measures “valuing”, which refers to actions one takes to live in accordance with values, rather than simply pleasant outcomes or satisfaction with life. It measures two constructs: 1. Progress, defined as enactment of values, perseverance, and including clear awareness of what is personally important. 2. Obstruction, which reflects the disruption of valued living due to avoidance of unwanted experience, distraction from values by inattention to values or undue attention to distress.

Validity

While developing the measure, Smout et al (2014) conducted factor analyses that supported a 2-factor solution in undergraduate university student (n= 630) and clinical adult (n= 285) samples. The clinical sample was from an outpatient CBT treatment clinic in Australia. There was a negative correlation (r=-.66) between the two factors. As one would expect, there was a pattern of different responding between the normative undergraduate sample and the clinical sample. For the Progress Subscale, scores were significantly lower in the clinical sample (M=12.8, SD=7.91) compared with the university sample (M=17.2, SD=6.44). The clinical sample had higher scores on the Obstruction subscale (M=18.9, SD=6.49) compared to the university sample (M=12.1, SD=6.88), indicating the clinical sample had more problems living consistently with their values. In the same study concurrent validity was established via comparison with the Satisfaction With Life Scale (SWLS), the Valued Living Questionnaire (VLQ), and the Acceptance and Action Questionnaire (AAQ-II).

Interpretation

Scoring and Interpretation Two subscale scores are presented, Progress and Obstruction, which typically have a negative correlation. — Progress (items, 3, 4, 5, 7,9. Range = 0 to 30) defined as enactment and perseverance in living consistently with one’s values. Higher scores represent a closer alignment between one’s internal values and one’s actions. — Obstruction (items 1, 2, 6, 8, 10. Range = 0 to 30) represents the extent to which various disruptions got in the way of valued living. Higher scores represent more interference with living consistently with one’s values. Scores indicative of psychological health are high scores on the Progress scale accompanied by low scores on the Obstruction scale. As well as raw scores being presented, percentile ranks compared to an undergraduate university sample and a clinical sample are presented. A percentile of 50 on the clinical sample on each subscale represents a typical score for people presenting to outpatient psychology clinics. When used as a monitoring tool during a course of ACT, successful treatment is indicated by increasing Progress Scores and decreasing Obstruction Scores.

Developer

Smout, M., Davies, M., Burns, N., & Christie, A. (2014). Development of the valuing questionnaire (VQ). Journal of Contextual Behavioral Science, 3(3), 164-172.

PTSD Checklist 5 (PCL-5)

Dr Ben Buchanan

The PCL-5 is a 20 item self-report measure of the 20 DSM-5 symptoms of Post Traumatic Stress Disorder (PTSD). Included in the scale are four domains consistent with the four criterion of PTSD in DSM-5: – Re-experiencing (criterion B) – Avoidance (criterion C) – Negative alterations in cognition and mood (criterion D) – Hyper-arousal (criterion E) The PCL-5 can be used to monitor symptom change, to screen for PTSD, or to make a provisional PTSD diagnosis.

Validity

The PCL-5 is a relatively new scale (released in 2013), therefore only preliminary validation is currently available. Validation research points to the clinical utility of the PCL-5. All four criterion scales demonstrate high internal consistency (Cohen et al., 2015). There was also a high correlation of PTSD prevalence in a student sample (n = 2490) between the symptom severity (1.4% meeting PTSD criteria) and diagnostic classification scoring methods (1.3% meeting PTSD criteria) (Cohen et al., 2015).

Interpretation

Scores consist of a total symptom severity score (from 0 to 80) and scores for four subscales: – Re-experiencing (items 1-5 – max score = 20) – Avoidance (items 6-7 – max score = 8) – Negative alterations in cognition and mood (items 8-14 – max score = 28) – Hyper-arousal (items 15-20 – max score = 24) In addition to a raw score being presented, a “mean score” is also computed, which is the subscale score divided by the number of items. These scores range between 0 to 5, where higher scores represent higher severity. Consistent with the likert scale: 0 = Not at all 1 = A little bit 2 = Moderately 3 = Quite a bit 4 = Extremely A provisional PTSD diagnosis can be made by treating each item rated as 2=”Moderately” or higher as an endorsed symptom, then following the DSM-5 diagnostic rule which requires at least: 1 B item (questions 1-5), 1 C item (questions 6-7), 2 D items (questions 8-14), 2 E items (questions 15-20). A cut-off raw score is 38 for a provisional diagnosis of PTSD. This cut-off has high sensitivity (.78) and specificity (.98) (Cohen et al., 2015). If the scale is used to track symptoms over time, a minimum 10 point change represents clinically significant change (as based on the PCL for DSM-IV change scores).

Developer

Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013).The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov.

Opioid Risk Tool (ORT)

Dr Ben Buchanan

The Opioid Risk Tool (ORT) is a brief, self-report or clinician rated screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse among individuals prescribed opioids for treatment of chronic pain. Patients categorized as high-risk are at increased likelihood of future abusive drug-related behaviours. This tool is best administered to patients upon an initial visit prior to beginning opioid therapy. The ORT measured the following risk factors based on scientific literature: personal and family history of substance abuse; age; history of preadolescent sexual abuse; and certain psychological diseases.

Validity

In the initial validation research by Webster (2005) administered the ORT to 85 patients treated with opioids at pain clinics. For those patients with a risk category of low, 17 out of 18 (94.4%) did not display an aberrant behaviour. For those patients with a risk category of high, 40 out of 44 (90.9%) did display an aberrant behaviour. The ORT displayed excellent discrimination for both the male (c = 0.82) and the female (c = 0.85) prognostic models. Among patients prescribed opioids for chronic pain, the ORT exhibited a high degree of sensitivity and specificity for determining which individuals are at risk for opioid-related, aberrant behaviours.

Interpretation

Scores range from 0 to 26, with scores calculated differently dependent on gender and age.The scores are categorized into three risk categories. – Low Risk= Scores 0-3 – Moderate Risk = scores 4 – 7 – High risk = Scores 8 or more According to the validation sample (Webster, 2005) patients in the low risk category have a 5.6% chance of developing one or more aberrant behaviour when prescribed opioids. The moderate risk category had a risk of 28% while the high risk category had a risk of 91%. Note that these percentages are not direct measures of risk of opioid abuse or dependence, but rather aberrant behaviours (which are known to be associated with abuse and dependence). Aberrant behaviours are defined as: -Used additional opioids than those prescribed -Used additional opioids than those prescribed more than once -Forged prescription -Sold prescription -Admitted to seeking euphoria from opioids -Admitted to wanting opioids for anxiety -Overdose and death -Injected drug -Abnormal urine/blood screen -Abnormal urine/blood screen positive for 2 or more substances -Solicited opioids from other providers -Unauthorized ER visits -Concurrent abuse of alcohol -Unauthorized dose escalation

Developer

Webster LR. Predicting aberrant behaviors in opioid-treated patients: Preliminary validation of the opioid risk tool. Pain Medicine. 2005;6(6):432-442. Used with permission.

Difficulties in Emotion Regulation Scale

Dr Ben Buchanan

The Difficulties in Emotion Regulation Scale (DERS) is a instrument measuring emotion regulation problems. The 36 items ask the respondent to rate themselves on how they relate to their emotions. This tool can be especially useful in helping patients identify areas for growth in how they respond to their emotions, especially those with Borderline Personality Disorder, Generalised Anxiety Disorder or Substance Use Disorder. This scale measures an integrative conceptualization of emotion regulation as involving not just the modulation of emotional arousal, but also the awareness, understanding, and acceptance of emotions, and the ability to act in desired ways regardless of emotional state. Given that successful emotion regulation is a key aspect of personal well-being, difficulties in emotion regulation are theorised to be a transdiagnostic risk for the onset and maintenance of psychopathological disorders. The scale has the following subscales: 1. Nonacceptance of emotional responses 2. Difficulty engaging in Goal-directed behaviour 3. Impulse control difficulties 4. Lack of emotional awareness 5. Limited access to emotion regulation strategies 6. Lack of emotional clarity

Validity

In a sample of undergraduate students (Gratz & Roemer, 2003) found that the DERS had high internal consistency, good test–retest reliability, and adequate construct and predictive validity. Based on a sample of 427 adults presenting at an outpatient clinic diagnosed with one or more DSM-5 disorder, Hallion et al. (2018) found that the DERS has good internal consistency, particularly when the Awareness subscale is excluded, indicating that Awareness may be a seperate construct. The means and standard deviations for the same sample are presented below. – Total M = 89.33, SD = 22.64 – Non-acceptance M = 14.67, SD = 5.92 – Goals M = 15.42, SD = 4.215 – Impulse M = 12.58, SD = 4.97 – Awareness M = 15.55, SD = 4.92 – Strategies M = 19.67, SD = 7.31 – Clarity M = 12.01, SD = 4.04

Interpretation

Higher scores suggest greater problems with emotion regulation. Scores are presented as a total score as well as a score for each of the 6 subscales. Scores are also presented as a percentile rank, which compares the scores against adults seeking outpatient psychological therapy (Hallion et al., 2018). A percentile of 50 indicates typical scores in comparison to others presenting for treatment, with high (more severe) scores being predictive of bigger treatment gains from CBT. 1. Nonacceptance of emotional responses: 11, 12, 21, 23, 25, 29 2. Difficulty engaging in goal-directed behaviour: 13, 18, 20R, 26, 33 3. Impulse control difficulties: 3, 14, 19, 24R, 27, 32 4. Lack of emotional awareness: 2R, 6R, 8R, 10R, 17R, 34R 5. Limited access to emotion regulation strategies: 15, 16, 22R, 28, 30, 31, 35, 36 6. Lack of emotional clarity: 1R, 4, 5, 7R, 9

Developer

Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment, 26(1), 41-54.

Panic Disorder Severity Scale (PDSS)

Dr Ben Buchanan

The PDSS is a self report scale that provides operationalized ratings of DSM-IV panic disorder symptoms. The PDSS consists of seven items, each rated on a 5-point scale. The items are carefully anchored and assess panic frequency, distress during panic, panic-focused anticipatory anxiety, phobic avoidance of situations, phobic avoidance of physical sensations, impairment in work functioning, and impairment in social functioning. The scale can be administered in 5 to 10 minutes. It is a useful way of assessing overall panic disorder severity at baseline, and it provides a profile of severity of the different panic disorder symptoms. It is a good monitoring tool because it is brief and sensitive to change. This scale is meant for use after diagnosis.

Validity

Evaluation of internal consistency in 198 patients with DSM-III-R panic disorder yielded a Cronbach’s alpha of 0.64. Joint reliability ranged from 0.84 to 0.88 for trained raters. The PDSS total score showed moderate correlations with both panic disorder severity ratings of the Anxiety Disorders Interview Schedule–Revised (ADIS-R) (r = 0.54) (DiNardo and Barlow 1988) and severity ratings of the Clinical Global Impression (CGI) Scale (r = 0.66). Individual PDSS item scores were strongly associated (r = 0.60–0.78) with ADIS-R items of similar content and less strongly associated (r = 0.35–0.47) with CGI Scale and ADIS-R severity ratings. The PDSS items most highly correlated with similar ADIS-R items were panic frequency (r = 0.71), anticipatory anxiety (r = 0.78), agoraphobic fear and avoidance (r = 0.73), and sensation fear and avoidance (r = 0.69). The PDSS total score was not significantly correlated with that of the Hamilton Rating Scale for Depression (Ham-D) (r = 0.11). The PDSS has proved to be sensitive to change with treatment

Interpretation

In scoring the Panic Disorder Severity Scale, items are rated on a scale of 0 to 4. A composite score is established by averaging the scores of the seven items. This composite score indicates, on average, how the test taker responded to each question, higher scores indicating a higher severity of panic disorder. Raw scores range from 0 to 28 and composite scores range from 0-4. This test is not diagnostic; however a score of 9 and above suggest the need for a formal diagnostic assessment. Scores are sensitive to change after psychological treatment.

Developer

Shear, M.K., Brown, T.A., Barlow, D.H., Money, R., Sholomskas, D.E., Woods, S.W., Gorman, J.M., Papp, L.A. (1997). Multicenter collaborative Panic Disorder Severity Scale. American Journal of Psychiatry, 154, 1571-1575.

Patient Health Questionnaire – Depression (PHQ-9)

Dr Ben Buchanan

The PHQ-9 is the nine item depression subscale of the Patient Health Questionnaire, and is a widely used tool for assisting primary care clinicians in diagnosing depression as well as monitoring treatment. The PHQ-9 is based directly on the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual Fourth Edition (DSM-IV).

Validity

To establish reliability and validity the PHQ-9 was administered to 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics, and construct validity and criterion validity were assessed against independent measures (Kroenke, Spitzer and Williams 2001). Criterion validity was assessed against an independent structured mental health professional interview in a sample of 580 patients. The mean PHQ-9 score was 17.1 (SD, 6.1) in the 41 patients diagnosed as having major depression; 10.4 (SD, 5.4) in the 65 patients diagnosed as other depressive disorder; and 3.3 (SD, 3.8) in the 474 patients with no depressive disorder. A PHQ-9 score of more than 10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively.

Interpretation

A raw score (from 0 to 27) is presented, as well as a percentile based on sample of non-depressed individuals, a sample of those diagnosed with major depression, and sample diagnosed as having other depressive disorders. An individual with a percentile of around 50 compared to the major depression (MD) sample has a typical level of depression when compared to others diagnosed with major depression. The non-depressed percentile and the other-depressed percentile will be substantially higher. Conversely, an individual who scores in the 50th percentile compared to the non-depressed sample will likely score very low on the two depressed sample subscales.

Developer

Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues

Social Avoidance and Distress Scale (SADS)

Dr Ben Buchanan

This is a 28 item true/false scale that measures distress in social situations and the avoidance of social interactions. It also measures aspects of social anxiety including distress, discomfort and fear. Social avoidance was defined as “being with, talking to, or escaping from others for any reason . . . both actual avoidance and the desire for avoidance were included” (Watson & Friend, 1969, p. 449). Individuals who score high in the SADS are those who experience anxiety or distress with social interaction or anticipations of social interactions. Geist and Borecki (1982) found that persons high on the SAD had significantly lower levels of self-esteem. High SADS scores indicated significantly lower values of self-confidence, need for affiliation, need for change, and need for dominance (Geist and Borecki 1982).

Validity

Watson & Friend (1969) studies 205 college students (145 females and 60 males). The distribution of scores was skewed, with high scores being rare; the modal score was 0. Mean scores differed by sex: males had a mean of 11.2 and females had a mean score of 8.24. Geist and Borecki (1982) also conducted a validation study with a similar college group, finding similar results. Discriminant and convergent validity from the scale was established through a correlation elf-confidence, need for affiliation, need for change, and need for dominance.

Interpretation

Scores consist of total raw score (from 0 to 28) and a percentile rank based on Watson and Friend’s validation sample. The overall mean for this sample was 9.11 and the standard deviation 8.01, although it should be noted that there was a strong positive skew in results. This, combined with the fact that the sample were university students, means that percentiles should be interpreted with caution. Watson & Friend divided their sample into high, average and low scorers as follows: Low 0 or 1. Average 2 to 11. High 12 and up. Generally the lower scores on the SAD are considered to be most adaptive because they are associated with self-esteem and social engagement, however, individuals who score very low on the SAD have been shown to have a higher need for social control and dominance (Geist & Borecki, 1982). Thus, very low scorers maybe resistant to prosocial activities. Higher scorers on the SADS have lower self confidence, lower need for social affiliation, low need for dominance and a high need for deference.

Developer

Watson, D., & Friend, R. (1969). Measurement of social-evaluative anxiety. Journal of Consulting and Clinical Psychology; Journal of Consulting and Clinical Psychology, 33(4), 448.

Tampa Scale of Kinesiophobia (TSK)

Dr Ben Buchanan

The TSK is a 17-item self report checklist using a 4-point Likert scale that was developed as a measure of fear of movement or (re)injury. Kinesiophobia is defined by the developers as “an irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury” (Kori et al., 1990). The scale is based on the model of fear avoidance, fear of work related activities, fear of movement and fear of re-injury (Vlaeyan et al., 1995). The TSK has also been linked to elements of catastrophic thinking (Burwinkle et al., 2005). The scale can be useful in measuring unhelpful thoughts and beliefs about pain in people with chronic pain or fibromyalgia.

Validity

Roelofs et al (2004) conducted a validation study with individuals with chronic low back pain (CLBP) and fibromyalgia patients, validating the two-factor model of the Tampa Scale for Kinesiophobia (TSK) by means of confirmatory factor analysis. Construct and predictive validity of the TSK subscales were also examined. Results clearly indicated that a two-factor model fitted best in both pain samples. Construct validity of the TSK and its subscales was supported by moderate correlation coefficients with self-report measures of pain-related fear, pain catastrophising, and disability, predominantly in patients with CLBP. Predictive validity was supported by moderate correlation coefficients with performance on physical performance tests (i.e., lifting tasks, bicycle task) mainly in CLBP patients.

Interpretation

Results consist of a total raw score and two subscale scores. Additionally, scores are presented in percentile terms in comparison to patients with chronic back pain (CBP Percentile) and Fibromyalgia (FM Percentile) using data from Roelofs et al (2004). Thus, a percentile of 50 compared to the Fibromyalgia sample represents an average level of kinesiophobia compared to others with Fibromyalgia. The total score ranges between 17 and 68. A high value on the TSK indicates a high degree of kinesiophobia, and a cutoff score was developed by Vlaeyen (1995), where a score of 37 or over is considered as a high score, while scores below that are considered as low scores. Use of a total score (including all 17 items) is recommended, although practitioners may wish to interpret results using two subscales; – Activity Avoidance – this subscale reflects the belief that activity may result in (re)injury or increased pain. – Somatic Focus – reflects the belief in underlying and serious medical problems

Developer

The original Tampa Scale of Kinesiophobia (TSK) was developed by R. Miller, S. Kopri, and D. Todd, in 1991. This represents a modified version.

Spence Children’s Anxiety Scale – Child (SCAS-Child)

Dr Ben Buchanan

The SCAS Child Version is a 45-item self-report scale used to assess severity of anxiety symptoms in children aged 8-15 years. This measure assesses six domains of anxiety which constitute six subscales: separation anxiety, social phobia, obsessive compulsive problems, panic/agoraphobia, generalised anxiety/overanxious symptoms and fears of physical injury. The SCAS Child Version is not designed to be used as a diagnostic tool in isolation, but it can be used in clinical and non-clinical settings to evaluate the impact of anxiety interventions over time.

Validity

The SCAS Child Version has been validated in a sample of Australian children (N = 218) by Spence (1998). The SCAS demonstrated convergent validity with other measures of child anxiety, and discriminant validity with a measure of child depressive symptoms. The same study also showed significantly higher SCAS scores on all six subscales among clinically anxious children than those in a non-clinical control group. For comprehensive information visit the Spence Children’s Anxiety Scale website at: www.scaswebsite.com

Interpretation

Scores consist of a total raw score (range from 0 to 114) and six sub-scale scores, with higher scores indicating greater severity of anxiety symptoms. These scores are also converted into percentiles based on age and gender from normative samples reported on www.scaswebsite.com. A percentile score more than 84 for any subscale score or the total SCAS score indicates clinically significant anxiety symptoms. Sub-scales are computed by summing the following items: Separation anxiety 5, 8, 12, 15, 16, 44 Social phobia 6, 7, 9, 10, 29, 35 Obsessive compulsive 14, 19, 27, 40, 41, 42 Panic/agoraphobia 13, 21, 28, 30, 32, 34, 36, 37, 39 Physical Injury 2, 18, 23, 25, 33 Generalised anxiety 1, 3, 4, 20, 22, 24 Items that are not scored in either the total score or the sub-scale scores are: 11, 17, 26, 31, 38, 43, 45 and 46. They are not scored because they did not meet sufficient psychometric requirements.

Developer

Spence, S.H. (1997). Structure of anxiety symptoms among children: A confirmatory factor-analytic study. Journal of Abnormal Psychology, 106(2), 280-297.

Vancouver Obsessional Compulsive Inventory (VOCI)

Dr Ben Buchanan

The VOCI was designed to provide a self-report assessment of a range of obsessions, compulsions, avoidance behaviour, and personality characteristics of known or theoretical importance in obsessive–compulsive disorder (OCD). It has 55 questions rated on a five point Likert-type scale. It is useful in tracking the underlying cognitive structure of OCD and assessing symptoms over time. This scale is a more up to date revision of the Maudsley Obsessional Compulsive Inventory-Revised (MOCI-R).

Validity

Thordarson et. al. (2004) evaluated the factor structure of the MOCI-R and modified the scale to produce a test with a high level of internal consistently and high loading factors (see reference). The authors established the validity of the VOCI through testing individuals with known diagnoses of either OCD (n = 88), depression or anxiety (n = 60). These scores were compared to community adult group (n = 39) and a student group (n = 200). A comparison between the mean score for the OCD sample and the mean for each comparison groups was conducted, using the Dunnett method of multiple comparisons. The OCD group scored significantly higher than the other groups on the VOCI total score, Contamination, Checking, Just Right, and Indecisiveness subscales. A t-test analysis was also undertaken to see if the scale could discriminate between different subtypes of OCD. The results clearly support the known-groups validity of the Contamination, Checking, Obsessions, and Hoarding subscales. Test re-test reliability among OCD groups is high, with all coefficients 0.9 or above after 47 days. For the student sample, however, test retest reliability was poor (0.5 to 0.6).

Interpretation

Results consist of a total raw score which is between 0 and 220, and 6 subscale scores: Contaminations (12 items, scores between 0 and 48) Checking (6 items, scores between 0 and 24) Obsessions (12 items, scores between 0 and 48) Hoarding (7 items, scores between 0 and 28) Just right (12 items, scores between 0 and 48) Indecisiveness (6 items, scores between 0 and 24) In addition to the raw scores, results are presented in terms of percentile ranks compared to an OCD group, anxious/depressed group (AD), community adults (CA), and a student (S) sample. Percentile ranks for the community adults group should be interpreted with caution as the validity group has a low sample size (n=39). High percentiles indicate high levels of symptoms compared to comparison group.

Developer

Thordarson, D.S., Radomsky, A.S., Rachman, S., Shafran, R., Sawchuk, C.N., Hakstian, A.R. (2004). The Vancouver Obsessional Compulsive Inventory (VOCI). Behaviour Research & Therapy, 42(11), 1289-1314

Social Phobia Scale (SPS)

Dr Ben Buchanan

The Social Phobia Scale is a 20-item self-report measure of fear of being scrutinised or observed during routine activities such as eating, drinking and writing. A typical question in this scale is “I get nervous that people are staring at me as I walk down the street“. This measure is useful in tracking symptoms of social phobia and self consciousness over time.

Validity

The SPS has demonstrated discriminant validity, with the scale distinguishing between clinical presentations of anxiety (i.e. social phobia, agoraphobia and simple phobia), and between social phobic and non-clinical (student and community) samples (Mattick & Clarke, 1998). Convergent validity of the SPS is also apparent, as the scale correlates highly with established measures of social anxiety (e.g. FNES and SADS) The SPS has high internal consistency and high test-retest reliability at 4 and 12 weeks. This measure also responds as expected (i.e. total scores decrease) to treatment of scrutiny fears (Mattick & Clarke, 1998).

Interpretation

A raw total score ranging from 0-80 is given as output, with higher scores indicating higher anxiety about being observed or scrutinised. The total raw score is converted into two percentiles, comparing the client to a social phobia sample (n = 243) and an adult community sample (n = 315) (Mattick & Clarke, 1998). A percentile of 50 compared to the social phobia group represents typical symptom severity for someone who has been independently diagnosed with social phobia. A percentile of 50 in the community sample represents the typical score among the population, and is indicative of a normal level of social fear.

Developer

Mattick, Richard P., & Clarke, J. Christopher. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36(4), 455-470. doi: 10.1016/S0005-7967(97)10031-6

Client Satisfaction Survey (CSS)

Dr Ben Buchanan

This survey asked the client about their level of satisfaction with the service they have received, both from their practitioner their experience in general. It is designed for practices to gain feedback on how they might improve their services. It is particularly useful to administer post discharge via email, or after the first six sessions.

Validity

NovoPsych is currently developing validity, reliability and benchmarking metrics.

Interpretation

A numerical score between 0 and 40 is presented, where higher scores mean higher levels of satisfaction. The clients are also asked to make comment on the following two questions. 1. Other areas of strength 2. Suggestions for improvements

Developer

NovoPsych

Dissociative Experiences Scale – II (DES-II)

Dr Ben Buchanan

The DES-II is a 28-item, self-report measure of dissociative experiences. Dissociation is often considered a psychological defense mechanism for victims of traumatizing events, and the scale is of particular use in measuring dissociation among people with PTSD, dissociative disorders, borderline personality disorder and those with a history of abuse. In fact, dissociative symptoms are considered by some to be a transdiagnostic indictor of dysfunctional coping, with many disorders being associated with higher than average dissociation. The scale can be used during the course of treatment to track progress over time. The DES has three sub-scales: 1. Amnesia Factor 2. Depersonalization/Derealization Factor 3. Absorption Factor

Validity

In a meta-analysis (IJzendoorn & Schuengel, 1996) showed DES has good convergent validity with other dissociative experiences questionnaires and interview schedules. The scale also showed impressive predictive validity, in particular concerning dissociative disorders, traumatic stress disorder and abuse. Another meta analysis (Lysesenko et al., 2018) found that the DES was a useful tool across many disorders. Normative data across clinical and non-clinical samples have been reported (IJzendoorn & Schuengel, 1996), with the following means and standard deviations: – Non-clinical adult: 11.6 (SD = 10.6) – Student/Adolescent: 14.3 (SD = 14.3) – General psychiatric patient: 16.7 (SD = 16.4) – History of abuse: 29.2 (SD = 21) – Personality Disorders: 19.6 (SD = 16.2) – PTSD: 32.0 (SD = 19.2) – Dissociative disorders: 41.2 (SD = 22) Some data has shown that the three subscales measured by the DES do not form distinct factors, with most factor analyses showing only one overarching factor (IJzendoorn & Schuengel, 1996). Therefore overall scores are the most reliable measure.

Interpretation

The total scores can be between 0 and 100, where high levels of dissociation are indicated by scores of 30 or more. Scores are also presented as percentile ranks compared with clinical and non-clinical samples (as reported by IJzendoorn & Schuengel, 1996). A percentile of 50 compared a general psychiatric patient indicates the typical score for those in psychiatric care, and is lower than than typical scores seen in personality disorders, PTSD and dissociative disorders. Raw scores (sum of items) and average scores (sum items / number of items) for the three subscales are also reported. 1. Amnesia Factor. This factor measures memory loss, i.e., not knowing how you got somewhere, being dressed in clothes you don’t remember putting on, finding new things among belongings you don’t remember buying, not recognizing friends or family members, finding evidence of having done things you don’t remember doing, finding writings, drawings or notes you must have done but don’t remember doing. Items — 3, 4, 5, 8, 25, 26. 2. Depersonalization/Derealization Factor: Depersonalization is characterized by the recurrent experience of feeling detached from one’s self and mental processes or a sense of unreality of the self. Items relating to this factor include feeling that you are standing next to yourself or watching yourself do something and seeing yourself as if you were looking at another person, feeling your body does not belong to you, and looking in a mirror and not recognizing yourself. Derealization is the sense of a loss of reality of the immediate environment. Items — 7, 11, 12, 13, 27, 28. 3. Absorption Factor: This factor includes being so preoccupied or absorbed by something that you are distracted from what is going on around you. The absorption primarily has to do with one’s traumatic experiences. Items of this factor include realizing that you did not hear part or all of what was said by another, remembering a past event so vividly that you feel as if you are reliving the event, not being sure whether things that they remember happening really did happen or whether they just dreamed them, when you are watching television or a movie you become so absorbed in the story you are unaware of other events happening around you, becoming so involved in a fantasy or daydream that it feels as though it were really happening to you, and sometimes sitting, staring off into space, thinking of nothing, and being unaware of the passage of time. Items — 2, 14, 15, 17, 18, 20.

Developer

Carlson, E.B. & Putnam, F.W. (1993). An update on the Dissociative Experience Scale. Dissociation 6(1), p. 16-27.

Social Interaction Anxiety Scale (SIAS)

Dr Ben Buchanan

The SIAS is a 20 item self report scale designed to measure social interaction anxiety defined as “distress when meeting and talking with other people” (Mattick and Clarke, 1998, p. 457). This tool is helpful in tracking social anxiety symptoms over time, and may be helpful as part of an assessment for social phobia or other anxiety related disorders.

Validity

The SIAS has been compared to other scales that measure social anxiety, including the Social Phobia and Anxiety Inventory (SPAI). Peters (2000) found that they were highly significantly correlated (r = 0.86, P<0.001) suggesting the scales tap similar constructs. Clinician-rated severity of social phobia has also been found to be moderately related to SIAS scores (Brown, et al., 1997). The SIAS has been found to have strong sensitivity to treatment change (Cox, et al., 1998). However, it does not distinguish between social phobia and other anxiety disorders (Peters, 2000). Accordingly, it is recommended that the SIAS should be used as a tool to track treatment progress, and should not be heavily relied upon for differential diagnosis.

Interpretation

Peters (2000) defined the cut off score as 36 for probable social phobia. At this score the scale has a sensitivity of 0.93 and specificity of 0.60, with a positive predictive value (PPV) of 0.84 and a negative predictive value (NPV) of 0.78. The average score among people with previously diagnosed social phobia (n=74) was 55.24 (SD=1.97) while for other anxiety disorders (n=34) the mean was 29.46 (SD=29). Results consist of three scores: the raw score, the raw score converted into a percentile using a social phobia sample, and a percentile in an anxiety sample. A percentile of 50 for the social phobia sample indicates that the client has an average level of symptoms compared to others with social phobia, while percentiles above 50 represent more severe symptoms. There is no standardisation using a normal sample.

Developer

Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety1. Behaviour Research and Therapy, 36(4), 455-470.

Scale of Positive and Negative Experience (SPANE)

Dr Ben Buchanan

The Scale of Positive and Negative Experience (SPANE) is a brief 12-item scale, with six items devoted to positive experiences and six items designed to assess negative experiences. In addition, the scale can measure feelings such as physical pleasure, engagement, interest, pain, and boredom. The scale can serve as useful feedback for clients who undergo an intervention to increase their positive feelings. The main advantage of the SPANE is that it uses a number of general feelings such as ”positive”, ”pleasant”, and ”negative”. This allows the SPANE to reflect the full range of emotions and feelings that a respondent might feel, both bad and good, without creating a list of hundreds of items to fully reflect the diversity of positive and negative feelings. It gives three scores. The summed positive score (SPANE-P) can range from 6 to 30, and the negative scale (SPANE-N) has the same range. The two scores can be combined by subtracting the negative score from the positive score, and the resulting SPANE-B scores can range from -24 to 24. SPANE-B shows balance between positive and negative scores, and is helpful when exploring the importance of emotions with a client.

Validity

The scale was evaluated in a sample of 689 college students from six locations. The SPANE performed well in terms of reliability and convergent validity with other measures of emotion, well-being, happiness, and life satisfaction. The three subscales had high Cronbach’s alpha and temporal stability over one month: SPANE-P .87, .62; SPANE-N, .81, .63; and SPANE-B, .89, .68.

Interpretation

The Scale of Positive and Negative Experience gives three scores: the overall affect balance score (SPANE-B) and the positive and negative feelings scales; the SPANE-P and SPANE-N. The latter two scale scores can vary from 6 to 30, where higher numbers represent higher positive or negative emotions. These scores indicate the individual’s tendency to feel and identify emotions in themselves. Extroverts are more likely to score higher on both these subscales compared with introverts. The affect balance (SPANE-B) subscale is a measure of the balance between positive and negative emotions, and the resultant score can vary from -24 (unhappiest) to 24 (happiest). A respondent with a very high score of 24 reports that she or he rarely or never experiences any of the negative feelings, and very often or always has all of the positive feelings. The mean and standard deviation (as derived by Diener et al (2009) with 689 college students) for each scale is as follows: – SPANE-P = 22.02 (SD=3.73), – SPANE-N = 15.36 (SD = 3.95), and – SPANE-B = 6.69 (SD=6.88). Raw scores and percentiles are presented for each subscale.

Developer

Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi. D., Oishi, S., & Biswas-Diener, R. (2009). New measures of well-being: Flourishing and positive and negative feelings. Social Indicators Research, 39, 247-266 Please visit: http://internal.psychology.illinois.edu/~ediener/SPANE.html

Satisfaction with Life Scale (SWLS)

Dr Ben Buchanan

The SWLS is a short 5-item instrument designed to measure global cognitive judgments of satisfaction with one’s life. The scale usually requires only about one minute of a respondent’s time, where respondents answer on a Likert scale. It’s questions are open to interpretation, making this scale suitable for adults with a range of background.

Validity

Subjective well-being is conceptualised as consisting of two major components: the emotional or affective component and the judgment or cognitive component. The SWLS was designed to measure the judgment component. Diener, Emmons, Larsen and Griffith (1985) have conducted a series of validation studies showing that the SWLS has a single factor, high internal consistency, is reliable and is content appropriate for a wide range of groups. Convergent validity was established through high correlations with other well-being measures, including the Fordyce Scale and the Giunn Scale. Additionally, the SWLS has a low correlation (.09) with measures of affect intensity, showing that it is likely to be reliable over affective states.

Interpretation

Scores consist of a raw score (between 5 and 35). Higher scores represent higher life satisfaction. Scorers can be assigned into six well-being categories and interpretative text in provided for each. – 30- 35 Extremely satisfied – 25 – 29 Satisfied – 20 – 24 Slightly satisfied – 15 – 19 Slightly dissatisfied – 10 – 14 Dissatisfied – 5 – 9 Extremely dissatisfied

Developer

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction with Life Scale.Journal of Personality Assessment, 49, 71-75. http://internal.psychology.illinois.edu/~ediener/SWLS.html