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Background: Knowledge about the quality of assessment methods used in the support of people with profound intellectual and multiple disabilities (PIMD) is scarce. This study aimed to provide an overview of the assessment methods used in practice and to examine whether these instruments were studied for their psychometric properties for people with PIMD. Method: Professionals (N = 148) from three European countries completed a survey on assessment practices. We performed a literature search to find information about the psychometric properties of the instruments that were identified in the survey. Results: Of the participants, 78.1% used assessments that were not developed for people with PIMD. Documentation on psychometric properties was found for 8 out of 116 instruments. Conclusions: Most of the instruments in use were not designed for people with PIMD, and information about their quality is lacking. Guidelines are needed regarding the use and development of assessment methods for people with PIMD.

Background: Research about the psychometric properties of the Behavioural Appraisal Scales (BAS) in people with profound intellectual and multiple disabilities (PIMD) is limited. This study evaluates invariance in factor structure, item bias and convergent validity of the BAS. Methods: Data on the BAS from two studies (n = 25; n = 52) were analysed using the oblique multiple group method. The scale structure and item ordering were compared in the two groups. Convergent validity was assessed by correlating scores on the BAS with scores on two other instruments. Results: Of all items, 16-18% correlated stronger with other subscales of the BAS than the subscale they were originally assigned to. Scale structure and order of difficulty differed between groups. Correlations between the BAS and two other instruments varied from low to excellent (r = 0.48-0.85). Conclusions: The results support the construct validity of the BAS. Removing, reassigning and adapting items may enhance construct validity.

Author(s): Benjamin R. Fletcher 1, Sarah Damery 2, Olalekan Lee Aiyegbusi 1,2,3, Nicola Anderson 1,4, Melanie Calvert 1,3,5, Paul Cockwell 1,4,6, James Ferguson 1,3, Mike Horton 7, Muirne C. S. [...], Background The importance of patient-reported outcome measurement in chronic kidney disease (CKD) populations has been established. However, there remains a lack of research that has synthesised data around CKD-specific symptom and health-related quality of life (HRQOL) burden globally, to inform focused measurement of the most relevant patient-important information in a way that minimises patient burden. The aim of this review was to synthesise symptom prevalence/severity and HRQOL data across the following CKD clinical groups globally: (1) stage 1-5 and not on renal replacement therapy (RRT), (2) receiving dialysis, or (3) in receipt of a kidney transplant. Methods and findings MEDLINE, PsycINFO, and CINAHL were searched for English-language cross-sectional/longitudinal studies reporting prevalence and/or severity of symptoms and/or HRQOL in CKD, published between January 2000 and September 2021, including adult patients with CKD, and measuring symptom prevalence/severity and/or HRQOL using a patient-reported outcome measure (PROM). Random effects meta-analyses were used to pool data, stratified by CKD group: not on RRT, receiving dialysis, or in receipt of a kidney transplant. Methodological quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data, and an exploration of publication bias performed. The search identified 1,529 studies, of which 449, with 199,147 participants from 62 countries, were included in the analysis. Studies used 67 different symptom and HRQOL outcome measures, which provided data on 68 reported symptoms. Random effects meta-analyses highlighted the considerable symptom and HRQOL burden associated with CKD, with fatigue particularly prevalent, both in patients not on RRT (14 studies, 4,139 participants: 70%, 95% CI 60%-79%) and those receiving dialysis (21 studies, 2,943 participants: 70%, 95% CI 64%-76%). A number of symptoms were significantly (p < 0.05 after adjustment for multiple testing) less prevalent and/or less severe within the post-transplantation population, which may suggest attribution to CKD (fatigue, depression, itching, poor mobility, poor sleep, and dry mouth). Quality of life was commonly lower in patients on dialysis (36-Item Short Form Health Survey [SF-36] Mental Component Summary [MCS] 45.7 [95% CI 45.5-45.8]; SF-36 Physical Component Summary [PCS] 35.5 [95% CI 35.3-35.6]; 91 studies, 32,105 participants for MCS and PCS) than in other CKD populations (patients not on RRT: SF-36 MCS 66.6 [95% CI 66.5-66.6], p = 0.002; PCS 66.3 [95% CI 66.2-66.4], p = 0.002; 39 studies, 24,600 participants; transplant: MCS 50.0 [95% CI 49.9-50.1], p = 0.002; PCS 48.0 [95% CI 47.9-48.1], p = 0.002; 39 studies, 9,664 participants). Limitations of the analysis are the relatively few studies contributing to symptom severity estimates and inconsistent use of PROMs (different measures and time points) across the included literature, which hindered interpretation. Conclusions The main findings highlight the considerable symptom and HRQOL burden associated with CKD. The synthesis provides a detailed overview of the symptom/HRQOL profile across clinical groups, which may support healthcare professionals when discussing, measuring, and managing the potential treatment burden associated with CKD. Protocol registration PROSPERO CRD42020164737.

The Level of Personality Functioning – Brief Form 2.0 (LPFS-BF 2.0) is a 12-item self-report questionnaire developed to gain a quick impression of the severity of personality pathology according to the DSM-5 Alternative Model for Personality Disorders (AMPD). The current study evaluated the construct validity and reliability of the Norwegian version of the LPFS-BF 2.0 in a large clinical sample (N = 1673). Dimensionality was examined using confirmatory factor analysis and bifactor analysis followed by an analysis of distinctiveness of the subscales using the proportional reduction in mean squared error (PRMSE), and the concurrent validity was examined using correlations with self-report questionnaires and clinical interviews assessing PDs according to section II of the DSM-5. Taking the findings of the dimensionality and concurrent validity results together, we found moderate to good support for the use of total scores for the Norwegian version of the LPFS-BF 2.0. We would advise against the use of subscale scores, since the subscales provided only a small amount of reliable unique variance. [ABSTRACT FROM AUTHOR]

This systematic review summarized findings of 29 studies evaluating visual presentation formats appropriate for communicating measurement uncertainty associated with standardized clinical assessment instruments. Studies were identified through systematic searches of multiple databases (Medline, Embase, PsycInfo, ERIC, Scopus, and Web of Science). Strikingly, we found no studies which were conducted using samples of clinicians and included clinical decision‐making scenarios. Included studies did however find that providing participants with information about measurement uncertainty may increase awareness of uncertainty and promote more optimal decision making. Formats which visualize the shape of the underlying probability distribution were found to promote more accurate probability estimation and appropriate interpretations of the underlying probability distribution shape. However, participants in the included studies did not seem to benefit from the additional information provided by such plots during decision‐making tasks. Further explorations into how presentations of measurement uncertainty impact clinical decision making are needed to examine whether findings of the included studies generalize to clinician populations. This review provides an important overview of pitfalls associated with formats commonly used to communicate measurement uncertainty in clinical assessment instruments, and a potential starting point for further explorations into promising alternatives. Finally, our review offers specific recommendations on how remaining research questions might be addressed. [ABSTRACT FROM AUTHOR]

The current study examined clinicians' utilization of the SCID-5-AMPD-I funnel structure. Across 237 interviews, conducted as part of the NorAMP study, we found that clinicians administered on average 2-3 adjacent levels under each subdomain, effectively administering only about 50% of available items. Comparing administration patterns of interviews, no two interviews contained the exact same set of administered items. On average, when comparing individual interviews, only about half of the administered items in each interview were administered in both interviews. Cross-classified mixed effects models were estimated to examine the factors affecting item administration. Results indicated that the interplay between patient preliminary scores and item level had a substantial impact on item administration, suggesting clinicians tend to administer items corresponding to expected patient severity. Overall, our findings suggest clinicians utilize the SCID-5-AMPD-I funnel structure to conduct efficient and individually tailored assessments informed by relevant patient characteristics. Adopting similar non-fixed administration procedures for other interviews could potentially provide similar benefits compared to traditional fixed-form administration procedures. The current study can serve as a template for verifying and evaluating future adoptions of non-fixed administration procedures in other interviews. [ABSTRACT FROM AUTHOR]

The DSM-5 Alternative Model for Personality Disorders (AMPD) includes two main criteria: moderate or greater impairment in personality functioning (Criterion A) and the presence of one or more pathological personality traits (Criterion B). The aim of the study was to investigate the incremental utility of Criteria A and B for predicting DSM-5 Section II personality disorders (PD). The sample (N = 317) consisted of three well-defined groups: non-clinical participants (n = 35), psychiatric patients with PD (n = 193), and without PD (n = 83). All were assessed using the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I (SCID-5-AMPD-I): Level of Personality Functioning Scale (LPFS), and the Personality Inventory for DSM-5 (PID-5). Logistic regression analyses showed that the SCID-5-AMPD-I could predict the presence of PDs in general, and the three specific PDs that were investigated (i.e., Antisocial, Borderline, and Avoidant PDs). The PID-5 domains enhanced prediction of the specific PDs, but not the presence of PDs in general, when entered in the second step. Our results support the AMPD model: Criterion A predicted the presence of DSM-5 Section II PDs in general, whereas measures of Criterion B incremented prediction of Antisocial, Borderline, and Avoidant PDs. [ABSTRACT FROM AUTHOR]

The use of empirical prior information about participants has been shown to substantially improve the efficiency of computerized adaptive tests (CATs) in educational settings. However, it is unclear how these results translate to clinical settings, where small item banks with highly informative polytomous items often lead to very short CATs. We explored the risks and rewards of using prior information in CAT in two simulation studies, rooted in applied clinical examples. In the first simulation, prior precision and bias in the prior location were manipulated independently. Our results show that a precise personalized prior can meaningfully increase CAT efficiency. However, this reward comes with the potential risk of overconfidence in wrong empirical information (i.e., using a precise severely biased prior), which can lead to unnecessarily long tests, or severely biased estimates. The latter risk can be mitigated by setting a minimum number of items that are to be administered during the CAT, or by setting a less precise prior; be it at the expense of canceling out any efficiency gains. The second simulation, with more realistic bias and precision combinations in the empirical prior, places the prevalence of the potential risks in context. With similar estimation bias, an empirical prior reduced CAT test length, compared to a standard normal prior, in 68% of cases, by a median of 20%; while test length increased in only 3% of cases. The use of prior information in CAT seems to be a feasible and simple method to reduce test burden for patients and clinical practitioners alike. [ABSTRACT FROM AUTHOR]

The DSM-5 presents two competing diagnostic frameworks for personality disorders: the standard categorical model and the Alternative Model of Personality Disorders (AMPD). The AMPD was initially criticized for being too complex and theory laden for clinical implementation. Though inter-rater reliability studies have contested initial claims of the model's complexity, little attention has been paid to how clinicians experience the usability and learnability of either model. We interviewed twenty Norwegian clinicians about their experiences with either the SCID-II/5-PD (n = 9), SCID-5-AMPD-I (n = 8), or both (n = 3). Separate thematic analyses were conducted for SCID-II/5-PD and SCID-5-AMPD-I groups, and group themes were compared. We identified four themes for each group, relating to required skills, training, challenges and information gained through the interview. We found that training and clinical experience were considered to be important for both interviews. Moreover, the SCID-5-AMPD-I was considered to rely more explicitly on theory specific to the development and content of the AMPD model in general and the LPFS specifically We also identified shared and unique challenges and shortcomings of each interview. We comment on how our findings relate to the debate surrounding the AMPD, and recommend development of clear training guidelines for both interviews. [ABSTRACT FROM AUTHOR]

The Behavioural Appraisal Scales (BAS) were developed in The Netherlands to assess functional abilities of people with profound intellectual and multiple disabilities (PIMD). It is recommended that further studies examine the psychometric properties of the BAS. The aim of this study was to evaluate and, if necessary, improve the content validity of the BAS. A two‐round Delphi study was used. In Round 1, parents, researchers and practice professionals indicated for each item whether they would retain, adapt or remove it, explaining their answers. The BAS were adapted based on this feedback. In Round 2, participants were given the adapted version and asked to indicate for each item whether they wanted to retain or remove it, again providing an explanation. Feedback was analysed by calculating the percentage of participants who wanted to retain, adapt or remove a certain item. Content analysis was used to analyse participants' explanations. In Round 1, more than 20% of the participants wanted to remove 11 from the 122 items, and wanted to retain or adapt the remaining items. Seven categories of adaptations emerged: (1) feasibility, (2) the construct the item measures, (3) applicability, (4) similarity among items, (5) splitting items, (6) reassignment and (7) the professionals who score the items. In Round 2, for all items >80% of the participants indicated they wanted to retain the item. Experts felt that the content validity of the BAS could be improved. After the adaptations, the content validity was evaluated as good. Further studies are needed to evaluate whether the new or adapted items are not too easy or too difficult, whether information from different informant groups results in being scored differently, and to evaluate possible differential item functioning. [ABSTRACT FROM AUTHOR]

Impulsivity is strongly associated with aggression and antisocial conduct. Although self-report measures are a time-efficient means to assess impulsivity, they may be susceptible to socially desirable responding, particularly in forensic psychiatry. The current study aimed to investigate the predictive validity of three measures of impulsivity in predicting self- and informant-reported antisocial behavior: the Barratt Impulsiveness Scale, the Self-Centered Impulsivity scale of the Psychopathic Personality Inventory-Revised and the general Disinhibition factor of the Externalizing Spectrum Inventory. Next, the mediating role of a measure of self-deception, the Virtuous Responding scale, was examined in these associations. Participants (N = 94) were inpatients from addiction care and forensic psychiatry. Two regression analyses were conducted using self-reported antisocial behavior in the first, and informant-reported antisocial behavior in the second analysis as outcome variables. In addition, a mediated regression analysis was conducted, using the Virtuous Responding scale as a mediator. The impulsivity measures showed a substantially lower predictive validity when informant-reported behavior was predicted. The Virtuous Responding scale appeared to be unreliable in the current sample and showed no mediation effect. The results showed insufficient support for the predictive validity of the three measures of impulsivity. Alternative time-efficient assessments for impulsivity are needed, such as informant-based measures. [ABSTRACT FROM AUTHOR]

The current study aims to examine the psychometric properties of the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I (SCID-5-AMPD-I) assessing the Level of Personality Functioning Scale (LPFS) in a heterogeneous sample of 282 nonpsychotic patients. Latent variable models were used to investigate the dimensionality of the LPFS. The results indicate that the LPFS, as assessed by the SCID-5-AMPD-I, can be considered as a unidimensional construct that can be measured reliably across a wide range of the latent trait. Threshold parameters for the 12 indicators of the LPFS increased gradually over the latent scale, indicating that the five LPFS levels were ordered as predicted by the model. In general, the increase of threshold parameters was relatively small for the shift from Level 2 to Level 3. A better distinction among the different severity levels might be obtained by fine-tuning the interview guidelines or the Level 2 indicators themselves. [ABSTRACT FROM AUTHOR]

The Externalizing Spectrum Inventory aims at assessing personality features that underlie externalizing disorders such as substance abuse and antisocial behaviors. The objective was to replicate the psychometric properties of the 160-item Externalizing Spectrum Inventory in Dutch clinical and non-clinical samples. First, Cronbach's alpha, test-retest reliability and the factor structure were analyzed on a mixed sample of inpatients (n = 149), undergraduates (n = 227), and community participants (n = 178). The factor structure was evaluated through confirmatory and exploratory factor analyses; for the latter Parallel Analysis was used, based on Minimum Rank Factor Analysis. Next, the criterion validity was analyzed using the Aggression Questionnaire and the NEO-Five Factor Inventory as external measures. The Dutch Externalizing Spectrum Inventory subscales showed sufficient reliability (α=.68-.94; ICC=.68-.91), except in the undergraduate sample (α=.49-.96; ICC=.43-.97). The factor structure of the Externalizing Spectrum Inventory was not confirmed and the exploratory analysis yielded different factor solutions across samples. The criterion validity was supported with regard to trait aggression and partly supported with regard to the Five Factor Model. The results suggest that the ESI-160 and its original factor model can be used for prediction purposes. However, further research of the factor structure is strongly recommended. [ABSTRACT FROM AUTHOR]

Fixed-precision between-item multidimensional computerized adaptive tests (MCATs) are becoming increasingly popular. The current generation of item-selection rules used in these types of MCATs typically optimize a single-valued objective criterion for multivariate precision (e.g., Fisher information volume). In contrast, when all dimensions are of interest, the stopping rule is typically defined in terms of a required fixed marginal precision per dimension. This asymmetry between multivariate precision for selection and marginal precision for stopping, which is not present in unidimensional computerized adaptive tests, has received little attention thus far. In this article, we will discuss this selection-stopping asymmetry and its consequences, and introduce and evaluate three alternative item-selection approaches. These alternatives are computationally inexpensive, easy to communicate and implement, and result in effective fixed-marginal-precision MCATs that are shorter in test length than with the current generation of item-selection approaches. [ABSTRACT FROM AUTHOR]

This study aims at evaluating the psychometric properties of the antisocial personality disorder (ASPD) criteria in a large sample of patients, most of whom had one or more personality disorders (PD). PD diagnoses were assessed by experienced clinicians using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Axis II PDs. Analyses were performed within an item response theory framework. Results of the analyses indicated that ASPD is a unidimensional construct that can be measured reliably at the upper range of the latent trait scale. Differential item functioning across gender was restricted to two criteria and had little impact on the latent ASPD trait level. Patients fulfilling both the adult ASPD criteria and the conduct disorder criteria had similar latent trait distributions as patients fulfilling only the adult ASPD criteria. Overall, the ASPD items fit the purpose of a diagnostic instrument well, that is, distinguishing patients with moderate from those with high antisocial personality scores. [ABSTRACT FROM AUTHOR]

It is currently not entirely clear to what degree the research on multidimensional computerized adaptive testing (CAT) conducted in the field of educational testing can be generalized to fields such as health assessment, where CAT design factors differ considerably from those typically used in educational testing. In this study, the impact of a number of important design factors on CAT performance is systematically evaluated, using realistic example item banks for two main scenarios: health assessment (polytomous items, small to medium item bank sizes, high discrimination parameters) and educational testing (dichotomous items, large item banks, small- to medium-sized discrimination parameters). Measurement efficiency is evaluated for both between-item multidimensional CATs and separate unidimensional CATs for each latent dimension. In this study, we focus on fixed-precision (variable-length) CATs because it is both feasible and desirable in health settings, but so far most research regarding CAT has focused on fixed-length testing. This study shows that the benefits associated with fixed-precision multidimensional CAT hold under a wide variety of circumstances. [ABSTRACT FROM AUTHOR]

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) presents an alternative model for personality disorders in which severity of personality pathology is evaluated by the Level of Personality Functioning Scale (LPFS). The Structured Interview for the DSM-5 Alternative Model for Personality Disorders, Module I (SCID-5-AMPD I) is a new tool for LPFS assessment, but its interrater reliability (IRR) has not yet been tested. Here we examined the reliability of the Norwegian translation of the SCID-5-AMPD I, applying two different designs: IRR assessment based on ratings of 17 video-recorded SCID-5-AMPD I interviews by five raters; and test-retest IRR based on interviews of 33 patients administered by two different raters within a short interval. For the video-based investigation, intraclass correlation coefficient (ICC) values ranged from.77 to.94 for subdomains,.89 to.95 for domains, and.96 for total LPFS. For the test-retest investigation, ICC ranged from.24 to.72 for subdomains,.59 to.90 for domains, and.75 for total LPFS. The test-retest study revealed questionable reliability estimates for some subdomains. However, overall the level of personality functioning was measured with a sufficient degree of IRR when assessed by the SCID-5-AMPD I. [ABSTRACT FROM AUTHOR]

Objectives: The assessment of health care professionals’ attitudes and beliefs towards musculoskeletal pain is essential because they are key determinants of their clinical practice behaviour. The Pain Attitudes and Beliefs Scale (PABS) biomedical scale evaluates the degree of health professionals’ biomedical orientation towards musculoskeletal pain and was never assessed using item response theory (IRT). This study aimed at assessing the psychometric performance of the 10-item biomedical scale of the PABS scale using IRT. Methods: Two cross-sectional samples (BeBack, n = 1016; DABS; n = 958) of health care professionals working in the UK were analysed. Mokken scale analysis (nonparametric IRT) and common factor analysis were used to assess dimensionality of the instrument. Parametric IRT was used to assess model fit, item parameters, and local reliability (measurement precision). Results: Results were largely similar in the two samples and the scale was found to be unidimensional. The graded response model showed adequate fit, covering a broad range of the measured construct in terms of item difficulty. Item 3 showed some misfit but only in the DABS sample. Some items (i.e. 7, 8 and 9) displayed remarkably higher discrimination parameters than others (4, 5 and 10). The scale showed satisfactory measurement precision (reliability > 0.70) between theta values -2 and +3. Discussion: The 10-item biomedical scale of the PABS displayed adequate psychometric performance in two large samples of health care professionals, and it is suggested to assess group-level professionals degree of biomedical orientation towards musculoskeletal pain. [ABSTRACT FROM AUTHOR]

As there is currently a marked increase in the use of both unidimensional (UCAT) and multidimensional computerized adaptive testing (MCAT) in psychological and health measurement, the main aim of the present study is to assess the incremental value of using MCAT rather than separate UCATs for each dimension. Simulations are based on empirical data that could be considered typical for health measurement: a large number of dimensions (4), strong correlations among dimensions (.77-.87), and polytomously scored response data. Both variable- (SE < .316, SE < .387) and fixed-length conditions (total test length of 12, 20, or 32 items) are studied. The item parameters and variance–covariance matrix Φ are estimated with the multidimensional graded response model (GRM). Outcome variables include computerized adaptive test (CAT) length, root mean square error (RMSE), and bias. Both simulated and empirical latent trait distributions are used to sample vectors of true scores. MCATs were generally more efficient (in terms of test length) and more accurate (in terms of RMSE) than their UCAT counterparts. Absolute average bias was highest for variable-length UCATs with termination rule SE < .387. Test length of variable-length MCATs was on average 20% to 25% shorter than test length across separate UCATs. This study showed that there are clear advantages of using MCAT rather than UCAT in a setting typical for health measurement. [ABSTRACT FROM AUTHOR]

Objective: The 12-item Partners in Health scale (PIH) was developed in Australia to measure self-management behaviour and knowledge in patients with chronic diseases, and has undergone several changes. Our aim was to assess the construct validity and reliability of the latest PIH version in Dutch COPD patients. Methods: The 12 items of the PIH, scored on a self-rated 9-point Likert scale, are used to calculate total and subscale scores (knowledge; coping; recognition and management of symptoms; and adherence to treatment). We used forward-backward translation of the latest version of the Australian PIH to define a Dutch PIH (PIH(Du)). Mokken Scale Analysis and common Factor Analysis were performed on data from a Dutch COPD sample to investigate the psychometric properties of the Dutch PIH; and to determine whether the four-subscale solution previously found for the original Australian PIH could be replicated for the Dutch PIH. Results: Two subscales were found for the Dutch PIH data (n = 118); 1) knowledge and coping; 2) recognition and management of symptoms, adherence to treatment. The correlation between the two Dutch subscales was 0.43. The lower-bound of the reliability of the total scale equalled 0.84. Factor analysis indicated that the first two factors explained a larger percentage of common variance (39.4% and 19.9%) than could be expected when using random data (17.5% and 15.1%). Conclusion: We recommend using two PIH subscale scores when assessing self-management in Dutch COPD patients. Our results did not support the four-subscale structure as previously reported for the original Australian PIH. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life (HRQoL) is widely used as an outcome measure in the evaluation of treatment interventions in patients with chronic obstructive pulmonary disease (COPD). In order to address challenges associated with existing fixed-length measures (e.g., too long to be used routinely, too short to ensure both content validity and reliability), a COPD-specific item bank (COPD-SIB) was developed.Methods: Items were selected based on literature review and interviews with Dutch COPD patients, with a strong focus on both content validity and item comprehension. The psychometric quality of the item bank was evaluated using Mokken Scale Analysis and parametric Item Response Theory, using data of 666 COPD patients.Results: The final item bank contains 46 items that form a strong scale, tapping into eight important themes that were identified based on literature review and patient interviews: Coping with disease/symptoms, adaptability; Autonomy; Anxiety about the course/end-state of the disease, hopelessness; Positive psychological functioning; Situations triggering or enhancing breathing problems; Symptoms; Activity; Impact.Conclusions: The 46-item COPD-SIB has good psychometric properties and content validity. Items are available in Dutch and English. The COPD-SIB can be used as a stand-alone instrument, or to inform computerised adaptive testing. [ABSTRACT FROM AUTHOR]

Background Numerous instruments are available to measure HRQoL in patients with COPD, covering a wide array of domains ranging from symptoms such as dyspnea, cough and wheezing, to social and emotional functioning. Currently no information or guide is available yet to aid the selection of domains for a particular study or disease population. The aim of this paper is to identify which domains of health-related quality of life (HRQoL) are most important with respect to Chronic Obstructive Pulmonary Disease (COPD), from the patient perspective. Methods Twenty-one Dutch patients with Chronic Obstructive Pulmonary Disease (COPD) were asked to describe important domains impacted by COPD freely; second, they were presented with cues (domains from the Patient-Reported Outcomes Measurement Information System (PROMIS) framework) and were asked to select the domains that were most relevant to them. During the interview, the patients were asked to indicate in which way the selected domains impact their lives. Both the answers to the open question, and the patient statements motivating nomination of PROMIS domains were coded into themes. Results The most relevant (sub)domains of HRQoL for patients with COPD were: physical health (fatigue, physical functioning), social health (instrumental support, ability to participate in social roles and activities, companionship, and emotional support), and coping with COPD. Conclusion We identified which domains of HRQoL are most important to patients with COPD. One of these (coping with COPD) is not explicitly covered by PROMIS, or by traditional questionnaires that are used to measure HRQoL in COPD. [ABSTRACT FROM AUTHOR]

Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects of the diagnostic criteria for GID. To investigate the way in which the diagnosis-specific Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria for GID were used to reach a psychiatric diagnosis in four European countries: the Netherlands (Amsterdam), Norway (Oslo), Germany (Hamburg), and Belgium (Ghent). The main goal was to compare item (symptom) characteristics across countries. The current study included all new applicants to the four GID clinics who were seen between January 2007 and March 2009, were at least 16 years of age at their first visit, and had completed the diagnostic assessment (N = 214, mean age = 32 ± 12.2 years). Mokken scale analysis, a form of Nonparametric Item Response Theory (NIRT) was performed. Operationalization and quantification of the core criteria A and B resulted in a 23-item score sheet that was filled out by the participating clinicians after they had made a diagnosis. We found that, when ordering the 23 items according to their means for each country separately, the rank ordering was similar among the four countries for 21 of the items. Furthermore, only one scale emerged, which combined criteria A and B when all data were analyzed together. Our results indicate that patients' symptoms were interpreted in a similar fashion in all four countries. However, we did not find support for the treatment of A and B as two separate criteria. We recommend the use of NIRT in future studies, especially in studies with small sample sizes and/or with data that show a poor fit to parametric IRT models. [ABSTRACT FROM AUTHOR]

Measurement error is an inherent part of any test score. This uncertainty is generally communicated in ways that can be difficult to understand for clinical practitioners. In this empirical study, we evaluate the impact of several communication formats on the interpretation of measurement accuracy and its influence on the decision-making process in clinical practice. We provided 230 clinical practitioners with score reports in five formats: textual, error bar, violin plot, diamond plot, and quantile dot plot. We found that quantile dot plots significantly increased accuracy in the assessment of measurement uncertainty compared with other formats. However, a direct relation between visualization format and decision quality could not be found. Although traditional confidence intervals and error bars were favored by many participants due to their familiarity, responses revealed several misconceptions that make the suitability of these formats for communicating uncertainty questionable. Our results indicate that new visualization formats can successfully reduce errors in interpretation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Currently, 3 competing conceptualizations of personality dysfunction can be distinguished: the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5 ) categorical model delineating 10 distinct types of personality disorders (PDs); the alternative model for PDs ( DSM-5 Section III), which assesses personality functioning and traits separately; and the International Classification of Diseases , 11 th Version conceptualization, which provides 1 single code for the presence of a PD (which is based on problems in functioning) as well as codes that specify the level of the disorder (mild/moderate/severe), and prominent trait domains or patterns (5 domains and 1 pattern). The current study aims to assess the incremental value of the DSM-5 PDs over and above a global personality dysfunction factor, using expert ratings obtained with the Structured Clinical Interview for DSM-IV PDs and the Structured Clinical Interview for DSM-5 PDs interview in a large sample of clinical patients ( N = 3,851). All estimated bifactor models provided adequate fit to the data. We found a surprisingly low explained common variance for the g-factor (<40%), indicating that ignoring the specific PD factors would lead to a substantial loss of information. The strongest specific PDs in terms of explained common variance were the avoidant, schizotypal, and schizoid PD factors and the conduct disorder criteria set if included. Correlations between our factors and external variables were relatively low, except for the Severity Indices of Personality Problems , which aims to measure personality functioning. Our findings suggest that specific PDs still have an important role to play in the assessment of personality pathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Five diagnostic criteria sets for pathological grief are currently used in research. Studies evaluating their performance indicate that it is not justified to generalise findings regarding prevalence rates and predictive validity across studies using different diagnostic criteria of pathological grief. We provide recommendations to move the bereavement field forward.

The Level of Personality Functioning Scale (LPFS) of the Alternative DSM-5 Model for Personality Disorders (AMPD) was formulated to assess the presence and severity of personality disorders (PDs). Moderate impairment (Level 2) in personality functioning, as measured by the LPFS, was incorporated into the AMPD as a diagnostic threshold for PD in Criterion A of the general criteria, as well as for the "any two areas present" rule for assigning a specific PD diagnosis. This study represents the first evaluation of the diagnostic decision rules for Criterion A, in a clinical sample ( N = 282). The results indicate that an overall diagnostic threshold for PDs should be used with caution because it may not identify all DSM-IV PDs. The "any two areas present" rule proved to be a reasonable alternative, although this finding should be interpreted with caution because the LPFS does not measure the disorder-specific A criteria.

This study investigated psychometric properties of two widely used instruments to measure subclinical levels of psychosis, the Community Assessment of Psychic Experiences (CAPE) and the Structured Interview for Schizotypy-Revised (SIS-R), and aimed to enhance measurements through the use of multidimensional measurement models. Data were collected in 747 siblings of schizophrenia patients and 341 healthy controls. Multidimensional Item-Response Theory, Mokken Scale and ordinal factor analyses were performed. Both instruments showed good psychometric properties and were measurement invariant across siblings and controls. The latent traits measured by the instruments show a correlation of 0.62 in siblings and 0.47 in controls. Multidimensional modeling resulted in smaller standard errors for SIS-R scores. By exploiting correlations among related traits through multidimensional models, scores from one diagnostic instrument can be estimated more reliably by making use of information from instruments that measure related traits., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms that hinder successful positive interaction with peers. The main goal of this study was to examine if the presence of symptoms of ODD and ADHD affects the relationship between positive social behavior and peer status found in 7-9-year-old children who show symptoms typical of ADHD and/or ODD. Furthermore, the possible interaction with sex was investigated. We used data collected in the first wave of The Bergen Child Study of mental health (BCS), a prospective longitudinal total population study of children's developmental and mental health. The target population consisted of children in the second to the fourth, in all public, private, and special schools in Bergen, Norway, in the fall of 2002 (N = 9430). All 79 primary schools in Bergen participated in the study. Both teacher (8809 complete cases) and parent (6253 complete cases) report were used in the analyses. ADHD and ODD scores were estimated using the Swanson Noland and Pelham rating scale version IV (SNAP-IV), and peer problems and prosocial behavior were assessed using the Strengths and Difficulties Questionnaire (SDQ). We replicated the relationship between peer problems and prosocial behavior found previously in typically developing children. Our results showed that the relationship between peer problems and prosocial behavior became weaker as the ODD symptoms increased in number and severity. For ADHD this effect was only found in the teacher report of the children. A sex effect for ODD symptoms was found only using the parent report: boys with ODD symptoms showed less prosocial behavior than girls with similar levels of ODD symptoms. Since this effect was not found using the teacher data, it may imply a situational effect (school/home) for girls with high levels of ODD. The moderator effect of ODD/ADHD was comparable for boys and girls. Our findings suggest that even if children with ADHD/ODD symptoms have the opportunity to practice their social skills in peer relationships, this is not necessarily accompanied by an increase in prosocial behavior.

Since its introduction, there has been a debate about the validity of the factorial structure of the SCL-90-R. In this study we investigate whether the lack of agreement with respect to the dimensionality can be partly explained by important variables that might differ between samples such as level of psychological distress, the variance of the SCL-90-R scores and sex. Three samples were included: a sample of severely psychiatrically disturbed patients (n=3078), a sample of persons with Gender Incongruence (GI; n=410) and a sample of depressed patients (n=223). A unidimensional pattern of findings were found for the GI sample. For the severely disturbed and depressed sample, a multidimensional pattern was found. In the depressed sample sex differences were found in dimensionality: we found a unidimensional pattern for the females, and a multidimensional one for the males. Our analyses suggest that previously reported conflicting findings with regard to the dimensional structure of the SCL-90-R may be due to at least two factors: (a) level of self-reported distress, and (b) sex. Subscale scores should be used with care in patient groups with low self-reported level of distress., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Rumination has been defined as a mode of responding to distress that involves passively focusing one's attention on symptoms of distress without taking action. This dysfunctional response style intensifies depressed mood, impairs interpersonal problem solving, and leads to more pessimistic future perspectives and less social support. As most of these results were obtained from younger people, it remains unclear how age affects ruminative thinking. Three hundred members of the general public ranging in age from 15 to 87 years were asked about their ruminative styles using the Response Styles Questionnaire (RSQ), depression and satisfaction with life. A Mokken Scale analysis confirmed the two-factor structure of the RSQ with brooding and reflective pondering as subcomponents of rumination. Older participants (63 years and older) reported less ruminative thinking than other age groups. Life satisfaction was associated with brooding and highest for the earlier and latest life stages investigated in this study.