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Background: Motivational factors are generally regarded as an important ingredient for change in therapy. However, there is currently a lack of available instruments that can measure clients' readiness for change in therapy. Aim: The objective of this paper was to create an instrument, the Readiness for Therapy Questionnaire (RTQ), which could measure clients' readiness for change. Method: The RTQ was created by researchers following analysis of themes drawn from a review of the literature and interviews with patients at the end of therapy. This included both people who completed therapy and those who dropped out. As part of the standard assessment process, the RTQ was administered to 349 participants (69.6% female and 30.4% male; mean age 37.1 years; 90.5% Caucasian) who were patients at a psychological therapy service for common mental health difficulties. Result: An initial 12-item scale was reduced to 6 items. This scale significantly correlated with post-therapy PHQ-9 and GAD-7 scores and changes in these scores across therapy. After controlling for baseline scores and demographic variables, a logistic regression showed that scores on this 6-item measure pre-therapy significantly predicted three outcome variables: completing therapy, being recovered on both PHQ-9 and GAD-7 post-therapy, and having a reliable change in both the PHQ-9 and GAD-7 post-therapy. However, receiver operating characteristic (ROC) curve analysis showed the measure had poor sensitivity and specificity. Symptom severity did not have a significant impact on motivation to change. Conclusion: The RTQ is potentially a valid measure with useful clinical applications in treatment of common mental health difficulties. [ABSTRACT FROM AUTHOR]

Research consistently demonstrates that positive student-teacher relationships are fundamental to the healthy development of all students. However, we lack a Portuguese-validated measure of student-teacher relationships. In this article we present the adaptation procedures and the psychometric properties of a Portuguese version of the Student-Teacher Relationship Scale - Short Form (Pianta, 1992). Five hundred and thirty five teachers from 127 schools completed the STRS-SF. The results demonstrate that this adapted version of the STRS-SF has good psychometric properties, namely high reliability (α = .84 to .87) and expected construct validity, which were tested through exploratory and confirmatory factor analyses (χ2/df = 1.65, CFI = .96, GFI = .93, RMSEA = 0.05). This study also showed that the correlations of studentteacher relationship with students' demographic variables are consistent with the evidence in the literature about this construct. Finally, the study indicated that female teachers reported more closeness, t(530) = 4.06, p < .001 and better overall student-teacher relationships, t(530) = 4.90, p < .001. In the discussion, we analyze the implications of these results. [ABSTRACT FROM AUTHOR]

Abstract: Background: There is a growing concern about satisfaction with inpatient psychiatric services. There are currently numerous satisfaction instruments available to psychiatric inpatients, but little guidance on which among them to select. Aims: To provide an overview of the psychometric properties and the content of satisfaction instruments available to psychiatric inpatients. Methods: Systematic searches of Medline database to identify inpatient satisfaction questionnaires. Assessment of the instruments according to relevant psychometric properties. Results: Fifteen satisfaction instruments were identified. The target population differed according to the instrument. Methods used to generate items were heterogeneous. These instruments were based on a mixed approach including patients’ points of view, expert opinions, and literature reviews, causing the content of questionnaires to vary. Reliability and validity were not systematically tested. Conclusion: The validation of a common inpatient satisfaction instrument is a major challenge. Recommendations for the future development of satisfaction instruments may include: item generation based exclusively on the patient''s point of view; a validation process on a large and representative population; and an instrument combining generic (core questionnaire) and specific (additional modules) approaches. [Copyright &y& Elsevier]

The article presents series of experiments which examine the causal processes underlying schizophrenic thought disorder considering the argument that the said condition is a result of serial invalidation. Researchers use a repertory grid measure to come up with a condition of weak conceptual structure in normal subjects under controlled conditions. Results suggest that conceptual structure as operationally defined is differentially modifiable by varying validational experience which can be introduced and measured in experimentally controlled conditions. Furthermore, it has been noted that collapse of conceptual structure is the ultimate outcome of serial invalidation, since the alternative reactions to invalidation have proven to be ineffective.

Introduction: Comorbid depression in somatic illness is highly prevalent. However, most depression questionnaires show violation of unidimensionality and hypersensitivity of items. Objectives: The Depression Screening (DESC) is a new self-rating scale for the measurement of depression severity that we developed from a calibrated Rasch-homogeneous item bank (N=367) to improve short depression assessment in patients beyond psychiatric settings. Aim: To present data for both parallel forms (10 questions each) of the DESC, and to examine its Rasch model qualities in different patient groups and a representative German general population sample. Methods: Patient groups with depression, heart disease, neurological or otolaryngological disease (N=333) were investigated with the DESC accompanied by diagnostic interviews and established depression scales. The demographic sample (N=2509) was interviewed face to face, too. Adherence to Rasch model assumptions was determined with analysis of model fit, and further measures. Norm values were calculated. Results: Both DESC versions feature different but highly correlated item sets. Cut-off scores with good sensitivity (0.82, 0.81) and specificity (0.78, 0.77) for the diagnosis of an affective disorder were developed with ROC analyses. No serious Differential Item Functioning in Rasch analyses for both scales was found. In the German validation sample the Rasch dimension “depression” explained 68.5% and 69.3% respectively of the variance. Validity was determined through sufficient intercorrelations with other scales (e.g. BDI, HADS). Conclusions: Our studies support the good psychometric RASCH qualities of both DESC forms and offer important advancements in depression screening being of use for time-limited clinical and research applications. [ABSTRACT FROM AUTHOR]

Introduction: Depression is common in nursing home residents, but is still underrecognized. Screening for depression could be a first step to increase recognition rates within this high-risk group. Objectives: Therefore, we investigated the validity of the WHO (Five) Well-Being Index (WHO-5) for early detection of depression in nursing home residents. Methods: The Structural Clinical Interview for DSM-IV (SCID) was used as the gold standard for the validation of the WHO-5. The diagnoses covered in this assessment were both current major depression (MD) as well as minor depression (MinD) according to DSM-IV research criteria. Results: In our sample of 92 nursing home residents in Munich aged 65–97 years, (73.9% female, 26.1% male) 14.1% fulfilled the criteria of MinD, and again 14.1% fulfilled the criteria of MD in the SCID. Overall diagnostic validity (area under the ROC curve) of the WHO-5 was 90.1% (95% confidence interval: 83.5%–96.7%). The World Health Organization''s recommended cut-off-point of 13 yielded a sensitivity of 92.3% for the category of ‘MinD or MD’, and a specificity of 74.2%. Corresponding values for an adapted cut-off point of 12 are 92.3% and 78.7%, respectively. Conclusions: The diagnostic accuracy of the WHO-5 in our study is promising. The WHO-5 might be an efficient screening tool for nursing home residents, especially with the adapted cut-off point, but results have to be replicated in a larger sample. [Copyright &y& Elsevier]

Background: The Edinburgh Postnatal Depression Scale (EPDS) has been used successfully across diverse cultural settings. However, a recent study found poor validity in detecting postnatal common mental disorders (CMD) in rural Ethiopia. Using similar methodology, the study was replicated in the capital, Addis Ababa. Methods: Semantic, content and criterion validity of EPDS, Kessler scale-6 (K6) and Kessler scale-10 (K10) were assessed in postnatal women attending vaccination clinics. Criterion validation was undertaken on 100 postnatal women, with local psychiatrist diagnosis of CMD using the Comprehensive Psychopathological Rating Scale (CPRS) as the criterion measure. Results: The areas under the Receiver Operating Characteristic (AUROC) curve for the EPDS, K6 and K10 were 0.85 (95%CI 0.77–0.92), 0.86 (95%CI 0.76–0.97) and 0.87 (95%CI 0.78–0.97), respectively. The EPDS generated sensitivity, specificity and misclassification rates of 78.9%, 75.3% and 24.0%, respectively at an optimal cut-off point of 6/7. The corresponding values for the K6 were 84.2%, 82.7% and 17.0% at a cut-off point of 4/5, and for K10 were 84.2%, 77.8% and 21.0% at a cut-off point of 6/7, respectively. The internal reliability Cronbach''s alpha for the EPDS, K6 and K10 were 0.71, 0.86 and 0.90, respectively. Limitations: Not all postnatal women bring their infants to vaccination clinics which may limit generalisability. Conclusion: The EPDS, K6 and K10 all demonstrated acceptable clinical utility as screening scales for postnatal CMD in an urban setting in Ethiopia. The marked urban-rural difference in EPDS performance within Ethiopia highlights the difficulty of applying urban-validated instruments to rural settings in LAMIC. [Copyright &y& Elsevier]

Introduction: Studies about Quality of Life (QOL) in schizophrenia usually involve the validation of questionnaires, the effects of treatments or its association with relevant variables but, so far, the literature about differences in QOL between groups of patients with schizophrenia is scarce. Objectives and aims: This work aims to show differences in QOL between groups of patients with schizophrenia defined according to socio-demographic, clinical, psychosocial and use of services variables. Method: The sample comprised 241 patients that meet the following inclusion criteria: 1) International Classification of Diseases-10 diagnosis of schizophrenia, 2) Global Assessment Functioning scores or GAF≤50 and 3) Illness duration greater than 2 years. Patients were evaluated regarding socio-demographic, clinical, psychosocial and use of service variables. T-tests and analysis of variance tests were used. Results: There were no differences in QOL between groups of patients with schizophrenia established according to socio-demographic variables. There were significant differences in QOL between groups of patients with schizophrenia defined according to clinical, psychosocial and use of service variables. Patients with schizophrenia who were anxious, disabled, lacked social support and used more social services showed poorer levels of QOL. Conclusions: Our results are consistent with previous studies that support that, in patients with schizophrenia, the association between socio-demographic characteristics and QOL cannot be considered significant and that QOL is associated with disability, social support, psychiatric symptoms and care needs. This work highlight differences between groups of patients with schizophrenia, which may be a useful information to tailor interventions to this sample population. [ABSTRACT FROM AUTHOR]

Introduction: Neuroticism is one of the five fundamental dimensions of personality based on the model of the Big Five. It is defined as the general tendency to experience unpleasant emotions such as hostile emotions, feelings of anxiety or depression. The objective of this work is to validate the Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985) among Tunisian students. Methods: Neuroticism among students was evaluated using the Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985). This scale provides an overall score of Neuroticism Lire phonétiquement Dictionnaire - Afficher le dictionnaire and also different scores for each of the six Neuroticism facets are: anxiety, depression, anger / hostility, impulsivity, social shyness and vulnerability to stress. The validation was made on a representative sample of university students (n=500) randomly selected. The main properties studied were: acceptability, reliability (Pearson’s coefficient ‘r’), face validity and content validity (Cronbach’s alpha). Results: The acceptability of the questionnaire was good, less than 10% of students were unable or unwilling to complete the questionnaire. The Pearson coefficient showed good reliability for this scale r=0.96, p<0.05. The Cronbach’s alpha was acceptable for all items of the scale α=0.73. Conclusion: The Neuroticism scale of the NEO-PI-R (Costa and McCrae, 1985) is valid in Tunisian students. It is now available for clinicians to measure the level of neuroticism among students. [ABSTRACT FROM AUTHOR]

Introduction: There are manic disorders with depressive symptoms in mixed mania that do not reach the threshold for the diagnosis of mixed episode.Mania and hypomania are evaluated with scales that do not detect the depressive symptoms of patients in manic episode. Objectives: To determine the usefulness of HAMD-5 and MES depression scales in patients with bipolar disorder type I and II who have a manic or hypomanic episode with depressive symptoms. These scales were compared with the HAMD-21 and the MADRS scales respectively. Methods: 100 subjects between 18 and 65 years old were included. All patients met the DSM-IV-TR criteria for bipolar disorder with manic or hypomanic symptoms and major depression.All patients were evaluated at baseline and at 3 and 4 weeks during the follow-up. Results: At baseline the HAMD-5 and the MES had high reliability (α=0.88 and α=0,74 respectively)The test-retest reliability between the 3rd and the 4th week was great for both scales (HAMD-5: r=0,89; p<0,001; MES: r=0,77; p<0,001).The convergent validity had an acceptable level for the HAMD-5 (HAMD-21/HAMD-5=0,73; 95% CI 0,599–0,873) and for the MES (MADRS/MES=0,79; 95% CI 0,766–0,894)Regarding the discriminant validity, the values for the HAMD-5 and MES were higher than for the HAMD-21 and MADRS respectively (HAM-5: AUC=0,92, 95% CI: 0,892–0,980; MES: AUC=0,86, 95% CI: 0,786–0,934). Conclusions: Both scales showed an adequate correlation with the HAMD-21 and MADRS and a high capacity of detection of mixed, pure and other symptoms as their remission. [ABSTRACT FROM AUTHOR]

Introduction: Neurocognitive deficits account for most of the long-term poor functional outcomes of patients with schizophrenia. Effective treatment of cognitive impairment is the most important challenge in the treatment of this disorder. Objectives: Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Project produced a battery of 10 tests called the MATRICS Consensus Cognitive Battery (MCCB), designed to asses cognitive treatment effects in clinical trials of patients with schizophrenia. Methods: In this validation study of Polish version of MCCB, 120 patients with schizophrenia will be investigated. 60 of them will be randomly chosen and examined again after 4 week. Altogether MCCB is going to be applied 180 times on 120 patients. The results will be compared with the results of American standardization study of MCCB (MATRICS-PASS). Results: Until now 19 patients (12 males, 7 females, mean age 25.63±5.14) have been investigated. Following MCCB T-scores in seven cognitive domains were obtained: attention/vigilance (38.33±9.03), working memory (40.95±14.35), verbal learning (38.11±8.37), visual learning (41.37±10.48), reasoning/problem solving (36.95±10.14), social cognition (35.79±10.67), composite T-score (30.22±12.93). Conclusions: These preliminary results show that MCCB could be successfully adopted into Polish. After the end of validation process MCCB will be an important research tool in studies aiming at improvement of cognitive functioning in Polish patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Objective: This study aims to validate a self-administered, multidimensional QoL instrument based on the point of view of caregivers of individuals with schizophrenia. Methods: Data were collected through the departments of six psychiatric hospitals in France (n=246). The item reduction and validation processes were based on both item response theory and classical test theory. Results: The S-CGQoL contains 25 items describing seven dimensions (Psychological and Physical Well-Being; Psychological Burden and Daily Life; Relationships with Spouse; Relationships with Psychiatric Team; Relationships with Family; Relationships with Friends; and Material Burden). The seven-factor structure accounted for 74.4% of the total variance. Internal consistency was satisfactory; Cronbach''s alpha coefficients ranged from 0.79 to 0.92 in the whole sample. The scalability was satisfactory, with INFIT statistics falling within an acceptable range. In addition, the results confirmed the absence of DIF and supported the invariance of the item calibrations. Conclusion: The S-CGQoL is a self-administered QoL instrument that presents satisfactory psychometric properties and can be completed in 5 min, thereby fulfilling the goal of brevity sought in research and clinical practice. [Copyright &y& Elsevier]

Introduction: The university transition life is the most frequent source of problems. These problems results from stress academic and family relationship dysfunction. These stress factors can pose a risk in student''s mental and physical health. However, stress is the result of a transaction between the person and the environment. The objective: Of this work is to validate the specific scale of perceived stress among Tunisian students. Methods: To evaluate the perceived stress among students, we used the specific scale of perceived stress (Boujut E, Bruchon-Schweitzer M, 2003). This scale was constructed and validated on French students. The scale is as a self-administered questionnaire consisting of 25 items. The validation was made on a representative sample of university students (n=500) randomly selected. The main properties studied were: acceptability, reliability (Pearson’s coefficient ‘r’), face validity and content validity (Cronbach''s alpha). Results: The acceptability of the questionnaire was good, less than 10% of students were unable or unwilling to complete the questionnaire. The Pearson coefficient showed good reliability for this scale r=0.98, p<0.05. The Cronbach''s alpha was acceptable for all items of the scale α=0.81. Conclusion: The specific scale of perceived stress is valid among Tunisian students. It is now available for clinicians to measure the level of perceived stress among students. [Copyright &y& Elsevier]

Introduction: The Changsha study identifies adult, non-psychotic relatives of patients with schizophrenia who show deficits in neurocognitive, social, clinical and other dimensions, and who meet proposed diagnostic criteria for a liability syndrome for schizophrenia (’schizotaxia’). Objectives: To define and validate schizotaxia. Aims: To develop and validate diagnostic criteria for schizoaxia, and to reduce its symptoms using risperidone. Methods: We investigated whether a low dose (2.0mg) of risperidone, a second generation antipsychotic medication, could attenuate negative symptoms, neurocognitive deficits, and other measures of clinical and social function in subjects who met our research criteria for schizotaxia. One hundred eighty nine relatives were assessed at the Mental Health Institute, Second Xiangya Hospital, in Changsha, China. Eighty six of these individuals met criteria for schizotaxia, and 36 agreed to enter a 6-week, double-blind, placebo-controlled protocol. Results: ANCOVAs using age and gender as covariates showed significant improvement in the risperidone group (n=20) on neurocognitive function (Wisconsin Card Sorting Test Total Errors and Perseverative Errors) and on a self-report measure of social function (Social Adjustment Scale), compared to the placebo-control group (n=16). Effect sizes were small to medium. Notably, risperidone effect sizes were larger (medium to large) in a subset of subjects (risperidone=15; placebo=10) whose membership in the schizotaxic group was confirmed by cluster analysis. Conclusions: The results are generally consistent with previous open-label investigations of risperidone administration in subjects with schizotaxia, and provide evidence that significant neurocognitive and clinical problems are amenable to remediation in non-psychotic relatives of people with schizophrenia. [ABSTRACT FROM AUTHOR]