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PubMed1999

Development of the fertility adjustment scale.

OBJECTIVE: To develop a standardized measure of psychological adjustment to infertility. DESIGN: A cross-sectional two-group comparison study. SETTING: Two specialized fertility clinics in large teaching hospitals. PATIENT(S): Fifty men and 50 women undergoing evaluation and/or treatment of fertility problems. INTERVENTION(S): The Fertility Adjustment Scale was administered with the Hospital Anxiety and Depression Scale as a measure of concurrent validity. MAIN OUTCOME MEASURE(S): Scores on the Fertility Adjustment Scale and the Hospital Anxiety and Depression Scale. RESULT(S): Scores on the Fertility Adjustment Scale were distributed normally. Split-half and internal consistency were high. A significant correlation with measures of mood, anxiety, and distress provided evidence of concurrent validity. CONCLUSION(S): Preliminary results suggest that this measure will be a useful tool in assessing psychological reactions to fertility problems and outcomes of treatment.

Adaptation, Psychological↗

PubMedDate not supplied

Item reliability for the Griffiths scales of mental development.

As a preliminary to the revision of the Griffiths scales, the 498 items constituting the original test were studied in terms of inter-observer agreement over the scoring, using videotapes of tests, given to children aged from 2 months to 7 years, and large scoring panels. Fifty-seven items failed to be administered or scored adequately often. One hundred and twelve were found to be unreliable on one in three administrations and only 23 were unreliable on two of three administrations. Among items scored sufficiently often, 88% of all administrations were reliable. Subscale differences were not as expected since the locomotor, personal--social and hearing and speech scales fared no worse than hand--eye coordination. Inter-observer agreement varied with the age of the children. Subscale weaknesses were examined in terms of the age ranges most concerned.

Child↗

PubMed2001

Media influence and body image in 8-11-year-old boys and girls: a preliminary report on the multidimensional media influence scale.

OBJECTIVE: To develop a scale for the assessment of multiple components of a media-based influence on body image. METHOD: Seventy-five boys and 107 girls, ranging in age from 8 to 11, completed a measure designed to assess five facets of a media influence previously conceptualized by researchers. RESULTS: Three distinct scales emerged, which appeared to focus on concepts defined as internalization, awareness, and pressure. Correlations between subscales of the Multidimensional Media Influence Scale (MMIS) and the Eating Disorder Inventory-Body Dissatisfaction subscale were significant for both boys and girls. Girls had higher levels on all three subscales and regression analyses indicated that the MMIS scores predicted 30% of the variance associated with body dissatisfaction for girls, but an R(2) of only 0.10 emerged for boys. Internalization levels predicted significant variance beyond that explained by awareness and pressures, but only for the female sample. DISCUSSION: The findings are discussed with regard to the usefulness of the MMIS for future research and the role of internalization as a risk factor for the development of body image disturbances and eating disorders.

Body Image↗

PubMed1998

The Extended Staff Observation Aggression Scale (SOAS-E): development, presentation and evaluation.

The Staff Observation Aggression Scale (SOAS) was developed as a scale for reporting aggressive incidents involving psychiatric in-patients. The SOAS -- Extended Version (SOAS-E) has the same aim, but has additional categories and subcategories. The SOAS-E clearly distinguishes between violent and non-violent aggressive behaviour and characterizes in more detail the associated situation. However, the main contribution of the SOAS-E is the introduction of a category of 'warning signals' that precede the releasing 'provocation factor' as a separate and primary aspect of the cyclus of aggressive incidents. The development of the SOAS-E is described, and the testing and inter-rater reliability of the warning signals category are examined. Compared to the SOAS, the additional categories of the SOAS-E are found to increase the scope for a detailed characterization of aggressive behaviour in psychiatric wards.

Adult↗

PubMed2004

Spanish and English Neuropsychological Assessment Scales (SENAS): further development and psychometric characteristics.

The Spanish and English Neuropsychological Assessment Scales were devised to be a broad set of psychometrically matched measures with equivalent Spanish and English versions. Study 1 in this report used item response theory methods to refine scales. Results strongly supported psychometric matching across English and Spanish versions and, for most scales, within English and Spanish versions. Study 2 supported in both English and Spanish subsamples the 6-domain model of ability that guided scale construction. Study 3 examined differential item functioning (DIF) of one scale (Object Naming) in relation to education, ethnicity, gender, and age. Effects of DIF on scale-level ability scores were limited. Results demonstrate an empirically guided psychometric approach to test construction for multiethnic and multilingual test applications.

Cognition↗

PubMed1999

The Obesity Adjustment Survey: development of a scale to assess psychological adjustment to morbid obesity.

OBJECTIVE: To develop a reliable and valid measure of distress, related to extreme obesity. DESIGN: Items related to distress over obesity were selected from the literature, clinical experience and from input provided by a gastroplasty patient support group. The items were assessed in a longitudinal study, with the body mass index (BMI) and psychological assessment occurring 2-6 months prior to, and 12 months following, gastroplasty surgery. SUBJECTS: 81 females and eight males (mean age 35.9 y) who had been accepted for gastroplasty surgery. All but two of the patients had BMIs > 40 (Mean = 48.11, s.d. = 6.84). MEASUREMENTS: BMIs were calculated using weight and height. Psychological characteristics were assessed using the Mental Health Inventory (MHI), the Sickness Impact Profile (SIP), and the Eating Inventory (EI). Demographic information was collected with a questionnaire. RESULTS: Attempts to factor analyse the 95 item questionnaire were unsuccessful. Alternatively, a shorter, 20 item questionnaire was developed. The questionnaire shows good test-retest reliability (r = 0.867), good internal consistency (coefficient alpha = 0.719), good face and construct validity, and is sensitive to pre-post surgical change. CONCLUSIONS: The Obesity Adjustment Survey (OAS) may be useful as a brief measure of distress in obese individuals. This measure can be used to index the psychological impact of gastroplasty surgery on psychological functioning, and can be used in future research as a disease-specific measure to predict success of surgery.

Adaptation, Psychological↗

PubMed1987

The Resource-Based Relative Value Scale. Toward the development of an alternative physician payment system.

This article describes the design and methods of a study currently under way to develop a Resource-Based Relative Value Scale (RBRVS); an alternative basis for establishing the payment rate for the services and procedures (S/Ps) of physicians in medical and surgical specialties. Physician resource inputs to be measured include (1) S/P time, (2) pre-S/P and post-S/P times, (3) intensity, (4) practice costs, including malpractice premiums, and (5) the cost of specialty training. These five factors will be combined to produce an RBRVS denominated in nonmonetary units. In the initial phase of the study, data on time and intensity will be obtained through a national survey of physicians who perform these S/Ps. In the second, consensus phase of the project, the investigators will convene a panel of representatives of the medical profession, third-party payers, consumers, and other interested parties to examine areas of agreement and disagreement as to how an RBRVS should be used for policy purposes. The final results of this study are expected by the summer of 1988.

Costs and Cost Analysis↗

PubMed2005

Stability of the Bayley II Scales of Infant Development in a sample of low-risk and high-risk infants.

The aim of this study was to examine the stability of the second edition of the Bayley Scales of Infant Development (Bayley II) by correlating Bayley II scores during the first year of life with Bayley II scores at approximately 18 months of age. Bayley II Mental and Motor Scales were administered to 119 infants (69 males, 50 females) during their first year of life; mean age for low-risk group 7 months (SD 3.01) and mean age for high-risk group 7.8 months (SD 2.46). A second set of Bayley II scores was collected on 104 of the infants at 17 to 22 months of age; mean age for low-risk group 18.5 months (SD 1.07) and mean age for high-risk group 18.9 months (SD 1.11). Mean time interval between the two assessments was 11.5 months for the low-risk group and 11.15 months for the high-risk group. Stability of the scores over time was assessed. Correlations for the Bayley II Mental Developmental Index and Psychomotor Developmental Index between administrations during the first and second years of life were r=0.49 (p<0.001) and r=0.48 (p<0.001) respectively. We conclude that approximately 23 to 24% of the variance in the infants' later Bayley II scores could be explained by the earlier scores. This is one of only two studies to examine the stability of Bayley II over time. Replication studies are needed to evaluate the consistency of these findings across other samples of infants.

Child Development↗

PubMed2006

Scale for the assessment and rating of ataxia: development of a new clinical scale.

OBJECTIVE: To develop a reliable and valid clinical scale measuring the severity of ataxia. METHODS: The authors devised the Scale for the Assessment and Rating of Ataxia (SARA) and tested it in two trials of 167 and 119 patients with spinocerebellar ataxia. RESULTS: The mean time to administer SARA in patients was 14.2 +/- 7.5 minutes (range 5 to 40). Interrater reliability was high, with an intraclass coefficient (ICC) of 0.98. Test-retest reliability was high with an ICC of 0.90. Internal consistency was high as indicated by Cronbach's alpha of 0.94. Factorial analysis revealed that the rating results were determined by a single factor. SARA ratings showed a linear relation to global assessments using a visual analogue scale, suggesting linearity of the scale (p < 0.0001, r(2) = 0.98). SARA score increased with the disease stage (p < 0.001) and was closely correlated with the Barthel Index (r = -0.80, p < 0.001) and part IV (functional assessment) of the Unified Huntington's Disease Rating Scale (UHDRS-IV) (r = -0.89, p < 0.0001), whereas it had only a weak correlation with disease duration (r = 0.34, p < 0.0002). CONCLUSIONS: The Scale for the Assessment and Rating of Ataxia is a reliable and valid measure of ataxia, making it an appropriate primary outcome measure for clinical trials.

Adolescent↗

PubMed1996

Preliminary physiologically based pharmacokinetic model for cocaine in the rat: model development and scale-up to humans.

A physiologically based multicompartmental model has been developed to describe the concentration-time course of cocaine in plasma and tissues in the rat. The compartments included in the model were brain, heart, gut, liver, muscle, fat, venous blood, arterial blood, and a mass-balance compartment. Drug delivery to the tissues was assumed to be flow limited. The model incorporated a nonsaturable binding site for cocaine in the liver. Elimination occurred via both blood and hepatic elimination. The model was validated using independently derived data. The model was scaled to humans and accurately predicted the cocaine levels following intranasal and inhalation administration. However, a poor fit was observed following intravenous administration. Future models incorporating non-constant blood flow and pharmacodynamics need to be developed.

Animals↗

PubMed1986

The Thompson-Patterson Scale of Psychosocial Development: I. Theoretical basis.

This paper presents a theoretical framework for describing childhood psychopathology in terms of coping styles and introduces a scale to measure psychosocial development in young children. It is hypothesized that coping styles characteristic of specific stages of development evolve in a predictable sequence with treatment. The term coping style rather than disorder is used to reflect the opinion that the child's behaviour constitutes an attempt to find a solution to difficulties encountered during the normal course of psychosocial development. These styles of relating are not static. The coping styles are presumed to arise from partial blocks to normal development during the period of early attachment and separation and individuation. A computer scored behaviour rating instrument, the Thompson-Patterson Scale, allows for the determination of the child's predominant coping style at a particular point in time. Clinical work and research has shown the utility of this paradigm and supports the hypothesis that changes in pathological behaviour patterns which emerge during treatment are predictable.

Adaptation, Psychological↗

PubMed1999

The development of a scale of the Guttman type for the assessment of mobility disability in multiple sclerosis.

OBJECTIVE: To develop a valid and reliable scale of the Guttman type for the assessment of mobility disability in multiple sclerosis (MS). SUBJECTS: Sixty-eight subjects with a definite diagnosis of MS participated. They were living in the community and attending as outpatients at a MS unit at a District General Hospital. Thirty had the primary progressive pattern of disease, and 38 had the relapsing-remitting pattern. METHODS: Formal assessments used for neurological disability were inspected, and 14 test items of gross motor function were extracted and ordered according to criteria. These were that tests required trunk control and did not require isolated movement at a single limb or body segment, that actions progressed from lying, to sitting, to standing and walking tasks, proceeding from broader to narrower bases of support. All subjects carried out all test items which were scored as 'pass' or 'fail'. ANALYSIS: Data were tested for internal consistency, reliability, inter-item correlation, reproducibility and scalability. On the basis of the results, the items were reordered in rank, and reduced to 11 tests. The 11-item scale was reanalysed. RESULTS: Results showed that the scale had an internal consistency of 0.88 (alpha coefficient) and a coefficient of reproducibility (CR) of 0.95 and above for both MS subject groups. The coefficient of scalability (CS) for items was 0.78 for primary progressive subjects and 0.74 for the relapsing-remitting group. Reliability ranged from moderate (kappa = 0.49) for one item, to perfect for six items. CONCLUSION: The scale was demonstrated to be a hierarchical scale of the Guttman type exhibiting homogeneity and good reliability. The high CR indicated that scores may be summed, and the very acceptable levels of CS indicated that the cumulative scores are meaningful within the defined concept of hierarchy used in this study.

Biomechanical Phenomena↗

PubMedDate not supplied

Development of the diabetes knowledge (DKN) scales: forms DKNA, DKNB, and DKNC.

The Diabetes Knowledge Assessment (DKN) scales were developed to meet a specific need for rapid and reliable knowledge assessment in diabetic patients. Item format and item selection from an initial pool of 89 items were determined by pilot-testing over 300 diabetic subjects. Reliability analysis of the resulting 40 multiple-choice items, with a further sample of 56 subjects, gave a Cronbach's alpha coefficient of 0.92. Parallel forms DKNA, DKNB, and DKNC, each of 15 items selected from the parent set, had alpha coefficients above 0.82 and correlated 0.90 with each other. A full clinical trial, using DKNA, DKNB, and DKNC in randomized order of presentation, was conducted with 219 subjects attending a 2-day diabetes education program. Overall DKN scores improved from 7.6 (51%) to 11.3 (75%). Analysis of variance confirmed that DKNA, DKNB, and DKNC were equivalent forms at pretest. Mean posttest scores on DKNB were lower than the other scales (P less than 0.001), but variances were equivalent for all three. A specific local change in the education program format was found to account for this discrepancy in the DKNB posttest mean. In situations where comprehensive assessment of diabetes knowledge would be time-consuming and unnecessary, these results indicate that rapid and reliable assessment is possible with a scale of only 15 validated items. The development of parallel forms of the scale extends the range of retesting possibilities for diagnosis and research.

Diabetes Mellitus↗

PubMed1999

A disease severity scale for systemic sclerosis: development and testing.

OBJECTIVE: To develop and test a severity scale for individual organ involvements in systemic sclerosis (SSc, scleroderma). METHODS: An international study group completed the following tasks: (1) developed a glossary of terms including all pertinent variables for 9 potentially affected organ systems; (2) collected prospective data to determine the feasibility and practicality of each proposed variable; (3) revised the initial list of variables; (4) determined the association of each variable with mortality (a proxy for morbidity) using 579 patients in an existing comprehensive longitudinal scleroderma databank; (5) developed a severity grading scale for each organ system by discussion and consensus; and (6) externally validated the scale using an independent group of 680 patients from the same databank. RESULTS: Nine organ-specific severity scales were developed from 0 (no documented involvement) to 4 (endstage disease). The data required for scale completion are relatively easy and practical for all physicians to obtain. CONCLUSION: This preliminary severity scale will be useful for assessing disease severity status in individual patients both at one point in time and longitudinally. The severity scale will assist in the design and conduct of clinical trials and the comparison of study populations with one another. The scale will serve as a framework for developing a scleroderma disease activity index.

Humans↗

PubMed2003

Validation of a Japanese patient-derived outcome scale for assessing total knee arthroplasty: comparison with Western Ontario and McMaster Universities osteoarthritis index (WOMAC).

We have developed a Japanese self-administered questionnaire based on an English version of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) to measure subjective function and pain status of patients who undergo a total knee arthroplasty procedure. Using multiple international cohorts, the performance of the developed Japanese scale was compared to the results of the WOMAC in the United Kingdom, United States, Canada, and Australia. The developed scale showed a comparable level of internal consistency and construct/criterion validity. The responsiveness of the scale was superior to the concurrently measured MOS Short Form 36 Physical Function scale. These results suggest that the developed scale is reliable, valid, and responsive for assessing the effectiveness of total knee arthroplasty in the Japanese context despite the cultural life style differences from Western countries.

Arthroplasty, Replacement, Knee↗

PubMed2004

Changes in performance over time on the Bayley Scales of Infant Development II when administered to infants at high risk of developmental disabilities.

PURPOSE: The purpose of this study was to analyze changes in performance over time on the Bayley Scales of Infant Development II (BSID-II) in a sample of infants at high risk of developmental disabilities. METHODS: Cognitive and motor performance of 53 infants, 34 with prenatal drug exposure (DE group) and 19 with perinatal medical concerns (PMC group), was measured at under one year of age (mean = 6.99 months) and again at 17-22 months of age (mean = 18.24 months). Changes in performance on both the Mental and Motor Scales over time were analyzed. RESULTS: Over time, cognitive performance decreased for both groups (p < 0.05). Rate of change in motor performance increased for the PMC group and decreased for the DE group (p < 0.01). CONCLUSIONS: Developmental changes over time should be studied separately for infants prenatally exposed to drugs and infants with perinatal medical concerns. Longer term follow-up with several repeat assessments would be desirable.

Journal Article↗

PubMed1990

The development of a Short Opiate Withdrawal Scale (SOWS).

In previous studies a 32-item Opiate Withdrawal Scale was found to provide a reliable and valid means of measuring the signs and symptoms of withdrawal among heroin (and other opiate) addicts. This paper describes the processes whereby a shorter 10-item version of the same scale was developed. The Short Opiate Withdrawal Scale (SOWS) is simple to understand and easy to administer, and it avoids the redundancy of items contained in the original scale. It is suggested that the SOWS provide a useful instrument which can be used both in research and clinical practice with opiate addicts.

Heroin↗

PubMed2002

Level of prenatal cocaine exposure and scores on the Bayley Scales of Infant Development: modifying effects of caregiver, early intervention, and birth weight.

OBJECTIVES: The objectives of this study were 1) to assess whether there is an independent association between the level of prenatal cocaine exposure and infants' developmental test scores after control of potential confounding variables; and 2) if such an association exists, to determine which biological and social variables, individually and in interaction with each other, may modify it. METHODS: In a prospective, longitudinal study of 203 urban term infants, 3 cocaine exposure groups were defined by maternal report and infant meconium assay: unexposed, heavier cocaine exposure (>75th percentile self-reported days of use or meconium benzoylecognine concentration), or lighter cocaine exposure (all others). Examiners, masked to exposure history, tested infants at 6, 12, and 24 months of age with the Bayley Scales of Infant Development. RESULTS: The final mixed linear regression model included as fixed covariates level of prenatal exposure to cocaine, alcohol, and cigarettes; prenatal marijuana exposure; gestational age and birth weight z score for gestational age; and gender. Age at test, caregiver at time of each test (biological mother, kinship caregiver, unrelated foster caregiver), and any previous child-focused early intervention were included as time-dependent covariates. There were no significant adverse main effects of level of cocaine exposure on Mental Development Index (MDI), Psychomotor Development Index (PDI), or Infant Behavior Record. Child-focused early intervention interacted with level of cocaine exposure such that heavily exposed children who received such intervention showed higher adjusted mean MDI scores than all other groups. Although the sample was born at or near term, there was also a significant interaction of cocaine exposure and gestational age on MDI scores, with those in the heavier exposure group born at slightly lower gestational age having higher mean MDI scores compared with other children born at that gestational age. There was also a significant interaction on MDI between child's age and caregiver. At 6 months, the adjusted MDI of children living with a kinship caregiver was 15.5 points lower than that of children living with their biological mother, but this effect was diminished and was no longer significant at 24 months (difference in means: 4.3 points). The adjusted mean MDI of children in unrelated foster care at 6 months was 8.2 points lower than children of biological mothers, whereas it was 7.3 points higher at 24 months. Early intervention attenuated the age-related decline in PDI scores for all groups. Birth weight <10th percentile was associated with lower PDI scores for children with heavier cocaine exposure and with lower MDI scores for all groups. CONCLUSIONS: Heavier prenatal cocaine exposure is not an independent risk factor for depressed scores on the Bayley Scales of Infant Development up to 24 months of age when term infants are compared with lighter exposed or unexposed infants of the same demographic background. Cocaine-exposed infants with birth weight below the 10th percentile for gestational age and gender and those placed with kinship caregivers are at increased risk for less optimal developmental outcomes. Pediatric clinicians should refer cocaine-exposed children to the child-focused developmental interventions available for all children at developmental risk.

Birth Weight↗