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A Chinese version of the Rheumatology Attitudes Index is a valid and reliable measure of learned helplessness in patients with SLE.

Despite the prognostic importance of learned helplessness (LH) in rheumatic diseases, there are no validated measures of LH in Chinese or other Asian languages. We therefore assessed the validity of a Chinese translation of the Rheumatology Attitudes Index (CRAI; a widely used measure of LH) and its Helplessness (CHS) and Internality (CIS) subscales in patients with SLE. Chinese-speaking SLE patients (n = 69) completed identical, self-administered questionnaires containing the CRAI and assessing demographic/socio-economic variables twice within 2 weeks. SLE activity, damage and quality of life were assessed using the BILAG, SLICC/ACR Damage Index and SF-36 respectively. Scale psychometric properties were assessed through Cronbach's alpha, intra-class correlations, quantifying test-retest differences, factor analysis and known-groups construct validity. Internal consistency and reliability were acceptable, with Cronbach's alpha for the CHS, CIS and CRAI being 0.70, 0.69 and 0.74, respectively. Mean differences in test-retest scores spanned 1.6-2.4% of possible scale ranges and intra class correlations ranged from 0.72 to 0.88. Factor analysis identified two major factors corresponding to the CHS and CIS subscales of the CRAI. Eight of 10 a priori hypotheses relating the CRAI and CHS to demographic, disease and quality of life variables were confirmed, supporting the construct validity of these scales. The CRAI and its helplessness subscale are valid and reliable measures of learned helplessness in Chinese-speaking SLE patients.

Adolescent↗

An instrument to measure the health status in children with hydrocephalus: the Hydrocephalus Outcome Questionnaire.

OBJECT: In the measurement of clinical outcome in pediatric patients with hydrocephalus the condition's effects on a child's physical, emotional, cognitive, and social health are frequently ignored. The authors developed a quantitative health status measure, the Hydrocephalus Outcome Questionnaire (HOQ), designed specifically for children with hydrocephalus, which can be completed by the children's parents. METHODS: The standardized steps in the development of a health status measure were followed. Item generation required involvement of health professionals and focus groups with parents of children with hydrocephalus. A comprehensive list of 165 unique health status items was thus generated. To streamline the list, questionnaires were sent to 69 sets of parents to solicit their opinions regarding the most important of these health issues, and the 51 most significant items were then selected to represent the following health domains: physical, social-emotional, and cognitive. In another cohort of 90 sets of parents, the 51-item questionnaire was then tested for reliability and construct validity against the following independent measures of specific components of health: Health Utilities Index, Wide Range Achievement Reading Test, Strengths and Difficulties Questionnaires, and Functional Independence Measure for Children. The HOQ took approximately 10 to 15 minutes for the parents to complete and demonstrated excellent test-retest reliability (0.93, 95% confidence interval [CI] 0.88-0.96), interrater reliability (0.88, 95% CI 0.79-0.93), and internal consistency (Cronbach alpha 0.94). Pearson correlation testing demonstrated very good construct validity between domain scores and their respective independent measures. CONCLUSIONS: The HOQ for children with hydrocephalus demonstrated excellent reliability and validity properties. This tool will be valuable for a wide range of clinical research projects in pediatric hydrocephalus.

Adolescent↗

Reliability, validity, and responsiveness of the short form 12-item survey (SF-12) in patients with back pain.

STUDY DESIGN: Secondary analysis of data collected from spine patients' normal clinic visits from 1998 to 2001. OBJECTIVE: To evaluate the reliability, validity, and responsiveness of the short form 12-item survey in patients with back pain. SUMMARY OF BACKGROUND DATA: The reliability, validity, and responsiveness of the short form 12-item survey in patients with back pain has not been previously evaluated. METHODS: Patients were asked to complete a comprehensive computerized survey questionnaire during their regular clinic visits. A total of 2520 patients who indicated in their first surveys that they had back pain were included in the study of the reliability and validity of the short form 12-item survey. Of these, 506 patients completed another survey within 3-6 months of follow-up and were included in the responsiveness evaluation. RESULTS: The two summary scales of the short form 12-item survey, physical component summary and mental component summary, demonstrated internal consistency reliability, with Cronbach alpha for both scales exceeding the recommended level of 0.70. Correlation of physical component summary and mental component summary with six other measures theoretically related or unrelated to these scales performed as expected without exception, demonstrating the construct validity of the short form 12-item survey. The responsiveness of the short form 12-item survey was supported by several pieces of evidence. First, the changes in physical component summary and mental component summary scores were correlated with the changes in back pain intensity. Second, for patients whose back pain improved, there was a significant increase in the follow-up physical component summary and mental component summary scores as compared to the baseline. Third, small to moderate effect size was observed for patients whose back pain became improved or became worse. CONCLUSIONS: The short form 12-item survey demonstrated good internal consistency reliability, construct validity, and responsiveness in patients with back pain.

Academic Medical Centers↗

Translation and validation of an Arabic version of the UK oral health related quality of life measure (OHQoL-UK) in Syria, Egypt and Saudi Arabia.

OBJECTIVE: The aim of this study was to translate and evaluate the performance of an oral health related quality of life measure--an Arabic version of OHQoL-UK in three middle eastern countries: Syria, Egypt and Saudi Arabia. BASIC RESEARCH DESIGN: Following forward and backwards translation of OHQoL-UK into Arabic and pilot testing the Arabic version among focus groups, a questionnaire containing the instrument was administered to 1,000 adults from the three Arab countries. In addition, the study participants were interviewed about their oral health status, experience of oral health problems in the past year, self-rating of oral health and also some socio-demographic information was collected. RESULTS: Among the three study populations, variations in OHQoL-UK scores were apparent in relation to socio-demographic factors (p<0.01), self-reported number of teeth possessed (p<0.001) and experience of oral health problems in the past year (p<0.01) which supports the construct validity of the instrument. Furthermore, variations in OHQoL-UK scores were apparent in relation to self-rating of oral health status (p<0.01) which supports the criterion validity of the measure. The internal reliability of the instrument was high in the three groups with Cronbach alpha values of above 0.90, indicating good internal consistency. CONCLUSION: The Arabic version of OHQoL-UK, an index of oral health related quality of life demonstrated satisfactory construct validity, criterion validity and internal reliability in Syria, Egypt and Saudi Arabia. This provides further evidence of the instrument's psychometric properties and its cross cultural use.

Adolescent↗

Measuring quality of life in cosmetic surgery patients with a condition-specific instrument: the Derriford Scale.

OBJECTIVE: To assess the reliability, validity and sensitivity to change of the Derriford Scale, a quality of life instrument designed to assess the distress and dysfunction experienced by people who are self-conscious about their physical appearance. SUBJECTS AND DESIGN: Postal questionnaire survey of 656 cosmetic surgery patients recruited from new referral letters and plastic surgery waiting list reports. A total of 443 subjects completed and returned the questionnaire. Of these respondents, 203 were sent a second questionnaire to assess reproducibility, of whom 155 subjects responded. MAIN OUTCOME MEASURES: Reliability was assessed in terms of internal consistency and reproducibility. Face, content and construct validity were also investigated. RESULTS: The analyses led to mixed results. There was some evidence of internal consistency, but a number of items had low endorsement levels and there may be scope for reducing the overall size of the instrument. When assessed for reproducibility, the level of agreement between scores of individuals completing the questionnaire on two occasions was high, but an important systematic shift in responses was also detected. Correlations between the other health status measures and the Derriford Scale provided some evidence of construct validity. CONCLUSION: In its present form the Derriford Scale has good descriptive value, but there are some measurement problems identified in this report that need to be addressed before the scale is taken up into general use.

Adult↗

Validation of a Chinese version of the Medical Outcomes Study Family and Marital Functioning Measures in patients with SLE.

The objective was to validate a Chinese translation of the Medical Outcomes Study Family and Marital Functioning Measures (FFM and MFM) in patients with systemic lupus erythematosus (SLE). Chinese-speaking SLE patients (n = 69) completed a self-administered questionnaire containing the FFM and MFM and assessing demographic and socio-economic status twice within a 2 week period. SLE activity, disease-related damage and quality of life were assessed using the BILAG, SLICC/ACR Damage Index and SF-36 Health Survey, respectively. Scale psychometric properties were assessed through factor analysis, Cronbach's alpha, quantifying test-retest differences and known-groups construct validity. Factor analysis identified 1 factor corresponding to the FFM and 2 factors corresponding to the MFM. Internal consistency for the FFM was excellent (alpha = 0.92) while that for the MFM was acceptable (alpha = 0.62). Mean (s.d.) test-retest differences were 0.06 (1.54) points for the FFM and 0.03 (2.08) points for the MFM. 11 and 10 of 13 a priori hypotheses relating the FFM and MFM, respectively, to demographic, disease and quality of life variables were confirmed, supporting the construct validity of these scales. The Chinese FFM and MFM are valid and reliable measures of family and marital functioning in Chinese-speaking SLE patients, with psychometric properties very similar to the source English version.

Adolescent↗

A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: The University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management I Study.

OBJECTIVE: Resuscitation of critically ill patients requires medical knowledge, clinical skills, and nonmedical skills, or crisis resource management (CRM) skills. There is currently no gold standard for evaluation of CRM performance. The primary objective was to examine the use of high-fidelity simulation as a medium to evaluate CRM performance. Since no gold standard for measuring performance exists, the secondary objective was the validation of a measuring instrument for CRM performance-the Ottawa Crisis Resource Management Global Rating Scale (or Ottawa GRS). DESIGN: First- and third-year residents participated in two simulator scenarios, recreating emergencies seen in acute care settings. Three raters then evaluated resident performance using edited video recordings of simulator performance. SETTING: A Canadian university tertiary hospital. INTERVENTIONS: : The Ottawa GRS was used, which provides a 7-point Likert scale for performance in five categories of CRM and an overall performance score. MEASUREMENTS AND MAIN RESULTS: Construct validity was measured on the basis of content validity, response process, internal structure, and response to other variables. One variable measured in this study was the level of training. A t-test analysis of Ottawa GRS scores was conducted to examine response to the variable of level of training. Intraclass correlation coefficient scores were used to measure interrater reliability for both scenarios. Thirty-two first-year and 28 third-year residents participated in the study. Third-year residents produced higher mean scores for overall CRM performance than first-year residents (p < .0001) and in all individual categories within the Ottawa GRS (p = .0019 to p < .0001). This difference was noted for both scenarios and for each individual rater (p = .0061 to p < .0001). No statistically significant difference in resident scores was observed between scenarios. Intraclass correlation coefficient scores of .59 and .61 were obtained for scenarios 1 and 2, respectively. CONCLUSIONS: Data obtained using the Ottawa GRS in measuring CRM performance during high-fidelity simulation scenarios support evidence of construct validity. Data also indicate the presence of acceptable interrater reliability when using the Ottawa GRS.

Adult↗

Adaptation of the postpartum support questionnaire for mothers with multiple sclerosis.

The purposes of this study were to determine the dimensionality of the Postpartum Support Questionnaire adapted for mothers with multiple sclerosis through factor-analytic techniques and to provide construct validity for the factored dimensions. One hundred and seventy-four mothers with multiple sclerosis comprised the sample. Using a priori criteria, a three-factor structure, resulting from principal components analysis with an orthogonal rotation consisting of 24 of the 28 items, was found to best represent the dimensionality of the instrument. The three support factors-emotional, instrumental, and informational-showed acceptable coefficient alpha reliabilities at the 1-, 3-, and 6-month administrations. Evidence of construct validity was shown in that, as hypothesized, (a) mothers with comparatively lower emotional distress reported higher levels of emotional and instrumental support, and (b) mothers with one child reported receiving more informational support during the 6-month postpartum period than did mothers with more than one child. The results support the use of the 24-item Postpartum Support Questionnaire in assessing the adequacy of these specific dimensions of social support needed by mothers with multiple sclerosis during the postpartum period.

Adult↗

A measure of disease-specific health-related quality of life for achalasia.

OBJECTIVES: To develop a measure of disease-specific health-related quality of life for achalasia for use as an outcome measure in clinical trials. METHODS: We generated a list of potential items for a measure of disease-specific health-related quality of life for achalasia by semistructured interviews with seven persons with achalasia, and by expert opinion. We then used factor analysis and item response theory methods for item reduction, using responses on the long-form questionnaire from 70 persons with achalasia. The severity measure underlying the item responses was constructed using a Rasch model. RESULTS: We developed a 10-item measure of disease-specific health-related quality of life that sampled the concepts of food tolerance, dysphagia-related behavior modifications, pain, heartburn, distress, lifestyle limitation, and satisfaction. The measure was reliable (person separation reliability 0.79, Cronbach's alpha 0.83), showed evidence of construct validity and good data-to-model fit (mean infit and outfit statistics for items, 1.00 and 0.98, respectively), and had a wide effective measurement range (able to discriminate between 87% of subjects with achalasia). The measure was recalibrated onto a 0-100 interval-level scale. CONCLUSIONS: We describe a reliable measure of achalasia disease-specific health-related quality of life that has a broad effective measurement range, interval-level properties, and evidence of construct validity. This measure is appropriate for use as an outcome measure in clinical trials and other evaluative studies on the effectiveness of treatment for achalasia.

Activities of Daily Living↗

Measurement characteristics of diet-related psychosocial questionnaires among African-American parents and their 8- to 10-year-old daughters: results from the Girls' health Enrichment Multi-site Studies.

OBJECTIVE: This paper presents the reliability and validity of several diet-related psychosocial questionnaires. METHODS: At baseline and 12 weeks follow-up, parents/caregivers of one hundred fifty 8- to 10-year-old African-American completed questionnaires on food preparation habits for their daughter, perceived home barriers to healthy eating, and fruit, juice, vegetable (FJV), low-fat and high-fat food availability. Girls completed a sweetened beverage preferences questionnaire and two 24-h dietary recalls to assess intake. Principal components analyses were conducted for two newly designed measures. Internal consistency was calculated and construct validity was assessed between the psychosocial scales and obesity-related dietary variables. RESULTS: Low-fat and high-fat food preparation for daughters, and perceived home barriers to eating low-fat food and FJV subscales were derived from the new questionnaires. Internal consistency reliabilities were moderate (0.58) to substantial (0.80) across all new and existing scales. Test-retest reliabilities were moderate (0.44) to substantial (0.79). Girls' intake of fat as a percentage of energy was positively related to parental high-fat food preparation for daughters (P < 0.01) and negatively related to parental low-fat food preparation practices for daughters (P < 0.05). CONCLUSIONS: Measures of family influences on FJV, fat, and sweetened beverage consumption were internally consistent with moderate to substantial stability. Scales for low-fat and high-fat food preparation practices for daughters achieved construct validity with fat consumption in the hypothesized direction. Family food preparation habits appear to be important targets for future interventions.

Black or African American↗

The Amyotrophic Lateral Sclerosis Functional Rating Scale. Assessment of activities of daily living in patients with amyotrophic lateral sclerosis. The ALS CNTF treatment study (ACTS) phase I-II Study Group.

OBJECTIVES: To test the utility of a new, easy to administer instrument for assessing activities of daily living in patients with amyotrophic lateral sclerosis (ALS), to validate its accuracy, and to assess its ability to record disease progression in patients with ALS against other functional scales, quantitative isometric muscle testing, and global assessment scales. DESIGN: Serial assessments of patients who presented to four ALS treatment centers in two multicenter studies. PATIENTS: Study 1 (cross-sectional) evaluated 75 consecutive patients who presented to four ALS treatment centers during a 2-month period. Study 2 (longitudinal) evaluated the progression of 53 patients who were enrolled in a multicenter, phase I-II clinical trial of recombinant human ciliary neurotrophic factor for treatment of ALS. OUTCOME MEASURES: The ALS Functional Rating Scale (ALSFRS) was compared with quantitative myometry and with other measures of daily function in patients with ALS both cross-sectionally and longitudinally. RESULTS: The first study of 75 patients evaluated the internal consistency, the test-retest reliability, and the construct validity of the ALSFRS. Internal consistency and test-retest reliability were high. Patient self-rating of upper- and lower-extremity-dependent tasks were highly correlated with measures of upper- and lower-extremity strength, respectively. Thus, the ALSFRS has good construct validity. In the second study, ALSFRS scores declined in tandem with deterioration in motor and pulmonary function, indicating its sensitivity to change. CONCLUSIONS: The ALSFRS is a useful instrument for evaluation of functional status and functional change in patients with ALS. Its results are in close agreement with objective measures of muscle strength and pulmonary function. The ALSFRS may be used as a screening measure for entry into clinical trials, as a surrogate measure of function in situations in which muscle strength cannot be measured directly, or as an adjunct to myometry.

Activities of Daily Living↗

Field trial of the Global Assessment of Functioning Scale--Modified.

OBJECTIVE: A field trial of the Global Assessment of Functioning Scale--Modified was conducted to test its construct validity. A slightly altered form of the scale, the Social and Occupational Functioning Assessment Scale, was used in DSM-IV. METHOD: Social, occupational, and clinical data on 196 subjects receiving outpatient mental health services were analyzed. RESULTS: Six significant predictors were found that accounted for 51.75% of the variation in scores on the Global Assessment of Functioning Scale--Modified. Scores were independent of axis I, axis II, and psychoactive substance dependence diagnoses from DSM-III-R. CONCLUSIONS: The construct validity of the Global Assessment of Functioning Scale--Modified and the Social and Occupational Functioning Assessment Scale is supported by these findings.

Ambulatory Care↗

An evaluation of a new measure of oral health related quality of life--OHQoL-UK(W).

OBJECTIVE: The aim was to test the reliability and validity of an instrument used to measure the impact of oral health on quality of life. BASIC RESEARCH DESIGN: The instrument tested was the indicator OHQoL-UK(W), which was developed, based on a general UK population's perceptions of how oral health affects life quality. OHQoL-UK(W) consists of a battery of 16 questions, which takes into account both 'effect' and 'impact' of oral health on life quality, incorporating dimensions and an individualised weighting system. A questionnaire containing the indicator was administered to a sample of 500 adults. Determining associations between OHQoL-UK(W) scores, socio-demographic and self-reported oral health status assessed its construct validity. The criterion validity of the indicator was assessed in the absence of a 'gold standard' by correlating OHQoL-UK(W) scores to self-rating of oral health status. The internal reliability of the indicator was assessed using Cronbach's alpha. RESULTS: The response rate was 78%. Associations between OHQoL-UK(W) scores and self-reported number of natural teeth (P<0.01) and denture status (P<0.01) supported the construct validity of the indicator. In addition, OHQoL-UK(W) scores were associated with socio-demographic factors; age (P<0.05), employment status (P<0.01) and ethnicity (P<0.05). The instrument was also associated with self-rating of oral health status (P<0.01), supporting the criterion validity of the indicator. The internal reliability was high with a Cronbach alpha value of 0.94. CONCLUSION: OHQoL-UK (W) appears to be a valid and reliable measure for assessing the impact of oral health on life quality.

Adolescent↗

The Juvenile Arthritis Functional Status Index (JASI): a validation study.

OBJECTIVE: To evaluate aspects of reliability and validity of the Juvenile Arthritis Functional Status Index (JASI). We developed this questionnaire to assess a variety of daily living and functional mobility tasks in children with juvenile rheumatoid arthritis (JRA). JASI part I consists of 100 functional items divided into 5 activity categories (self-care, domestic, mobility, school, extracurricular). A 7 point degree of difficulty rating scale is used for responses. JASI Part II is a priority function section within which the child identifies and scores important activities for improvement. METHODS: The JASI was administered to 30 children with JRA 8 to 19 years of age at baseline, 3 weeks, and 3 months to determine test-retest reliability. Various rheumatology measures were used to evaluate the JASI construct validity. RESULTS: Reliability of JASI Part I was excellent (intraclass correlation coefficients > or = 0.95) for both retest intervals. Reliability was lower for respondents with mild disease than those with polyarticular disease. JASI Part I scores correlated strongly with rheumatology measures including joint count, grip strength, hip synovitis, timed walk and run. ACR functional class, and range of motion (r > 0.50), indicating construct validity. There was fair to good agreement between scores from the child's self-report and those from therapist observation of the child's abilities on the same activities. This provides evidence that children as young as 8 years of age can realistically report on function on their own. In JASI Part II, respondents identified a mean of 5.9 functional items in the baseline priority activity list. Test-retest reliability for JASI Part II was fair (kappa = 0.57). Further work is needed to determine the most reliable and sensitive response sequence for evaluating change in priority functions with JASI Part II. CONCLUSION: JASI Part I is a reliable and valid functional measure for school age children and adolescents with JRA. Research is under way to evaluate responsiveness to change. Comparisons will be made with shorter JRA functional measures to determine differences in sensitivity.

Activities of Daily Living↗

Automated brain tissue assessment in the elderly and demented population: construction and validation of a sub-volume probabilistic brain atlas.

OBJECTIVES: To develop an automated imaging assessment tool that accommodates the anatomic variability of the elderly and demented population as well as the registration errors occurring during spatial normalization. METHODS: 20 subjects with Alzheimer's disease (AD), mild cognitive impairment, or normal cognition underwent MRI brain imaging and had their 3D volumetric datasets manually partitioned into 68 regions of interest (ROI) termed sub-volumes. Gray matter (GM), white matter (WM), and cerebral spinal fluid (CSF) voxel counts were then made in the subject's native space for comparison against automated volumetric measures within three sub-volume probabilistic atlas (SVPA) models. The three SVPAs were constructed using 12 parameter affine (12 p), 2nd order (2nd), and 6th order (6th) transforms derived from registering the manually partitioned scans into a Talairach compatible AD population-based target. The three SVPA automated measures were compared to the manually derived measures in the 20 subjects' native space with a "jack-knife" procedure in which each subject was assessed by an SVPA they did not contribute toward constructing. RESULTS: The mean left and right GM ratio (GM ratio = [GM + CSF] / CSF) "r values" for the 3 SVPAs compared to the manually derived ratios across the 68 ROIs were 0.85 for the 12p SVPA, 0.88 for the 2nd SVPA, and 0.89 for the 6th SVPA. The mean left and right WM ratio (WM ratio = [WM + CSF] / CSF) "r values" for the 3 SVPAs being 0.84 for the 12p SVPA, 0.86 for the 2nd SVPA, and 0.88 for the 6th SVPA. CONCLUSION: We have constructed, from an elderly and demented cohort, an automated brain volumetric tool that has excellent accuracy compared to a manual gold standard and is capable of regional hypothesis testing and individual patient assessment compared to a population.

Aged↗

Construction and validation of yeast artificial chromosome contig maps by RecA-assisted restriction endonuclease cleavage.

RecA-assisted restriction endonuclease (RARE) cleavage is an "Achilles' heel" approach to restriction mapping whereby a RecA-protein-oligodeoxynucleotide complex protects an individual restriction site from methylation, thus limiting subsequent digestion to a single, predetermined site. We have used RARE cleavage to cut yeast artificial chromosomes (YACs) at specific EcoRI sites located within or adjacent to sequence-tagged sites (STSs). Each cleavage reaction produces two YAC fragments whose sizes are a direct measure of the position of the STS in the YAC. In this fashion, we have positioned 45 STSs within a contig of 19 independent YACs and constructed a detailed RARE-cleavage map that represents 8.4 Mbp of human chromosome 6p21.3-22. By comparing maps of overlapping YACs, we were able to detect seven internal deletions that ranged from approximately 75 kbp to approximately 1 Mbp in size. Thirteen pairs of EcoRI sites were targeted for double RARE cleavage in uncloned total human DNA. The excised fragments, up to 2 Mbp in size, were resolved by pulsed-field gel electrophoresis and were detected by hybridization. In general, the genomic RARE-cleavage results support the YAC-based map. In one case, the distance in uncloned DNA between the two terminal EcoRI sites of a YAC insert was approximately 1 Mbp larger than the YAC itself, indicating a major deletion. The general concept of RARE-cleavage mapping as well as its applications and limitations are discussed.

Chromosome Mapping↗

Can communication deviance be measured in a family problem-solving interaction?

Communication deviance (CD) refers to confusing and fragmented communication that prevents family members from attaining a shared focus of attention and meaning. Levels of communication deviance based on individual parental projective test protocols--Thematic Apperception Test (TAT) and Rorschach--have repeatedly been found to be higher in parents of schizophrenic offspring than in parents of normal or nonpsychotic offspring. CD has also been measured in family transactions in which parents and their offspring interact with one another around a projective test stimulus, the Consensus Rorschach. There have been relatively few attempts to measure specific CD codes in familial interaction that is not initiated around an ambiguous visual stimulus. The present article examines the reliability and construct validity of an interactional measure (ICD) obtained from family transactions in which parents and patients are working toward the solution of a salient family problem. ICD from this family problem-solving task was compared to more traditional measures of CD from parental TAT protocols in a sample of 59 parents of 37 recent-onset schizophrenic patients. Results indicated that CD could be reliably measured in an interactive setting not initiated around a projective test stimulus, and provided evidence for the construct validity of ICD.

Adolescent↗

The Italian version of the Obsessive-Compulsive Drinking Scale: validation, comparison with the other versions, and difference between type 1- and type 2-like alcoholics.

The Obsessive-Compulsive Drinking Scale (OCDS) is a quick and reliable self-rating instrument for alcohol craving. Translated and validated versions are available and all of them have confirmed the utility of the scale in clinical situations. The purpose of this study was to translate and validate the Italian version of the OCDS, to assess its psychometric properties, to compare it with the other versions, and to search for possible differences between subgroups distinguished according to socio-demographic and clinical variables. The OCDS and a visual analogue scale (VAS) for alcohol craving were given to 103 Italian-speaking alcohol-dependent patients, who were assessed for their typology of alcoholism according to Cloninger's criteria. The reliability, the correlations between the variables and the influence of other factors were measured. Principal component analysis was performed to detect underlying dimensionality of the scale. The construct validity of the total scale and the subscales, as tested with Cronbach alpha analysis, was good. The r-values between total (TOT) and obsessive (OB) and compulsive (CP) subscales were comparable with those obtained in the other European studies. None of the socio-demographic parameters, nor the majority of the clinical factors significantly influenced the OCDS scores; however, there was a significant difference in total and subscale scores between Cloninger's "type 1-like" and "type 2-like" alcoholics, with the former having lower scores than the latter ones, whereas the VAS was not able to discriminate them. Principal component analysis of the 14 OCDS items showed that the scale is better described by a three-factor solution. The Italian version of the OCDS exhibited good reliability and construct validity, confirmed its psychometric properties, showed higher scores than in other studies, showed CP consistently higher than OB score, confirmed the validity of the French method for score calculation and was able to discriminate Cloninger's "type 1-like" and "type 2-like" alcoholics.

Adult↗