A confirmatory factor analysis of the WAIS-III in patients with traumatic brain injury

Maximum likelihood confirmatory factor analysis was performed on the WAIS-III data of a sample of 166 patients with traumatic brain injury (TBI). Four competing hypothetical models were tested for model fit and parsimony. A four-factor model composed of Verbal Comprehension, Perceptual Organization, Working Memory, and Processing Speed, identical to that proposed for the standardization sample, provided the best fit to the clinical data. The results support the construct validity of these four factors in patients with TBI.     

Construct validity of the Chinese version of the Chalder Fatigue Scale in a Chinese community sample

Objective

This paper aims to evaluate the factorial validity of the Chinese version of the Chalder Fatigue Scale (ChCFS) using a Chinese community sample.

Methods

A total of 201 Chinese adults completed the ChCFS, the 12-item Short-Form Health Survey (SF12), and the Hospital Anxiety and Depression Scale (HADS). Confirmatory factor analysis was conducted to assess the fit of a one-factor model, a two-factor correlated model, and a three-factor hierarchical model in both the 14-item and 11-item versions of ChCFS to the current data.

Results

ChCFS successfully replicated the original two-factor structure in the current Chinese community sample, and the 11-item version demonstrated better data-model fit than the 14-item version. The instrument possessed good internal consistency (Cronbach's α=.863). The convergent validity with HADS and divergent validity with SF12 were also evident.

Conclusions

ChCFS is valid and reliable among Chinese adults in the general population.     

Abnormal subjective experiences of schizophrenia: evaluation of the Eppendorf Schizophrenia Inventory

The Eppendorf Schizophrenia Inventory (ESI) is a new clinical questionnaire aimed at self-experienced cognitive disturbances that are considered to be diagnostically specific for schizophrenia. Two ESI validation studies are presented in this report. The aim of study I was to search for objective correlates of the ESI in 100 schizophrenic inpatients. In study II, the diagnostic validity of the ESI was examined by group comparisons (inpatients with first episode or chronic schizophrenia, alcoholism, depression, or obsessive-compulsive disorder, and healthy adults). Study I yielded numerous plausible correlations between ESI subscales and other clinical scales, neuropsychological tests, psychopathological interview data, and neurological symptoms. Study II supported the diagnostic validity of the ESI. A confirmatory factor analysis conducted with the combined schizophrenic sample from both studies corroborated the assumed factor structure. These results confirm the reliability and validity of the ESI.     

精神分裂症认知功能成套测验中文版临床信度及效度的研究

目的 对中文版精神分裂症认知功能成套测验(MCCB)的信度及效度进行临床测试.方法 对122例符合美国精神障碍诊断与统计手册第4版精神分裂症诊断标准的住院患者(患者组)进行MCCB测验,4周后重测,同期接受威斯康星卡片分类测验(WCST)、瑞文推理测验(RAVEN)、色词测验(Stroop)及阳性和阴性症状量表(PANSS)测查;并与122名性别、年龄和文化程度与患者组相匹配的社区正常人(对照组)进行比较.结果 (1)MCCB重测相关系数为0.88,P<0.001;(2)评定者间组内相关系数为0.97,P<0.001;(3)MCCB的A、B版本间的复本相关系数为0.64～0.74,P<0.001;A、B版本间的差异无统计学意义(P>0.05);(4)患者组各个分测验得分均低于对照组(P<0.001);逻辑回归分析,用MCCB区分精神分裂症患者与正常人,符合率达到84.8%(P<0.001),敏感性83.6%,特异性86.1%;(5)关联效度:MCCB与WCST、RAVEN和Stroop呈显著性相关(r=0.54～0.55),P<0.001;(6)结构效度:验证性因素分析证明中文版MCCB与英文版7个维度结构模型拟合良好;(7)MCCB平均完成时间为(58±10)min,耐受性和操作性达到中等偏上水平.结论 中文版MCCB的重测信度、评定者间信度、同质性信度、复本信度、关联效度、结构效度和效标效度等指标满足心理测量学要求,MCCB作为精神分裂症患者认知功能疗效评估的新标准,值得进一步修订和完善.     

Comparing cognitive functioning in schizophrenia and autism using WAIS-III

The main goal of this study was to investigate differences and similarities in general cognitive functioning between adults with schizophrenia and autism, because this has not been systematically investigated. We used a cross-sectional design to compare adults with schizophrenia (n = 27), with autism (n = 114) and a healthy control group (n = 30). Schizophrenia diagnoses were based on the Structured Clinical Interview for the DSM-IV Axis I (SCID-I) and behavioral symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Autism was diagnosed with a DSM-IV questionnaire for autism spectrum disorders and the Autistic Diagnostic Interview, revised version. The Wechsler Adult Intelligence Scale, third version (WAIS-III) was used to assess cognitive functions. All participants were between 18 and 65 years of age and had a minimum full scale intelligence of 80. Results showed that patients with schizophrenia scored significantly lower on processing speed than patients with autism and the healthy control group. Differences on other index scales were not found. In participants with schizophrenia a correlation was found between processing speed impairment and negative symptoms. Diagnosis could be predicted correctly with WAIS-III profile in 70.4% of the cases with schizophrenia compared to 56.7% of the healthy control group and 22.8% of the autism group.     

Psychometric Evaluation of the Child PTSD Symptom Scale in Spanish and English

Given the consistent growth of the Latino population in the United States, there is a critical need for validated Spanish measures to assess posttraumatic stress disorder (PTSD) symptoms in children. The current study examines the psychometric properties of the Child PTSD Symptom Scale (CPSS). We examined 259 children (8–17 years) who had experienced a recent traumatic event. Study measures were completed in Spanish (n = 106; boys = 58, girls = 48) or in English (n = 153; boys = 96, girls = 57). In addition to internal consistency, confirmatory factor analyses were conducted by testing four models to examine construct validity: (1) PTS single-factor, (2) DSM-IV three-factor, (3) Numbing four-factor, and (4) Dysphoria four-factor models. Findings demonstrated good internal consistency for both the English and Spanish versions of the CPSS. The English version revealed superior fit to the data for several models of PTS symptoms structure compared to the Spanish version. The current study demonstrated construct validity for the English CPSS, but not for the Spanish CPSS. Future studies will examine additional alternative models as well as convergent and discriminant validity of the Spanish CPSS.     

Do patients with schizophrenia distinguish between attitudes toward antipsychotic medication and pharmacotherapy in general? Validation of the Beliefs About Medication Questionnaire

Attitudes toward medication are important predictors of medication adherence in schizophrenia. However, monitoring their strength and influence in clinical settings is challenged by the absence of assessments separating them from adherence and subjective response and distinguishing between attitudes toward pharmacotherapy in general and antipsychotic medications. This study examined the applicability of the Beliefs about Medication Questionnaire (BMQ) in outpatients with schizophrenia (N = 131). Confirmatory factor analysis (CFA) could not support the original four-factor structure. A subsequent exploratory factor analysis revealed the factors Antipsychotics Necessity, Antipsychotics Concern, and Pharmacotherapy Distrust were supported by an acceptable fit of a completing CFA. These subscales have satisfactory internal reliability, test-retest reliability, and local fit indices. Modest correlations with insight and illness perception indicate construct validity. Criterion validity was supported by a significantly higher medication adherence of accepting patients compared with skeptical patients. The BMQ is a psychometrically sound and valid measure of attitudes toward medication in outpatients with schizophrenia.     

Reliability and Validity of the Short Version of Udvalg for Kliniske Undersogelser in Antipsychotic Treatment

The aim of this study was to develop a reliable and valid short version of the Udvalg for Kliniske Undersogelser (UKU) to efficiently evaluate the side effects of antipsychotics in patients with schizophrenia. This multi-site study included 10 hospitals, which included 331 inpatients and outpatients diagnosed with schizophrenia. UKU, Clinical Global Impression-Severity (CGI-S), Personal and Social Performance (PSP) and dosage of paliperidone were collected. The predictive validity of the UKU-short version, as well as that of the CGI-S, PSP and paliperidone dosages, was analyzed using structural equation modeling (SEM), latent growth models (LGM), and confirmatory factor analysis to test its content and construct validity. The UKU-short included nine-items of sedation, reduced sleep, rigidity, tremor, akathisia, headache, reduced salivation, constipation and orthostatic dizziness, and has good construct and content validity over time. Confirmatory factor analysis showed good construct validity, with the psychic, neurological and autonomic side effect dimensions having correlations between 0.60 and 0.71. The predictive validity of the short-version UKU for psychiatric symptoms (CGI-S), quality of life (PSP) and dosage showed that the effects of drug dosage were negligible, and only neurological side effects were associated with psychiatric symptoms and quality of life. The UKU-short showed good content, construct and predictive validity. It is a more time-efficient instrument than the original UKU. This study only included patients treated with paliperidone, larger scale studies is needed to validate the UKU-short in detection of side effects in routine clinical practice to prevent non-adherence in patients with schizophrenia.     

Is anhedonia a specific dimension in chronic schizophrenia?

This article explores the relationships among anhedonia, depression, and schizophrenic symptomatology in chronic schizophrenia. To explore these relationships, factor analysis methods were used to analyze the latent organization of the variables. The Fawcett Clark Pleasure Capacity Scale-Physical Pleasure (FCPCS-PP) and the abridged version of the Beck Depression Inventory (BDI) were completed by 150 subjects who met research diagnostic criteria for definite chronic schizophrenia. The schizophrenic symptomatology was rated using the Positive and Negative Syndrome Scale (PANSS). Two separate exploratory principal components analyses were completed, followed by varimax rotation. The first was made on the correlation matrix comprising items from both the FCPCS-PP and PANSS and yielded a five-factor solution with virtually no overlap of the significant factor loadings for the items from each scale. The second was made on the correlation matrix comprising items from both the FCPCS-PP and BDI and yielded a two-factor solution with virtually no overlap of the significant factor loadings for the items from each scale. Confirmatory factor analyses corresponding to the two exploratory factor analyses were done to examine the goodness of fit of the five-factor solution versus a four-factor solution and the two-factor solution versus a one-factor solution. The five-factor and the two-factor solutions yielded the best fit to the data relative to the other models tested. The findings support the view that part of anhedonia is a construct that is distinct and separate from depression and schizophrenic symptomatology in chronic schizophrenia.     

Prospective memory in healthy Chinese people: The latent structure of the Comprehensive Assessment of Prospective Memory Questionnaire

This study aimed to examine the latent structure of the Chinese version of the Comprehensive Assessment of Prospective Memory (CAPM) using confirmatory factor analysis. A total of 264 healthy Chinese participants (118 men and 146 women) took part in the study and their ages ranged from 17 to 90 years. There was no gender effect upon the frequency of prospective memory (PM) forgetting but age and education were found to be correlated significantly with these frequencies in the current sample. Results of the study also showed that the model with the best fit had a tripartite structure which consisted of a general memory factor (with all items loading on it) plus a basic activities of daily living as well as an instrumental activities of daily living factor. Furthermore, this tripartite model was robust across subgroups with respect to gender, education, and age. These findings provide support for the construct validity of the original CAPM and demonstrate its utility in another culture.