The List of Threatening Experiences: the reliability and validity of a brief life events questionnaire

During the 23 years since the original work of Holmes & Rahe, research into stressful life events on human subjects has tended towards the development of longer and more complex inventories. The List of Threatening Experiences (LTE) of Brugha et al., by virtue of its brevity, overcomes difficulties of clinical application. In a study of 50 psychiatric patients and informants, the questionnaire version of the list (LTE-Q) was shown to have high test-retest reliability, and good agreement with informant information. Concurrent validity, based on the criterion of independently rated adversity derived from a semistructured life events interview, making use of the Life Events and Difficulties Scales (LEDS) method developed by Brown & Harris, showed both high specificity and sensitivity. The LTE-Q is particularly recommended for use in psychiatric, psychological and social studies in which other intervening variables such as social support, coping, and cognitive variables are of interest, and resources do not allow for the use of extensive interview measures of stress.     

Assessment of adverse events and quality of life in epilepsy: design of a new community-based trial

Improving health-related quality of life (HRQOL) has become recognized as an essential component of treating patients with epilepsy. In recent years, several rating scales have been developed that focus on both common adverse effects and various aspects of HRQOL that are more relevant to this patient population. Increasingly, such assessments are being incorporated into clinical trials, as it becomes clear that improvements in overall quality of life are an important feature of drug therapy. Here we present the design of a large, community-based trial evaluating the effects of switching from immediate-release carbamazepine to twice-daily, beaded, extended-release carbamazepine (Carbatrol). As this trial involves switching formulations of the same compound, we expect to find only small differences in efficacy but significant differences in tolerability and quality-of-life measures. To identify appropriate instruments that could measure these factors, here we review several epilepsy-specific scales used to monitor adverse events and HRQOL and discuss their potential utility in the context of the proposed trial.     

Nightmares and dissociative experiences: the key role of childhood traumatic events

In order to examine the co-occurrence of nightmares with dissociative experiences in the adolescent population and to demonstrate the impact of childhood traumatic events in this association, 292 undergraduate students were interviewed for childhood traumatic events. The Van Dream Anxiety Scale (VDAS) and Dissociative Experiences Scale (DES) were also administered to the subjects. For nightmares a 7.5% prevalence of 'often' and a 58.2% prevalence of 'sometimes' was found for college students. Nightmare prevalence was higher in women than in men. The rate of childhood traumatic experiences was higher in nightmare sufferers than in those who did not have nightmares. The subjects who had undergone physical and sexual abuse had higher VDAS global scores and item scores. When the DES scores of the subjects with nightmares were compared with that of those who had never reported nightmares, the subjects with nightmares had significantly higher scores on DES. The DES scores were also negatively correlated with duration of nightmares in subjects who had childhood traumatic experiences. These findings suggest that the subjects with childhood traumatic events failed to psychologically integrate their traumatic experiences and used dissociation as a coping strategy.     

The accuracy of dating childhood life events on a parental questionnaire

The accuracy in dating events by parents on the Coddington childhood life-event self-report inventory was assessed, by examining the concordance between events reported on the inventory and at a subsequent life-events interview. Seventy per cent of all the events reported on the inventory were dated at interview within the stated three month period. On group comparisons of all events reported, concordance in dating was not significantly related to the nature of the events classified according to desirability, specificity or direction (exit/entrance). Nor was it related to psychological deviance in the mother or in the child. However, when statements in the questionnaire were examined individually for concordance, there was full concordance for desirable events and for hospitalizations. In contrast, there was no concordance when marital separation, remarriage and birth of a sib were reported. The reasons for this are explored.     

Childhood unwanted sexual events and degree of psychopathology of psychiatric patients: research with a new anamnestic questionnaire (the CHUSE)

By means of a recently constructed anamnestic instrument, the questionnaire Childhood Unwanted Sexual Events (the CHUSE), the incidence of childhood experiences with sexual threat and/or abuse is investigated among 152 female psychiatric patients. The construction and applicability of the questionnaire are described. A Guttman scale-analysis shows a unidimensional construct (severity of the sexual abuse) for the CHUSE. Within this psychiatric population, sexually abused women report significantly more psychopathological symptoms than non-abused women. The correlation between severity of the abuse and severity of the psychopathological symptoms is investigated. The use of questionnaires concerning sexual abuse is compared with the more common interview techniques, and suggestions for future research are given.     

The Twin Inventory of Relationships and Experiences (TIRE): psychometric properties of a measure of the non‐shared and shared environmental experiences of twins and singletons

We examined longitudinally the psychometric properties of the Twin Inventory of Relationships and Experiences (TIRE), an instrument designed to assess non‐shared and shared environmental experiences in twins and siblings. A community sample of 1,117 pairs of like‐sex monozygotic and dizygotic twins, aged eight to 16, and their parents, was used. Results indicated that the TIRE provided constructs that are consistent across informants, gender and time. These dimensions showed good longitudinal stability within raters, and low to moderate inter‐rater agreement; the results are consistent with those of other studies using different instruments to assess family environment. It is concluded that the TIRE may be used to assess dimensions of the non‐shared environment of twins and siblings and their influence on children's development. Copyright © 2001 Whurr Publishers Ltd.     

The Social Behaviour Assessment Schedule (SBAS): Rationale,contents, scoring and reliability of a new interview schedule

Summary A critical review of interview schedules currently available for the assessment of the psychiatric patient's social functioning and its impact on significant others demonstrates a number of problems in the conceptualization of role behaviour and burden on the household. The Social Behaviour Assessment Schedule (SBAS) has been designed to meet the need for a more theoretically adequate research instrument which will be of practical use in the evaluation of different treatment regimes. The SBAS takes the form of a standardized, semi-structured interview with the patient's most closely involved relative or friend. The overall structure of the schedule is described, and detailed consideration given to the contents, scoring and inter-rater reliability of the scales in the three core sections. These sections measure the patient's disturbed behaviour, the patient's social performance, and the adverse effects on the household.This schedule was developed during the course of a research investigation which was supported by a grant from the Department of Health and Social Security. We would like to thank Mr. J. W. Borland for writing the computer programme to calculate the values of weighted kappa, and Dr. K. D. Macrae for general statistical advice.     

Measuring awareness of financial skills: reliability and validity of a new measure

This paper examines the psychometric properties of a three-part (participant, informant, and performance) Measure for assessing Awareness of Financial Skills (MAFS). The MAFS was administered to 10 seniors with dementia and 25 well-functioning seniors, and their informants. Measures of cognitive functioning, social desirability, neuroticism, and perceived control were administered to each participant to allow for an assessment of validity. Internal consistency estimates for the participant and informant questionnaires were found to be 0.92 and 0.97, respectively. Convergent validity analysis indicated that performance on this measure was related to level of cognitive functioning, with higher level of unawareness associated with decreased cognitive ability. Discriminant validity analysis showed that performance on this measure was not related to social desirability or neuroticism. This study provides evidence that the MAFS is a reliable and valid tool for assessing awareness of financial skills in older adults.     

Childhood life events and childhood trauma in adult patients with depressive,anxiety and comorbid disorders vs. controls

Hovens JGFM, Wiersma JE, Giltay EJ, van Oppen P, Spinhoven P, Penninx BWJH, Zitman FG. Childhood life events and childhood trauma in adult patients with depressive, anxiety and comorbid disorders vs. controls. Objective: To investigate the association between childhood life events, childhood trauma and the presence of anxiety, depressive or comorbid anxiety and depressive disorders in adulthood. Method: Data are from 1931 adult participants in the Netherlands Study of Depression and Anxiety (NESDA). Childhood life events included divorce of parents, early parental loss and ‘placed in care’, whereas childhood trauma was assessed as experienced emotional neglect, psychological, physical and sexual abuse prior to age 16. Results: Childhood life events were not associated with psychopathology, except for ‘placed in care’ in the comorbid group. All types of childhood trauma were increasingly prevalent in the following order: controls, anxiety, depression, and comorbid group (P < 0.001). The higher the score was on the childhood trauma index, the stronger the association with psychopathology (P < 0.001). Conclusion: Childhood trauma rather than childhood life events are related to anxiety and depressive disorders. The strong associations with the comorbid group suggest that childhood trauma contributes to the severity of psychopathology. Our study underscores the importance of heightened awareness of the possible presence of childhood trauma, especially in adult patients with comorbid anxiety and depressive disorders.     

Childhood life events and psychological symptoms in adult survivors of the 2004 tsunami

Background: Negative life events in childhood have an adverse influence on adult psychological health, and increase vulnerability to subsequent potential traumas. It remains unclear whether this is also true in the case of disasters. Aim: This study investigates whether the experience of negative life events in childhood and adolescence was associated with psychological symptoms in groups of Swedish survivors with different types of exposure to the tsunami. Methods: 1505 survivors from Stockholm responded to a questionnaire on psychological distress, which was sent by post 14 months after the 2004 Indian Ocean tsunami. Psychological distress was measured by General Health Questionnaire-12 and suicidal ideation, and post-traumatic stress was measured by Impact of Event Scale—Revised. Life events prior to age 16 were collected and categorized under the indices accident, violence, loss and interpersonal events. Exposure to the tsunami was categorized in different types, and controlled for in the analyses. Results: With the adjustment for confounders, significant odds ratios were found for all indices on at least one outcome measure, despite the powerful effect of the tsunami. We could not discern any distinct difference in the distribution of the tendency to report the different outcomes depending on types of prior life events. Conclusions: The implication of the study is that, for adult survivors of disaster, the reporting of adverse life events from childhood may influence future decisions regarding therapy.     

The Philadelphia Brief Assessment of Cognition (PBAC): a validated screening measure for dementia

The Philadelphia Brief Assessment of the Cognition (PBAC) is a brief dementia-screening instrument. The PBAC assesses five cognitive domains: working memory/executive control; lexical retrieval/language; visuospatial/visuoconstructional operations; verbal/visual episodic memory; and behavior/social comportment. A revised version of the PBAC was administered to 198 participants including patients with Alzheimer's disease (AD) (n=46) and four groups of patients with frontotemporal dementia (FTD) syndromes: behavioral-variant FTD (bvFTD; n=65), semantic-variant primary progressive aphasia (PPA) (svPPA; n=22), non-fluent/agrammatic-variant PPA (nfaPPA; n=23), and corticobasal syndrome (CBS; n=42), and a group of normal controls (n=15). The total PBAC score was highly correlated with the MMSE. The criterion validity of the PBAC was assessed relative to standard neuropsychological test performance. Using standard neuropsychological test performance as a criterion, the total PBAC score accurately identified the presence and severity of dementia. Intra-class correlations between PBAC subscales and standard neuropsychological tests were highly significant. PBAC subscales demonstrated good clinical utility in distinguishing AD and FTD subtypes using receiver operating characteristic analysis and standard diagnostic performance statistics to determine optimal subscale cut scores. The PBAC is a valid tool and able to assesses differential patterns neuropsychological/behavioral impairment in a broad range of neurodegenerative conditions.     

Measuring trauma and stressful events in childhood and adolescence among patients with first-episode psychosis: Initial factor structure,reliability, and validity of the Trauma Experiences Checklist

Past trauma and stressful events, especially in childhood and adolescence, are common among individuals with serious mental illnesses like schizophrenia. Traumatic experiences are thought to be a socio-environmental risk factor not only for poorer outcomes, but also potentially for the onset of these disorders. Because improved measurement tools are needed, we developed and studied, among 205 first-episode psychosis patients, the factor structure, internal consistency reliability, and initial validity of the Trauma Experiences Checklist (TEC), our measure of trauma and stressful events during childhood/adolescence. We assessed validity of subscales using correlations with Childhood Trauma Questionnaire-Short Form, Parental Harsh Discipline, Violence Exposure, and TEC-Informant Version scores. Exploratory factor analysis resulted in two internally consistent subscales (Cronbach's α=0.79 and 0.80, respectively), interpersonal abuse and family stress, and violence, death, and legal involvement. Scores from the former subscale were substantially associated with CTQ-SF physical, emotional, and sexual abuse (r=0.42–0.57, all p<0.001) and Violence Exposure (r=0.49, p<0.001). On the other hand, violence, death, and legal involvement scores were most highly correlated with Violence Exposure (r=0.49, p<0.001), and not with most CTQ-SF subscales. The TEC is a potentially useful tool in assessing diverse traumatic life events across various social contexts during childhood and adolescence.     

The relationship between adolescent suicidal behavior and life events in childhood and adolescence.

OBJECTIVE: Although the relationship between experience of problematic life events and adolescent suicidal behavior has frequently been recognized during the past decade, few studies of life events have been initiated that discriminated between adolescent suicide attempters and depressed adolescents. Therefore, the authors compared adolescent suicide attempters with both depressed and nondepressed adolescents who never attempted suicide with respect to life events that happened in two periods: childhood (defined as the period up to age 12 years) and adolescence (age 12 and older). METHOD: Using a semistructured interview, the authors gathered life event data about childhood and adolescence from three groups of adolescents: 48 suicide attempters, 66 depressed adolescents who had never made a suicide attempt, and 43 nondepressed adolescents who had never made a suicide attempt. RESULTS: The group of adolescents who attempted suicide differed from both of the other groups in that they had experienced more turmoil in their families, starting in childhood and not stabilizing during adolescence. During adolescence, they were more often sexually abused. During the last year before the attempt, further social instability, such as changes in residence and having to repeat a class, occurred. CONCLUSIONS: For suicidal adolescents, the suicide attempt seems embedded not just in the problems every adolescent has to deal with but in greater turmoil in their families, rooted in childhood and not stabilizing during adolescence, in combination with traumatic events during adolescence and social instability in the year preceding the attempt.     

The Assessment of the Phenomenology of Sleep Paralysis: The Unusual Sleep Experiences Questionnaire (USEQ)

Previous research has found a relationship between sleep paralysis (SP) and anxiety states and higher rates have been reported among certain ethnic groups. To advance the cross-cultural study of SP, we developed a brief assessment instrument (which can be self-administered), the Unusual Sleep Experiences Questionnaire (USEQ). In this article, we report on a pilot study with the USEQ in a sample of 208 college students. The instrument was easily understood by the participants, with one quarter reporting at least one lifetime episode of SP. As in previous studies, SP was associated with anxiety (in particular, panic attacks).