The Center for Epidemiologic Studies Depression Scale: factor validity and reliability in a French sample of adolescents with Intellectual Disability

The purpose of this study was to test the factor validity and reliability of the Center for Epidemiologic Studies Depression Scale (CES-D) within a sample of adolescents with mild to moderate Intellectual Disability (ID). A total sample of 189 adolescents (121 boys and 68 girls), aged between 12 and 18 years old, with mild to moderate ID were involved in two studies. In study 1, the content, phrasing and answering format of the CES-D were adapted for adolescents with ID. This instrument was renamed CES-D for ID (CES-D-ID) and two different versions based on two alternative answer scales (Likert and Likert-graphical) were developed and their psychometric properties were verified in study 2. The results provided support for the factor validity, reliability and invariance across gender and age of a 14-item version of the CES-D-ID based on a Likert-graphical answer scale.     

Construct validity of the Nutrition and Activity Knowledge Scale in a French sample of adolescents with mild to moderate intellectual disability

The purpose of this study was to test the reliability (i.e. internal consistency and test–retest reliability) and construct validity (i.e. content validity, factor validity, measurement invariance, and latent mean invariance) of the Nutrition and Activity Knowledge Scale (NAKS) in a sample of French adolescents with mild to moderate Intellectual Disability (ID). A total sample of 260 adolescents (144 boys and 116 girls), aged between 12 and 18 years old, with mild to moderate ID was involved in two studies. In the first study, analysis of items’ content reveals that many words from the original version were not understood or induced confusion. These items were reworded and simplified while retaining their original meaning. In the second study, results provided support for: (i) the factor validity and reliability of a 15-item French version of the NAKS; (ii) the measurement invariance of the resulting NAKS across genders and ID levels; (iii) the partial measurement invariance of the resulting NAKS across age groups and type of school placement. In addition, the latent means of the 15-item French version of the NAKS proved to be invariant across gender, age categories, and ID levels, but to vary across type of school placement (with adolescents schooled in self-contained classes from regular schools presenting higher levels of NAK than adolescents placed in specialized establishments). The present results thus provide preliminary evidence regarding the construct validity of a 15-item French version of the NAKS in a sample of adolescents with ID.     

The intellectual disability version of the very short form of the physical self-inventory (PSI-VS-ID): cross-validation and measurement invariance across gender, weight, age and intellectual disability level

Recently Maïano, Bégarie, Morin, and Ninot (2009) developed and validated an intellectual disability (ID) version of the very short form of the physical self-inventory (PSI-VS-ID). In a recent review of the various physical self-concept instruments Marsh and Cheng (in press) noted that the short and very short versions of the French PSI represent an important contribution to applied research but that further research was needed to investigate the robustness of their psychometric properties in new and diversified samples. Thus, this study is specifically designed to investigate the robustness of the PSI-VS-ID psychometric properties in a new independent sample of 248 adolescents and young adults with ID. In particular, tests of measurement invariance were conducted across the present sample and the original sample from Maïano et al. (2009) study in order to more precisely assess the degree of replication of the results. Overall, results from a series of confirmatory factor analyses of the PSI-VS-ID provided support for its: (i) factorial validity and reliability; (ii) factorial invariance across gender and weight status; (iii) partial (strict or strong) factorial invariance across age, ID level and samples; and (iv) latent mean differences across gender, weight status and ID level groups.     

Self-reports on mental health problems of youth with moderate to borderline intellectual disabilities

OBJECTIVE: To determine the extent to which the Youth Self-Report (YSR) can be used to assess emotional and behavioral problems in adolescents with intellectual disabilities (IDs). METHOD: In 2003, 281 11- to 18-year-olds with IDs (IQ > or =48) completed the YSR in an interview, and in 1993, 1,047 non-ID adolescents completed the YSR themselves. Parents completed the Child Behavior Checklist (CBCL). The ID sample was split into lower (IQ 48-69) and higher (IQ > or =70) IQ groups. Cronbach's alpha values of the YSR scales and (intraclass) correlation coefficients between and within YSR and CBCL scale scores were calculated to determine parent-adolescent agreement and YSR construct validity, which were compared between samples. Mean YSR scale scores were compared between adolescents with ID with and without psychiatric symptoms. RESULTS: Cronbach's alpha, parent-adolescent agreement, and indications of construct validity were about similar in all samples, although discriminant validity was somewhat weaker in the lower IQ group. Mean scale scores were 1.5 to 2.0 times higher for ID adolescents with psychiatric symptoms. CONCLUSIONS: The YSR seems applicable in youth with an IQ > or =48. Further research is needed to refine and confirm these findings and the factor structure of the YSR in adolescents with ID and to differentiate between adolescents with moderate and mild IDs.     

Reliability and validity of the Italian version of the Temperament and Character Inventory-Revised in an outpatient sample

OBJECTIVE: The aim of this study was to evaluate the reliability and validity of the Temperament and Character Inventory-Revised (TCI-R) in an outpatient sample. METHOD: The TCI-R was administered to 404 consecutively admitted subjects. The TCI-R scale 1-month test-retest reliability and TCI-R/TCI convergent validity were assessed in 2 independent subsamples. RESULTS: The TCI-R scales showed adequate Cronbach alpha values and acceptable 1-month test-retest reliability coefficients. Although many TCI-R facets showed factorial complexity, factor analysis results were consistent with the 7-factor structure of the TCI-R scales. The predictive validity of TCI-R profiles for personality disorder diagnoses was confirmed, with different combinations of temperament dimensions being associated with specific personality disorders. CONCLUSIONS: The TCI-R was a reliable and valid instrument for assessing temperament and character features, at least among Italian outpatients. The TCI-R psychometric properties support its clinical usefulness in the assessing of personality psychopathology.     

Reliability and validity of the Japanese version of the Behavior Problem Inventory-Short Form

BackgroundThe Behavior Problems Inventory-Short Form (BPI-S), which assesses behavior problems in individuals with intellectual disabilities (ID), is a shorter version of the BPI-01. This study investigated the reliability and validity of the BPI-S Japanese version (BPI-S-J) for adolescents/adults with ID and behavior problems.MethodsThe test–retest reliability included participants with ID and behavioral problems who were enrolled in welfare services. For test–retest reliability, 42 caregivers independently responded to the BPI-S-J every two weeks. Inter-rater reliability was independently assessed using the BPI-S-J by two caregivers who were familiar with the 42 participants. The participants of the validity assessment were 227 students from special needs schools or patients with ID admitted to medical institutions. The total frequency total score was compared based on the degree of ID. To examine the criterion-related validity, we analyzed the total frequency score, the total score of the Criteria for Determining Severe Problem Behavior (CDSPB) and the total score of the Aberrant Behavior Checklist-Japanese version (ABC-J).ResultsThe BPI-S-J of test–retest reliability was satisfactory (intra-class correlation; ICC) = 0.954), and the total score significantly (ICC = 0.721) represented good inter-rater reliability. For the validity, the BPI-S-J score of participants who had severe and profound ID was significantly higher than those who had mild and moderate ID. Significant correlations were observed between the BPI-S-J score and CDSPB score (r = 0.499), and the ABC-J score (r = 0.699), indicating adequate criterion-related validity.ConclusionThis study showed the utility of the BPI-S-J to assess behavior problems in the Japanese ID population.     

Spanish Validation of the Separation Anxiety Assessment Scale

The aim of this study was to investigate the factorial structure and psychometric properties of the Separation Anxiety Assessment Scale (SAAS) with Spanish schoolchildren. The participants in Study 1 were 1281 children aged 8–11. Exploratory factor analysis identified four factors: worry about calamitous events, fear of abandonment, fear of being alone, and fear of physical illness, which explained 47.77 % of the variance. The participants of Study 2 were 4628 schoolchildren aged 8–11. The four related factors model was validated by confirmatory factor analysis. The internal consistency (α = .84) and temporal stability (r = .77) were good. The convergent validity was evident from the pattern of correlations with the measures of separation anxiety, sensitivity to anxiety and school fears. The sensitivity of the scale was 83 %, and its specificity, 93 %. The complementary subscales predicted the diagnosis of separation anxiety disorder. The results support the reliability, validity and clinical utility of the SAAS.     

Assessing the Wish to Die: A 30-Year Review of the Suicide Intent Scale

This analysis drew from decades of published research to evaluate the Suicide Intent Scale (SIS), the dominant research tool for assessing intent to die in apparent suicide attempts. The review sought to 1) synthesize findings related to the scale's normative scores, reliability, and validity (factorial, convergent, and predictive), and 2) examine the objective and subjective subscales' performance. A literature search yielded 158 studies reporting findings for the SIS. Psychometric properties were summarized. Studies supported the scale's reliability, especially that of the subscale assessing self-reported (versus circumstantial indicators) of intent. Mixed findings emerged regarding convergent and predictive validity. The review identified shortcomings in factorial validity and the subscales' performance, especially for adolescents. The Suicide Intent Scale has some strengths, but the weaknesses require further investigation into how to better measure intent to die in attempted suicide.     

An Independent Investigation Into the Psychometric Properties of the Adult Scale of Hostility and Aggression (A-SHARP)

Background: The Adult Scale of Hostility and Aggression (A-SHARP) rating scale assesses the frequency/severity (problem scale) and the reactive-proactive motivation (provocation scale) of aggressive behaviors in adults with intellectual disabilities (ID). Items are assigned to five subscales (Verbal Aggression, Physical Aggression, Hostile Affect, Covert Aggression, and Bullying). Although psychometric properties reported by the scale’s developers were very good, we wanted to corroborate them independently. We were also interested in whether the reactive-proactive distinction of aggressive behavior is related to a behavioral/functional classification. Method: Staff at a day-treatment program for adults with ID completed ratings for 155 clients using the A-SHARP, the Behavior Problems Inventory-01 (BPI-01), and the Questions about Behavioral Function (QABF). Results: Internal consistency was found to be excellent, and the A-SHARP Physical Aggression subscale had good congruent and clinical validity. Confirmatory factor analysis showed sufficient evidence toward the factorial validity of the A-SHARP’s problem scale. The reactive-proactive classification of aggressive behavior motivation by the A-SHARP’s provocation scale was independent of the functional classification. Conclusions: The A-SHARP is a useful addition to a small number of existing instruments for assessing aggressive behavior in adults with ID, especially its problem scale. We discuss how the A-SHARP provocation scales might provide therapy-relevant information. Empirical evidence for the clinical utility of the A-SHARP provocation scale will have to be established by future research.     

Factorial validity and consistency of the Maslach Burnout Inventory among staff working with persons with intellectual disability and dementia

Background Burnout has been considered important to understanding the well‐being of workers in the intellectual disabilities (ID) field and the quality of services delivered to clients/consumers. However, little research has examined the psychometric properties and applicability to staff in ID services of one of the most widely used burnout measurements – the Human Services Survey version of the Maslach Burnout Inventory (MBI‐HSS). Methods Data were gathered using a mailed questionnaire comprising the MBI‐HSS and demographic information. The sample consisted of 435 staff delivering direct care and working in out‐of‐home community placements for persons with ID in New York state. The factorial structure of the scale was examined using confirmatory and exploratory factor analysis. Internal consistency estimates of reliability of the MBI‐HSS were determined using Cronbach's alpha. Results Confirmatory factor analysis supported the MBI‐HSS as an acceptable measure to evaluate burnout in ID services staff. However, the reliability statistics obtained for the Depersonalization (DP) sub‐scale was much lower than what has been reported in studies with other staff populations. An exploratory factor analysis suggested that a four‐factor solution, dividing the DP sub‐scale into two factors, provided a somewhat better fit for the sample. Conclusions The use of the MBI‐HHS as an instrument for measuring burnout among ID workers has its attraction but also its limitations. In particular, the DP sub‐scale should be used with caution because there appear to be wording issues for staff in ID settings that may lead to inconsistent responses.     

MUSAD-Short – A music-based screening tool to assess autism spectrum disorder in people with intellectual disability

BackgroundThe Music-based Scale for Autism Diagnostics (MUSAD) is an observational instrument for assessing ASD in adults with intellectual disability (ID) and limited verbal abilities. The MUSAD prompts diagnostically relevant behaviors in twelve musical interactional situations. This study explores the psychometric properties of a short version (MUSAD-Short) for ASD screening.MethodExcerpts from 60 videotaped assessments conducted with the original MUSAD were re-coded with a reduced item set. Based on these ratings, items were selected for the MUSAD-Short. Criterion validity of the MUSAD-Short was tested by comparing the MUSAD-Short assignment with the clinical ASD diagnosis. Inter-rater reliability was tested on a subsample of 22 individuals. A dichotomous response format was also examined to investigate whether further simplification is possible.ResultsFour situations (congas; ocean drum; symbolic instruments; movement to music) and fourteen items were selected for the MUSAD-Short. The diagnostic accuracy was appropriate, as indicated by sensitivity/specificity values of 73/75% (AUC =0.78). The inter-rater reliability was excellent, measured by the intra-class correlation (ICC) of.77. After item-dichotomization, sensitivity/specificity values were 73/70% (AUC =0.79).ConclusionsThe results indicate that the MUSAD-Short provides adequate diagnostic accuracy and sufficient inter-rater reliability. Shortening the original MUSAD is a promising approach to improving the scale’s applicability. However, future studies are needed that assess the MUSAD-Short's clinical and psychometric utility in an independent sample. Also, testing its practicability in children and adolescents with ID is indicated.     

Development and validation of an instrument to assess future orientation and resilience in adolescence

The study is aimed at providing the development and initial validation of the Design My Future (DMF), which may be administered in career counseling and research activities to assess adolescents' future orientation and resilience. Two studies with two independent samples of Italian adolescents were conducted to examine psychometric requisites of DMF. Specifically, in the first study, after developing items and examined the content validity, the factorial structure, reliability and discriminant validity of the DMF were tested. In the second study, the measurement invariance across gender, conducing a sequence of nested CFA models, was evaluated. Results showed good psychometric support for the instrument with Italian adolescents.     

Psychometric properties of the Chinese Behavior Problems Inventory-01 in children and adolescents with or at risk for intellectual disabilities

As the world's most populous country, China is likely to have the highest number of people with intellectual disabilities (ID) in the world. As many people with ID are susceptible to serious and persistent behavior problems, research by Chinese scientists on this public health issue is needed. However, there are only very few reliable Chinese-language behavior assessment instruments for problem behaviors. To fill this gap we translated the Behavior Problems Inventory-01 (BPI-01; Rojahn, Matson, Lott, Esbensen, & Smalls, 2001) into Chinese. The BPI-01 is an informant-based behavior rating instrument that was designed to assess self-injurious behavior (SIB), stereotyped behavior, and aggressive/destructive behavior in individuals with ID. We then assessed the behavior of 222 children and young adults (age range 1.5–21.5 years) with or at risk for ID from three special needs service programs in mainland China. Teachers or staff members, respectively, served as respondents. The Chinese version of the BPI-01 showed good reliability (internal consistency) and good factor validity tested by confirmatory factorial analysis. We conclude that the Chinese version of the BPI-01 can be used for research and clinical evaluation of Chinese children and adolescents with ID.     

Psychometric evaluation of a Dutch version of the Mini PAS‐ADD for assessing psychiatric disorders in adults with different levels of intellectual disability

Background People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. Method A Dutch version of the Mini PAS‐ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and criterion validity based on a large‐scale random sample (n = 377) and a clinical sample (n = 99) of adults with ID. Results The Dutch version of the Mini PAS‐ADD showed moderate internal consistency, and moderate concordance among informants. Both aspects of the reliability were comparable for different levels of ID. A factor analysis largely confirmed the scale structure. Concurrent validity with the Reiss Screen for Maladaptive Behavior was high for the Depression, Psychosis and Autism scale. The outcome of the criterion‐validity analysis indicated high specificity. The sensitivity for specific psychiatric disorders by the corresponding scales was moderate, but the general sensitivity for the presence of psychopathology on the basis of any of the scales was satisfying. Conclusions The present research reconfirmed the use of the Mini PAS‐ADD as a primary screening device for the identification of mental health problems among people with ID.     

Validation of the Korean version of the Eppendorf Schizophrenia Inventory as a screening measure to detect adolescents at ultra‐high risk for psychosis

Aim: No validated self‐report scale is available for use as a screening tool to detect non‐help‐seeking adolescents at ultra‐high risk (UHR) for psychosis in a community setting. The study aims to examine the reliability and validity of the Korean version of the Eppendorf Schizophrenia Inventory (K‐ESI) for assessing adolescents at UHR for psychosis in a community setting. Methods: In the first study, to confirm the reliability and discriminant validity of the K‐ESI, community sample (782 adolescents, 281 young adults, 122 early and middle‐aged adults) and outpatients with schizophrenia (109) were recruited. A single cross‐sectional survey was performed using the K‐ESI for the community sample and the K‐ESI and Positive and Negative Syndrome Scale for patients. In the second study, the Korean version of Youth Self Report (K‐YSR) was administered initially to 1002 students. Of the 217 students whose scores were equal to or higher than the cut‐off point of the K‐YSR, 120 who agreed to an in‐depth evaluation were interviewed using the Comprehensive Assessment of At‐Risk Mental States to confirm the predictive validity of the K‐ESI. Results: The K‐ESI showed good internal consistency and excellent test–retest reliability and discriminant validity. However, the factor structure in adolescents was substantially different from that of the original ESI. The best cut‐off point for the K‐ESI to identify UHR adolescents was 29, with a sensitivity of 77% and a specificity of 70%. Conclusion: The results revealed that the K‐ESI can be used as a valid and reliable instrument to identify adolescents at UHR for psychosis in a community setting.     

Psychometric properties of the Aberrant Behavior Checklist, the Anxiety, Depression and Mood Scale, the Assessment of Dual Diagnosis and the Social Performance Survey Schedule in adults with intellectual disabilities

Progress in clinical research and in empirically supported interventions in the area of psychopathology in intellectual disabilities (ID) depends on high-quality assessment instruments. To this end, psychometric properties of four instruments were examined: the Aberrant Behavior Checklist (ABC), the Assessment of Dual Diagnosis (ADD), the Anxiety, Depression and Mood Scale (ADAMS), and the Social Performance Survey Schedule (SPSS). Data were collected in two community-based groups of adults with mild to profound ID (n = 263). Subscale reliability (internal consistency) ranged from fair to excellent for the ABC, the ADAMS, and the SPSS (mean coefficient α across ABC subscales was .87 (ranging from fair to excellent), the ADAMS subscales .83 (ranging from fair to good), and the SPSS subscales .91 (range from good to excellent). The ADD subscales had generally lower reliability scores with a mean of .59 (ranging from unacceptable to good). Convergent and discriminant validity was determined by bivariate Spearman ρ correlations between subscales of one instrument and the subscales of the other three instruments. For the most part, all four instruments showed solid convergent and discriminant validity. To examine the factorial validity, Confirmatory Factor Analyses (CFA) were attempted with the inter-item covariance matrix of each instrument. Generally, the data did not show good fits with the measurement models for the SPSS, ABC, or the ADAMS (CFA analyses with the ADD would not converge). However, most of the items on these three instruments had significant loadings on their respective factors.     

Evaluation of intolerance of uncertainty: development and validation of a new self-report measure

Intolerance of uncertainty represents an important risk factor for development of anxiety disorders. However, few measures have been developed in order to evaluate this construct. Four studies were conducted in order to validate a new instrument evaluating intolerance of uncertainty: the Intolerance of Uncertainty Inventory (IUI). The first study described the questionnaire's development and evaluated the psychometric properties of its preliminary version. Study 2 examined the reliability and the factorial validity of the final version of the questionnaire, while Study 3 mainly addressed its convergent validity. Finally, Study 4 examined the questionnaire's temporal stability. Factorial analyses confirmed the IUI's validity. Results also supported the IUI's reliability, convergent validity, and temporal stability. The IUI is the first instrument that offers the possibility of measuring intolerance of uncertainty as a tendency to consider uncertainties to be unacceptable, as well as in terms of cognitive and behavioral manifestations.     

Partial validation of a French version of the ADHD-rating scale IV on a French population of children with ADHD and epilepsy. Factorial structure,reliability, and responsiveness

ObjectiveAttention deficit hyperactivity disorder (ADHD) is a well-known comorbidity in children with epilepsy. In English-speaking countries, the scores of the original ADHD-rating scale IV are currently used as main outcomes in various clinical trials in children with epilepsy. In French-speaking countries, several French versions are in use though none has been fully validated yet. We sought here for a partial validation of a French version of the ADHD-RS IV regarding construct validity, internal consistency (i.e., scale reliability), item reliability, and responsiveness in a group of French children with ADHD and epilepsy.MethodThe study involved 167 children aged 6–15 years in 10 French neuropediatric units. The factorial structure and item reliability were assessed with a confirmatory factorial analysis for ordered categorical variables. The dimensions' internal consistency was assessed with Guttman's lambda 6 coefficient. The responsiveness was assessed by the change in score under methylphenidate and in comparison with a control group.ResultsThe results confirmed the original two-dimensional factorial structure (inattention, hyperactivity/impulsivity) and showed a satisfactory reliability of most items, a good dimension internal consistency, and a good responsiveness of the total score and the two subscores.ConclusionThe studied French version of the ADHD-RS IV is thus validated regarding construct validity, reliability, and responsiveness. It can now be used in French-speaking countries in clinical trials of treatments involving children with ADHD and epilepsy. The full validation requires further investigations.     

Study of Beck's hopelessness scale. Validation and factor analysis]

The validation study and factorial analysis of the Beck's hopelessness scale is presented. Two groups were compared including patients suffering from depression (n = 100) and a control group (n = 93). Age and sex were comparable in the two groups. The hopelessness scale is valid, and differentiates depressive patients from control subjects. The scale has a good reliability (test-retest, r = .81) and a good internal consistency (alpha = .97) for depressive subjects and alpha = .79 for control subjects). It also shows a good concurrent validity with other scales assessing depressive cognitions, the automatic thoughts questionnaire, the dysfunctional attitudes scale (form A) and a scale assessing the suicidal risk (ERSD). No concurrent validity is found with scales assessing the intensity of depression, the Beck depression inventory and the Hamilton scale. The factorial analysis elicits a general factor, accounting for 38.15% of the variance, and reflecting negative feelings about the future. The study of all the factorial analysis shows the stability of the factorial structure.