Effects of a Detailed Sexual Behavior Interview on Perceived Risk of HIV Infection: Preliminary Experimental Analysis in a High Risk Sample

Effects of the HIV-Risk Timeline Followback Interview (TLFB), which uses detailed memory cues to assess retrospectively sexual behavior and substance use on a day-by-day basis, on HIV risk-reduction motivation were tested. Thirty-four adults (76% male, 100% African American) were randomly assigned to three interview conditions: (a) HIV-Risk TLFB Interview, (b) 27 sexual behavior frequency questions, and (c) diet and nutrition using the TLFB format. Participants completed measures of HIV risk-reduction motivation immediately before and after the experimental assessment component. The a priori hypotheses that the HIV-Risk TLFB group would exhibit greater increases on indices of HIV risk reduction motivation than participants in either of the other two groups and that participants in the nutrition interview condition would exhibit greater increases in motivation for dietary improvement were supported, indicating that participating in detailed health behavior interviews, but not cursory assessments, may lead to increased motivation for behavior change.     

Brief motivational interventions for heavy college drinkers: A randomized controlled trial

In this randomized controlled trial, the authors evaluated brief motivational interventions (BMIs) for at-risk college drinkers. Heavy drinking students (N = 509; 65% women, 35% men) were randomized into 1 of 6 intervention conditions formed by crossing the baseline Timeline Followback (TLFB) interview (present versus absent) and intervention type (basic BMI, BMI enhanced with a decisional balance module, or none). Assessments completed at baseline, 1, 6, and 12 months measured typical and risky drinking as well as drinking-related problems. Relative to controls, the TLFB interview reduced consumption but not problems at 1 month. The basic BMI improved all drinking outcomes beyond the effects of the TLFB interview at 1 month, whereas the enhanced BMI did not. Risk reduction achieved by brief interventions maintained throughout the follow-up year.     

The validity of self-reported cocaine use in two groups of cocaine abusers

To evaluate the validity of 2 self-report methods for estimating cocaine use, Timeline Follow-Back (TLFB) and weekly calendar reports from 65 patients with a cocaine use disorder were compared with urine drug test results. The TLFB showed fair to moderate validity, and the weekly calendar showed moderate to high validity in measuring the frequency of cocaine use. Similar results were obtained when the self-report measures were used to time specific cocaine use episodes. In addition to evidence for superiority of the weekly calendar, the validity of self-reports was inversely related to the percentage of positive urine test results. Furthermore, there was some evidence that validity increased as the time window over which the comparisons were drawn increased. Given the central role of self-reports in the clinical and research evaluation of drug use, factors affecting their validity warrant further investigation.     

Can clinical features of bipolar-I disorder be assessed reliably on the telephone?

BACKGROUND: The reliability of telephone interviews for rating 25 selected individual items of the Diagnostic Interview for Genetic Studies (DIGS) was assessed among persons with remitted bipolar disorder I (BPD I, n = 20). METHODS: The Diagnostic Interview for Genetic Studies (DIGS) was administered directly (with two raters present) and by telephone in random order to 20 adults with bipolar disorder I. RESULTS: Telephone interviews achieved reliability comparable to direct interviews for 16 items (64%), but were considered unsatisfactory for seven others (28%). Two other items, which evaluated the overlap between substance abuse and mood disorder, were considered unreliable for both methods of interview. LIMITATIONS: The presence of two interviewers for the in-person interview may have led to over-estimation of in-person reliability. Investigator bias in favor of phone interviews and a relatively small sample may have confounded the results. CONCLUSIONS: Telephone interviews may be used to evaluate individuals with BPD I in remission, provided the limitations of this method are recognized. They have limited reliability for dissecting overlap between mood abnormalities and psychotic phenomena or substance abuse.     

Measuring homelessness and residential stability: The residential time‐line follow‐back inventory

Reliable and valid longitudinal residential histories are needed to assess interventions to reduce homelessness and increase community tenure. This study examined the test‐retest reliability, sensitivity to change, and concurrent validity of the Residential Time‐Line Follow‐Back (TLFB) Inventory, a method used to record residential histories in the Collaborative Program to Prevent Homelessness (n = 1,381). The Residential TLFB Inventory yielded temporally stable aggregate measures of duration in residential categories, and it revealed significant differences in change over time when contrasting study groups. A comparison of agency and participant data at one site.     

Comparison of clinical and research assessments of diagnosis, suicide attempt history and suicidal ideation in major depression

A number of studies have compared clinical diagnostic and suicide assessments to standardized schedules to determine the level of agreement. At best there is only moderate diagnostic agreement, but most often it is fair. There are only a few reports comparing clinical assessments for suicidal behavior with standardized schedules. We present the data from 201 inpatient admissions for major depression that had both clinical diagnostic and suicide evaluations by PGYII resident physicians under supervision from an attending psychiatrist and research evaluations using standardized schedules for diagnosis and suicide by at least masters' level clinicians. There was moderate agreement for diagnosis and suicide attempt history but only fair agreement for the presence of suicidal ideation using Cohen's kappa statistic. In regards to suicide attempt history a cross-tabulation demonstrated that 18.7% of those patients identified by a research schedule as having a past suicide attempt were not identified as such by the clinicians. A cross-tabulation demonstrated that 29.7% of those patients identified by structured interview as having suicidal ideation were not identified as such by the clinician. There was a statistically significant difference in the level of agreement for suicide attempt history between clinical and research assessments for attempts within a year of admission and those beyond a year. These findings suggest the importance of adding a structured diagnostic and suicide assessment to routine clinical care to improve the reliability and validity of clinical evaluations and to inform treatment planning to benefit our patients.     

A structured interview for medical school admission, Phase 1: initial procedures and results.

PURPOSE: Despite their widespread use, medical school admission interviews often are unstructured and lack reliability. This report describes the development of a structured admission interview designed to eliminate bias and provide valid information for selecting medical students, with preliminary information about the interview's reliability and validity. METHOD: After screening applications, 490 applicants to a public medical school residency program were interviewed by two faculty members using a structured interview format. Interview scores were compiled and correlated with undergraduate grade-point averages (GPAs); Medical College Admission Test (MCAT) scores; Iowa Evaluation Form (IEF) scores, an in-house evaluation of applicants' noncognitive abilities; and eventual admissions status. RESULTS: Interrater agreement was good; the percentages of rater pairs whose scores differed by one point or less ranged from 87% to 98%. Scores on the structured interview revealed low to moderate correlations with other admission criteria: 10 (p < 0.05) for cumulative GPA, 0.18 (p < 0.01) for MCAT Biological Science, 0.08 (p > 0.05) MCAT Physical Science, and 0.10 (p < 0.05) MCAT Verbal Reasoning. None of the correlations between the overall interview scores and the IEF scores reached statistical significance (p = 0.05). Higher overall scores on the structured interview did predict a greater likelihood of being accepted into the medical school and the interview score accounted for 20% of the incremental variance in admission status beyond GPA, MCAT, and IEF scores. CONCLUSIONS: The moderate-to-low correlations with other admission criteria suggest that the interview provided information about candidate credentials not obtained from other sources and accounted for a substantial proportion of the variance in admission status. This finding supports the considerable time and resources required to develop a structured interview for medical student admissions. Final judgment on the validity and utility of this interview should be made after follow-up performance data have been obtained and analyzed.     

婴儿和学前幼儿诊断性评估中文版注意缺陷多动障碍模块的效度和信度

目的:引进婴儿和学前幼儿诊断性评估(DIPA),评价其中注意缺陷多动障碍(ADHD)诊断模块的效度和信度。方法:经原作者同意后,将DIPA翻译为中文版。根据以注意力不集中或多动为主诉的244例疑似ADHD学龄前儿童及医院周边社区幼儿园招募的90例正常学龄前儿童,以精神科临床医生根据精神障碍诊断与统计手册的ADHD诊断标准进行的临床诊断为金标准,评价DIPA诊断学龄前ADHD的效度。4名评定者分别独立对被试进行DIPA诊断,考察评定者间一致性。其中39例被试在DIPA访谈后14d,再次接受DIPA访谈,考察重测信度。结果:以临床诊断为金标准,对DIPA进行效度检验显示,诊断一致性的kappa值为0.81,诊断学龄前注意缺陷多动障碍的灵敏度为89%,特异度为96%。DI-PA的评定者间一致性kappa值为0.79,重测信度为0.89。结论:婴儿和学前幼儿诊断性评估中文版的ADHD诊断模块具有较高的效度和信度,可用于临床学龄前ADHD的诊断。     

Feasibility and Reliability of Interactive Voice Response Assessment of HIV Medication Adherence: Research and Clinical Implications

Abstract

Background: There are well-documented negative consequences of nonadherence to HIV medications. Telephone-based interactive voice response (IVR) technologies may hold promise for assessing nonadherence in both research and clinical contexts; however, little psychometric research has been conducted on this topic.Objective: In the present pilot study, we test the feasibility and reliability of a simplified patient-initiated, daily IVR system with a convenience sample of HIV patients attending a university-affiliated infectious disease clinic.Methods: Participants were asked to call in to an IVR system to report adherence daily during 2 weeks of a larger prospective study. Response rates and patterns were analyzed for feasibility and compared to retrospective, self-report timeline follow-back (TLFB) adherence reporting.Results: The IVR protocol showed moderate feasibility, with participants reporting adherence behavior on 63.4% of days. However, agreement with TLFB data was low, particularly for days in which participants reported incomplete adherence.Conclusions: The IVR protocol tested in the current trial shows some promise. Completion rates were higher than in previous trials. Future research is needed to further enhance the feasibility of IVR for HIV medication adherence and to compare responses to more objective measures on HIV adherence.     

Further analysis of a doctor-patient nonverbal communication instrument

This study examines the reliability and validity of the relational communication scale for observational measurement (RCS-O) using a random sample of 80 videotaped interactions of medical students interviewing standardized patients (SPs). The RCS-O is a 34-item instrument designed to measure the nonverbal communication of physicians interacting with patients. The instrument was applied and examined in two different interview scenarios. In the first scenario (year 1), the medical student's interview objective is to demonstrate patient-centered interviewing skills as the SP presents with a psychosocial concern. In the second scenario (year 3), the student's interview objective is to demonstrate both doctor-centered and patient-centered skills as the SP presents with a case common in primary care. In the year 1 scenario, 19 of the 34 RCS-O items met acceptable levels of inter-rater agreement and reliability. In the year 3 scenario, 26 items met acceptable levels of inter-rater agreement and reliability. Factor analysis indicated that in both scenarios each of the four primary relational communication dimensions was salient: intimacy, composure, formality, and dominance. Measures of correlation and differences involving the RCS-O dimensions and structural features of the interviews (e.g., number of questions asked by the medical student) are examined.     

Development of a questionnaire to assess patients'' satisfaction with consultations in general practice.

The assessment of patient satisfaction has become an important concern in the evaluation of health services. Measures of satisfaction must be valid and reliable if they are to be used widely. This paper reports the development of a new questionnaire to assess patients' satisfaction with consultations together with initial tests of the questionnaire's reliability and validity. Principal components analysis of the patients' assessments of care revealed three factors of satisfaction: the professional aspects of the consultation, the depth of the patient's relationship with the doctor, and the perceived length of the consultation. The consultation satisfaction questionnaire is reliable under the conditions of this study and may have a role in research, medical education and audit.     

Hypochondriasis Y‐BOCS: a study of the psychometric properties of a clinician‐administered semi‐structured interview to assess hypochondriacal thoughts and behaviours

Introduction: This study investigated the psychometric properties of the first clinician‐administered semi‐structured interview for assessing the severity of hypochondriacal symptoms. The Hypochondriasis Yale‐Brown Obsessive–Compulsive Scale (H‐YBOCS) consisted of three a priori dimensions: hypochondriacal obsessions, compulsions and avoidance. Methods: The 16‐item interview was conducted with 112 participants with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, hypochondriasis. We analysed factor analytic structure, reliability, construct validity and sensitivity to change. Results: Factor analysis supported a three‐factor model similar to the a priori dimensions. Internal consistency ranged from satisfactory to good. Inter‐rater reliability was excellent. The construct validity was low to moderate. The H‐YBOCS was sensitive for measuring changes in symptom severity. Conclusion: The H‐YBOCS is a (factorially) valid and coherent interview with a high level of agreement across different raters. The relatively low discriminant validity could be due to co‐morbid anxiety and depressive disorders. Overall, the H‐YBOCS seems to be a promising contribution to the assessment of hypochondriasis. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: ? The hypochondriasis Y‐BOCS is a feasible clinician rated interview to assess the severity of hypochondriacal complaints.     

The Revised Toronto Alexithymia Scale: some reliability, validity, and normative data.

Addressing certain problems with the compositional structure of the self-report Toronto Alexithymia Scale, this paper reports the development of a revised version of the scale as well as results from a preliminary series of studies evaluating its reliability and validity. The Revised Toronto Alexithymia Scale (TAS-R) demonstrated good internal consistency and a stable and replicable two-factor structure that is congruent with the two major dimensions of the alexithymia construct. Evidence of convergent and discriminant validity for the TAS-R was provided by correlations with measures of other constructs. Criterion validity was demonstrated by the ability of TAS-R scores to discriminate between behavioral medicine outpatients designated alexithymic and those designated non-alexithymic on the basis of clinical interview ratings. Normative data are provided for university student, normal adult, and psychiatric outpatient populations.     

The royal free interview for spiritual and religious beliefs: development and validation of a self-report version

BACKGROUND: Spiritual beliefs are rarely considered in psychological or medical publications. We recently published the psychometric properties of an interview designed to measure religious and spiritual belief. In this study, we aimed to develop this instrument further as a self-report questionnaire and to make it more comprehensive by including measurement of spiritual experiences in addition to faith or intellectual assent. METHODS: Based on extensive discussion with colleagues, advice from users of the interview and comments from respondents, a self-report format was designed. We then evaluated the final format of the questionnaire in terms of (1) patterns of response and demographic predictors of beliefs; (2) test-retest reliability and internal consistency; (3) criterion and internal validity; and (4) the nature of spiritual experiences and their relationship to beliefs and strength of beliefs. RESULTS: Two hundred and ninety-seven people took part in the validity and reliability tests of the questionnaire. Criterion validity, predictive validity, internal consistency and test-retest reliability were acceptably high. The instrument consistently differentiated between people with high and low spiritual beliefs. CONCLUSIONS: This instrument is brief and simple to complete. We would recommend that measures of religious and/or spiritual belief like this be more widely applied in health services research as they evaluate aspects of people's lives that go somewhat further than health status or quality of life.     

The reliability and validity of a structured interview for the assessment of infectious illness symptoms

Respiratory infections are the leading cause of morbidity in community populations. We developed a structured interview based on the Health Review (Roseet al., Psychosom. Med. 40: 142–165, 1978) to provide a simple method for periodic assessment of infectious illness, particularly upper respiratory infections. Congruence between interview data and physician diagnoses demonstrated excellent agreement regarding the presence or absence of an infection. Subjects who showed a clinically significant increase in antibody titers to an influenza virus vaccine reported fewer than half as many respiratory infections in the subsequent year as subjects who did not show a significant response. Interrater and test-retest reliabilities were satisfactory. These data support the reliability and validity of this method of assessing infectious illnesses.This research and preparation of this article were supported by National Institute of Mental Health Grants R37 MH42096 and R01 MH50538.     

Developing empowering health counseling measurement. Preliminary results

OBJECTIVE: This article describes the derivation of an instrument (Empowering Speech Practices Scale) for assessing the empowerment of dyadic counseling, the evaluation of the validity and reliability of the ESPS and the results acquired with the instrument from hospital counseling. METHODS: ESPS was constructed on the basis of empowerment theory and foregoing conversation analytic research. Nurses and patients assessed the same counseling session by way of parallel statements. Structure and reliability of the scale were evaluated with Cronbach alpha, percentage of agreement, factor analysis and logistic regression analysis. RESULTS: According to these preliminary results, ESPS described the realization of empowerment, directing attention to patient participation. By means of the scale, we assessed 127 counseling sessions and found evidence of the realization of empowering counseling. According to the results, nurses were the most successful in constructing a positive emotional atmosphere and in giving information. CONCLUSION: We found evidence that nurses need to improve the active mutuality of the counseling relationship by asking for patients' opinions and views, by facilitating the patients' assessment of their personal health and their participation in decision-making and coming up with options for their individual treatment. PRACTICE IMPLICATIONS: The developed scale can be utilized, in addition to assessing the quality in hospital care, for improving nursing education programs. Further study is needed to evaluate the usability of the scale and to examine its stability and validity.     

A comparison of 16 systems to diagnose schizophrenia.

Sixteen diagnostic classification systems were compared to determine the degree of agreement on the diagnosis of schizophrenia. Data were collected by a structured interview method with 284 patients, 52 first admissions, and 196 readmissions. The kappa coefficient was used to calculate interrater reliability and concordance of the systems. Adequate reliability was found for 12 of the systems. However, concordance was generally low; 11 of 120 combinations reached kappa of .40 or higher for the total sample, 16 of 120 for first admissions, and only 6 of 120 for readmissions. These results indicate the restriction of generalization and raise questions as to the empirical validity of the construct of schizophrenia.     

Shared Environmental Contributions to Substance Use

The current study examined the association between substance use in the household during childhood, parental attitudes towards substance use and lifetime substance use in males. Subjects included 1081 monozygotic and 707 dizygotic twins from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Retrospective reports of substance use and features of the family environment (adult household substance use and parental attitudes towards substance use) were obtained using a life history interview. A trivariate Cholesky decomposition was conducted using the program Mx to decompose common shared environmental variance. Findings suggest that family environmental factors accounted for a large proportion of the shared environmental effects for illicit drug use. Results illustrate an important way of extending behavior genetic research to reveal specific etiological environmental mechanisms.