Diagnosis of sexual dysfunction: Relationships between DSM-III(R) and the GRISS

The diagnostic categories for sexual dysfunction provided by the revised third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IIIR) are compared with those of the Golombok Rust Inventory of Sexual Satisfaction (GRISS) and the Golombok Rust Inventory of Marital State (GRIMS). Similarities and differences are considered. It is concluded that the psychometric profile provided by the GRISS is more appropriate for judging severity of symptoms.     

Marital Problems in General Practice

The prevalence of marital problems among general practice attenders was investigated by interviewing a random selection of 78 men and women who were waiting to see their doctor, and asking them to complete the Golombok Rust Inventory of Marital State, which includes 28 questions about the state of the relationship. It was found that about 10% of marriages are on the verge of collapse, while a further 20% show characteristics which indicate that the participants would benefit from some form of advice or therapy     

Sexual Problems in Epileptic Women

Using the Golombok Rust Inventory of Sexual Satisfaction (GRISS), the sexual activity of 14 epileptic women was compared with that of 30 normal controls. The epileptic women were found to have sexual intercourse less frequently, and to be less sexually active. Subscale results suggested a problem of arousal rather than orgasm.     

Sexual and marital dysfunction and polypartnerism in STD clinic attenders

Sexual dysfunctions are common in STD clinic attenders. Marital/relationship dysfunctions frequently follow specific sexual dysfunctions such as erectile difficulties, impotence and premature ejaculation. In addition concomitant marital therapy has been shown to enhance treatment for sexual dysfunction. Polypartnerism, or multiple or serial sexual partners, is also a common feature of STD clinic attenders. To date no study has fully evaluated the social, psychological and medical determinants of this behaviour. The study examined the relationship between sexual dysfunction, marital difficulties and polypartnerism in 50 heterosexual STD clinic attenders. Thirty-one per cent of the sample had pathological scores on the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Forty-two per cent of the sample had pathological scores on the Golombok-Rust Inventory of Marital Satisfaction (GRIMS). There was a significant relationship between sexual dysfunction and marital dysfunction. Polypartnerism was also correlated with sexual and relationship dysfunction. It was felt that by offering treatment for specific sexual dysfunction identified at STD clinics, marital/relationship difficulties could be averted. Subsequently polypartnerism could be reduced. By altering polypartnerism in this way, an important opportunity to influence vector spread of STD, including HIV infection, is presented.     

An audit of acceptability of clinical services provided for patients with male erectile dysfunction

Appropriate delivery of clinical services has increasingly been recognized as an important factor in ensuring patient compliance and reducing non-attendance at outpatient clinics. Men attending a couple-orientated service for assessing erectile disorders, found an introductory letter about the assessment service helpful. A quarter of men found the GRIMS and GRISS questionnaires difficult to follow, and a third of men would prefer to complete these in the clinic, in preference to completing them at home before attending the clinic. However, the questionnaires were probably not a major factor in non-attendance at the clinic. A majority of men who chose couple therapy were very satisfied with the treatment. The majority of men who were given open appointments for follow-up, after receiving instruction in physical treatments for their problem, were unaware that their treatment was completed, suggesting a need for a more explicit communication between doctor and patient at the time of discharge.     

Sexual problems in a sample of the Turkish psychiatric population

Introduction

Sexual functioning has received little attention as an important aspect of patient care for those who have severe mental disorders.

Aim

The aim of this study is to compare sexual difficulties seen in Turkish psychiatric patients and healthy control subjects.

Methods

Study group consisted of outpatients in remission with schizophrenia (n = 84), bipolar affective disorders (n = 90), heroin addiction (n = 88), and healthy control group (n = 98). A sociodemographical data form and the Golombok Rust Inventory of Sexual Satisfaction were applied to all groups (N = 360).

Results

Half of the patient groups and 72.8% of control subjects reported that they had regular sexual life. The patients with heroin addiction complained about more problems in their sexual life than in the other groups. Controls (86.2%) felt more satisfied with their sexual life. Female patients with heroin addiction had statistically significant higher scores in nonsensuality subscale of Golombok Rust Inventory of Sexual Satisfaction. Female patients with schizophrenia and bipolar disorder had statistically significant higher scores in vaginismus subscale than in control group. Between the groups, male patients with bipolar disorder had higher score in most of the items except noncommunication and erectile dysfunction and also had higher total score than in the controls. More men (especially with heroin addiction) thought that their illness and drugs were responsible for their sexual problems, knew the effect of the illness and drugs on their sexual life, and asked questions to their psychiatrists about the problems more than women.

Conclusion

Patients with bipolar disorders and schizophrenia were unaware of effects of their medication on their sexual life. Finally, it was also found that clinicians in our country do not pay sufficient attention to the sexual problems of psychiatric patients.     

The Relationship Between Family-of-Origin and Marital Adjustment for Couples in Brazil

ABSTRACT

The experiences in the family of origin, especially the relationship with the parents during childhood, are normally taken as the basis of relationships to be experienced in adult life. In order to analyze which experiences with the family of origin might be associated with better or worse levels of quality in marital adjustment, a sample of 542 participants resident in Porto Alegre, State of Rio Grande do Sul, Brazil, all of average socioeconomic level, was investigated. Of the total, 78.5% of the participants were officially married and 21.5% lived in a stable union. The mean time of marital union was 17.58 years. The instruments used were the Family Background Questionnaire (FBQ; Melchert, 1998a Melchert, T. 1998a. A review of instruments for assessing family history. Clinical Psychology Review, 18(2): 163–187. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar], 1998b Melchert, T. 1998b. Testing the validity of an instrument for assessing family of origin history. Journal of Clinical Psychology, 54: 863–875.  [Google Scholar]) and the Golombok Rust Inventory of Marital State (GRIMS; Rust, Bennun, Crowe, & Golombok, 1988 Rust, J., Bennun, I., Crowe, M. and Golombok, S. 1988. The Golombok Rust Inventory of Marital State, Windsor, , UK: NFER-NELSON.  [Google Scholar]). Results show that there is an association between the type of experience that the participants lived in their families of origin and the quality of their marital relationship. However, those childhood and teenage experiences accounted for only 10.8% of the quality of the marital relationship. These findings suggest that there may be a relationship between the legacies that people bring from their families of origin and their later marital adjustment; however, lived experiences and environments also represent opportunities to administer the past and to redefine choices.     

Fluid Intake Appraisal Inventory: development and psychometric evaluation of a situation-specific measure for haemodialysis patients' self-efficacy to low fluid intake

OBJECTIVE: Self-efficacy is an important determinant of health behaviour and reflects a person's belief about their capability to complete a given task. The relationship between self-efficacy and fluid adherence has been investigated, although limited attention has been given to measurement issues. The purpose of this study was to develop a measure of situation-specific self-efficacy for constructive fluid intake behaviour in haemodialysis patients, the Fluid Intake Appraisal Inventory (FIAI). METHODS: Items were generated from an analysis of empirical studies available in the literature and exposed to an interpretability critique before haemodialysis patients confirmed sufficiency of each item. In a multi-centre study, data from 144 haemodialysis patients were collected regarding general self-efficacy, situation-specific self-efficacy, and estimated fluid consumption. Internal consistency, criterion-related validity, and structural validity were tested. RESULTS: The FIAI was found to have high internal consistency (Cronbach alpha 0.96) and the theoretical assumptions for criterion-related validity and known-group validity were supported. Structural validity was not confirmed, however, because the theoretically hypothesized four-factor model was not the prime structure. CONCLUSION: The FIAI was revealed to have satisfactory psychometric properties. The scale may be used in research or in clinical settings to study the mediating effects of self-efficacy or to modify haemodialysis patients' fluid-intake behaviour. Although this first validity study is promising, further validation focusing on reliability and cultural validity is needed.     

An item response analysis of the international restless legs syndrome study group rating scale for restless legs syndrome

BACKGROUND AND PURPOSE: Restless legs syndrome (RLS) is a common central nervous system disorder; however, there is currently a lack of well-validated and easily-administered measures of RLS severity available. The International Restless Legs Syndrome Study Group has recently developed a 10-item scale to meet this need. The International Restless Legs Severity Scale (IRLS) has been shown to have a high degree of reliability, validity, and internal consistency. In order to further demonstrate the validity of the IRLS, the present study examined the relationship between scores on individual IRLS items and overall RLS severity. PATIENTS AND METHODS: The 10-item IRLS was administered to 196 RLS patients. Option characteristic curves (the probability of scoring different options for a given item as a function of overall IRLS score) were generated in order to illustrate the scoring patterns for each item across the range of total RLS severity. Item characteristic curves (the expected score on an item as a function of overall IRLS score) were also generated to illustrate the relationship between scores on the individual items and total RLS severity. RESULTS: The IRLS items demonstrated excellent item response properties, with option and item characteristic curves closely approximating those of an ideal item. Item 3 (relief of arm or leg discomfort from moving around) was the most problematic item in that a 'floor' effect was evident; however, the item response characteristics for this item were still acceptable. CONCLUSIONS: Each IRLS item showed a good relationship between responses on that item and overall RLS severity, providing further evidence for the validity of the IRLS as a measure of RLS severity in RLS patients.     

Schizotypy, attention deficit hyperactivity disorder, and dopamine genes

Previous research has suggested that there may be overlap between schizophrenia and attention-deficit hyperactivity disorder (ADHD). The relationship between schizotypal personality traits, ADHD features and polymorphisms was evaluated in dopamine-related genes. Thirty-one healthy, Caucasian men completed the Rust Inventory of Schizotypal Cognitions (RISC) and the ADHD Self-Report Scale (ASRS). Catechol-O-methyltransferase (COMT) Val158Met, dopamine receptors of the D3 type (DRD3) Ser9Gly, DRD4 variable number of tandem repeats (VNTR), and SLC6A3 VNTR polymorphisms were analyzed. RISC score was correlated with ASRS score (r = 0.54, P = 0.003). COMT Met homozygotes had higher ASRS scores than Val homozygotes (P = 0.005). These findings are consistent with evidence of overlap between schizophrenia and ADHD and support an involvement of COMT genotype in ADHD features.     

Sexual and relationship dysfunction in people with Parkinson's disease

ObjectivesTo quantify the extent of self-reported sexual and relationship problems in people with Parkinson's disease (PD).MethodsA cross-sectional correlation design was used. All people with idiopathic PD, according to the UK Brain Bank criteria, who were known to the Northumbria Healthcare NHS Trust PD service, were asked to participate. Those who consented were assessed by a research nurse during a six month period using a series of rating scales, including the Unified Parkinson's Disease Rating Scale (UPDRS), the PD Questionnaire-39, the Mini Mental State Examination (MMSE), the Szasz sexual functioning scale and, for those in long-term relationships, the Golombok Rust Inventory of Marital State.ResultsConcern over sexual function was reported in 22 (25%) of the 88 participants in the study. Males (p = 0.001) and younger people with PD (p = 0.001) were significantly more likely to report problems with sexual function. Gender (p = 0.007) and UPDRS score (p = 0.045) were significant independent predictors of relationship problems. Males with PD and those with increasing functional problems (UPDRS score) were more likely to report problems in their relationship. Disease duration and levels of anxiety and depression (Hospital Anxiety and Depression scale) were not associated with sexual or relationship problems.ConclusionsSexual and relationship dysfunction was a problem for many people in this study, but these problems were unlikely to be volunteered unless specifically enquired about. Problems were apparent across all age groups and genders.     

The Rust Inventory of Schizotypal Cognitions (RISC)

The Rust Inventory of Schizotypal Cognitions (RISC) is a new, psychometrically constructed, short questionnaire for assessing the schizotypal cognitions associated with the positive symptoms of acute schizophrenia. It differs from previous scales in having been developed and standardized with special attention to normal distribution in the general population, and in emphasizing cognitive content rather than cognitive deficit. The scale has good reliability and validity, and it can clearly discriminate acute schizophrenic subjects from normal subjects. Although containing no obviously extreme items, the scale, in its cumulative effect, may be used to identify bizarre and eccentric thought patterns, and as an estimate of risk in the general population for schizotypal symptoms phenomenologically related to acute schizophrenia.     

Assessing autonomic symptoms of Parkinson’s disease with the SCOPA‐AUT: a new perspective from Rasch analysis

Background: The Scale for Outcomes in Parkinson’s disease (PD) for Autonomic Symptoms (SCOPA‐AUT) is a specific scale to assess autonomic dysfunction in PD patients. It was developed and validated under the classic test theory approach. This study sought to test whether the SCOPA‐AUT meets item response theory standards for reliability, internal construct validity, response category ordering, and differential item functioning by gender and age group. Method: The Rasch measurement model was applied to a sample of 385 PD patients. Results: Model fit was obtained after the response categories were rescored and item 10‐Incomplete emptying deleted because of redundancy. Person separation index, a reliability measure, was 0.82. All but two items (2‐Sialorrhea and 13‐Nocturia) were free of gender‐ and age‐related bias. The strict tests of unidimensionality were met, indicating the validity of the total sumscore. Scale targeting suggested the need for items representing milder autonomic symptoms. Conclusions: Suggestions for improving the SCOPA‐AUT include a shorter scale with a simpler response scheme and a combination of sexual items for men and women. The resulting SCOPA‐AUT is a reliable scale, with good internal construct validity, providing Rasch transformed results on a linear metric scale.     

患者健康问卷-15在卒中门诊的信度和效度研究

目的 研究卒中人群中患者健康问卷-15（Patient Health Questionnaire-15,PHQ-15）的信度和效度。 方法 对107例门诊复查的卒中患者分别进行PHQ-15、Beck焦虑自评量表（Beck Anxiety Inventory, BAI ）、患者健康问卷-9（Patient Health Questionnaire-9,PHQ-9）、汉密尔顿抑郁量表（Hamil ton Depression Rating Scale,HDMA）、汉密尔顿焦虑量表（Hamilton Anxiety Rating Scale,HAMA）和症状自 评量表-12（the Sel f-report Symptom Inventory,Symptom Checklist-12,SCL-12）,分析PHQ-15应用于卒中 患者的信度、效度。信度检验用克朗巴赫α系数;用条目和总分的相关系数评价内容效度,用SCL-12 与PHQ-15的相关性评价效标效度,用BAI 、HDMA、HAMA、PHQ-9与PHQ-15的相关性评价结构效度。 结果 （ 1）PHQ-15克朗巴赫α系数为0.811,提示该量表内部一致性较好;（2）15项条目与总分的相 关系数为0.275～0.763（均P <0.001）,提示该量表内部一致性较好;（3）PHQ-15的效标效度为0.768 （P <0.001）,提示该量表效标效度良好;（4）PHQ-15与BAI的相关系数为0.602（P <0.001）,与PHQ-9 的相关系数为0.654（P <0.001）,与HDMA的相关系数为0.769（P <0.001）,与HAMA的相关系数为0.793 （P <0.001）,提示该量表结构效度良好。 结论 P HQ-15具有良好的信度和效度,基本符合心理测量学标准,可作为门诊评价卒中患者躯体化 症状的良好工具。     

Gender differences in psychosocial risk factors for psychological distress among immigrants

The reasons for a greater prevalence of psychological distress among women than men remain unknown. We sought to test two hypotheses that gender operates either as (1) a moderator or (2) a mediator between psychosocial risk factors and experienced distress. A cross-sectional community survey of 1,062 adult Russian-born Jewish immigrants to Israel was conducted. The Demographic Psychosocial Inventory (DPSI) and the Talbieh Brief Distress Inventory (TBDI) were used to measure the parameters of interest. Univariate and multivariate analyses were used to test the moderation versus mediational hypotheses of gender in the stress-distress relationship. The aggregate levels of psychological distress and depression, anxiety, and obsessive symptoms were significantly higher for women than for men. Five sources of distress were more likely to be reported by women: family problems, inappropriate climatic conditions, anxiety about the future, poor health status, and uncertainty in the present life situation. Men scored higher on three stress-protective factors: the number of reasons for immigration, commitment to the host country, and job adequacy. Results of multiple regression and multivariate analysis of variance (MANOVA) supported the mediation hypothesis that gender differences in psychological distress stem from women's greater exposure to specific psychosocial stressors. Our findings demonstrate the validity of gender as an important mediating mechanism underlying the differential perception of risk factors for the development of psychological distress.     

Factorial validity of the Childhood Trauma Questionnaire in men and women.

In an effort to confirm the factorial validity of the Childhood Trauma Questionnaire (CTQ) across sex, the items from the CTQ for 916 university students were subjected to confirmatory factor analysis. Results indicated that the factor structure for the CTQ was significantly different for men and women. For women, the items from the Physical Abuse subscale did not create a stable factor and thus appear not to be conceptually valid. Conversely, for men, the five-factor model provided a relatively good fit to the data. This investigation provides important information regarding sex differences in the factorial validity of the CTQ. Implications and future research directions are discussed.     

Serum levels of estradiol and testosterone and performance in different cognitive domains in healthy elderly men and women

Sex hormones could protect against age-related cognitive decline in elderly men and women. We investigated the relationships between serum total testosterone (TT), total estradiol (TE2) levels and cognitive function in 145 non-demented elderly volunteers (aged 61-91 years) who were not using hormone replacement therapy (HRT).Women (n=66) were better at verbal recall than men (n=79) and men were slightly better at naming. There was a positive relationship between serum levels of TE2 and verbal list recall but not with other verbal memory tests (e.g. Verbal Paired Associates) in women. There was a negative relationship of serum TT levels with verbal recall. Surprisingly, women who were in the upper age tertile (> 77 years of age) were better at verbal recall than men and than women younger than 72; this effect was independent of hormone levels. Men between 61 and 72 years of age showed a positive relationship between high TE2 levels and Spatial Span performance and between high TT levels and speed of information processing, while for women of this age-group, a negative relationship was found. These preliminary results were unchanged when controlling for education, sex hormone binding globulin levels, body mass index, depression, daily alcohol use and smoking.In sum, not all cognitive functions were better with higher levels of sex steroids and effects seemed to be modified by sex; the sex-sensitive tests showing the clearest effects. More research is required to investigate whether there is a window of time in which hormone therapy could be beneficial for middle-aged men.     

Psychopathy and personality. An investigation of the relationship between the NEO-Five Factor Inventory (NEO-FFI) and the Psychopathy Checklist-Revised (PCL-R) in a hospitalized sample of male offenders with personality disorder

Background The concept of psychopathy, as measured by the Psychopathy Checklist‐Revised (PCL‐R), has good reliability and validity and there is a small amount of literature relating it to more general personality traits. Such relationships have not, however, been demonstrated across a variety of populations. Aim To examine the relationship between the PCL‐R and the NEO‐Five Factor Inventory (NEO‐FFI) in a sample of men detained in a secure hospital unit because of personality disorder and having been convicted of at least one criminal offence. Method PCL‐R and NEO‐FFI measures were obtained for 100 men as part of a pre‐admission assessment to a specialist personality disorder treatment unit. Results After controlling for Intelligence Quotient (IQ) and scores on the other four NEO‐FFI domains, PCL‐R total scores were significantly negatively correlated with agreeableness (r = ?0.36) and neuroticism (r = ?0.22). No other correlations with total scores were significant. PCL‐R Factor 1 scores were significantly negatively correlated with agreeableness (r = ?0.31) and with neuroticism (r = ?0.26) whereas Factor 2 scores were significantly positively correlated with extraversion (r = 0.22) and negatively with agreeableness (r = ?0.21). Conclusions Results were in line with findings from previous studies and were explained in part by considering how facets of the NEO‐FFI map onto the concept of psychopathy. Further research is needed to ascertain whether similar relationships also apply among women, and to examine the relationship between psychopathy and specific facets of the five factor model. Copyright © 2008 John Wiley & Sons, Ltd.     

Psychometric evaluation of a brief geriatric depression screen

This article is a psychometric evaluation of the experimental Geriatric and Extended Careline Depression Screen (GEDS) for geriatric nursing care residents. The GEDS is a five-item depression screen based on an abbreviated version of the Center for Epidemiological Studies Depression Scale (CES-D). A total sample of 91 male residents over the age of 60 were recruited from a Veterans Administration Nursing Home Care Unit. The Geriatric Depression Scale-Short Form (GDS-SF) was used as a gold standard test to examine the convergent validity of the GEDS. The Discriminant Trait Inventory was used to assess divergent validity and the confounding effects of method variance in this research design. Test-retest reliability, redundance and omission in item content validity were systematically evaluated. A receiver operating characteristics (ROC) curve was used to identify the most effective cut-off score for clinical selection. Reliability was significant, but moderate. Convergent validity with the Geriatric Depression Scale was high. No items were identified as redundant. A review of literature suggested that irritability is an important factor of geriatric depression that had not been included in the original screen. The inclusion of an experimental item to assess irritability, however, did not improve the psychometric properties of the GEDS.     

The psychometric properties of the Socio-Moral Reflection Measure – Short Form and the Moral Theme Inventory for men with and without intellectual disabilities

Drawing conclusions from the literature regarding the moral development of people with intellectual disabilities (IDs) is difficult because of the use of unstandardised and idiosyncratic measures. In order to address this short-coming, a moral reasoning production measure (the Socio-Moral Reflection Measure – Short Form; SRM-SF) and a recognition measure (the Moral Theme Inventory; MTI) were presented to men with and without IDs who had no known history of engaging in illegal behaviour. The instruments were completed on two occasions, separated by a two-week interval, in order to investigate their basic psychometric properties. The results indicated that there was a strong relationship between the MTI and the SRM-SF, suggesting that the MTI has convergent validity. The internal consistency of the MTI and the SRM-SF ranged from moderate to substantial for both men with and without IDs. However, the test–retest reliability of the MTI was poor for men with IDs, while it was good for men without IDs. The test–retest reliability of the SRM-SF was good for both men with and without IDs. Comparison of the moral reasoning abilities of men with and without IDs suggested that many of the differences between the two groups could be accounted for by general intellectual functioning. The exception was overall score on the SRM-SF and moral reasoning in relation to the law, where men with IDs scored at stage 2(1), when intelligence was controlled. The results were interpreted by suggesting that the relationship between moral reasoning and illegal behaviour may take an inverted U curve shape, moderated by intelligence.