Development and preliminary validation of a Finnish version of the Eating Disorder Examination Questionnaire (EDE-Q)

Background: Eating behaviour can be viewed as a continuum, ranging from extremely restrictive to extremely disinhibited eating. Valid and reliable instruments are needed to ensure detection of individuals with risk for eating disorders (ED). Self-report methods are the most feasible, cost, and time efficient. One of the most widely used self-reports is the Eating Disorder Examination Questionnaire (EDE-Q).

Aim: The aim of this study was to develop a Finnish version of the EDE-Q version 6.0 and to assess its psychometric properties in adolescents, adults, and ED patients.

Methods: The present study utilized data from three different samples: adolescents (n?=?242), adults (n?=?133), and ED patients (n?=?52). The patient group comprised different EDs, but individual ED diagnoses were not studied separately. Data was collected January 2014 through June 2015.

Results: The Finnish version of the EDE-Q showed acceptable-to-excellent internal consistency on all sub-scales in all three samples and discriminated patients from healthy individuals. Female participants generally scored higher than male and sex differences were more pronounced among the younger age group.

Conclusions: The Finnish version of the EDE-Q can, based on this study, be regarded as reliable, valid, and functional. Further studies are needed to evaluate the population norms and to test the validity in individual ED diagnoses.     

Spanish validation of the 10-item Connor–Davidson Resilience Scale (CD-RISC 10) with non-professional caregivers

Objectives: Despite the importance of resilience in populations under stress, and the fact that the 10-item version Connor–Davidson Resilience Scale (CD-RISC 10) is the shortest instrument for reliable and valid evaluation of resilience, there are no data on their psychometric properties in non-professional caregivers. The aim of this study was to analyze the psychometric properties and factorial structure of the spanish version of the CD-RISC 10 in non-professional caregivers.

Method: Independently trained assessors evaluated resilience, self-esteem, social support, emotional distress and depression in a sample of 294 caregivers (89.8% women, mean age 55.3 years).

Results: The internal consistency of CD-RISC 10 was α = .86. A single factor was found that accounted for 44.7% of the total variance. Confirmatory factor analysis corroborated this unifactorial model. The CD-RISC 10 was significantly correlated with the self-esteem (r = .416, p < .001) and social support (r = .228, p < .001) scales, and the emotional distress scale (r = –.311, p < .001), though this was an inverse relationship. A score ≤ 23 was a suitable cut-off point for discriminating caregivers with depression (sensitivity = 70.0%, specificity = 68.2%).

Conclusion: The CD-RISC 10 is a reliable and valid instrument to evaluate resilience in the caregiver population.     

The subjective burden of informal caregivers of persons with dementia: extended validation of the German language version of the Burden Scale for Family Caregivers (BSFC)

Objective: In research as well as in the practice of caregiver counselling, the subjective burden of family caregivers is considered an important characteristic of home care. The objective of the present study was to provide an extended validation of the German language version of the Burden Scale for Family Caregivers (BSFC) published in 2001.

Methods: Extended validation was performed using medical, interview, and health insurance data of 351 informal caregivers and their relatives who had dementia. Cronbach's alpha was calculated to assess the internal consistency of the items, and an exploratory factor analysis was conducted to determine the structure of the BSFC. The discriminatory power and item difficulties of the 28 BSFC items were examined. Five research questions addressed construct validity. Question six addressed the BSFC score as a potential predictor of institutionalization at a follow-up time of 2.5 years (predictive validity).

Results: Exploratory factor analysis indicated that the BSFC had a single-factor structure. Cronbach's alpha for the total scale was 0.93. A significant increase in the BSFC score was observed when the severity of cognitive impairment increased, persons with dementia showed disturbing behaviour, caregivers were diagnosed with depression, care requirements increased, or the family caregiver and the person with dementia lived together. Caregiver burden emerged as a significant predictor of institutionalization. The validity of the BSFC was confirmed by the results.

Conclusion: The BSFC score allows for a valid assessment of the total caregiver burden in both research and practice. The BSFC is available for free in 20 languages (http://www.caregiver-burden.eu).     

新兵精神障碍筛查问卷的初步编制

目的：初步编制适用于部队新兵的精神障碍筛查问卷.方法根据部队新兵精神障碍终极鉴定疾病谱的构成比,结合美国精神障碍诊断与统计手册第5版(DSM－5)和中国精神障碍分类与诊断标准第3版(CCMD－3)中对相关精神障碍的诊断标准,编制他评问卷“新兵精神障碍筛查问卷”,问卷含34个条目,用于筛查13种常见精神障碍.根据39名专家的咨询结果以及100名新兵的理解力测试结果,对问卷条目进行修订,修订后的正式问卷仍含34个条目.438例精神障碍患者的家属接受正式问卷调查,采用 SPSS 16．0统计软件检验问卷的灵敏度和信度.结果问卷条目的有效性(W ＝0.149,P ＜0．05)和可操作性(W ＝0．112,P ＜0．05)较好.新兵对问卷条目的理解力为63％~94％.当问卷划界分为3~4分时,灵敏度为89．95％~93．84％.问卷内部一致性 Cronbach’s α系数为0．889,分半信度经 Spearman－Brown 校正后为0．814.问卷调查结果显示,精神分裂症患者最多(72．6％),其次是心境障碍(9．8％).结论该初步编制的新兵精神障碍筛查问卷具有良好的灵敏度和信度.     

Validation of the Spanish version of the Trunk Impairment Scale Version 2.0 (TIS 2.0) to assess dynamic sitting balance and coordination in post-stroke adult patients

Background: In recent years the Trunk Impairment Scale version 2.0 (TIS 2.0) has been a frequently used scale to assess dynamic sitting balance and trunk control for stroke patients. Objective: To translate the TIS 2.0 into Spanish and validate it as an instrument to evaluate dynamic sitting balance and trunk control and coordination for post-stroke adult patients. Methods: The original version was translated into Spanish and was agreed by a team of experts. A back-translation into English was subsequently performed and sent to the original author, who approved this version. 58 post-stroke patients’ performance was recorded on a videotape. These videos were then used to carry out four measurements to assess the intra-rater and inter-rater reliability, two of these were performed by the same rater and the third and fourth by a second and third rater. Results: The reliability was calculated by the Kappa index, and was superior to 0.80 for intra-rater reliability, while inter-rater reliability varied from 0.487 to 1. Cronbach’s alpha for internal consistency was 0.896 and to subscales dynamic sitting balance and coordination were 0.899 and 0.613 respectively. Intra-class correlations (ICC) for the summed scores of the different subscales were above 0.90 for all of them. Conclusion: The Spanish version of the TIS 2.0 is valid and reliable, and can be recommended for use in the evaluation of dynamic sitting balance and trunk control and coordination in future research on post-stroke patients. Guidelines for treatment and level of quality of trunk activity can be derived from its use.     

Spanish validation of the Person-centered Care Assessment Tool (P-CAT)

Objectives: Person-centered Care (PCC) is an innovative approach which seeks to improve the quality of care services given to the care-dependent elderly. At present there are no Spanish language instruments for the evaluation of PCC delivered by elderly care services. The aim of this work is the adaptation and validation of the Person-centered Care Assessment Tool (P-CAT) for a Spanish population.

Method: The P-CAT was translated and adapted into Spanish, then given to a sample of 1339 front-line care professionals from 56 residential elderly care homes. The reliability and validity of the P-CAT were analyzed, within the frameworks of Classical Test Theory and Item Response Theory models.

Results: The Spanish P-CAT demonstrated good reliability, with an alpha coefficient of .88 and a test–retest reliability coefficient of .79. The P-CAT information function indicates that the test measures with good precision for the majority of levels of the measured variables (θ values between ?2 and +1). The factorial structure of the test is essentially one-dimensional and the item discrimination indices are high, with values between .26 and .61. In terms of predictive validity, the correlations which stand out are between the P-CAT and organizational climate (r = .689), and the burnout factors; personal accomplishment (r = .382), and emotional exhaustion (r = ? .510).

Conclusion: The Spanish version of the P-CAT demonstrates good psychometric properties for its use in the evaluation of elderly care homes both professionally and in research.     

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Eating Disorders

Abstract

Objectives. The treatment of eating disorders is a complex process that relies not only on the use of psychotropic drugs but should include also nutritional counselling, psychotherapy and the treatment of the medical complications, where they are present. In this review recommendations for the pharmacological treatment of eating disorders (anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED)) are presented, based on the available literature. Methods. The guidelines for the pharmacological treatment of eating disorders are based on studies published between 1977 and 2010. A search of the literature included: anorexia nervosa bulimia nervosa, eating disorder and binge eating disorder. Many compounds have been studied in the therapy of eating disorders (AN: antidepressants (TCA, SSRIs), antipsychotics, antihistaminics, prokinetic agents, zinc, Lithium, naltrexone, human growth hormone, cannabis, clonidine and tube feeding; BN: antidepressants (TCA, SSRIs, RIMA, NRI, other AD), antiepileptics, odansetron, d-fenfluramine Lithium, naltrexone, methylphenidate and light therapy; BED: antidepressants (TCA, SSRIs, SNRIs, NRI), antiepileptics, baclofen, orlistat, d-fenfluramine, naltrexone). Results. In AN 20 randomized controlled trials (RCT) could be identified. For zinc supplementation there is a grade B evidence for AN. For olanzapine there is a category grade B evidence for weight gain. For the other atypical antipsychotics there is grade C evidence. In BN 36 RCT could be identified. For tricyclic antidepressants a grade A evidence exists with a moderate-risk-benefit ratio. For fluoxetine a category grade A evidence exists with a good risk-benefit ratio. For topiramate a grade 2 recommendation can be made. In BED 26 RCT could be identified. For the SSRI sertraline and the antiepileptic topiramate a grade A evidence exists, with different recommendation grades. Conclusions. Additional research is needed for the improvement of the treatment of eating disorders. Especially for anorexia nervosa there is a need for further pharmacological treatment strategies.     

Validation of the Hamilton Depression Rating Scale (HDRS) and sociodemographic factors associated with Lebanese depressed patients

Objectives

The Hamilton Depression Rating Scale (HDRS) is the most commonly used scale for the evaluation of patients’ treatments for depression. Since the HDRS has never been validated in Lebanon to our knowledge, our primary objective, therefore, is to investigate the correlation, sensitivity, specificity, as well as the reliability and the validity of the Hamilton Depression Rating Scale (HDRS) among Lebanese depressed patients. The secondary objective is to identify sociodemographic factors that would be correlated to depression among our sample.

Psychometric validation of the Geriatric Suicide Ideation Scale (GSIS) among older adults with bipolar disorder

Objectives: Across age groups, bipolar disorder (BD) carries the greatest risk of death by suicide of all psychiatric conditions; 25%–50% of those with BD will make one or more suicide attempt. Psychometrically sound instruments are required to reliably measure suicide ideation and risk of self-harm for older adults with BD. For this study, we validate the geriatric suicide ideation scale (GSIS) with adults 50+ years with BD.

Methods: We recruited a global sample of 220 older adults with BD (M = 58.50 years of age) over 19 days using socio-demographically targeted, social media advertising and online data collection. To demonstrate the construct validation of GSIS responses by older adults with BD, we computed correlations and performed regression analyses to identify predictors of suicide ideation.

Results: Our analyses support a four-factor model of responses to the GSIS (ideation, death ideation, loss of personal and social worth, and perceived meaning in life) measuring a higher order latent construct. Older adults with BD reporting low satisfaction with life and current depressive symptoms, and who misuse alcohol, report significantly higher levels of suicide ideation. Sleep quality and cognitive failures are also correlated with GSIS responses.

Conclusions: Results support the factorial validity of the GSIS with older adults with BD. Similar to other populations, the GSIS measures a four-factor structure of suicide ideation. Across BD subtypes, the GSIS appears to reliably measure suicide ideation among older adults with BD.     

Spanish validation of the Brief Assessment in Cognition in Schizophrenia (BACS) in patients with schizophrenia and healthy controls

Neurocognitive impairment is a core feature of schizophrenia and is closely associated with functional outcome. The importance of cognitive assessment is broadly accepted today, and an easy-to-use, internationality validated cognitive assessment tool is needed by researchers and in daily clinical practice. The Brief Assessment of Cognition in Schizophrenia (BACS) has been validated in English, French, Japanese and Italian. It is as sensitive to cognitive dysfunction as a standard test battery, with the advantage of requiring less than 35 minutes to complete. In our study, we tested the psychometric characteristics of a Spanish version of the BACS in 117 patients with schizophrenia-spectrum disorders and 36 healthy controls. All BACS cognitive subtests discriminated between patients and controls (P < .001), and the concurrent validity between the BACS and a traditional neuropsychological test battery was similar to that reported in other languages. We conclude that the BACS can facilitate the comparison of the cognitive performance of patients with schizophrenia in many different countries.     

The Bipolar Depression Rating Scale (BDRS): its development, validation and utility

OBJECTIVES: Unipolar and bipolar depression differ neurobiologically and in clinical presentation. Existing depression rating instruments, used in bipolar depression, fail to capture the necessary phenomenological nuances, as they are based on and skewed towards the characteristics of unipolar depression. Both clinically and in research there is a growing need for a new observer-rated scale that is specifically designed to assess bipolar depression. METHODS: An instrument reflecting the characteristics of bipolar depression was drafted by the authors, and administered to 122 participants aged 18-65 (44 males and 78 females) with a diagnosis of DSM-IV bipolar disorder, who were currently experiencing symptoms of depression. The Bipolar Depression Rating Scale (BDRS) was administered together with the Hamilton Depression Rating Scale (HAM-D), Montgomery Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). RESULTS: The BDRS has strong internal consistency (Cronbach's alpha = 0.917), and robust correlation coefficients with the MADRS (r = 0.906) and HAM-D (r = 0.744), and the mixed subscale correlated with the YMRS (r = 0.757). Exploratory factor analysis showed a three-factor solution gave the best account of the data. These factors corresponded to depression (somatic), depression (psychological) and mixed symptom clusters. CONCLUSIONS: This study provides evidence for the validity of the BDRS for the measurement of depression in bipolar disorder. These results suggest good internal validity, provisional evidence of inter-rater reliability and strong correlations with other depression rating scales.     

Linguistic validation of the Sleep Disturbance Scale for Children (SDSC) in Iranian children with Persian language

ObjectiveThe aim of this study was to have a linguistic validation of the Sleep Disturbance Scale for Children (SDSC) in Iranian children with Persian language.MethodsThe study included a randomly selected sample of children, aged 6–15 years, from three primary and secondary schools located in Isfahan City, Iran. Following the forward–backward translation method, parents completed the SDSC as well as the Pediatric Quality of Life Inventory (PedsQL™). Reliability (Cronbach’s α) and convergent validity (item–subscale and subscale–total correlations) were assessed. The association of SDSC scores with PedsQL scores was evaluated for construct validity.ResultsOne hundred children were studied; mean age, 9.36 ± 2.58 years, 68 girls. Scale Cronbach’s α was 0.82, ranging from 0.40 for ‘disorder of arousal’ to 0.86 for ‘sleep hyperhidrosis’ subscales. Convergent validity was acceptable according to the corrected item–subscale correlations (r = 0.22–0.76) and corrected subscale–total correlations (r = 0.30–0.50). The SDSC total score as well as its subscales, except the ‘disorder of arousal’, were associated with the total PedsQL score and its factors (r = −0.20 to −0.64).ConclusionThe overall psychometric properties of the Persian version of the SDSC seem to be appropriate in Iranian children.