The Italian version of the Fibrofatigue Scale, a reliable tool for the evaluation of fibromyalgia symptoms

Objective: To validate a translated Italian version of the Fibrofatigue Scale (FFS). Methods: The Italian version of FFS was administered to 60 patients affected by fibromyalgia (FM) (57 patients were interviewed again 10 days later) together with the Italian version of the Fibromyalgia Impact Questionnaire (FIQ), the Stanford Health Assessment Questionnaire (HAQ) and the Medical Outcome Survey Short Form-36 (SF-36). All patients were asked about the severity of pain today (10-cm visual analogue scale) and the duration of symptoms. Test-retest reliability was assessed using Spearman correlations. Internal consistency was evaluated with Cronbach's alpha of reliability. Construct validity of the FFS was evaluated by correlations among the FFS, the FIQ and the subscales of the SF-36. Results: Mean duration of symptoms was 7.6 years, and mean age of participants was 56.3 years. Test-retest reliability was between 0.70 and 0.95 for the single items as well as for the total FFS and other components. Internal consistency was 0.90 for the overall FFS. Significant correlations were obtained between the FFS items and the SF-36. Conclusions: The Italian FFS is a reliable and valid instrument for detecting and measuring functional disability and symptoms severity in Italian patients with FM.     

Validation of the Italian version of the Charcot‐Marie‐Tooth Health Index

The Charcot‐Marie‐Tooth Health Index (CMT‐HI) is a disease‐specific patient‐reported outcome measure measuring overall disease burden in Charcot‐Marie‐Tooth (CMT) patients, designed for natural history studies and clinical trials in English‐speaking affected individuals. We developed and validated its Italian Charcot‐Marie‐Tooth Health Index (I‐CMT‐HI) version. The questionnaire was translated and culturally adapted from source into Italian by two neurologists experienced in CMT and neuromuscular disorders (NMDs). The two translations were reviewed by a panel of seven experts in CMT and NMD. The provisional version was back‐translated into English by a professional translator. The definitive Italian version was developed during a consensus teleconference by the panel and a patient representative from ACMT‐Rete. A series of clinically and genetically characterized CMT patients completed the final questionnaire; 11 participated in a test‐retest reliability assessment of the instrument. The I‐CMT‐HI was administered to 30 CMT patients (13 CMT1A, eight CMTX1, two CMT1B, two CMT1E, two CMT2I, one CMT2A, one CMT2N, one distal Hereditary Motor Neuropathy), with test‐rest in 11:14 females and 16 males, aged (mean ± SD) 48.0 ± 16.4 years (range 18‐81), with CMT Examination Score (CMTES) = 10.0 ± 4.4 (range 2‐18). The I‐CMT‐HI mean total score was 29.4 ± 21.2 (range 0.1‐60.3). The I‐CMT‐HI showed a high test‐retest reliability: intraclass correlation coefficient = 0.95 (95% confidence interval, 0.84‐0.99). No patient had difficulty in completing the questionnaire and none reported any problem with the questions' formulation. The total CMT‐HI score was positively correlated with age and CMTES, with higher disease burden with increasing age and disease severity according to the CMTES. The I‐CMT‐HI is now ready for use in clinical studies in the Italian population.     

Validation of the Italian version of the Charcot‐Marie‐Tooth disease Pediatric Scale

The Charcot‐Marie‐Tooth disease Pediatric Scale (CMTPedS) is a Rasch‐built clinical outcome measure of disease severity. It is valid, reliable, and responsive to change for children and adolescents aged 3 to 20 years. The aim of this study was to translate and validate an Italian version of the CMTPedS using a validated framework of transcultural adaptation. The CMTPedS (Italian) was translated and culturally adapted from source into Italian by two experts in CMT with good English language proficiency. The two translations were reviewed by a panel of experts in CMT. The agreed provisional version was back translated into English by a professional translator. The definitive Italian version was developed during a consensus teleconference by the same panel. CMT patients were assessed with the final version of the outcome measure and a subset had a second assessment after 2 weeks to evaluate test‐retest reliability. Seventeen patients with CMT aged 5 to 20 years (eight female) were evaluated with the CMTPedS (Italian), and test‐retest was performed in three patients. The CMTPedS (Italian) showed a high test‐retest reliability. No patient had difficulty in completing the scale. The instructions for the different items were clearly understood by clinicians and therefore the administration of the outcome measure was straight forward and easily understood by the children assessed. The CMTPedS (Italian) will be used for clinical follow‐up and in clinical research studies in the Italian population. The data is fully comparable to that obtained from the English language version.     

Building the bodily self‐awareness: Evidence for the convergence between interoceptive and exteroceptive information in a multilevel kernel density analysis study

Exteroceptive and interoceptive signals shape and sustain the bodily self‐awareness. The existence of a set of brain areas, supporting the integration of information coming from the inside and the outside of the body in building the sense of bodily self‐awareness has been postulated, yet the evidence remains limited, a matter of discussion never assessed quantitatively. With the aim of unrevealing where in the brain interoceptive and exteroceptive signals may converge, we performed a meta‐analysis on imaging studies of the sense of body ownership, modulated by external visuotactile stimulation, and studies on interoception, which involves the self‐awareness for internal bodily sensations. Using a multilevel kernel density analysis, we found that processing of stimuli of the two domains converges primarily in the supramarginal gyrus bilaterally. Furthermore, we found a right‐lateralized set of areas, including the precentral and postcentral, and superior temporal gyri. We discuss these results and propose this set of areas as ideal candidates to match multiple body‐related signals contributing to the creation of a multidimensional representation of the bodily self.     

Assessing body awareness and autonomic reactivity: Factor structure and psychometric properties of the Body Perception Questionnaire‐Short Form (BPQ‐SF)

Body awareness and reactivity dysfunction are characteristic of a range of psychiatric disorders. Although the neural pathways communicating between the body and brain that contribute to these experiences involve the autonomic nervous system, few research tools for studying subjective bodily experiences have been informed by these neural circuits. This paper describes the factor structure, reliability, and convergent validity of the Body Awareness and Autonomic Reactivity subscales of the Body Perception Questionnaire‐Short Form (BPQ‐SF). Exploratory and confirmatory factor analyses were applied to data from three samples collected via the internet in Spain and the US and a college population in the US (combined n = 1320). Body awareness was described by a single factor. Autonomic reactivity reflected unique factors for organs above and below the diaphragm. Subscales showed strong reliability; converged with validation measures; and differed by age, sex, medication use, and self‐reported psychiatric disorder. Post hoc analyses were used to create the 12‐item Body Awareness Very Short Form. Results are discussed in relation to the distinct functions of supra‐ and sub‐diaphragmatic autonomic pathways as proposed by the Polyvagal Theory and their potential dysfunction in psychiatric disorders.     

Validation of the Peritraumatic Dissociative Experiences Questionnaire self-report version in two samples of French-speaking individuals exposed to trauma.

OBJECTIVE: Peritraumatic dissociation is a risk factor for developing PTSD. The Peritraumatic Dissociative Experiences Questionnaire (PDEQ) is a self-report inventory used to assess dissociation that occurred at the time of a trauma. The aim of this study was the validation the PDEQ in French. METHOD: Ninety French speaking traumatized victims presenting to the emergency department were recruited. They were administered the PDEQ shortly after exposure and others trauma-related measures 2 weeks and 1 month posttrauma. RESULTS: Principal components factor analyses suggested a single factor solution for the PDEQ. Significant correlations between the PDEQ and acute and posttraumatic stress symptoms indicated moderate to strong convergent validity. The PDEQ also showed satisfactory test-retest reliability and internal consistency. CONCLUSION: This study is the first one to investigate such detailed psychometric findings on the PDEQ. This confirms the unity of the concept of peritraumatic dissociation and the value of the PDEQ-French Version to assess it.     

Validation of the Italian spine youth quality of life (ISYQOL) in Korean population

We aimed to evaluate the reliability and validity of the adapted Korean version of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire. Translation/retranslation of the English version of ISYQOL was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the ISYQOL and the previously validated Scoliosis Research Society-22 (SRS-22) questionnaire were mailed to 120 consecutive idiopathic scoliosis patients wearing brace. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient (ICC) and Cronbach’s α were conducted. Construct validity was also evaluated by comparing the responses of ISYQOL with the responses of SRS-22 by using Pearson’s correlation coefficient. Factor analysis extracted 2 factors. All items had a kappa statistics of agreement greater than 0.6. The ISYQOL showed good test/re-test reliability (ICC = 0.812). Internal consistency of Cronbach’s α was found to be very good (α = 0.873). The Korean version of ISYQOL showed good significant correlation with SRS-22 total score and with single SRS-22 domains scores. The adapted Korean version of the ISYQOL was successfully translated and showed acceptable measurement properties, and as such, is considered suitable for outcome assessments in the Korean speaking patients with idiopathic scoliosis.     

Validation of the Spanish version of the EURO-D scale: an instrument for detecting depression in older people

OBJECTIVE: To standardize the EURO-D scale as a method for detecting depression in Spanish older people. METHODS: In a first phase, a sample of 1080 community older people was assessed with the GMS-AGECAT by lay interviewers. In a second phase, all the probable cases and a similar number of randomly selected probable non-cases were assessed using DSM-III-R diagnosis by psychiatrists. To test reliability, internal consistency with the Cronbach alpha coefficient and test-retest reliability (Kappa value) were obtained. Validity, sensitivity and specificity, predictive values, Receiver Operating Characteristic (ROC) curve, and Specific Likelihood Ratios (SSLR) were calculated. RESULTS: A high internal consistency was obtained in both phases of the study (alpha = 0.75; alpha = 0.79, respectively). Test-retest reliability was acceptable (weighted kappa = 0.60). For the prediction of DSM-III-R diagnosis validity coefficients (cut-off point 3/4) were: sensitivity 91.8%, specificity 76.6% and area under the ROC curve 0.92 [95% Confidence Intervals (0.89-0.95)]. Illiteracy and cognitive difficulties had a small negative effect on the performance of the scale. CONCLUSIONS: The EURO-D scale is a reliable and valid instrument for detecting probable cases of depression in older people in Spain. Illiteracy and cognitive difficulties should be considered when interpreting the results.     

A common gustatory and interoceptive representation in the human mid‐insula

The insula serves as the primary gustatory and viscerosensory region in the mammalian cortex. It receives visceral and gustatory afferent projections through dedicated brainstem and thalamic nuclei, which suggests a potential role as a site for homeostatic integration. For example, while human neuroimaging studies of gustation have implicated the dorsal mid‐insular cortex as one of the primary gustatory regions in the insula, other recent studies have implicated this same region of the insula in interoception. This apparent convergence of gustatory and interoceptive information could reflect a common neural representation in the insula shared by both interoception and gustation. This idea finds support in translational studies in rodents, and may constitute a medium for integrating homeostatic information with feeding behavior. To assess this possibility, healthy volunteers were asked to undergo fMRI while performing tasks involving interoceptive attention to visceral sensations as well as a gustatory mapping task. Analysis of the unsmoothed, high‐resolution fMRI data confirmed shared representations of gustatory and visceral interoception within the dorsal mid‐insula. Group conjunction analysis revealed overlapping patterns of activation for both tasks in the dorsal mid‐insula, and region‐of‐interest analyses confirmed that the dorsal mid‐insula regions responsive for visceral interoception also exhibit strong responses to tastants. Hum Brain Mapp 36:2996–3006, 2015. © 2015 Wiley Periodicals, Inc.     

Chinese version of the Aging Perceptions Questionnaire (C-APQ): assessment of reliability and validity

Objectives: To assess the reliability and validity of the Chinese version of Aging Perceptions Questionnaire (C-APQ).

Method:Participants aged 65 years and over were recruited from February 2012 to November 2012. The Aging Perceptions Questionnaire was translated into Chinese version professionally. Content validity was examined by a panel of seven experts; item reliabilities were assessed by test–retest; internal consistency was assessed by Cronbach's α coefficient; half of the sample (N = 379) was selected to explore factorial structure of the C-APQ by exploratory factor analysis (EFA) and another half of the sample (N = 379) was selected to confirm the findings from the EFA by confirmatory factor analysis (CFA). Statistical package SPSS version 18.0 and Amos 17.0 were used for the analysis.

Results: The Cronbach's α coefficient of the C-APQ was 0.884. The test–retest reliability was satisfactory, with all intraclass correlation coefficients greater than 0.4. The overall content validity index was greater than 0.99. Seven factors (timeline acute/chronic, timeline cyclical, emotional representations, control positive, control negative, consequences positive and consequences negative) were identified in EFA and confirmed in CFA.

Conclusion: The C-APQ could be a reliable and a valid measure of the self-perceptions of aging in the elderly in China, which may help to improve the life quality and extend longevity of the elderly.     

Validation of Serbian version of the disease‐specific myasthenia gravis questionnaire

Basta I, Pekmezovi? T, Padua L, Stojanovi? V, Stevi? Z, Nikoli? A, Peri? S, Lavrni? D. Validation of Serbian version of the disease‐specific myasthenia gravis questionnaire.
Acta Neurol Scand: 2010: 122: 110–114.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Aim – The aim of this study was to validate translated and cross‐cultural adapted Italian version of myasthenia gravis‐specific questionnaire (MGQ) in Serbian MG patients. Materials and Methods – The questionnaire was validated in 140 consecutive MG patients from Belgrade. In each patient association between the total MGQ score and form and severity of the disease was determined. Also, correlation between regional domain scores of MGQ and main clinical findings according to Besinger’s clinical score was analyzed. Results – Patients’ participation in the assessment was satisfactory with excellent internal consistency and reproducibility. Total MGQ score, as well as domain scores, correlated with highly significant inverse relationship with the disease severity and clinical status of patients at the moment of completing the questionnaire. Furthermore, the bulbar domain of the questionnaire appeared more specific and sensitive than clinical history and examination. Conclusion – We concluded that the Serbian version of the MGQ may be useful as a measure of clinical outcome in patients with MG.     

Validation of the Chinese version of the Mood Disorder Questionnaire in a psychiatric population in Hong Kong

Aims:  The aim of the present study was to determine the validity of a Chinese version of the Mood Disorder Questionnaire (MDQ) as a screening instrument for bipolar disorder in a psychiatric outpatient population in Hong Kong.
Methods:  A total of 185 patients primarily being treated for mood disorders were asked to fill in the Chinese MDQ and supply other personal data during their scheduled clinic visit. The mean age was 43.0 years and 65.9% were female. A subsample of 102 randomly selected subjects, stratified by the MDQ symptom score, received a telephone-based Structured Clinical Interview for DSM-IV (SCID). Sixty-two patients (60.8%) were suffering from bipolar disorder (bipolar I, n  = 48; bipolar II, n  = 9; bipolar disorder not otherwise specified, n  = 5), 35 (34.3%) from depressive disorder, and one (1.0%) from substance dependence, while four (3.9%) were unaffected by either mood or alcohol/substance use disorder. The internal consistency, factor structure and operating characteristics of the Chinese MDQ were analyzed.
Results:  The internal consistency of the Chinese MDQ, evaluated using Cronbach alpha, was 0.82. Principal component analysis with varimax rotation indicated an 'energized-activity' factor and an 'irritability-racing thoughts' factor, which explained 47.2% of the rotated variance. The optimal cut-off was seven or more manic symptoms occurring within the same time period, which yielded a sensitivity of 0.73 and a specificity of 0.88 for detecting bipolar disorder. An additional criterion that the symptoms cause impairment resulted in significant loss of sensitivity.
Conclusion:  The Chinese MDQ is a valid screening instrument for bipolar disorder in a psychiatric outpatient population.     

Validation of the Italian version of the Neuropathic Pain Symptom Inventory in peripheral nervous system diseases

The aim of this study was to validate the Italian version of the Neuropathic Pain Symptom Inventory (NPSI) in patients with neuropathic pain due to peripheral nerve diseases, and also to evaluate the validity of a new NPSI score: a frequency weighted NPSI score (NPSI-FW). First, the original version of the NPSI was translated into Italian. Then the validity and reliability of the Italian NPSI (I-NPSI) were tested in 392 Italian patients consecutively referred to 16 Italian outpatient services for peripheral nerve diseases, by correlating the I-NPSI scores with other pain scales. The repeatability and responsiveness were assessed. A significant correlation between the I-NPSI scores and all the other pain measures was seen. Reproducibility and responsiveness were good. Our study shows the validity of the I-NPSI and demonstrates its reliability for assessing neuropathic pain in patients with peripheral nerve diseases. The I-NPSI scores represent reliable measurements to assess neuropathic symptoms and effectiveness of treatment on them.     

The 15-item version of the Boston Naming Test as an index of English proficiency

Objective: The present study was designed to examine the potential of the Boston Naming Test – Short Form (BNT-15) to provide an objective estimate of English proficiency. A secondary goal was to examine the effect of limited English proficiency (LEP) on neuropsychological test performance.Method: A brief battery of neuropsychological tests was administered to 79 bilingual participants (40.5% male, M_Age = 26.9, M_Education = 14.2). The majority (n = 56) were English dominant (EN), and the rest were Arabic dominant (AR). The BNT-15 was further reduced to 10 items that best discriminated between EN and AR (BNT-10). Participants were divided into low, intermediate, and high English proficiency subsamples based on BNT-10 scores (≤6, 7–8, and ≥9). Performance across groups was compared on neuropsychological tests with high and low verbal mediation.Results: The BNT-15 and BNT-10 respectively correctly identified 89 and 90% of EN and AR participants. Level of English proficiency had a large effect (partial η² = .12–.34; Cohen’s d = .67–1.59) on tests with high verbal mediation (animal fluency, sentence comprehension, word reading), but no effect on tests with low verbal mediation (auditory consonant trigrams, clock drawing, digit-symbol substitution).Conclusions: The BNT-15 and BNT-10 can function as indices of English proficiency and predict the deleterious effect of LEP on neuropsychological tests with high verbal mediation. Interpreting low scores on such measures as evidence of impairment in examinees with LEP would likely overestimate deficits.     

Psychometric Properties of the Korean version of the Emotion Regulation Questionnaire (K-ERQ) in a Clinical Sample

ObjectiveThe Emotion Regulation Questionnaire (ERQ) is one of the widely used instruments to assess emotion regulation skills in many countries, including Korea. However, its psychometric properties have not been validated within this population. Also, the ERQ has increasingly been used in studies with psychiatric patients despite a general lack of validation in clinical settings. Therefore, the present study aimed to investigate the psychometric properties of the Korean version of the ERQ (K-ERQ) using a clinical sample in Korea. MethodsOne hundred and ninety-three psychiatric patients completed a packet of self-report measures, including K-ERQ, K-BDI-II, K-ASI-3, PCL-5-K, AUDIT-K. Confirmatory factor analysis (CFA) was administered to investigate the factor structure of the K-ERQ, and internal reliability and validity were examined. ResultsResults of the CFA supported the two-factor structure, but only after the removal of one item. The K-ERQ showed good internal consistency reliability, and its concurrent validity was also confirmed. Cognitive reappraisal was negatively correlated with depression and alcohol use disorder-related symptoms, and expressive suppression was positively correlated with depression, anxiety sensitivity, posttraumatic stress disorder (PTSD)-related symptoms and alcohol use disorder-related symptoms. Significant group differences were found in the use of emotion regulation strategies; patients with PTSD reported the higher level of cognitive reappraisal than patients with depressive disorders, bipolar disorders, and attention-deficit hyperactivity disorder. Conclusion The 9-itemed K-ERQ is a reliable and valid tool to assess the emotion regulation strategies in a Korean clinical sample. Our study also adds preliminary evidence on the usefulness of the ERQ in clinical settings.