Validity and reliability of the Structured Clinical Interview for Obsessive‐Compulsive Spectrum (SCI‐OBS) and of the Structured Clinical Interview for Social Phobia Spectrum (SCI‐SHY)

This paper reports on the psychometric properties of the Structured Clinical Interview for Obsessive‐Compulsive Spectrum (SCI‐OBS) and the Structured Clinical Interview for Social Phobia Spectrum (SCI‐SHY). Interviews were administered to 135 patients with psychiatric disorders and 119 controls. During the same session, subjects were given the Mini International Neuropsychiatric Interview (MINI), the Liebowitz Social Anxiety Scale (LSAS), the Checklist for Obsessions and Compulsions and the Yale‐Brown Obsessive‐Compulsive Scale (Y‐BOCS). Patients and raters also answered specific questions on acceptability and usefulness of the interviews. Inter‐rater reliability was assessed by administering the interviews to 36 patients with psychiatric disorders and 12 controls. The internal consistency of all domains of the interviews was from moderate to substantial (Kuder‐Richardson coefficient >0.60). Discriminant validity was excellent. The concurrent validity of the SCI‐SHY versus the LSAS and of the SCI‐OBS versus the Checklist for Obsessions and Compulsions was satisfactory. However, no association was found between Y‐BOCS and the SCI‐OBS domains. Inter‐rater reliability was substantial. Both interviews were rated as meaningful and clear by most subjects. Raters' attitudes toward the utility of these interviews for understanding patients and their foreseeable use in their practice varied, but most were in favour of administering them as self‐report instruments. Copyright © 2000 Whurr Publishers Ltd.     

A Structured Clinical Interview for Kleptomania (SCI‐K): preliminary validity and reliability testing

Kleptomania presents difficulties in diagnosis for clinicians. This study aimed to develop and test a DSM‐IV‐based diagnostic instrument for kleptomania. To assess for current kleptomania the Structured Clinical Interview for Kleptomania (SCI‐K) was administered to 112 consecutive subjects requesting psychiatric outpatient treatment for a variety of disorders. Reliability and validity were determined. Classification accuracy was examined using the longitudinal course of illness. The SCI‐K demonstrated excellent test‐retest (Phi coefficient = 0.956 (95% CI = 0.937, 0.970)) and inter‐rater reliability (phi coefficient = 0.718 (95% CI = 0.506, 0.848)) in the diagnosis of kleptomania. Concurrent validity was observed with a self‐report measure using DSM‐IV kleptomania criteria (phi coefficient = 0.769 (95% CI = 0.653, 0.850)). Discriminant validity was observed with a measure of depression (point biserial coefficient = −0.020 (95% CI = −0.205, 0.166)). The SCI‐K demonstrated both high sensitivity and specificity based on longitudinal assessment. The SCI‐K demonstrated excellent reliability and validity in diagnosing kleptomania in subjects presenting with various psychiatric problems. These findings require replication in larger groups, including non‐psychiatric populations, to examine their generalizability. Copyright © 2006 John Wiley & Sons, Ltd.     

Acceptability,validity and reliability of the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS): a pilot study

This paper reports on the acceptability, reliability and validity of the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS), a new instrument exploring the interactive pathway between substance abuse and psychiatric disorders. Psychiatric outpatients with (n = 21) and without (n = 32) substance abuse comorbidity according to the DSM-IV, non-psychiatric subjects with opioid dependence (OD, n = 14) and normal controls (n = 33) were assessed with the SCI-SUBS. The presence or absence of psychiatric disorders was determined with the Structured Clinical Interview for DSM IV (SCID). The SCI-SUBS was well accepted by participants. The internal consistency of the domains was satisfactory (between 0.64 and 0.93). Domain scores of OD subjects were significantly higher than those of controls and of psychiatric patients without substance abuse. The cut-off point on the SCI-SUBS total score at which there was optimal discrimination between the presence and the absence of a DSM-IV diagnosis of substance abuse was 45. The pilot version of the SCI-SUBS has satisfactory internal consistency and construct validity.     

A semi-structured clinical interview for psychosis sub-groups (SCIPS): development and psychometric properties

Background

Clinical sub-groups of schizophrenia, namely drug related, traumatic, anxiety and stress sensitivity sub-types, have been proposed for use in research, training and practice. They were developed on the basis of clinical observation but have not yet been used in research or clinical practice to any great extent.

Aims

To develop a semi-structured clinical interview for psychosis sub-groups (SCIPS) and determine the best diagnostic criteria with the highest inter-rater reliability, test–retest reliability and concurrent validity for sub-grouping patients with schizophrenia according to a newly developed classification scheme.

Methods

The SCIPS was developed based upon discussion with the clinician researchers who had developed and were using the sub-groups. Kappa coefficients were calculated between two independent diagnostic assessments with the SCIPS (for inter-rater reliability and test–retest reliability, n?=?20) and between the SCIPS diagnosis and the sub-groupings as determined independently with highest achievable validity (for concurrent validity, n?=?21) for patients with schizophrenia. These inter-rater reliability and concurrent validity were compared among five different sets of diagnostic criteria to determine which was most reliable and valid.

Results

A set of diagnostic criteria with the highest inter-rater reliability and concurrent validity was determined. Kappa coefficients (95% confidence interval) for the inter-rater reliability and concurrent validity were 0.93 (0.66–1.20) and 0.73 (0.47–1.00), respectively, with these diagnostic criteria.

Conclusions

The SCIPS is a promising tool with which to sub-group patients with schizophrenia according to this recently developed classification scheme. The semi-structured interview achieves acceptable inter-rater and test–retest reliability and concurrent validity.     

Internal consistency and discriminant validity of the Structured Clinical Interview for Panic Agoraphobic Spectrum (SCI-PAS)

This paper reports on the feasibility, acceptability and psychometric properties of the Structured Clinical Interview for Panic-Agoraphobic Spectrum (SCI-PAS). This interview was designed to assess the lifetime presence of symptoms and other clinical features considered to comprise the panic-agoraphobic spectrum. The interview has 114 items grouped into nine domains. A total of 422 subjects, from 11 centres located throughout Italy, participated in this study. Data were collected from three groups of subjects: psychiatric patients meeting DSM-IV criteria for panic disorder (n = 141), cardiovascular patients (n = 140), including 29 with post-myocardial infarction, and university students (n = 141). The inter-rater reliability and the internal consistency of the SCI-PAS measures were assessed using the intra-class correlation coefficient and the Kuder-Richardson coefficient, respectively. Discriminant validity was assessed by comparing results in patients with panic disorder to those in the other groups. The interview required an average of 25 (±5) minutes to administer. Patients and clinicians found the scale to be highly useful, providing information not previously obtained. Internal consistency was good (>0.70) for six out of nine SCI-PAS domains. The inter-rater reliability was excellent (>0.70) for all the domains except for ‘other phobias’ (0.467). Patients with panic disorder scored significantly higher on each domain, and on the overall panic spectrum, than did the control subjects. In conclusion, the SCI-PAS is a useful clinical interview, which can be administered in a reasonable period of time. This assessment further demonstrates good internal consistency, discriminant validity, and inter-rater reliability. Copyright © 1999 Whurr Publishers Ltd.     

Cross-cultural validity of the Structured Clinical Interview for Panic-Agoraphobic Spectrum

Abstract Background We sought to develop a series of assessment measures of psychiatric spectrum conditions associated with major DSM-IV mood and anxiety disorders that might capture the true phenotypes underlying these disorders. The specific objective of this report was to describe the methods we employed to create instruments that could cross linguistic and national boundaries and to evaluate the comparability of results obtained when one of these instruments, the Structured Clinical Interview for Panic-Agoraphobic Spectrum (SCI-PAS), was administered in the United States and in Italy. Method After developing, in parallel, the English and the Italian versions of the SCI-PAS, identical protocols were conducted in patients and control samples at the University of Pittsburgh and the University of Pisa to examine the reliability and validity of the interview. Results Total and domain scores on the SCI-PAS were strikingly similar in the US and Italian patient groups and in controls. In addition, similarly high levels of inter-rater and test-retest reliability were found at the two sites. Finally, virtually identical patterns of relationships were found between the domains of the SCI-PAS and established measures of the same constructs. Conclusions The SCI-PAS displays similar reliability and validity properties in the two versions. This suggests that the instrument taps a phenotype that is consistent in American and Italian patient and control populations.     

Validity and reliability of a new instrument for assessing mood symptomatology: the Structured Clinical Interview for Mood Spectrum (SCI-MOODS)

We evaluated the internal consistency, discriminant validity, inter-rater reliability and test–retest reliability of a new instrument for the assessment of lifetime symptoms related to mood spectrum disorders: the Structured Clinical Interview for Mood Spectrum (SCI-MOODS). We report on results obtained from 491 subjects assessed across eight psychiatric centres in Italy who were given the SCI-MOODS and the Mini International Neuropsychiatric Interview (MINI). The study sample consisted of four groups: 141 students, 116 gastrointestinal (GI) patients, 112 bipolar patients and 122 patients with recurrent depression. To evaluate the inter-rater reliability and the test–retest reliability, an additional group of 30 subjects (10 non-psychiatric patients enrolled in an orthopaedic clinic, 10 unipolar patients and 10 bipolar patients) was given the SCI-MOODS at a baseline assessment and six to eight days later. At the baseline assessment, these subjects were also interviewed using the Structural Clinical Interview for DSM-IV (SCID IV) and were rated for the severity of symptomatology using the Clinical Global Impression Scale (CGI). The internal consistency of the four domains and six subdomains of the interview, expressed in terms of the Kuder–Richardson coefficient, was high, ranging from 0.79 to 0.92. Correlations of each of the domains with the others ranged from 0.63 to 0.85, indicating a strong interrelationship among the domains. Moreover, the correlations of each of the three manic subdomains with the others and each of the three depressive subdomains with the others were consistently higher than those between manic and depressive subdomains. The SCI-MOODS was found to discriminate between patients with mood disorders and subjects belonging to two control groups as well as between bipolar and unipolar patients. The inter-rater reliability for the four domains and the six subdomains was excellent, with the intra-class correlation coefficient being close to unity for each of them. Test–retest reliability was also excellent, ranging from 0.93 to 0.94 for the four domains. Test–retest reliability was slightly lower in the manic (0.86 to 0.89) than in the depressive subdomains (0.95 to 0.96), but well within the acceptable range. These findings provide strong support for the internal consistency, the discriminant validity and the reliability of the SCI-MOODS. Copyright © 1999 Whurr Publishers Ltd.     

Reliability and validity of severity dimensions of psychopathology assessed using the Structured Clinical Interview for DSM‐5 (SCID)

This study examined whether the Structured Clinical Interview for DSM (SCID), a widely used semistructured interview designed to assess psychopathology categorically, can be adapted to identify reliable and valid severity dimensions of psychopathology. The present study also examined whether these severity dimensions have better psychometric properties (internal consistency, test–retest reliability, and concurrent and predictive validity) than categorical diagnoses. Participants (N = 234) were recruited from the community and clinics. Retest reliability and prospective predictive validity (symptoms and functioning 1 year later) were examined in subsamples of participants. Dimensional severity scales were created from an adapted version of the SCID for both current and lifetime major depression, alcohol, substance, post‐traumatic stress disorder, panic, agoraphobia, social anxiety, specific phobia, obsessive–compulsive disorder, and generalized anxiety disorder. The SCID's severity scales demonstrated substantial internal consistency (all Cronbach's αs >.80), test–retest reliability, and concurrent and predictive validity. Symptom severity scales demonstrated significant incremental validity over and above categorical diagnoses for both current and prospective outcomes. The psychometric properties of SCID‐identified symptom scales were far superior to the psychometrics of categorical diagnoses for both current and lifetime psychopathology. These results highlight the feasibility and utility of the SCID to assess reliable and valid symptom severity dimensions of both current and lifetime psychopathology.     

Comparing self- and expert rating: a self-report screening version (SIAB-S) of the Structured Interview for Anorexic and Bulimic Syndromes for DSM-IV and ICD-10 (SIAB-EX)

Objective: Carrying out structured interviews in larger numbers by well-trained interviewers is costly and time consuming. Therefore, we developed parallel to the existing Structured Interview for Anorexic and Bulimic Syndromes (SIAB-EX) a similarily designed questionnaire for symptoms of disordered eating and related areas (SIAB-S). Method: 377 treated eating disordered patients were assessed within a two-week time period using both the SIAB-EX and SIAB-S. Results: Generally, self-ratings based on the SIAB-S were quite similar to expert ratings. Cohen's kappa showed good agreement between self- and expert ratings. Factor structure based on principal component analyses of expert ratings or self-ratings led to rather similar results confirming the robustness of the subscales in self- and expert ratings. Using expert rating as a criterion, the self-rating (SIAB-S) – which can more easily be used for screening purposes – had a sensitivity of 0.70, a specificity of 0.80 and a PPV = 0.91 for the DSM-IV diagnoses of AN and/or BN (worst ever condition). Diagnostic sensitivity (79/73%) and specificity (66/63%) were in an acceptable range (past/current). If we focus on the differences between the two approaches the following was found: self-rating (compared to expert-rating) resulted in lower scores for items inquiring about binges and inappropriate compensatory behaviour, attitudes towards food and eating, and social interaction. On the other hand, self-rating (compared to expert-rating) led to higher scores for items measuring general psychopathology and atypical bingeing. Conclusion: compared to the “gold standard” of data obtained with investigator-based standardised or structured interviews, data based on self-rating with items formulated clearly and concisely can lead to reliable and valid results. While complex issues (what is a binge) are difficult to assess in self-ratings, some (very personal) questions may even be better asked in a self-report questionnaire. Received: 21 June 1999 / Accepted: 22 March 2000     

Using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN 2.1) as a diagnostic interview providing dimensional measures: cross-national findings on the psychometric properties of psychopathology scales.

BackgroundThe Schedules for Clinical Assessment in Neuropsychiatry (SCAN) is a set of clinical assessment instruments developed under the auspices of WHO. In contrast to other structured diagnostic interviews, SCAN also provides possibilities for dimensional assessment of psychopathology. This paper reports cross-national findings on the psychometric properties of psychopathology scales derived from SCAN 2.1.MethodsWithin a randomized controlled trial, SCAN 2.1 was used in Dresden (Germany), Michalovce (Slovak Republic), Prague (Czech Republic), and Wrocław (Poland). Forty-seven items from Part I of SCAN 2.1, identified as qualifying for constructing dimensional measures, were, on the one hand, grouped according to their allocation to five specific SCAN 2.1 sections. On the other hand, principal component analyses were used to group the items according to their statistical relationship. To estimate the reliability of the scales, Cronbach's α was computed. To assess factor similarity across sites, Tucker's congruence coefficients were calculated. To appraise concurrent validity, mean scale scores were compared across different diagnostic groups.ResultsReliability was qualified as moderate to substantial for all generated scales. Factor-solutions differed across sites. Differences in mean scores supported the assumption that the scales might possess, in addition to face validity, concurrent validity.ConclusionsThis is the first cross-national study on the psychometric properties of psychopathology scales derived from SCAN 2.1, and findings are very encouraging concerning its use as a dimensional measure. However, further studies are needed to substantiate implementation of the scales established.     

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.     

A Persian translation of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: psychometric properties

Objective

The aim of this study is to assess the reliability and validity of a Persian translation of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders (SCID-I) through a multicenter study in a clinical population in Iran.

Method

The sample consisted of 299 subjects admitted to outpatient or inpatient services of 3 psychiatric centers in Tehran, Iran. The SCID was administered by trained interviewers. To study the test-retest reliability, a second independent SCID interview was administered to 104 of the entire sample within 3 to 7 days of the first interviews. For the assessment of validity, the SCID diagnoses were compared with the consensus clinical diagnoses made by 2 psychiatrists for all 299 patients.

Results

Diagnostic agreements between test and retest SCID administration were fair to good for most diagnostic categories. Overall weighted κ was 0.52 for current diagnoses and 0.55 for lifetime diagnoses. Specificity values for most psychiatric disorders were high (>0.85); the sensitivity values were somewhat lower.

Conclusions

The Persian translation of the SCID yields diagnoses with acceptable to good reliability and validity in a clinical population in Iran. This supports the cross-cultural use of the instrument.     

Development and psychometric validation of the Clinical Assessment Interview for Negative Symptoms (CAINS)

Progress in the development of new pharmacological and psychosocial treatments for the negative symptoms of schizophrenia is impeded by limitations of available assessment instruments. The multi-site Collaboration to Advance Negative Symptom Assessment in Schizophrenia (CANSAS) was established to develop and validate a new clinical rating scale using a transparent, iterative, and data-driven process. The Clinical Assessment Interview for Negative Symptoms (CAINS) was designed to address limitations of existing measures and assess consensus-based sub-domains, including asociality, avolition, anhedonia, affective blunting, and alogia. The structure and psychometric properties of the CAINS were evaluated in a sample of 281 schizophrenia and schizoaffective outpatients at four sites. Converging structural analyses indicated that the scale was comprised of two moderately correlated factors - one reflecting experiential impairments (diminished motivation and enjoyment of social, vocational, and recreational activities) and one reflecting expressive impairments (diminished non-verbal and verbal communication). Item-level analyses revealed generally good distributional properties, inter-rater agreement, discriminating anchor points, and preliminary convergent and discriminant validity. Results indicate that the CAINS is a promising new measure for quantifying negative symptoms in clinical neuroscience and treatment studies. Results guided item modification or deletion, and the reliability and validity of the revised, shorter version of the CAINS is in the final phase of development within the CANSAS project.     

A multidimensional spectrum approach to post-traumatic stress disorder: comparison between the Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS) and the Self-Report instrument (TALS-SR)

Dimensional approaches to psychiatric disorders have shown an increased relevance in the ongoing debate for the forthcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. In line with previously validated instruments for the assessment of different mood, anxiety, eating and psychotic spectra, we tested the validity and reliability of a newly developed Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS). The instrument is based on a multidimensional approach to post-traumatic stress spectrum that includes a range of threatening or frightening experiences, as well as a variety of potentially significant losses, to which an individual can be exposed. Furthermore, it explores the spectrum of the peritraumatic reactions and post-traumatic symptoms that may ensue from either type of life events, targeting soft signs and subthreshold conditions, as well as temperamental and personality traits that may constitute risk factors for the development of the disorder. The aim of the present study is to describe the reliability of the self-report version of the SCI-TALS: the TALS-SR.Thirty patients with PTSD and thirty healthy control subjects were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Half of the patients and controls received the TALS-SR first and the SCI-TALS after 15 days; for the other half of the sample, the order of administration was reversed.Agreement between the self-report and the interview formats was substantial. Intraclass correlation coefficients ranged from 0.934 to 0.994, always exceeding the threshold of 0.90. Our findings provide substantial support for the reliability of the TALS-SR questionnaire.