Attitudes towards neuroleptic treatment: reliability and validity of the attitudes towards neuroleptic treatment (ANT) questionnaire

Non-compliance problems may rise to 50% among patients undergoing neuroleptic treatment. There are no direct measures available to predict compliance, if previous non-compliance is not taken into account. Attitudes towards neuroleptic treatment and insight into psychotic symptoms may vary during the course of the treatment process. It would be relevant to evaluate these items before taking any clinical action and later reassess the degree of change. The instrument thus far available has been the Drug Attitude Inventory. It has limitations for use with first-episode-patients and their follow-up. Its statements are dichotomous, which makes it difficult to determine the variation of attitudes e.g. during maintenance treatment, and most of the items concentrate on the subjective state of the patient, leaving attitudes as a minority in the scale.In this study, we report the new Attitudes towards Neuroleptic Treatment (ANT) questionnaire for the quantitative assessment of attitudes. We developed 10 statements for attitudes and two items for insight in the Visual Analogue Scale form (0-100 points). These were compared with the Drug Attitude Inventory 10 Questionnaire (DAI-10) (Hogan, T. P., Awad, A.G., Eastwood, R., 1983. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol. Med. 13, 177-183.) among 106 subjects receiving neuroleptic medication.The 12 Visual Analogue Scales showed a high inter-item consistency and fair test-retest validity. The results were in accordance with the DAI-10. The scales comprised three factors: general attitudes, subjective feeling and expectations and insight.Attitudes towards neuroleptic treatment and insight into psychotic symptoms are different dimensions and can be measured quantitatively. The Attitudes towards Neuroleptic Treatment scale is useful in assessing the state of attitudes before starting medication and for follow-up among patients receiving neuroleptic medication.     

Illness concerns, attitudes towards homosexuality, and social support in gay men with AIDS

High levels of illness-related psychologic distress, marked social stigmatization and loss of social support, and negative internalized feelings towards homosexuality have previously been reported in homosexual men with the diagnosis of acquired immune deficiency syndrome (AIDS). We assessed 50 homosexual or bisexual men who were within 3 months of their AIDS diagnosis with respect to medical status, illness concerns, attitudes towards homosexuality, and social support. Subjects reported levels of illness-related concerns comparable to previously studied cancer patients. Their attitudes towards homosexuality were similar to previously studied healthy homosexual males. Their social support needs were variable, as was their satisfaction with specific types of social support. Their social networks were moderately small. In this AIDS subject group, illness concerns, attitudes toward homosexuality, and social support satisfaction were significantly correlated with each other, and with previously reported levels of psychologic distress and subjective (but not objective) measures of health status.     

Attitude measurement using the Implicit Association Test (IAT)

Three years ago, Greenwald, McGhee, and Schwartz (1998) presented a new method to measure differential evaluative association of two target concepts: the Implicit Association Test (IAT). It has been asserted that the IAT allows for the assessment of implicit attitudes by comparing response times in two combined discrimination tasks. Although the distribution and employment of this method has been quite successful, the processes underlying IAT-effects, as well as the psychometric properties of specific IAT-variants, have received relatively little attention up to now. The articles included in the present special issue especially focus on these aspects.     

Figure-ground asymmetries in the Implicit Association Test (IAT)

Based on the assumption that binary classification tasks are often processed asymmetrically (figure-ground asymmetries), two experiments showed that association alone cannot account for effects observed in the Implicit Association Test (IAT). Experiment 1 (N = 16) replicated a standard version of the IAT effect using old vs. young names as target categories and good and bad words as attribute categories. However, reliable compatibility effects were also found for a modified version of the task in which neutral words vs. nonwords instead of good vs. bad words were used as attribute categories. In Experiment 2 (N = 8), a reversed IAT effect was observed after the figure-ground asymmetry in the target dimension had been inverted by a previous go/nogo detection task in which participants searched for exemplars of the category "young." The experiments support the hypothesis that figure-ground asymmetries produce compatibility effects in the IAT and suggest that IAT effects do not rely exclusively on evaluative associations between the target and attribute categories.     

Doctors' attitudes to male homosexuality: A survey

A 31-item questionnaire examining doctors' attitudes to male homosexuality was circulated to 510 psychiatrists and trainee psychiatrists and 510 general practitioners (GPs) in the Midlands region of the United Kingdom. In spite of the low response rates, the psychiatrists showed consistently more liberal responses. However, 3% of the psychiatrists and 9% of the general practitioners still see homosexuality as an illness. General Practitioners tended to be less liberal in their attitudes and more likely to believe in stereotypes of male homosexuals; they also felt that their religious views were more important in moulding their attitudes. Psychiatrists saw fear of heterosexual activities and unsuccessful heterosexual experiences as important causes of male homosexuality. The differences in responses are compared and suggestions for future research made.     

Implicit association measurement with the IAT: evidence for effects of executive control processes

It is argued that a model of goal-independent spreading activation in a social or semantic knowledge structure is insufficient to explain implicit association effects in the IAT (Greenwald, McGhee, & Schwartz, 1998). An alternative account is proposed, which attributes IAT effects to differential costs for switching between task sets. Two experiments were conduced to test this account. In Experiment 1, specific task-set switching cost was a function of IAT condition: switching between tasks was associated with significantly more cost in the incompatible IAT phase. In a second experiment the magnitude of the IAT effect was reduced when task-set reconfiguration was possible in advance of or simultaneously with the upcoming stimulus. The results are discussed with respect to recently suggested accounts of the effect.     

世界卫生组织残疾态度量表中文版的信度、效度分析**

背景：为客观科学地评价人们对待残疾和残疾人的态度,需研制出一份专门针对残疾和残疾人的态度量表,以了解人们对待残疾人的态度及其影响因素。 目的：考核世界卫生组织残疾态度量表中文版的信度和效度。 方法：采用全球多中心同步研究的方法研制世界卫生组织残疾态度量表。通过多阶段分层整群随机抽样抽取1 037名残疾人、507名残疾人照顾者及354名正常人,对其进行问卷调查。对其中109名残疾人间隔1周进行量表的重复测量。采用克朗巴赫α系数评价量表的内部一致性信度,通过前后2次测量各方面得分的相关系数以及配对检验来考察量表的重测信度,采用探索性因子分析评价量表的结构效度。 结果与结论：共回收残疾人问卷1 000份、残疾人照顾者问卷507份、正常人问卷354份。量表回收率大于95.0%,条目缺失率低于1.10%;量表各个方面的克朗巴赫α系数为0.588~0.837;重复测量前后得分差异无显著性意义;不同人群对待残疾的态度各有不同,因子分析结果表明量表反映出的内在结构与原量表构造基本一致。说明世界卫生组织残疾态度量表中文版具有较好的可接受性、信度和效度,可用于国人对待残疾和残疾人态度的研究。 关键词：残疾人;态度;信度;效度;世界卫生组织残疾态度量表     

Child mania rating scale: development, reliability, and validity

OBJECTIVE: To develop a reliable and valid parent-report screening instrument for mania, based on DSM-IVsymptoms. METHOD: A 21-item Child Mania Rating Scale-Parent version (CMRS-P) was completed by parents of 150 children (42.3% female) ages 10.3 +/- 2.9 years (healthy controls = 50; bipolar disorder = 50; attention-deficit/hyperactivity disorder [ADHD] = 50). The Washington University Schedule for Affective Disorders and Schizophrenia was used to determine DSM-IV diagnosis. The Young Mania Rating Scale, Schedule for Affective Disorders and Schizophrenia Mania Rating Scale, Child Behavior Checklist, and Child Depression Inventory were completed to estimate the construct validity of the measure. RESULTS: Exploratory and confirmatory factor analysis of the CMRS-P indicated that the scale was unidimensional. The internal consistency and retest reliability were both 0.96. Convergence of the CMRS-P with the Washington University Schedule for Affective Disorders and Schizophrenia mania module, the Schedule for Affective Disorders and Schizophrenia Mania Rating Scale, and the Young Mania Rating Scale was excellent (.78-.83). The scale did not correlate as strongly with the Conners parent-rated ADHD scale, the Child Behavior Checklist -Attention Problems and Aggressive Behavior subscales, or the child self-report Child Depression Inventory (.29-.51). Criterion validity was demonstrated in analysis of receiver operating characteristics curves, which showed excellent sensitivity and specificity in differentiating children with mania from either healthy controls or children with ADHD (areas under the curve of.91 to.96). CONCLUSION: The CMRS-P is a promising parent-report scale that can be used in screening for pediatric mania.     

Development of the Bipolar Inventory of Symptoms Scale: concurrent validity, discriminant validity and retest reliability

Scales used in studies of bipolar disorder have generally been standardized with major depressive or hospitalized manic patients. A clinician rated scale based on a semi-structured interview for persons with bipolar disorder, with comprehensive coverage of bipolar symptomatology, is needed. We report concurrent, divergent and convergent psychometric reliability, discriminant validity and relationship to a measure of overall function for a new psychometric rating instrument. A primarily outpatient sample of 224 subjects was assessed using the Bipolar Inventory of Symptoms Scale (BISS). The BISS total score and depression and mania subscales were compared to the Young Mania Rating Scale (YMRS), the Montgomery Asberg Depression Rating Scale (MADRS) and the Global Assessment of Functioning Scale (GAF). Clinical mood states were also compared using the BISS. The BISS scores demonstrated good concurrent validity, with estimates (Pearson correlations) ranging from 0.74 to 0.94 for YMRS and MADRS and test-retest reliability from 0.95 to 0.98. BISS concurrent validity with the GAF was significant for four clinical states, but not mixed states. The BISS discriminated primary bipolar mood states as well as subjects recovered for eight weeks compared to healthy controls. In conclusion, the BISS is a reliable and valid instrument broadly applicable in clinical research to assess the comprehensive domains of bipolar disorder. Future directions include factor analysis and sensitivity to change from treatment studies.     

Impact of illness scale: reliability, validity, and cross-cultural utility

We report on the development of a brief (nine-item) Impact of Illness Scale (IIS), which measures the degree that an illness is perceived to restrict psychosocial functioning. The measure is shown to have high internal consistency in a variety of samples. Its construct validity is indicated by correlations with other scales measuring general functioning in samples affected by illness. There is little variation in correlations between the IIS and other measures across a number of groups from different language and cultural backgrounds. This, together with the finding that items retain their psychometric properties when used to make general ratings of mental disorders, suggests that the content of the IIS is valid. The results suggest the IIS is a reliable and valid measure of psychosocial impact of illness that may be applicable in a wide range of sociocultural settings.     

The Psychiatric Diagnostic Screening Questionnaire: development, reliability and validity

The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is a self-report scale designed to screen for the most common DSM-IV axis I disorders encountered in outpatient mental health settings. We report the results of four studies of the PDSQ involving more than 2,500 subjects receiving outpatient mental health care. In two studies we examined the understandability of the items on the PDSQ. Items that initially were less well understood were rewritten, and all items of the final version of the scale were understood by more than 90% of the respondents. In the other two studies, the reliability and validity of the PDSQ subscales was examined. A priori criteria were established to guide the revision of subscales. The final version of the questionnaire contains 13 subscales (major depressive disorder [MDD], bulimia, post-traumatic stress disorder [PTSD], panic disorder, agoraphobia, social phobia, generalized anxiety disorder [GAD], obsessive-compulsive disorder [OCD], alcohol abuse/dependence, drug abuse/dependence, somatization, hypochondriasis, and psychosis), each of which achieved good to excellent levels of internal consistency, test-retest reliability, and discriminant, convergent, and concurrent validity.     

The reliability and validity of the SAS-SMI

The reliability and validity of the SAS-SMI (Social Adjustment Scale for the Severely Mentally Ill) were assessed in three samples of 670 persons with severe mental illness from a public mental health system. The SAS-SMI retained comparable factor structures (Social, Family, Work, Residential Stability, Romantic Interest, and Personal Well-being) to its predecessor, the SAS-II, and yielded high item-to-scale internal consistency correlations, good interrater reliability, and comparable convergent and divergent validity. The SAS-SMI's performance across these dimensions makes it a potentially valuable tool in mental health services research investigations. Limitations and suggestions for further development are discussed.     

Intermittent explosive disorder-revised: Development, reliability, and validity of research criteria

The study of human aggression has been hindered by the lack of reliable and valid diagnostic categories that specifically identify individuals with clinically significant displays of impulsive aggressive behavior. DSM intermittent explosive disorder (IED) ostensibly identifies one such group of individuals. In its current form, IED suffers from significant theoretical and psychometric shortcomings that limit its use in clinical or research settings. This study was designed to develop a revised criteria set for IED and present initial evidence supporting its reliability and validity in a well characterized group of personality disordered subjects. Accordingly, research criteria for IED-Revised (IED-R) were developed. Clinical, phenomenologic, and diagnostic data from 188 personality disordered individuals were reviewed. IED-R diagnoses were assigned using a best-estimate process. The reliability and construct validity of IED-R were examined. IED-R diagnoses had high interrater reliability (kappa = .92). Subjects meeting IED-R criteria had higher scores on dimensional measures of aggression and impulsivity, and had lower global functioning scores than non-IED-R subjects, even when related variables were controlled. IED-R criteria were more sensitive than DSM-IV IED criteria in identifying subjects with significant impulsive-aggressive behavior by a factor of four. We conclude that in personality disordered subjects, IED-R criteria can be reliably applied and appear to have sufficient validity to warrant further evaluation in field trials and in phenomenologic, epidemiologic, biologic, and treatment-outcome research.     

Implicit attitudes towards children with autism versus normally developing children as predictors of professional burnout and psychopathology

Tutors trained in applied behaviour analysis (n = 16) and mainstream school teachers (n = 16) were exposed to an Implicit Relational Assessment Procedure (IRAP) designed to assess implicit attitudes towards individuals with autism versus normally developing individuals. Participants also completed a range of explicit measures, including measures of professional burnout and psychopathology. All participants produced more negative biases towards children with autism compared to children who were normally developing. Increased negativity towards autism on the IRAP predicted similar attitudes on some of the explicit measures and also correlated with increased levels of self-reported psychopathology and professional burnout for the tutors working with children with autism. Results suggest that implicit measures of attitudes may provide a marker for professional burnout.