Assessment of Physical Self-Concept in Adolescents with Intellectual Disability: Content and Factor Validity of the Very Short Form of the Physical Self-Inventory

The purpose of this study was to test the factor validity and reliability of the Very Short Form of the Physical Self-Inventory- (PSI-VSF) within a sample of adolescents with mild to moderate Intellectual Disability (ID). A total of 362 ID adolescents were involved in two studies. In Study 1, the content and format scale response of the PSI-VSF were adapted for adolescents with ID. This instrument was thus renamed PSI-VSF-ID and two versions with two alternative responses scales format, were developed: Likert and graphical. In Study 2, results provided support for: (1) the factorial validity and reliability; and (2) factorial invariance across gender, age, type of school placement and ID level of the PSI-VSF-ID associated with a graphical response scale format.     

Construct validity of the Nutrition and Activity Knowledge Scale in a French sample of adolescents with mild to moderate intellectual disability

The purpose of this study was to test the reliability (i.e. internal consistency and test–retest reliability) and construct validity (i.e. content validity, factor validity, measurement invariance, and latent mean invariance) of the Nutrition and Activity Knowledge Scale (NAKS) in a sample of French adolescents with mild to moderate Intellectual Disability (ID). A total sample of 260 adolescents (144 boys and 116 girls), aged between 12 and 18 years old, with mild to moderate ID was involved in two studies. In the first study, analysis of items’ content reveals that many words from the original version were not understood or induced confusion. These items were reworded and simplified while retaining their original meaning. In the second study, results provided support for: (i) the factor validity and reliability of a 15-item French version of the NAKS; (ii) the measurement invariance of the resulting NAKS across genders and ID levels; (iii) the partial measurement invariance of the resulting NAKS across age groups and type of school placement. In addition, the latent means of the 15-item French version of the NAKS proved to be invariant across gender, age categories, and ID levels, but to vary across type of school placement (with adolescents schooled in self-contained classes from regular schools presenting higher levels of NAK than adolescents placed in specialized establishments). The present results thus provide preliminary evidence regarding the construct validity of a 15-item French version of the NAKS in a sample of adolescents with ID.     

Reliability and validity of the Japanese version of the Behavior Problem Inventory-Short Form

BackgroundThe Behavior Problems Inventory-Short Form (BPI-S), which assesses behavior problems in individuals with intellectual disabilities (ID), is a shorter version of the BPI-01. This study investigated the reliability and validity of the BPI-S Japanese version (BPI-S-J) for adolescents/adults with ID and behavior problems.MethodsThe test–retest reliability included participants with ID and behavioral problems who were enrolled in welfare services. For test–retest reliability, 42 caregivers independently responded to the BPI-S-J every two weeks. Inter-rater reliability was independently assessed using the BPI-S-J by two caregivers who were familiar with the 42 participants. The participants of the validity assessment were 227 students from special needs schools or patients with ID admitted to medical institutions. The total frequency total score was compared based on the degree of ID. To examine the criterion-related validity, we analyzed the total frequency score, the total score of the Criteria for Determining Severe Problem Behavior (CDSPB) and the total score of the Aberrant Behavior Checklist-Japanese version (ABC-J).ResultsThe BPI-S-J of test–retest reliability was satisfactory (intra-class correlation; ICC) = 0.954), and the total score significantly (ICC = 0.721) represented good inter-rater reliability. For the validity, the BPI-S-J score of participants who had severe and profound ID was significantly higher than those who had mild and moderate ID. Significant correlations were observed between the BPI-S-J score and CDSPB score (r = 0.499), and the ABC-J score (r = 0.699), indicating adequate criterion-related validity.ConclusionThis study showed the utility of the BPI-S-J to assess behavior problems in the Japanese ID population.     

Examining the psychometrics of the Psychopathology Inventory for Mentally Retarded Adults-II for individuals with mild and moderate intellectual disabilities

With growing recognition of the occurrence of psychological disorders in individuals with intellectual disability (ID), researchers and clinicians alike have placed emphasis on developing measures to assess for psychopathologies in this population. Despite an increased interest in the topic, there is still a dearth of psychometrically robust measures available to assess for psychopathology in adults with mild and moderate ID. The purpose of this study was to examine the psychometric properties of a revised measure for psychopathology in individuals with mild and moderate ID, the Psychopathology Inventory for Mentally Retarded Adults – second edition (PIMRA-II). Internal consistency, inter-rater reliability, and test–retest reliability were investigated. Validity was studied via convergent validity by comparing the PIMRA-II to the Assessment of Dual Diagnosis (ADD) and via discriminate validity by comparing the PIMRA-II to the Social Performance Survey Schedule (SPSS) prosocial scores. Lastly, an exploratory factor analysis was conducted to determine the factor structure of the scale.     

Self-reports on mental health problems of youth with moderate to borderline intellectual disabilities

OBJECTIVE: To determine the extent to which the Youth Self-Report (YSR) can be used to assess emotional and behavioral problems in adolescents with intellectual disabilities (IDs). METHOD: In 2003, 281 11- to 18-year-olds with IDs (IQ > or =48) completed the YSR in an interview, and in 1993, 1,047 non-ID adolescents completed the YSR themselves. Parents completed the Child Behavior Checklist (CBCL). The ID sample was split into lower (IQ 48-69) and higher (IQ > or =70) IQ groups. Cronbach's alpha values of the YSR scales and (intraclass) correlation coefficients between and within YSR and CBCL scale scores were calculated to determine parent-adolescent agreement and YSR construct validity, which were compared between samples. Mean YSR scale scores were compared between adolescents with ID with and without psychiatric symptoms. RESULTS: Cronbach's alpha, parent-adolescent agreement, and indications of construct validity were about similar in all samples, although discriminant validity was somewhat weaker in the lower IQ group. Mean scale scores were 1.5 to 2.0 times higher for ID adolescents with psychiatric symptoms. CONCLUSIONS: The YSR seems applicable in youth with an IQ > or =48. Further research is needed to refine and confirm these findings and the factor structure of the YSR in adolescents with ID and to differentiate between adolescents with moderate and mild IDs.     

Quality of life assessment in intellectual disabilities: The Escala Pessoal de Resultados versus the World Health Quality of Life-BREF

The aim of this study is to compare the applications of the Escala Pessoal de Resultados (EPR) and the World Health Quality of Life-BREF (WHOQOL-BREF) in quality of life (QOL) assessment of people with intellectual disabilities (ID). A total of 216 adults with ID were assessed (age ranging from 18 to 64 years; 128 people were diagnosed with mild, and 88 with moderate ID). The two scales were administered to each person to obtain their perception about their QOL. Statistically significant correlations (weak to moderate) were observed between both scales. The EPR and the WHOQOL-BREF demonstrated adequate reliability, construct, and discriminant validity in our sample. However, the group of adults with moderate ID scored higher on the WHOQOL-BREF than on the EPR. Results indicated that the two assessment instruments aim to evaluate different measures, and seem to be not interchangeable.     

Psychometric evaluation of a Dutch version of the Mini PAS‐ADD for assessing psychiatric disorders in adults with different levels of intellectual disability

Background People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. Method A Dutch version of the Mini PAS‐ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and criterion validity based on a large‐scale random sample (n = 377) and a clinical sample (n = 99) of adults with ID. Results The Dutch version of the Mini PAS‐ADD showed moderate internal consistency, and moderate concordance among informants. Both aspects of the reliability were comparable for different levels of ID. A factor analysis largely confirmed the scale structure. Concurrent validity with the Reiss Screen for Maladaptive Behavior was high for the Depression, Psychosis and Autism scale. The outcome of the criterion‐validity analysis indicated high specificity. The sensitivity for specific psychiatric disorders by the corresponding scales was moderate, but the general sensitivity for the presence of psychopathology on the basis of any of the scales was satisfying. Conclusions The present research reconfirmed the use of the Mini PAS‐ADD as a primary screening device for the identification of mental health problems among people with ID.     

The General Depression Scale in diagnosis of adolescents

A German version of the Center for Epidemiological Studies Depression Scale (CES-D) was used in the Zurich Epidemiological Study of Child and Adolescent Psychopathology (ZESCAP). Psychometric analyses revealed clear evidence of a central factor of depression as reflected by the CES-D. Due to good reliability, a total score of the CES-D should be used in clinical diagnostics. The first cross-sectional wave of assessment within ZESCAP found that gender, nationality (indigenous vs. migrants) and residence (urban vs. rural) are important determinants of the total score. The article provides norms for adolescents. The study of the validity of the CES-D warrants further research.     

Factor structure of the Center for Epidemiologic Studies Depression Scale in Taiwanese adolescents

BackgroundThe original study of Radloff (Appl Psychol Meas. 1977. 1:385-401) on the Center for Epidemiologic Studies Depression Scale (CES-D) indicated a 4-factor model in the adult population. However, the factor structure of the CES-D in Asian adolescents has not been extensively validated. The aim of this study was to examine the factor structure of the Chinese version of the CES-D in a large representative Taiwanese adolescent population.MethodA total of 10 116 adolescents completed the Chinese version of the CES-D. We used confirmatory factor analysis to examine the adequacy of 5 models of the factor structure in adolescents who were divided into 4 groups by sex and age. We also enrolled the variables of suicide tendency, insomnia, and peer relationships into the confirmatory factor analysis to examine the factor structure of the CES-D and examined the correlations between the CES-D factors and these variables.ResultsThe results of this study indicated that the four-factor model (depressed affect, somatic symptoms, interpersonal problems, and positive affect) had the highest validity in Taiwanese adolescents. We also found that although the 4 factors of the CES-D were correlated with each other, their correlations with suicide tendency, insomnia, and peer relationships were different.ConclusionsThis study supported the usefulness of the Chinese version of the CES-D as a tool to understand the concept of depression in Taiwanese adolescents.     

The performance of the Center for Epidemiologic Study Depression Scale (CES-D) in an Arab female community

BACKGROUND: The purpose of this study was to investigate the psychometric properties of the Arabic version of the CES-D. METHODS: Three samples of young Arab females were chosen from different young female populations (n =450). The translated version of the CES-D, sociodemographic and risk factors questionnaires were applied to the above three samples. A subsample was selected (n = 30) to re-rate the scale items and the same sample was interviewed by the SCID. The internal consistency and test-re-test reliability were estimated as well as the factor structure of the Arabic CES-D. The discriminative and criterion validity of the scale was also investigated using the ROC analysis. RESULTS: Seventy five percent (n = 350) of the subjects completed the scale. Alpha coefficient was found to be 0.88 and the split-half reliability was 0.83. The average re-test reliability (ICC = 0.59). Factor analysis yielded three factors: interpersonal problems, mixed affective/somatic factor and the positive affect factor. There was significant differences in mean total score between depressed and non-depressed subjects as classified by SCID as well as by self-perception of depression and the need for treatment. ROC analysis revealed that a cut-off point of 21 discriminated best between depressed and non-depressed subjects (sensitivity= 82%, specificity = 83% with AUC of 84%). CONCLUSION: The Arabic CES-D was found to possess reasonable reliability and reasonable discriminative and criterion validity.     

Practice-based depression screening for psychiatry outpatients: Feasibility comparison of two-types of Center for Epidemiologic Studies Depression Scales

Aims:  The Center for Epidemiologic Studies Depression Scale (CES-D) has been validated to avoid misdiagnoses of major depression in routine psychiatric outpatient settings, but it was reported to be only marginally feasible in these specific settings. A briefer and simpler version, known as the 10-item CES-D, meant to attain adequate feasibility, has been validated in geriatric outpatient settings, but it has not yet been examined in psychiatry outpatient settings. The purpose of the present study was therefore to compare the feasibility, reliability, and validity of the two types of CES-D.
Methods:  A cross-sectional analysis was conducted of 86 consecutive outpatients in a psychiatric department in a general hospital.
Results:  The 10-item CES-D has a higher feasibility than the 20-item CES-D, and its internal consistency, reliability, and validity are almost identical to those of the 20-item CES-D.
Conclusions:  The 10-item CES-D is the better instrument to use because of the higher feasibility than the 20-item CES-D in psychiatric outpatient settings. The different answer format used in each questionnaire (a yes or no format in the former vs a multiple-choice format in the latter) may influence the feasibility, rather than the number of items.     

Reliability and Validity of the Chinese Version of the Multidimensional Anxiety Scale for Children Among Chinese Secondary School Students

The objective of the current study was to develop a Chinese translation of the Multidimensional Anxiety Scale for Children (MASC) [March (1997) Multidimensional anxiety scale for children: Technical manual, Multi health systems, Toronto, ON], and to evaluate its reliability and validity. The original version of the MASC was translated into Chinese (MASC-C) and administered to 1,538 Chinese adolescents between the ages of 14 and 19. In comparison to the American normative sample [March (1997) Multidimensional anxiety scale for children: Technical manual, Multi health systems, Toronto, ON], Chinese adolescents reported significantly higher scores on the subscales of social anxiety and separation anxiety. Girls reported higher levels of anxiety on all subscales than males. Participants between the ages of 16 and 19 reported higher scores on the physical symptoms and harm avoidance subscales. The MASC-C exhibited strong internal consistency (Cronbach's alpha coefficient was 0.91 and the mean inter-item correlation coefficient was 0.20) and moderate test-retest reliability (intra-class correlation coefficient was 0.84 over a one-month interval). MASC scores inter-correlated a small to moderate degree with measures assessing negative life events and depressive symptoms indicating acceptable convergent validity. The results of confirmatory factor analyses indicated that the four-factor structure of the MASC was suitable for the Chinese sample. The four factor structure was also invariant across sex and age. As the Chinese translation of the MASC indicated high levels of reliability and validity, the MASC-C is appropriate for assessing anxiety in Chinese adolescents.     

Epidemiology of depressive symptoms in the National Longitudinal Study of Adolescent Health

OBJECTIVE: To describe the range of depressive symptoms reported by adolescents in a nationally representative U.S. sample and to examine factors associated with persistent depressive symptoms. METHOD: Secondary analysis was done on National Longitudinal Study of Adolescent Health (AddHealth) data from 13,568 adolescents who completed the initial survey in 1995 and follow-up 1 year later. Main outcomes of Center for Epidemiologic Studies-Depression Scale (CES-D) scores were analyzed by chi2 comparisons and sample-weighted logistic regression. RESULTS: Over 9% of adolescents reported moderate/severe depressive symptoms at baseline (CES-D > or = 24). Females, older adolescents, and ethnic minority youths were more likely to report depressive symptoms at baseline. Only 3% of adolescents with low initial CES-D scores (CES-D < 16) developed moderate/severe depressive symptoms at follow-up. Factors associated with persistent depressive symptoms at 1-year follow-up included: female gender, fair/poor general health, school suspension, weaker family relationships, and health care utilization. Other factors, including race and socioeconomics, did not predict persistent depressive symptoms. CONCLUSIONS: Depressive symptoms are common in adolescents and have a course that is difficult to predict. Most adolescents with minimal symptoms of depression maintain their status and appear to be at low risk for depression; however, adolescents with moderate/severe depressive symptoms warrant long-term follow-up and reevaluation.     

Working memory structure in 10- and 15-year old children with mild to borderline intellectual,disabilities

The validity of Baddeley's working memory model within the typically developing population, was tested. However, it is not clear if this model also holds in children and adolescents with mild to, borderline intellectual disabilities (ID; IQ score 55–85). The main purpose of this study was therefore, to explore the model's validity in this population. Several verbal and visuo-spatial STM and WM tasks, were administered to 115 children with mild to borderline ID (mean age 10 years) and to 98, adolescents with mild to borderline ID (mean age 15). Structural equation modeling (LISREL) shows, that Baddeley's working memory model does not fit the data of the 10-year and 15-year old, participants. Principal components analyses on the other hand show a hazy pattern with on the one, side an indication for a ‘general’ component with loadings of visuo-spatial short-term memory and, working memory tasks and a separate verbal short-term memory component. On the other hand there, is also an indication of a modality specific memory structure; a visuo-spatial- versus a verbal, component. A straight-forward dichotomy between STM and WM indicates apparently an, oversimplification, at least it is for children and adolescents with mild to borderline ID.     

Reliability and validity of the Center for Epidemiological Studies Depression Scale in 2 special adult samples from rural China

Few studies on the validation of the Center for Epidemiological Studies Depression Scale (CES-D) in Chinese have been conducted in the samples from rural area, whereas the mental health problems among rural Chinese deserve more attention. For instance, the suicide rate in rural China is about 3 times that of the urban rate. This study aimed at assessing reliability and validity of the CES-D in 2 special adult samples in rural China, with data obtained by face-to-face interviews. One sample consisted of the proxy informants for subjects who committed suicide, and the other was of the proxy informants for living controls. For each person who committed suicide and each control, a family member and close friend served as informants. This study focused on informants themselves (not the persons who committed suicide or the living control himself/herself). Suicide informants (n = 781) who had experienced the suicide of a relative or close friend in the past 6 months were compared with the control informants (n = 832) who had no such experience. Internal reliability was satisfactory (Cronbach coefficients were .949 for suicide informants and .880 for control informants). Good concurrent validity and criterion validity were found by analyzing the relations to negative life events and the Scale for Suicide Ideation. Confirmatory factor analyses indicated that 3-factor structure (positive affect, interpersonal problems, depressive mood and somatic symptoms combined) had good fit in rural Chinese. These findings suggested that the CES-D had good reliability and validity when applied in these 2 adult samples in rural China. Factor structure analyses of the CES-D indicated that “somatization” process of expressing depressive symptoms still existed among rural Chinese.     

Initial validation of the Chinese Quality of Life Questionnaire-Intellectual Disabilities (CQOL-ID): a cultural perspective

Background In the field of intellectual disabilities (ID), the quality of life concept has been developing rapidly in Chinese societies including Hong Kong, mainland China and Taiwan. However, there is a lack of locally validated instruments to measure the quality of life of people with ID. The study reported in this paper attempted to validate the Chinese Quality of Life Questionnaire – Intellectual Disabilities adapted from the Quality of Life Questionnaire developed by Schalock & Keith. Methods People with mild/moderate ID aged 15 years or above were recruited from special schools, skills centres, community service units and residential units in different regions of Hong Kong. A number of procedures were followed including reliability tests, factor analysis, content validity and construct validity. Results A total of 359 participants were recruited for the study. Factor analysis was conducted according to the rotated component matrix method, in which 23 items were extracted from the original 40‐item version of the Quality of Life Questionnaire and three domains (renamed satisfaction, competence and daily choice making/interpersonal relations) were observed. The items in each domain were shown to have factor loadings ranging from 0.42 to 0.90. Construct validity tests indicated the positive nature of the relationship between earnings, and that self‐determination and social interaction increase with more independent living environments and less segregated work environments achieving higher scores (P < 0.000, P < 0.01 and P < 0.05 respectively). The scale also achieved a good degree of reliability (Cronbach's α = 0.79). Conclusions Initial validity tests indicated that the Chinese Quality of Life Questionnaire – Intellectual Disabilities may be a useful instrument for measuring the quality of life of Chinese people with ID. Cultural issues are discussed and recommendations for future research and service development are made.     

The intellectual disability version of the very short form of the physical self-inventory (PSI-VS-ID): cross-validation and measurement invariance across gender, weight, age and intellectual disability level

Recently Maïano, Bégarie, Morin, and Ninot (2009) developed and validated an intellectual disability (ID) version of the very short form of the physical self-inventory (PSI-VS-ID). In a recent review of the various physical self-concept instruments Marsh and Cheng (in press) noted that the short and very short versions of the French PSI represent an important contribution to applied research but that further research was needed to investigate the robustness of their psychometric properties in new and diversified samples. Thus, this study is specifically designed to investigate the robustness of the PSI-VS-ID psychometric properties in a new independent sample of 248 adolescents and young adults with ID. In particular, tests of measurement invariance were conducted across the present sample and the original sample from Maïano et al. (2009) study in order to more precisely assess the degree of replication of the results. Overall, results from a series of confirmatory factor analyses of the PSI-VS-ID provided support for its: (i) factorial validity and reliability; (ii) factorial invariance across gender and weight status; (iii) partial (strict or strong) factorial invariance across age, ID level and samples; and (iv) latent mean differences across gender, weight status and ID level groups.     

Factor structure of the Schalock and Keith Quality of Life Questionnaire (QOL-Q): validation on Mexican and Spanish samples

Background The Quality of Life Questionnaire (QOL-Q) is used widely to evaluate the quality of life of persons with intellectual disability (ID). Its validity for use with Spanish-speaking cultures has been demonstrated for individuals with visual disabilities, but not for those with physical or intellectual disabilities. Such was the purpose of the present study. Method Two samples were administered the QOL-Q under standardized procedures. The first sample was composed of 209 Mexican participants with physical disabilities; the second was composed of 424 Spanish participants with ID. The hypothesis tested was: the applicability (i.e. etic properties) of the measure across countries and respondents would be demonstrated if reliability data and if factor composition were similar to the original measure. Cronbach's alpha was used to test reliability and exploratory factor analyses were used to test validity (i.e. factor structure). Results Data indicated that the reliability and factor structure was similar to that reported in the questionnaire's standardization manual and consistent with that reported in a number of Anglo-Saxon countries. Conclusion The present study offers additional support for the valid use of the QOL-Q with Spanish-speaking populations.     

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.