Assessing Stressors Related to Migration in Patients With Psychiatric Disorders

2012 ◽  
Vol 28 (4) ◽  
pp. 262-269 ◽  
Author(s):  
Matthias Johannes Müller ◽  
Suzan Kamcili-Kubach ◽  
Songül Strassheim ◽  
Eckhardt Koch
Keyword(s):  
Interrater Reliability ◽  
Item Analysis ◽  
Global Assessment Of Functioning ◽  
Family Conflicts ◽  
Response Options ◽  
Reliability Indices ◽  
Dsm Iv ◽  
Functional Relevance ◽  
Sum Scores ◽  
Gaf Scores

A 10-item instrument for the assessment of probable migration-related stressors was developed based on previous work (MIGSTR10) and interrater reliability was tested in a chart review study. The MIGSTR10 and nine nonspecific stressors of the DSM-IV Axis IV (DSMSTR9) were put into a questionnaire format with categorical and dimensional response options. Charts of 100 inpatients (50 Turkish migrants [MIG], 50 native German patients [CON]) with affective or anxiety disorder were reviewed by three independent raters and MIGSTR10, DSMSTR9, and Global Assessment of Functioning scale (GAF) scores were obtained. Interrater reliability indices (ICC) of items and sum scores were calculated. The prevalence of single migration-related stressors in MIG ranged from 15% to 100% (CON 0–92%). All items of the MIGSTR10 (ICC 0.58–0.92) and the DSMSTR9 (ICC 0.56–0.96) reached high to very high interrater agreement (p < .0005). The item analysis of the MIGSTR10 revealed sufficient internal consistency (Cronbach’s α = 0.68/0.69) and only one item (“family conflicts”) without substantial correlation with the remaining scale. Correlation analyses showed a significant overlap of dimensional MIGSTR10 scores (r² = 0.25; p < .01) and DSMSTR9 scores (r² = 9%; p < .05) with GAF scores in MIG indicating functional relevance. MIGSTR10 is considered a feasible, economic, and reliable instrument for the assessment of stressors potentially related to migration.

Research Note: Inter-Rater Reliability of the Global Assessment of Functioning Scale in a Psychogeriatric Population

2003 ◽  
Vol 22 (2) ◽  
pp. 229-233 ◽  
Author(s):  
Roger Hildebrand ◽  
Erin McCann ◽  
Monty Nelson ◽  
Peter Wass
Keyword(s):  
Acute Care ◽  
Global Assessment ◽  
Cognitive Screening ◽  
Global Assessment Of Functioning ◽  
Global Functioning ◽  
Rater Reliability ◽  
Screening Assessment ◽  
Dsm Iv ◽  
Time Of Admission ◽  
Gaf Scores

ABSTRACTThe purpose of this study was an examination of the inter-rater reliability for a psychogeriatric population of the Global Assessment of Functioning (GAF), Axis V of the DSM-IV Classification System,. One-hundred-and-eight psychogeriatric patients, admitted to an acute-care psychiatric hospital, were rated on the GAF by three clinicians: a psychiatrist, a physician, and a psychologist. The psychologist also conducted a cognitive screening assessment at the time of admission, as well as a second rating of global functioning, which was carried out at the time of transfer/discharge from the admission unit. Results indicated good inter-rater reliability, with values ranging from 0.78 to 0.86. Comparisons were also made between the admission and transfer/discharge GAF scores. Implications for improving the inter-rater reliability of the GAF are discussed.

“You Say Severe, I Say Mild”: Toward an Empirical Classification of Dysarthria Severity

2021 ◽  
pp. 1-18
Author(s):  
Kaila L. Stipancic ◽  
Kira M. Palmer ◽  
Hannah P. Rowe ◽  
Yana Yunusova ◽  
James D. Berry ◽  
...  
Keyword(s):  
Speech Intelligibility ◽  
Interrater Reliability ◽  
Reliability And Validity ◽  
Roc Curves ◽  
Speaking Rate ◽  
Response Options ◽  
Cutoff Points ◽  
Healthy Control ◽  
Dysarthric Speech ◽  
Surrogate Measures

Purpose: The main purpose of this study was to create an empirical classification system for speech severity in patients with dysarthria secondary to amyotrophic lateral sclerosis (ALS) by exploring the reliability and validity of speech-language pathologists' (SLPs') ratings of dysarthric speech. Method: Ten SLPs listened to speech samples from 52 speakers with ALS and 20 healthy control speakers. SLPs were asked to rate the speech severity of the speakers using five response options: normal, mild, moderate, severe, and profound. Four severity-surrogate measures were also calculated: SLPs transcribed the speech samples for the calculation of speech intelligibility and rated the effort it took to understand the speakers on a visual analog scale. In addition, speaking rate and intelligible speaking rate were calculated for each speaker. Intrarater and interrater reliability were calculated for each measure. We explored the validity of clinician-based severity ratings by comparing them to the severity-surrogate measures. Receiver operating characteristic (ROC) curves were conducted to create optimal cutoff points for defining dysarthria severity categories. Results: Intrarater and interrater reliability for the clinician-based severity ratings were excellent and were comparable to reliability for the severity-surrogate measures explored. Clinician severity ratings were strongly associated with all severity-surrogate measures, suggesting strong construct validity. We also provided a range of values for each severity-surrogate measure within each severity category based on the cutoff points obtained from the ROC analyses. Conclusions: Clinician severity ratings of dysarthric speech are reliable and valid. We discuss the underlying challenges that arise when selecting a stratification measure and offer recommendations for a classification scheme when stratifying patients and research participants into speech severity categories.

Predictors of outcome in first-episode schizophrenia over the first 4 years of illness

2008 ◽  
Vol 38 (8) ◽  
pp. 1141-1146 ◽  
Author(s):  
P. Whitty ◽  
M. Clarke ◽  
O. McTigue ◽  
S. Browne ◽  
M. Kamali ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode ◽  
Global Assessment Of Functioning ◽  
Methodological Issues ◽  
Course Of Illness ◽  
Dsm Iv ◽  
First Episode Schizophrenia ◽  
The Relationship ◽  
Positive And Negative Symptoms

BackgroundThe outcome of schizophrenia appears to be more favourable than once thought. However, methodological issues, including the reliance on diagnosis at first presentation have limited the validity of outcome studies to date.MethodWe conducted a first-episode follow-up study of 97 patients with DSM-IV schizophrenia over the first 4 years of illness. First presentation and follow-up assessments were compared using paired t tests and a forced-entry regression analysis was used to determine prognostic variables.ResultsThere were significant improvements in positive and negative symptoms and global assessment of functioning between first presentation and follow-up. At first presentation, fewer negative symptoms (t=−3.40, p<0.01), more years spent in education (t=3.25, p<0.01), and a shorter duration of untreated psychosis (DUP) (t=−2.77, p<0.01) significantly predicted a better outcome at follow-up.ConclusionsThe outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness. This study supports the relationship between DUP and outcome beyond the early stages of illness.

scholarly journals Duration of untreated psychosis of first-episode psychotic disorders in Yogyakarta, Indonesia

2019 ◽  
Vol 7 (2) ◽  
pp. 61-64
Author(s):  
Carla R. Marchira ◽  
Irwan Supriyanto
Keyword(s):  
Psychotic Disorders ◽  
Rating Scale ◽  
First Episode ◽  
Medical Facility ◽  
Duration Of Untreated Psychosis ◽  
Global Assessment Of Functioning ◽  
Global Functioning ◽  
Syndrome Scale ◽  
Negative Syndrome ◽  
Gaf Scores

Introduction: Duration of untreated psychosis (DUP) is an important predictor for prognosis in first episode of psychotic disorders. Caregivers often seek help from alternative healers first and health professional later. These would delay proper treatments for the patients, resulting in more severe symptoms and lower functioning on their visit to medical facility. The present study aims to find the association between DUP, symptoms severity, and global functioning in patients with first-episode psychotic disorders. Methods: We identified 100 patients with first episode of psychotic disorders and their caregivers. The instruments used were Brief Psychotic Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Premorbid Schizoid-Schizotypal Traits (PSST), and Global Assessment of Functioning (GAF). Results: There were no significant association between BPRS, PANSS, PSST, and GAF scores and DUP in our subjects. Nevertheless, we found that men had significantly longer DUP compared to women. Conclusion: We found significant association between sex and DUP in this study. Longer DUP leads to delayed treatments and poorer prognosis. Further study is required to confirm our finding.

scholarly journals Reliability of Physiological Responses Induced by Basic Emotions: A Pilot Study

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Eun-Hye Jang ◽  
Sangwon Byun ◽  
Mi-Sook Park ◽  
Jin-Hun Sohn
Keyword(s):  
Internal Consistency ◽  
Interrater Reliability ◽  
Physiological Responses ◽  
Skin Conductance Level ◽  
Intraclass Correlation ◽  
Repeated Measurements ◽  
Physiological Signals ◽  
Basic Emotions ◽  
Reliability Indices ◽  
Film Clips

Abstract Background Although emotion-specific autonomic responses based on the discrete theory of emotion have been widely studied, studies on the reliability of physiological responses to emotional stimuli are limited. In this study, we aimed to assess the reliability of physiological changes induced by the six basic emotions (happiness, sadness, anger, fear, disgust, and surprise) that were measured during 10 weekly repeated experiments. Methods Twelve college students participated, and in each experiment, physiological signals were collected before and while participants were watching emotion-provoking film clips. Additionally, the participants self-evaluated the emotions that they experienced during the film presentation at the end of each emotional stimulus. To avoid adaptation of participants to identical stimuli during repeated measurements, we used 10 different film clips for each emotion, and thus a total of 60 film clips over 10 weeks were used. Physiological features, such as skin conductance level (SCL), fingertip temperature (FT), heart rate (HR), and blood volume pulse (BVP), were extracted from the physiological signals. Two reliability indices, Cronbach’s alpha and intraclass correlation coefficient, were calculated from the physiological features to assess internal consistency and interrater reliability, respectively. Results We found that SCL, HR, and BVP measured during the emotion-provoking phase over the 10 weekly sessions were more reliable than those assessed at baseline. Furthermore, SCL, HR, and BVP from the emotion-provoking phase exhibited excellent internal consistency and interrater reliability. Conclusions Our findings suggest that these features can be used as reliable physiological indices in emotion studies. The results also support the significance of physiological signals as meaningful indicators for emotion recognition in HCI (human computer interface) area.

Short-Interval Test-Retest Interrater Reliability of the Dutch Version of the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II)

2003 ◽  
Vol 17 (6) ◽  
pp. 562-567 ◽  
Author(s):  
Anoek Weertman ◽  
Arnoud ArntZ ◽  
Laura Dreessen ◽  
Carol van Velzen ◽  
Stefaan Vertommen
Keyword(s):  
Personality Disorders ◽  
Interrater Reliability ◽  
Short Interval ◽  
Clinical Interview ◽  
Dutch Version ◽  
Dsm Iv

scholarly journals Fatores associados a abandono precoce do tratamento em psicoterapia de orientação analítica

2007 ◽  
Vol 29 (3) ◽  
pp. 265-267 ◽  
Author(s):  
Simone Hauck ◽  
Letícia Kruel ◽  
Anne Sordi ◽  
Gabriela Sbardellotto ◽  
Aline Cervieri ◽  
...  
Keyword(s):  
Global Assessment ◽  
Self Report ◽  
World Health ◽  
Global Assessment Of Functioning ◽  
World Health Organization Quality ◽  
Dsm Iv ◽  
Organization Quality ◽  
Defensive Style ◽  
Health Organization

INTRODUÇÃO: A eficácia da psicoterapia psicanalítica foi bem estabelecida através de ensaios clínicos controlados; no entanto, algumas das características individuais que predizem melhores resultados são ainda pouco estudadas. O objetivo do estudo foi avaliar a associação entre os dados demográficos, o diagnóstico psiquiátrico, a sintomatologia clínica, a qualidade de vida, os critérios de indicação da psicoterapia, o estilo defensivo e o abandono da psicoterapia psicanalítica antes de 3 meses de tratamento. MÉTODO: Uma amostra consecutiva de 56 pacientes foi avaliada após a indicação da psicoterapia, através de um protocolo padronizado, do World Health Organization Quality of Life Bref (WHOQOL-Bref), do Self Report Questionnaire, do Defensive Style Questionnaire, da Escala de Funcionamento Defensivo do Manual de Diagnóstico e Estatística das Perturbações Mentais, 4ª edição, texto revisado (DSM-IV-TR) e da Avaliação do Funcionamento Global (Global Assessment of Functioning), e acompanhada por 3 meses. RESULTADOS: A taxa de abandono foi de 12,5%. Não houve diferença quanto à Avaliação do Funcionamento Global, Self Report Questionnaire e Defensive Style Questionnaire. Os pacientes que abandonaram estavam satisfeitos com sua saúde, apesar da gravidade da sua psicopatologia, mesmo controlando para outras variáveis (p < 0,0001). O grupo que permaneceu em tratamento apresentava melhor adaptação prévia e maior proporção de indivíduos com inteligência estimada como média ou superior (p < 0,05). Maior proporção de pacientes no grupo do abandono foi classificada em níveis imaturos, segundo a Escala de Funcionamento Defensivo do DSM-IV-TR. CONCLUSÕES: A gravidade da psicopatologia, isoladamente, não teve associação com o abandono; entretanto, menor nível de insight e defesas mais imaturas (especialmente narcisistas) foram associados a maiores taxas de abandono. Esses aspectos devem ser seriamente considerados, juntamente com as expectativas do paciente quanto ao método analítico, e avaliados criteriosamente antes da indicação.

De Widlöcher Remmingsschaal, een Nederlandse Schaal Voor het Meten van Psychomotorische Remming

1996 ◽  
Vol 8 (3) ◽  
pp. 56-63 ◽  
Author(s):  
R.J.C. de Weme ◽  
T. Hoeksema ◽  
J.G. Goekoop
Keyword(s):  
Depressive Disorder ◽  
Clinical Picture ◽  
Interrater Reliability ◽  
Rating Scale ◽  
Psychomotor Retardation ◽  
Divergent Validity ◽  
Dutch Translation ◽  
Chronic Disorder ◽  
Convergent And Divergent Validity ◽  
Sum Scores

SummaryAim: Translation of a specific instrument to measure psychomotor retardation, the “Widlöcher Retardation Rating Scale” and validation of this Dutch translation (Widlöcher remmingsschaal, WRS). Method: In three separate studies, we studied reliability (n = 26), concurrent and divergent validity (n = 25) and predictive validity (n = 28) of the WRS. In- and outpatients with a depressive disorder or schizophrenia participated, and scores on the WRS were compared with those on the Montgomery Asberg Depression Rating Scale (MADRS) and retardation items of the Comprehensive Psychopathological Rating Scale (CPRS).Results: The internal consistency was good (Cronbach alpha = 0.86), interrater reliability was sufficient to good, the correlation between the sumscores of both raters was r = 0.84, n = 23, p <0.01 and the kappa's were between 0.23 and 0.80. Convergent and divergent validity showed in comparing the correlation between the sum scores on the WRS and the CPRS retardation items (r = 0.91, n = 25, p < 0.01 ) with the correlation between the sumscores on the WRS and the MADRS (r = 0.40, n = 25, p = 0.1). The decrease of the sum scores on the WRS after two weeks of treatment with antide-pressants predicted remission after six weeks. A subgroup of the patients who were not in remission after six weeks, showed a predominance of retardation signs over mood disturbances. The same clinical picture was seen in a group of patients with a chronic disorder.Conclusion: De Widlöcher Retardation Rating Scale in this Dutch translation is a usefull instrument to measure psychomotor retardation. The connection between remaining retardation symptoms and longterm prognosis deserves further investigation.

Exploring Outcome and Validity of the GAF in Psychiatric Inpatient Care

2015 ◽  
Vol 31 (3) ◽  
pp. 195-201
Author(s):  
Ove Sonesson ◽  
Hans Arvidsson ◽  
Tomas Tjus
Keyword(s):  
Psychotic Disorders ◽  
Psychiatric Inpatient ◽  
Inpatient Setting ◽  
Multiple Linear Regressions ◽  
Global Assessment Of Functioning ◽  
Treatment Results ◽  
Episodes Of Care ◽  
Socio Demographic Factors ◽  
Gaf Scores ◽  
Linear Regressions

Abstract. A small number of studies have investigated predictive factors in relation to the Global Assessment of Functioning (GAF) scale. This study aimed to explore the influence of clinical and socio-demographic factors in a psychiatric inpatient setting in relation to treatment outcome measured by the GAF. The studied psychiatric inpatient sample consisted of 816 episodes of care, with GAF ratings made at both admission and discharge. Multiple linear regressions were performed to analyze what variables predicted GAF scores at admission and at discharge. Significant predictors of GAF scores at admission were age, schizophrenia, other psychotic disorders, and no registered diagnosis. GAF scores at admission, patients’ diagnoses, and ward affiliation were able to significantly predict GAF at discharge. Specialized wards did not necessarily deliver the best treatment results in spite of their diagnostic specialization. This study provides support to the construct validity of the GAF when used as a measure of outcome.

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