Item response analysis of the Positive and Negative Syndrome Scale

<p>Abstract</p> <p>Background</p> <p>Statistical models based on item response theory were used to examine (a) the performance of individual Positive and Negative Syndrome Scale (PANSS) items and their options, (b) the effectiveness of various subscales to discriminate among individual differences in symptom severity, and (c) the appropriateness of cutoff scores recently recommended by Andreasen and her colleagues (2005) to establish symptom remission.</p> <p>Methods</p> <p>Option characteristic curves were estimated using a nonparametric item response model to examine the probability of endorsing each of 7 options within each of 30 PANSS items as a function of standardized, overall symptom severity. Our data were baseline PANSS scores from 9205 patients with schizophrenia or schizoaffective disorder who were enrolled between 1995 and 2003 in either a large, naturalistic, observational study or else in 1 of 12 randomized, double-blind, clinical trials comparing olanzapine to other antipsychotic drugs.</p> <p>Results</p> <p>Our analyses show that the majority of items forming the Positive and Negative subscales of the PANSS perform very well. We also identified key areas for improvement or revision in items and options within the General Psychopathology subscale. The Positive and Negative subscale scores are not only more discriminating of individual differences in symptom severity than the General Psychopathology subscale score, but are also more efficient on average than the 30-item total score. Of the 8 items recently recommended to establish symptom remission, 1 performed markedly different from the 7 others and should either be deleted or rescored requiring that patients achieve a lower score of 2 (rather than 3) to signal remission.</p> <p>Conclusion</p> <p>This first item response analysis of the PANSS supports its sound psychometric properties; most PANSS items were either very good or good at assessing overall severity of illness. These analyses did identify some items which might be further improved for measuring individual severity differences or for defining remission thresholds. Findings also suggest that the Positive and Negative subscales are more sensitive to change than the PANSS total score and, thus, may constitute a "mini PANSS" that may be more reliable, require shorter administration and training time, and possibly reduce sample sizes needed for future research.</p

Dependency and self-criticism : individual differences in strategies for negotiating changes in and threats to social rank

The two studies reported in this thesis examine the influence of two depressive personality styles, dependency and self-criticism, on how individuals respond to potentially disruptive events, such as a change in or threat to social rank. The studies used an experimental protocol in which participants were allowed to believe firstly that they outperformed a close friend or were outperformed by a close friend and secondly that friends generally agreed or disagreed with them. Findings offer support for the integration of depressive personality styles and interpersonal factors within a social rank framework. Results from the two studies suggest that dependency and self-criticism (a) moderate the impact of interpersonal events, (b) influence how individuals behave towards close friends, (c) affect how individuals remember interpersonal interactions with others, and (d) moderate the manner in which individuals actively structure their social environments. Depressive personality styles may contribute to maladaptive environments and depressive processes in complex ways by influencing the types of strategies individuals adopt to deal with threats to interpersonal relatedness and self-definition

The Automaticity of Positive and Negative Thinking: A Scoping Review of Mental Habits

Background Our thoughts impact our mental health and there is a distinction between thought content (what we think) and thought process (how we think). Habitual thinking has been proposed as one such process. Habits, which are cue-dependent automatic responses, have primarily been studied as behavioural responses. Methods The current scoping review investigated the extent to which the thinking patterns important for mental health have been conceptualized as habits. Using systematic search criteria and nine explicit inclusion criteria, this review identified 20 articles and 24 empirical studies examining various mental habits, such as negative self-thinking, self-criticism, and worry. Results All of the included empirical studies examined maladaptive (negative) mental habits and no study investigated adaptive (positive) mental habits. We categorized the characteristics of each study along several dimensions including how mental habits were defined, measured, and which constructs were studied as habitual. Conclusions Although mental habits appear to be relevant predictors of mental health, habitual thinking has not been well-integrated with psychological constructs related to mental health, such as automatic thoughts. We discuss the implications of mental habits for future research and clinical practice

Restricting Our Consumption of Material Goods: An Application of the Theory of Planned Behavior

Despite the increasing number of studies investigating environmentally friendly behavior, relatively little research has examined the attitudes, subjective norms, perceived ability, and intentions of individuals to restrict their consumption. The current study validated a new measure of consumption restriction developed from the Theory of Planned Behavior. A total of 243 college-aged students completed the Consumption Restriction Questionnaire (CRQ), in addition to measures of greed, frugality, materialism, and consumption. Results confirmed the importance of attitudes, subjective norms and perceived control as determinants of both intentions to restrict consumption in addition to actual consumption, and also demonstrated the superiority of attitudes, subjective norms and perceived control in predicting consumption related to individual differences in greed, frugality and materialism. However, intentions to restrict consumption were modest. Results have implications for both our understanding of environmentally friendly behavior, as well as for the targets that interventions designed to restrict our consumption should address

Bipolar mood disorders : Diagnosis, etiology, and treatment

NRC publication: Ye

Operational Definitions of Attributes of Primary Health Care: Consensus Among Canadian Experts

PURPOSE In 2004, we undertook a consultation with Canadian primary health care experts to define the attributes that should be evaluated in predominant and proposed models of primary health care in the Canadian context

Mapping the coverage of attributes in validated instruments that evaluate primary healthcare from the patient perspective

Abstract Background Primary healthcare in developed countries is undergoing important reforms, and these require evaluation strategies to assess how well the population's expectations are being met. Although numerous instruments are available to evaluate primary healthcare (PHC) from the patient perspective, they do not all measure the same range of constructs. To analyze the extent to which important PHC attributes are covered in validated instruments measuring quality of care from the patient perspective. Method We systematically identified validated instruments from the literature and by consulting experts. Using a Delphi consensus-building process, Canadian PHC experts identified and operationally defined 24 important PHC attributes. One team member mapped instrument subscales to these operational definitions; this mapping was then independently validated by members of the research team and conflicts were resolved by the PHC experts. Results Of the 24 operational definitions, 13 were evaluated as being best measured by patients, 10 by providers, three by administrative databases and one by chart audits (some being best measured by more than one source). Our search retained 17 measurement tools containing 118 subscales. After eliminating redundancies, we mapped 13 unique measurement tools to the PHC attributes. Accessibility, relational continuity, interpersonal communication, management continuity, respectfulness and technical quality of clinical care were the attributes widely covered by available instruments. Advocacy, management of clinical information, comprehensiveness of services, cultural sensitivity, family-centred care, whole-person care and equity were poorly covered. Conclusions Validated instruments to evaluate PHC quality from the patient perspective leave many important attributes of PHC uncovered. A complete assessment of PHC quality will require adjusting existing tools and/or developing new instruments.</p