What can you use to assess suicidality?
Beck Hopelessness Scale (BHS)
Suicidal Behaviours Questionnaire (SBQ)
Columbia Suicide Severity Rating Scale
Explain the BHS
- assesses -ve attitudes about the future
- loss of motivation
- expectations
- 5-10mins, 20 T/F items
- past week
- items summed to get scores from 0-20
- 0-3 = minimal hopelessness, 4-8 mild, 9-14 moderate, >14 severe
- reliability (high IC, test-retest) + concurrent validity + discriminant validity
CLINICAL APPLICATIONS
- as a predictor of suicidal behaviour
- as a lead in to ax of suicidal ideation
- as a clue to underlying beliefs impeding progress in CBT
Explain the SBQ
- 34 items: past, current, and future suicidal behaviours (ideation, past threats, future attempts, likely lethality of future attempt)
- past several days, past month, past 4 months, last year, lifetime
- reliable (high IC) + validity (concurrent)
Explain the CSSRS
- structured approach to investigating type and intensity of suicidal ideation and behaviour
- desire to be dead + suicidal thoughts/intent + suicidal behaviour over lifetime
- validated in a range of settings (ED, primary care, community clinic, military, school, research)
- adult/adolescent, child, cog impairment versions
- screen, first ax, repeat ax
- good-excellent psychometrics
What can you use to measure anxiety?
Beck Anxiety Inventory (BAI)
- self-report, 21 items on 4pt scale (0-4), 5-10mins
- past month
- anxiety severity in adolescents + adults
- reliable (IC + test-retest) + valid (concurrent + construct)
- focus on somatic sx
FACTOR ANALYSES:
- 2: somatic factor + cognitive factor (fear of losing control)
- 4: neurophys (numb, tingling), subjective (unable to relax, scared), panic (heart racing), autonomic (hot, sweaty)
Penn State Worry Questionnaire (PSWQ)
- self-report, scale 1-5
What can you use to measure depression and anxiety?
DASS
- 42 items, self-report, past week
- good reliability
- correlations with BDI and BAI
Why use a standardised measure?
- useful adjunct to clinical interview
- helpful to assess progress over time
- used in conjunction (NOT REPLACE) with clinical/diagnostic interview and clinical judgment
What can you use to measure depression?
Beck Depression Inventory II (BDI-II)
Hamilton Rating Scale for Depression - R
Centre for Epidemiological Study Depression-R (CESD-R)
- very compatible with BDI, good reliability, FREE
What can you use to assess psychosis? What else should you assess?
- Brief Psychotic Rating Scale (BPRS)
- PSYRATS
- good to use early on to inform diagnostic and etiological formulations
- should also assess anxiety, depression and manic sx
Explain the BDI-II
- 21 items, 5-10mins, self-administered, past
2weeks, 4pt scale - measures depression presence + severity in adults and adolescents (13yrs+)
- not to be used as sole diagnostic measure for clinical depression
- reliable (high IC, test-retest) + valid (construct - BHS, HRSD)
- 2 factors: subjective (sadness, guilt, self-dislike) + biological (loss of interest, fatigue, sleep probs)
Explain the BPRS
- clinical-administered broad psychopathology severity rating (i.e. both psychotic and non-psychotic)
- 24/18 items (18 more common), 7pt scale, 15-30mins, past 2-3 days
- observed and reported items
- structured and unstructured interviews + observations over past 2-3 days OR informant report
- assess psychopathology (+ve, -ve, affective)
- excellent reliability (inter-rater)
FACTOR ANALYSES
- 2 factors: general sx + factors specific to SCZ
- 5 factors: disturbed thinking, withdrawal/retardation, hostile/suspiciousness, anxious/dep, activation
- division of +ve/-ve sx
Explain the PSYRATS and it’s two scales
- measures hallucinations and delusions
- reliability (intra-class correlations)
Auditory Hallucinations (AH) scale (11 items) - freq, duration, location, loudness, beliefs re: origins, -ve content (amount + degree), distress (amount + intensity), life disruption caused, controllability
Delusion scale (6 items) - preoccupation (amount + duration), conviction, distress (amount + intensity), life disruption caused
What can you use to assess personality?
- SCID-5-PD
- MMPI
- NEO-PI-R
What does the BPRS measure? (18)
OBSERVED
- emotional withdrawal
- conceptual disorganisation
- tension
- mannerisms/posturing
- motor retardation
- uncooperativeness (during interview)
- blunted affect
- excitement
REPORTED
- somatic concern
- anxiety
- guilt
- grandiosity
- depressed mood
- hostility (outside context of interview)
- suspiciousness
- hallucinatory behaviour
- unusual thought content
- disorientation
What can you use to assess insight?
Beck Cognitive Insight Scale (BCIS)
Scale to assess Unawareness of Mental Disorder (SUMD)
Explain the BCIS
Beck Cognitive Insight Scale
- assess cog insight in patients with psychosis
- self-reflective + self-certainty subscales
- 15 items, self-report, 4pt scale
2 Q groups
- Objectivity, reflectiveness and openness to feedback
- Decision-making regarding mental products (jumping to conclusions, certainty about being right, resistance to correction)
Explain the SUMD
Scale to assess Unawareness of Mental Disorder
- VERY LONG (74 items)»_space; use BCIS instead
- measures awareness in clients with psychosis
- semi-structured interview
- past/present awareness of: mental disorder, response to medication, need for medication
- insight into sx (hallucination, delusions, blunted affect, asociality) > rated in terms of awareness, attribution + past/present
What can you use to assess prodromal psychosis?
CAARMS
- to determine if UHR criteria met
- +ve sx: unusual thought content, non-bizzare delusions, perceptual abnormalities, disorganised speech
BPRS
Explain the HRSD-R
- for bio sx
- dep mood, guilt, suicide, work/activities, insight
- insomnia (going to bed, middle of night, early morning)
- retardation/agitation
- anxiety (psych + phys)
- somatic (gastro + general)
- hypochondriasis
- weight loss
