The validity of using patient self-report to assess psychotic symptoms in schizophrenia

Department of Psychiatry and Biobehavioural Sciences, University of California, Los Angeles, Los Ángeles, California, United States
Schizophrenia Research (Impact Factor: 3.92). 03/2007; 90(1-3):245-50. DOI: 10.1016/j.schres.2006.11.011
Source: PubMed


Brief, reliable and valid measures of psychosis can be very useful in both clinical practice and research, and for identifying unmet treatment needs in persons with schizophrenia. This study examines the concurrent validity and receiver operating characteristics of the psychosis scale of the Revised Behavior and Symptom Identification Scale (BASIS-R). The study was conducted with 71 adults with schizophrenia who were randomly sampled from a large mental health clinic. Study participants at the West Los Angeles Veterans Healthcare Center were assessed using the BASIS-R, a subjective, self-report measure, and the UCLA Brief Psychiatric Rating Scale (BPRS), a clinician-rated measure administered by highly trained research staff. The psychosis scale of the BASIS-R shows good concurrent validity with the psychosis items on the BPRS. Using the BPRS as the gold standard for measuring psychosis, receiver operating characteristics suggest that both the weighted and unweighted versions of the BASIS-R psychosis scale adequately identify psychosis that is moderate or greater or severe. The performance of the two versions was similar. Unweighted scores are easier to calculate, and we therefore recommend cutoff scores based on the unweighted BASIS-R. We identified a cutoff score of 0.5 to best detect moderate or greater psychosis, and a cutoff score of 1.0 to best detect severe or extremely severe psychosis. The BASIS-R has potential as an assessment tool and screening instrument in schizophrenia.

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    • "Delusions Inventory (PDI) [9] and the Community Assessment of Psychic Experiences (CAPE) [10] are widely used for both clinical and subclinical populations. Refuting initial concern that self-report questionnaires may be problematic in schizophrenia due to low patient insight [11] [12], several studies have demonstrated high concordance between self-and observer-ratings, which indicates that patients can reliably self-report on these symptoms [13] [14]. In regard to negative symptoms, for which insight-related problems are less likely, existing research suggests a satisfactory concordance between self-and observer-ratings of experiential domains of negative symptoms such as asociality [15] [16] [17] [18]. "
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    ABSTRACT: Objectives: Validated self-report instruments could provide a time efficient screening method for negative symptoms in people with schizophrenia. The aim of this study was to examine the psychometric properties of a German version of the Motivation and Pleasure Scale-Self-Report (MAP-SR) which is based on the Clinical Assessment Interview for Negative Symptoms (CAINS). Methods: In- and outpatients (N = 50) with schizophrenia or schizoaffective disorder were assessed with standardized interviews and questionnaires on negative and positive symptoms and general psychopathology in schizophrenia, depression, and global functioning. Results: The German version of the MAP-SR was found to show high internal consistency. Convergent validity was supported by significant correlations between the MAP-SR with the experience scale of the CAINS and the negative symptom scale of the Positive and Negative Syndrome Scale. The MAP-SR also exhibited discriminant validity indicated by its non-significant correlations with positive symptoms and general psychopathology, which is in line with the findings for the original version of the MAP-SR. However, the MAP-SR correlated moderately with depression. Conclusion: The German MAP-SR appears to be a valid and suitable diagnostic tool for the identification of negative symptoms in schizophrenia.
    No preview · Article · Nov 2015 · Comprehensive psychiatry
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    • "Depressive symptoms in individuals with schizophrenia are most commonly assessed using measures such as the Hamilton Rating Scale for Depression, the Calgary Depression Scale for Schizophrenia, or the Beck Depression Inventory, which have been shown to be highly correlated and reported to have good validity and test–retest reliability (Niv et al., 2007). However, these measures are retrospective in nature, asking participants to recall experiences from the past week or two weeks, thus vulnerable to longterm memory impairments and biases. "
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    ABSTRACT: Depressed mood is prevalent among individuals with schizophrenia, leading to difficulties in functioning. Typically, depressed mood is evaluated using retrospective assessments during which individuals are asked to recall their mood during the past week or month. However, as individuals with schizophrenia may display memory difficulties, the results of such assessments may be biased, potentially leading to inaccurate clinical characterizations and/or suboptimal treatment. Our aim was to assess the potential impact of long-term memory on depressed mood in individuals with schizophrenia. Employing an Experience Sampling Method (ESM) approach, 51 individuals with schizophrenia and 22 healthy controls rated their momentary emotions up to 10 times/day over a two-day period, along with retrospective measures of depressed mood, long-term memory, quality of life, social functioning, and symptoms. ESM assessment of real-time depressed mood demonstrated discriminant and convergent validity. Among the schizophrenia group, there was a significant correlation between the real-time and retrospective measures of depressed mood. However, once variance due to long-term memory was controlled, the relationship between the real-time and retrospective measure was no longer significant. The findings suggest that a real-time measure of depressed mood may allow overcoming some of the limitations associated with long-term memory difficulties common among individuals with schizophrenia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · Jun 2015 · Psychiatry Research
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    • "Additionally, the CTQ has been used in previous studies as an assessment of childhood trauma amongst psychotic disorder patients [6] [17] [19] and prior research has demonstrated the validity of self-report measures in individuals with serious mental illness [25] [26] [27] and of reports of abuse in patients with psychosis [28] [29] [30]. "
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    ABSTRACT: Previous studies point to an association between childhood sexual abuse (CSA) and auditory hallucinations (AH). However, methodological issues limit the strength of these results. Here we compared childhood abuse between psychotic disorder patients and healthy control subjects using a reliable measure of abuse, and assessed the relationship between CSA and AH. 114 psychotic disorder patients and 81 healthy control subjects were administered the Structured Clinical Interview of the DSM-IV (SCID) and the Childhood Trauma Questionnaire (CTQ). We compared the severity of abuse between groups, and tested the relationship between different types of childhood abuse and specific psychotic symptoms. Psychotic patients reported more childhood abuse than controls (p<.001). Psychotic patients with a history of AH reported significantly more sexual, emotional, and physical abuse than patients without a history of AH (p<.05). Emotional and physical abuse, in the absence of sexual abuse, did not lead to a higher rate of AH. Finally, reports of childhood abuse did not increase the risk of any form of hallucination other than AH or of any form of delusion. These results suggest that childhood abuse, especially childhood sexual abuse, shapes the phenotype of psychotic disorders by conferring a specific risk for AH.
    Full-text · Article · Jun 2013 · Comprehensive psychiatry
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