R P Snaith’s research while affiliated with St. James University and other places

The Snaith-Hamilton-Pleasure-Scale (SHAPS), introduced in English in 1995, assesses self-reported anhedonia in psychiatric patients. It has proven psychometric properties and advantages in applicability compared to other instruments assessing anhedonia. This study presents results of a systematic transcultural protocol translating the SHAPS into German (SHAPS-D). Quality of translation was confirmed on the one hand by bilingual reviewers with regard to equivalence in content and tone. On the other hand stable results were found in a test-retest-design crossing the English and German version with bilingual persons. SHAPS-D was obtained from schizophrenic (n = 50) and depressive (n = 33) patients and from healthy controls (n = 67). Results on applicability, internal consistency and relationship to depression, subjective quality of life, well-being as well as psychopathology indicate that the SHAPS-D is a useful and promising instrument in assessing anhedonia.

The report indicates that a psychosurgery service can be established on aregional basis. The outcome study of the Yorkshire Regional Psychosurgery Service indicates that the treatment should retain a place in the treatment of patients who have failed to respond to other available approaches. For such patients (and their carers) life is a state of persisting torment. Some psychiatrists consider psychosurgery as a procedure not to be countenanced, or outmoded, but patients have a right to know what may be achieved by the treatment and at what cost in terms of possible failure to improve and adverse effects. An audit of the Regional Psychosurgery Service indicates a favourable result of the intervention. All patients improved to some extent, some very remarkably, and no adverse effects were encountered.

The Hamilton Depression Rating Scale retains its primacy in research. There have been recent important critiques. It is clear that instructions provided by its author are widely overlooked. A survey of the present use of the HDRS was conducted by inspection of five major journals publishing studies in the field of psychiatry. Note was especially made of whether a recognised version of the Scale was quoted; also of whether authors had selected specific scores on one or other of the versions to indicate a criterion for inclusion of a subject in a study, and likewise whether a specific score had been selected as an indication of recovery following some procedure or treatment. One hundred and fourteen articles were reviewed in which 71 had used a depression scale. This was the HDRS in 66% of the studies. There was considerable evidence that the instruction that the HDRS was only to be used in situations where the patient had received a diagnosis of a primary depressive illness had been ignored. There was considerable degree of arbitrary selection of Scale scores. The survey causes concern about the methodology of much research in the field as of assessment of severity of psychiatric disorder. The rationale of assessment by the rating scale method is considered and suggestion made for improvement in research practice.

Keedwell P, Snaith RP. What do anxiety scales measure? Acta Psychiatr Scand 1996: 93: 177–180. c̊ Munksgaard 1996. At present researchers appear to rely on instruments for the assessment of anxiety without due consideration of what it is that the instrument may be presumed to measure. A survey was undertaken of the presently most frequently used rating scales which purport to assess anxiety. The allocation of items of the scales to the major aspects of anxiety was examined. It was found that the scales tapped different areas of psychopathology. Furtherance of research requires closer attention to the nature of the scales and the assumption that they all measure much the same construct must be discarded.

Hedonic tone and its absence, anhedonia, are important in psychopathological research, but instruments for their assessment are lengthy and probably culturally biased. A new scale was constructed from the responses of a large sample of the general population to a request to list six situations which afforded pleasure. The most frequent items were reviewed and those likely to be affected by cultural setting, age, or sex were removed. A pilot study led to an abbreviated scale of 14 items, covering four domains of pleasure response. This questionnaire was subjected to psychometric evaluation in new samples from the general population and psychiatric patients. The scale was found to have a score range that would distinguish a 'normal' from an 'abnormal' response. Validity and reliability were found to be satisfactory. The new scale, the Snaith-Hamilton Pleasure Scale (SHAPS), is an instrument which may be recommended for psychopathological research.