Self-administered Assessments Research Articles

Routine screening for psychosocial distress following hematopoietic stem cell transplantation

The diagnosis and treatment of cancer is often associated with high levels of psychosocial distress, yet exploration of these issues is rarely included in routine oncologic care. We conducted a pilot study to evaluate the feasibility of screening for psychosocial distress after autologous and allogeneic stem cell transplantation. A total of 80 adults were enrolled in Boston, MA, USA. Subjects completed self-administered assessments prior to hospital admission, at their first clinic visit after hospital discharge, and at 100 days post transplant. Assessments included validated instruments assessing psychosocial distress and quality of life (QOL). Elevated levels of anxiety and/or depression were detected in 55% of those providing pre-transplant assessments and were associated with compromised QOL. Post transplant screening was successfully performed in 69% of subjects and identified that 44% had symptoms of depression, anxiety or post traumatic stress disorder. Pre-transplant distress was associated with detection of distress after transplantation (81 vs 13%, P< 0.0001). In summary, we detected high levels of distress in transplant patients using self-administered tools. Pre-transplant distress appears to be highly predictive of distress post transplant and is a feasible marker to target screening and intervention programs.

Reliability and reproducibility of a Chinese-language visual function assessment

OBJECTIVE The purpose of the study was to validate a Chinese-language visual function assessment within the context of a routine cataract surgery practice and to assess the contribution of the method of questionnaire administration.DESIGN The visual function assessment (VFA) was translated into Chinese. Two groups of study subjects were recruited: Chinese who did not speak English and Chinese conversant in English. Consecutive preoperative cataract patients of Chinese ancestry presenting to an urban ophthalmology practice were recruited. The questionnaire was administered in person or by telephone interview. Pre-operative visual acuity was recorded. Visual function scores were analyzed to assess reliability and correlation with visual acuity.RESULTS Among the 186 potential study subjects, 155 patients completed the study. The Chinese-language visual function assessment had good internal consistency (Cronbach α = 0.97, inter-item correlations = 0.43 to 0.96). Reliability (with regard to the English version) and test-retest reproducibility of the Chinese questionnaire were strong with intraclass correlation coefficients greater than 0.60. The method of administration contributed to the measures of reliability and reproducibility.CONCLUSION These results show that a Chinese-language version of the VFA questionnaire is reliable and valid. In industrialized countries with large Chinese-speaking populations and newly developed countries of East and Southeast Asia, the visual function assessment may be helpful in assisting routine clinical patient evaluation and cross-cultural outcome assessment programmes. Our findings also suggest that self-administered visual function assessments may be more reliable and valid than interview-generated assessments.

Stability and change in personality disorder features: the Longitudinal Study of Personality Disorders.

There exists no empirical literature documenting the long-term longitudinal stability of personality pathology comparable to that available for normal personality. A number of test-retest studies have usefully established the short-term reliability of Axis II measures. However, the test-retest design is methodologically inadequate for resolving issues related to the long-term stability of personality disorder (PD). This prospective longitudinal study evaluated the stability of PD features in multiwave perspective. Subjects (N = 250) drawn from a nonclinical university population were examined for PD features at 3 different time points using the International Personality Disorders Examination (IPDE) and the Millon Clinical Multiaxial Inventory II (MCMI-II) during a study period of 4 years. Features of PD displayed considerable evidence of stability for individual differences and group means, at the dimensional level of analysis, on both the IPDE and the MCMI-II. Both measures revealed modest declines in PD features over time; however, the observed changes were associated with relatively small effect sizes. Features of PD, viewed from a dimensional perspective, seem to be relatively stable in terms of individual differences and group means based on both clinical interview and self-administered PD assessments.

Ethnicity and body dissatisfaction: Are Hispanic and Asian girls at increased risk for eating disorders?

To compare prevalences and correlates of body dissatisfaction among white, Hispanic, and Asian girls. A total of 939 6th and 7th grade girls (mean age 12.4 years) attending four middle schools in northern California completed self-administered assessments of age, ethnicity, desired body shape, parent education levels, mother's and father's body shapes, pubertal stage, and body dissatisfaction. Body dissatisfaction was assessed with the Body Dissatisfaction scale of the Eating Disorder Inventory. Height, weight, triceps skinfold thickness, and waist and hip circumferences were measured by trained examiners. Hispanic girls reported significantly greater body dissatisfaction than white girls, with Asian girls in-between. After adjustment for body mass index (weight/height), normal and overweight white, Hispanic, and Asian girls reported similar levels of body dissatisfaction. However, among the leanest 25% of girls, Hispanics and Asians reported significantly more body dissatisfaction than white girls. Body mass index was the strongest independent predictor of increased body dissatisfaction in all three ethnic groups. Shorter height among white girls and taller height among Asian girls also made significant independent contributions. Parent education level, a measure of socioeconomic status, was not significantly associated with body dissatisfaction. Body dissatisfaction is not limited to white girls in middle and upper socioeconomic strata. These findings suggest Hispanic and Asian girls may be at greater risk for adopting eating disorder behaviors than previously recognized.