The Autism Spectrum Rating Scale (ASRS) and the Social Responsiveness Scale (SRS) have been widely used for screening autism spectrum disorder (ASD) in the general population during epidemiological studies, but studies of individuals with intellectual disability (ID) are quite limited. Therefore, we recruited the parents/caregivers of 204 ASD cases, 71 ID cases aged 6-18 years from special education schools, and 402 typically developing (TD) children in the same age span from a community-based population to complete the ASRS and SRS. The results showed that the ID group scored significantly lower on total and subscale scores than the ASD group on both scales (P < 0.05) but higher than TD children (P < 0.05). Receiver operating characteristic analyses demonstrated a similar fair performance in discriminating ASD from ID with the ASRS (area under the curve (AUC) = 0.709, sensitivity = 77.0%, specificity = 52.1%, positive predictive value (PPV) = 82.2%) and the SRS (AUC = 0.742, sensitivity = 59.8%, specificity = 77.5%, PPV = 88.4%). The results showed that individuals with ID had clear autistic traits and discriminating ASD from ID cases was quite challenging, while assessment tools such as ASRS and SRS, help to some degree.
Adolescent ; Age Distribution ; Age Factors ; Autism Spectrum Disorder ; complications ; psychology ; Child ; China ; Female ; Humans ; Intellectual Disability ; etiology ; Male ; Psychiatric Status Rating Scales ; Psychometrics ; Retrospective Studies ; Social Behavior ; Statistics, Nonparametric

BACKGROUND: Dundee Ready Educational Environment Measure (DREEM) is a 50-item tool to assess the educational environment of medical institutions as perceived by the students. This cross-sectional study developed and validated an abridged version of the DREEM-50 with an aim to have a less resource-intensive (time, manpower), yet valid and reliable, version of DREEM-50 while also avoiding respondent fatigue. METHODS: A methodology similar to that used in the development of WHO-BREF was adopted to develop the abridged version of DREEM. Medical students (n = 418) from a private teaching hospital in Madurai, India, were divided into two groups. Group I (n = 277) participated in the development of the abridged version. This was performed by domain-wise selection of items that had the highest item-total correlation. Group II (n = 141) participated in the testing of the abridged version for construct validity, internal consistency and test-retest reliability. Confirmatory factor analysis was performed to assess the construct validity of DREEM-12. RESULTS: The abridged version had 12 items (DREEM-12) spread over all five domains in DREEM-50. DREEM-12 explained 77.4% of the variance in DREEM-50 scores. Correlation between total scores of DREEM-50 and DREEM-12 was 0.88 (p < 0.001). Confirmatory factor analysis of DREEM-12 construct was statistically significant (LR test of model vs. saturated p = 0.0006). The internal consistency of DREEM-12 was 0.83. The test-retest reliability of DREEM-12 was 0.595, p < 0.001. CONCLUSION DREEM-12 is a valid and reliable tool for use in educational research. Future research using DREEM-12 will establish its validity and reliability across different settings.
Adolescent ; Cross-Sectional Studies ; Education, Medical ; statistics & numerical data ; Female ; Humans ; India ; Male ; Psychometrics ; methods ; Reproducibility of Results ; Students, Medical ; psychology ; Young Adult

INTRODUCTIONThe Diabetes Health Profile-18 (DHP-18) measures diabetes-related psychological well-being in patients with type 2 diabetes mellitus (T2DM). It includes 3 subscales: psychological distress (PD), barriers to activity and disinhibited eating. The psychometric properties of the DHP have not been evaluated in Asia. The aim of this study was to determine the psychometric properties of the DHP in multiethnic Singapore.

MATERIALS AND METHODSPatients between the ages of 18 to 65 diagnosed with diabetes (either type 1 or type 2) for at least 1 year were recruited from a diabetes outpatient clinic in a tertiary hospital. They completed a set of self-administered questionnaires including sociodemographic information and the DHP. Validity of the DHP was evaluated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Reliability was assessed with internal consistency and sensitivity was determined by effect size, associated with detecting a statistically significant and clinically important difference between various patient subgroups.

RESULTSA total of 204 patients with mean age 45.4 (11.9) years, comprising 64% males and 50% Chinese, 27% Indian and 12% Malay were studied. In CFA, model fit was poor. Forced 3-factor EFA supported the original 3-factor structure of the DHP. Convergent and discriminant validity was demonstrated (100% scaling success). DHP was sensitive across majority of social demographic, clinical and social-functioning determinants (i.e., effect size >0.3). Cronbach's alpha exceeded 0.70 for all subscales. Ceiling effects were negligible but large floor effects were seen for the PD subscale (23%).

CONCLUSIONThe DHP is valid, reliable and sensitive for measuring well-being in Asian patients with T2DM.

Adolescent ; Adult ; Aged ; Diabetes Mellitus, Type 1 ; psychology ; Diabetes Mellitus, Type 2 ; psychology ; Emotional Adjustment ; Ethnic Groups ; psychology ; statistics & numerical data ; Factor Analysis, Statistical ; Feeding Behavior ; psychology ; Female ; Humans ; Male ; Middle Aged ; Psychological Tests ; Psychometrics ; Reproducibility of Results ; Sensitivity and Specificity ; Singapore ; Stress, Psychological ; diagnosis ; etiology ; psychology ; Surveys and Questionnaires ; Young Adult

The present study aimed to examine the psychometric properties of the Korean version of Stanford Acute Stress Reaction Questionnaire (SASRQ). A Korean version of the SASRQ was produced through forward translation, reconciliation, and back translation. A total of 100 healthy, non-clinical participants were selected through screening and clinical interview, and they each were given a set of questionnaires including SASRQ. Psychometric properties of SASRQ were then examined through statistical analyses. Full-scale and subscales of SASRQ yielded excellent internal consistency (Cronbach's alpha=0.98 and 0.78-0.95, respectively). Test-retest reliability at 2-week intervals was satisfactory, with coefficient r ranging between 0.47 and 0.71. Convergent validity was also demonstrated by strong correlations between SASRQ and other trauma-related questionnaires. Correlation with Social Desirability Scale, however, was not found to be significant; thus evidenced divergent validity. The Korean version of SASRQ appears to be a reliable and valid measurement tool for assessing symptoms of acute stress disorder. Including clinical samples for comparison with controls would be necessary in future studies.
Adult ; Disability Evaluation ; Female ; Humans ; Male ; Psychometrics/*statistics & numerical data ; Questionnaires ; Reproducibility of Results ; Republic of Korea ; Stress Disorders, Post-Traumatic/*diagnosis ; Stress Disorders, Traumatic, Acute/*diagnosis

INTRODUCTIONThe aims of this study were two-fold; to investigate the validity and reliability of the Thai version of the Inventory of Interpersonal Problems (IIP) and to compare the characteristics of the interpersonal problems experienced in a non-clinical sample and psychiatric outpatients.

METHODSA total of 689 subjects (452 non-clinical sample and 237 psychiatric outpatients) completed the IIP-32 and IIP-64, Symptom checklist-90 (SCL-90) and 16 Personality Factor (16 PF) Questionnaire, after which a four-week retest was carried out. Cronbach's alpha was used for internal consistency and the intra-class correlation coefficient was used to determine test-retest reliability. Factor analysis of the IIP sub-scales and Pearson's correlation were used for construct and concurrent validity.

RESULTSBoth versions of the IIP showed good internal consistency. Factor analysis revealed two factors that corresponded to the circumplex property. The expected correlation between the SCL-90 and 16 PF subscales reflected the level of concurrent validity. There was a significant difference in the cold, socially-inhibited and self-sacrificing subscales between the non-clinical and clinical samples, while major depressive disorder was found to have a significantly higher score in the subscales of the control dimension, i.e. the non-assertive, socially inhibited and self-sacrificing subscales, than the neurotic and non-clinical groups, whereas, the neurotic group differed from the normative sample in terms of the affiliation axis.

CONCLUSIONThe IIP-64 and IIP-32 demonstrated their reliability and are suitable for use in either clinical or non-clinical setting.

Adolescent ; Adult ; Aged ; Data Interpretation, Statistical ; Female ; Humans ; Interpersonal Relations ; Language ; Male ; Mental Disorders ; complications ; diagnosis ; Middle Aged ; Models, Statistical ; Outpatients ; Personality Assessment ; statistics & numerical data ; Personality Disorders ; classification ; diagnosis ; Psychometrics ; methods ; standards ; Reference Values ; Reproducibility of Results ; Surveys and Questionnaires ; Thailand

To report on the validity and reliability of the Chronic Liver Disease Questionnaire (CLDQ) for assessing subjects with posthepatitic B cirrhosis. The CLDQ was administered to 117 healthy volunteers and 297 patients with posthepatitic B cirrhosis. All posthepatic B cirrhosis patients were assessed for the Child-Pugh stage. The entire questionnaire and each individual item was analyzed for precision and reliability. Exploratory factor analysis, responsiveness, and discrimination validity were also assessed. No significant floor effects were detected, but a moderate ceiling effect (less than 30%) was found for the following subscales: abdominal symptoms (AS), activity (AC), and worry (WO). For most items, the ceiling effect was between 30% to 60%. The internal consistency (Cronbach's a) on total scale level was good (a = 0.905), and ranged from 0.442 to 0.848 for the different subscales. The correlation coefficients of the total scale with subscales were above 0.6 (P less than 0.01) for reliability. The CLDQ and subscale scores for healthy controls were higher than those for the patients (P less than 0.001), and were gradated from the patients with Child-Pugh A cirrhosis to those with Child-Pugh B or C cirrhosis. Increase in severity of liver disease was accompanied by lower scores by the CLDQ and 4 out 6 subscales. Exploratory factor analysis moderately reproduced the original factor structure. The CLDQ has good reliability, satisfactory content, responsiveness and discriminant validity, and moderate precision and construct validity. It is useful for effectively evaluating health-related quality of life and curative effect in patients with posthepatitic B cirrhosis.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Chronic Disease ; Female ; Health Status ; Hepatitis B, Chronic ; psychology ; Humans ; Liver Cirrhosis ; psychology ; Male ; Middle Aged ; Pain ; physiopathology ; psychology ; Psychometrics ; Quality of Life ; psychology ; Reproducibility of Results ; Sensitivity and Specificity ; Severity of Illness Index ; Statistics as Topic ; Surveys and Questionnaires ; Young Adult

INTRODUCTIONA knowledge-attitude dissociation often exists in geriatrics where knowledge but not attitudes towards elderly patients improve with education. This study aims to determine whether a holistic education programme incorporating multiple educational strategies such as early exposure, ageing simulation and small group teaching results in improving geriatrics knowledge and attitudes among medical students.

MATERIALS AND METHODSWe administered the 18-item University of California Los Angeles (UCLA) Geriatric Knowledge Test (GKT) and the Singapore-modified 16-item UCLA Geriatric Attitudes Test (GAT) to 2nd year students of the old curriculum in 2009 (baseline reference cohort, n = 254), and before and after the new module to students of the new curriculum in 2010 (intervention cohort, n = 261), both at the same time of the year.

RESULTSAt baseline, between the baseline reference and intervention cohort, there was no difference in knowledge (UCLA-GKT Score: 31.6 vs 33.5, P = 0.207) but attitudes of the intervention group were worse than the baseline reference group (UCLA-GAT Score: 3.53 vs 3.43, P = 0.003). The new module improved both the geriatric knowledge (UCLA-GKT Score: 34.0 vs 46.0, P <0.001) and attitudes (UCLA-GAT Score: 3.43 vs 3.50, P <0.001) of the intervention cohort.

CONCLUSIONA geriatric education module incorporating sound educational strategies improved both geriatric knowledge and attitudes among medical students.

Curriculum ; Education, Medical, Undergraduate ; Educational Measurement ; Educational Status ; Geriatrics ; education ; Health Knowledge, Attitudes, Practice ; Humans ; Psychometrics ; Singapore ; epidemiology ; Statistics as Topic ; Students, Medical

INTRODUCTIONSuicide is one of the most tragic problems medical schools are facing today. It is an issue that has not escaped medical schools in either developing or developed nations. To combat this trend, medical educators require efficient and effective strategies for the immediate identification of students who are at an elevated risk of harming themselves.

MATERIALS AND METHODSNational Yang Ming University medical students were surveyed on various demographic, academic, personal, and extracurricular subjects as well as assessed for suicidal ideation. In addition, students completed the Chinese Health Questionnaire (CHQ, a translated and modified version of the General Health Questionnaire, GHQ), and the Taiwanese Depression Questionnaire (TDQ, a translated and modified version of the Center for Epidemiologic Studies' Depression Scale, CES-D).

RESULTSThe rate of suicidal ideation was significantly higher in second year students as opposed to fi rst year students (P <0.01). Students of lower socioeconomic status (P = 0.04), with non-inflammatory joint pain (P = 0.02), with headache (P = 0.047), with sleep disorders (P = 0.04), who scored as depressed on the TDQ (P <0.01), and/or who scored abnormally on the CHQ (P <0.01) were all significantly more likely to have experienced suicidal ideation.

CONCLUSIONA number of groups at high risk for suicidal ideation, and thus in greater need of support, were identified. Suicide intervention programmes and depression counselling should target older students and students of lower socioeconomic status. Students presenting to university clinics with non-inflammatory joint pain, headache, and/or sleep disorders should be evaluated for suicidal tendencies. The TDQ and CHQ are potentially valuable screening tests for early detection of potential suicidal students.

Adaptation, Psychological ; Adult ; Depression ; epidemiology ; psychology ; Female ; Humans ; Male ; Psychometrics ; Risk Assessment ; methods ; Social Class ; Statistics as Topic ; Stress, Psychological ; epidemiology ; psychology ; Students, Medical ; psychology ; Suicidal Ideation ; Surveys and Questionnaires ; Young Adult

PURPOSE: The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. METHODS: A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated. RESULTS: The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t=-14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001). CONCLUSION: Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.
Adult ; *Critical Care ; Critical Illness ; Female ; Humans ; Intensive Care Units ; Intubation ; Male ; Middle Aged ; Pain Measurement/*statistics & numerical data ; Psychometrics ; ROC Curve ; Republic of Korea ; Respiration, Artificial ; Suction ; *Translating

OBJECTIVE: To introduce and revise the Violence Risk Scale (VRS) for assessing violence risk and risk change, and to examine the reliability of Violence Risk Scale of Chinese version(VRS-C). METHODS: The original English version of the VRS was translated into Chinese according to established translation procedures. To examine the scorer reliability the 14 cases assessed by 3 assessors separately. One hundred and twenty-five patients with mental disorders from 3 different institutions in Sichuan province (Refined Control Ward in Ankang Hospital, Department of Forensic Psychiatry, Institute of Forensic Science and Mental Health Center of West China Hospital) were collected to examine the reliability of VRS-C. RESULTS: The results showed moderately good scale reliability of the VRS-C, with 0.80 of ICC for scorer reliability. All items have significant consistence with Cronbach's alpha coefficient as 0.921, split-half reliability as 0.906 and item total correlation as 0.246-0.849. CONCLUSION The reliability of the VRS-C version is acceptable.
Adolescent ; Adult ; Age Factors ; China/epidemiology* ; Educational Status ; Female ; Forensic Psychiatry/methods* ; Humans ; Language ; Male ; Mental Disorders/psychology* ; Middle Aged ; Psychological Tests/standards* ; Psychometrics ; Reproducibility of Results ; Risk Assessment/standards* ; Surveys and Questionnaires ; Violence/statistics & numerical data* ; Young Adult