Clinical Psychometrics E-Book

Per Bech

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 274

Veröffentlichungsjahr: 2012

Beschreibung

Clinical Psychometrics is an introduction to the long-term attempt to measure the psychiatric dimension of dementia, schizophrenia, mania, depression, anxiety, neuroticism, extraversion/introversion and health-related quality of life.

The two psychometric procedures, classical factor analysis and modern item-response models, are presented for readers without any requirement for particular mathematical or statistical knowledge. The book is unique in this attempt and provides helpful background information for the dimensional approach that is being used in the forthcoming updates to the diagnostic classification systems, ICD-11 and DSM-5.

The book is written for everyone who is interested in the origins and development of modern psychiatry, and who wants to be familiar with its practical possibilities; how it is possible to compare different individuals with each other, how one may determine the boundary between what is normal and what is disease, or how one may assess the clinical effect of the various forms of treatment, available to present day psychiatry.

Leseprobe

Contents

Cover

Half Title page

Title page

Copyright page

Dedication

About the author

Preface

Introduction

Chapter 1: Classical psychometrics

Emil Kraepelin: Symptom check list and pharmacopsychology

Charles Spearman: Factor analysis and intelligence tests

Harold Hotelling: Principal Component Analysis

Hans Eysenck: Factor analysis and personality questionnaires

Max Hamilton: Factor analysis and rating scales

Pierre Pichot: Symptom rating scales and clinical validity

Chapter 2: Modern psychiatry: DSM-IV/ICD-10

Focusing on reliability

Focusing on validity

Quantitative, dimensional diagnosis

Chapter 3: Modern, dimensional psychometrics

Ronald A. Fisher: From Galton’s pioneer work to the sufficient statistic

Georg Rasch: From Guttman’s pioneer work to item response theory analysis (IRT)

Sidney Siegel: Non-parametric statistics

Robert J. Mokken: Non-parametric analysis for item response theory (IRT)

Chapter 4: Modern psychometrics: Item categories and sufficient statistics

Rensis Likert: Scale step measurements

John Overall: Brief, sufficient rating scales

Clinical versus psychometric validity

Item-response theory versus factor analysis

Jacob Cohen: Effect size

Chapter 5: The clinical consequence of IRT analyses: The pharmacopsychometric triangle

Effect size and clinical significance

The pharmacopsychometric triangle

Antidementia medication

Antipsychotic medication

Antimanic medication

Antidepressive medication

Antianxiety medication

Mood stabilising medications

Combination of antidepressants

Chapter 6: The clinical consequence of IRT analyses: Health-related quality of life

The WHO-5 Questionnaire

Chapter 7: The clinical consequences of IRT analyses: The concept of stress

Post-traumatic stress disorder

The work-related stress condition

Integration of Selye’s medical stress model

Chapter 8: Questionnaires as ‘blood tests’

Population studies in depression and anxiety

The predictive validity of WHO-5

Screening scales

Chapter 9: Summary and perspectives

Chapter 10: Epilogue: Who’s carrying Einstein’s baton?

Appendices

Appendix 1: The clinical validity of rating scales for depression Copenhagen 1977

Appendix 2: The ABC profile of the HAM-D17

Appendix 3a: Hamilton Depression Scale (HAM-D17)

Appendix 3b: Hamilton Depression Scale (HAM-D24)

Appendix 3c: ABC Version of the Montgomery-Åsberg Depression Scale (MADRS10)

Appendix 3d: The Bech-Rafaelsen Melancholia Scale (MES)

Appendix 3e: ABC version of the SCL-92 analogue with HAM-D17

Appendix 3f: HAM-D6 – clinician version

Appendix 3g: The HAM-D6 Questionnaire

Appendix 3h: SCL-D6 subscale for depression

Appendix 3i: The BDI6 subscale for depression

Appendix 4a: Major Depression Inventory

Appendix 4b: Dealing with missing values in the Major Depression Inventory (MDI)

Appendix 5a: Hamilton Anxiety Scale HAM-A14

Appendix 5b: Anxiety Symptom Scale (ASS)

Appendix 6: The Bech-Rafaelsen Mania Scale (MAS)

Appendix 7: Brief Psychiatric Rating Scale (BPRS)

Appendix 8a: Psychiatric Research Unit, WHO Collaborating Center for Mental Health

Appendix 8a: Psychiatric Research Unit, WHO Collaborating Center for Mental Health

Appendix 9a: Etiological considerations in major depression by use of the Clinical Interview for Depression and Related Syndromes (CIDRS)

Appendix 9b: Newcastle Diagnostic Depression Scale (1965)

Appendix 10: The modified PRISE20 questionnaire for side effects of antidepressants

Appendix 11a: Calculus Example 1

Appendix 11b: Calculus Example 2

Glossary

References

Index

Clinical Psychometrics

This edition first published 2012 © 2012 by John Wiley & Sons, Ltd

Danish original title: Klinisk psykometri, by Per Bech, ISBN 97887628-1011-2, copyright Munksgaard Danmark, Copenhagen 2011.

This edition of Klinisk psykometri is published with the title “Clinical Psychometrics”, by arrangement with Munksgaard Danmark.

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Library of Congress Cataloging-in-Publication Data

Bech, Per. [Klinisk psykometri. English] Clinical psychometrics / Per Bech. – 1st ed. p.; cm. Includes bibliographical references and index. ISBN 978-1-118-51178-7 (pbk. : alk. paper)  1. Psychometrics.  2. Psychiatry.  I. Title. [DNLM:  1. Psychometrics–history.  2. Factor Analysis, Statistical.  3. Psychology, Clinical–instrumentation.  4. Psychopharmacology. BF 39]   BF39.B417 2012   150.1’5195–dc23 2012009839

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

I attempted to effect the scientific in my psychopathology by methodological investigations, not by a dogmatic exposition of a complete psychiatric epistemology.

Karl Jaspers (1950)

The debt of psychiatry to the psychologist is now great and growing. From [Eysenck’s] rigorous inquiries, sustained and resourcefully developed over years, psychiatry stands to gain an impetus and accuracy in some essential matters which will advance it and reinforce the free play of clinical skill and insight.

Aubrey Lewis (1952)

Emil Kraepelin is probably the most outstanding psychiatrist who ever lived.

Max Hamilton (1978)

To Ole Rafaelsen, a man larger than life, and to Erling Dein whoshowed me how to use Occam’s razor in psychopathology

About the author

Per Bech

Per Bech received a medical degree from Copenhagen University in 1969. In 1972 he received a gold medal award from Århus University for his thesis on the dose-response relationship between cannabis (tetrahydrocannabinole) and various psychological measurements, including time experience and reaction time in simulated car driving.

He completed a doctorate thesis (Dr. Med. Sci) at Copenhagen University on the clinical and psychometrical validity of rating scales in depression and mania in 1981.

He was appointed Professor of Psychiatry at Odense University in 1992 and in 2008 he was appointed Professor of Applied or Clinical Psychometrics at Copenhagen University.

Since 1981 he has held the post of chief psychiatrist at The Mental Health Centre North Zealand in Hillerød (Capital Region of Denmark) and is Head of the Psychiatric Research Unit there. He is an honorary member of the Royal College of Psychiatrists and of the European Psychiatric Association (EPA).

Preface

The first edition of this book was the original Danish version published in January 2011, as an introduction to the very broad field covering clinical psychology, psychiatry and clinical psychopharmacology. It was an attempt to follow Kraepelin’s rating scale approach and his pharmacopsychometrics as they have developed in the twentieth century, especially with the introduction of psychopharmacology in the 1960s. The central concept here is the Pharmacopsychometric Triangle, in which (A) covers desired clinical effect, (B) unwanted effects, or side effects, and (C) patient-reported quality of life. In connection with (A), short psychometric scales are described which can be used to measure such classes of drugs as antidementias, antipsychotics, antimanics, antidepressants, antianxiety drugs, and mood stabilisers.

The psychometric performances of scales for (A), (B) and (C) are described with reference to both factor analysis and to item response theory models. These models have been amended for readers without mathematical knowledge. However, throughout the book experienced psychiatrists are referred to as an index of validity in an attempt to bring the symptoms home to the dimensions within (A), (B) and (C) where they belong.

My thanks when preparing the Danish version of my book went, as so often before, to Peter Allerup, Professor of Theoretical Psychometrics at the University of Århus. He has been a ‘basic factor’ for my work with rating scales over nearly 40 years! My research coordinator Lone Lindberg has made a unique contribution, with invaluable help in typing and layout. Gabriele Bech-Andersen and Susan Søndergaard are behind the translation procedures for the scales in the Danish version, and Susan has translated this English version from the Danish. Ove Aaskoven has been my statistical research assistant for many years, often in collaboration with Peter Allerup. Finally, I owe a debt of thanks to the Munksgaard editors Marie Schack and Daniel R. Andersen who made helpful suggestions for the earlier Danish versions.

In this English version editor Jesper Konradsen has raised challenging queries, especially on the philosophical lines running through it, with focus on the development of psychometrics from a philosophical start to mathematical aspects of measuring mental stages, to clinical validity and dose–response relationships and then back to the philosophy of Wittgenstein, which brings symptoms home to form relevant syndromes or dimensions.

Introduction

Clinical psychiatry has incorporated psychology as an important auxiliary subject in the same way as neuropharmacology and neuroanatomy. As a branch of medicine, clinical psychiatry has especially attempted to determine the organic cause of mental disorders; and before the establishment of psychometrics, the psychological approach to patients was seen as a non-organic explanatory model for mental disorders. Freud’s psychoanalysis, in particular, was seen as a psychological explanatory model; partly because psychiatry was regarded for many years as an atypical branch of medicine due to the non-testability of the Freudian theories, which were thus without clinical validity (1).

The scientific approach to psychology launched by psychometrics has resulted in psychiatry being regarded as a clinical branch of medicine. This only took place with the 1987 publication of Feinstein’s monograph on clinimetrics (2). Finding a comprehensive overview of the role of psychometrics in clinical psychiatry has proved difficult. The following is an attempt to put this to rights.

It falls naturally to divide clinical psychometrics into two eras. The first of these, the classical era, covers the period from 1879 to 1945. It is the era of the greatest names: Wilhelm Wundt who founded psychometrics in 1879 and his two most important pupils; Kraepelin and Spearman. The modern period developed after 1945 has Eysenck, Hamilton and Pichot as the major psychometricians. They developed the questionnaires and rating scales archetypal of modern clinical psychometrics in the period from 1945 to the 1970s (3). From a statistical point of view, however, Francis Galton and his London psychometric laboratory (founded in 1884) are essential elements, together with Galton’s two most important ‘students’ (Pearson and Fisher) and the three people (Rasch, Siegel and Mokken) who developed the psychometric analyses that are archetypal of modern clinical psychometrics in the period from 1945 to the 1970s (4) (see Figure I.1).

Figure I.1 Psychometrics

The most obvious impact of modern psychometric research, which has resulted in short valid rating scales and the descriptive statistics of effect sizes, is the pharmacopsychometric triangle. It was the revolution in pharmacology 50 years ago that led to the rebirth of Kraepelin’s pharmacopsychology, now crystallised in the pharmacopsychometric triangle, the major focus of this book.

Chapter 1

Classical psychometrics

More than a century ago, psychology was defined as the science of human mental manifestations and phenomena. However, it was psychometrics (the science of measuring these mental manifestations and phenomena) that made psychology scientific. Thus, psychometrics is a purely psychological area of research.

From a historical point of view, psychology branched out from philosophy as an independent university discipline at the close of the nineteenth century. It all started in Leipzig in 1879. Here the philosopher Wilhelm Wundt (1832–1920) established his psychological laboratory at the university. Formally, however, his laboratory remained under the faculty of philosophy. Wundt succeeded in detaching psychology from philosophy, especially freeing it from the influence of Emanuel Kant, an extremely influential philosopher who stated that it is impossible to measure manifestations of the mind in the same way as physical objects (5). With his criticism of pure reason, Kant (1724–1804) established the very important distinction between ‘the essential nature of things’ (things in themselves) and ‘things as they seem’ (i.e., that which we sense or perceive as a phenomenon when faced with the object we are examining).