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The Clinician Affective Reactivity Index: Validity and Reliability of a Clinician-Rated Assessment of Irritability.

ABSTRACT: Irritability is impairing in youth and is the core feature of disruptive mood dysregulation disorder (DMDD). Currently, there are no established clinician-rated instruments to assess irritability in pediatric research and clinical settings. Clinician-rated measures ensure consistency of assessment across patients and are important specifically for treatment research. Here, we present data on the psychometric properties of the Clinician Affective Reactivity Index (CL-ARI), the first semistructured interview focused on pediatric irritability. The CL-ARI was administered to a transdiagnostic sample of 98 youth (M age?=?12.66, SD?=?2.47; 41% female). With respect to convergent validity, CL-ARI scores were (a) significantly higher for youth with DMDD than for any other diagnostic group, and (b) showed uniquely strong associations with other clinician-, parent-, and youth-report measures of irritability compared to measures of related constructs, such as anxiety. The three subscales of the CL-ARI (temper outbursts, irritable mood, impairment) showed excellent internal consistency. Test-retest reliability of the CL-ARI was adequate. These data support that irritability can be feasibly, validly, and reliably assessed by clinicians using the CL-ARI. A validated, gold-standard assessment of pediatric irritability is critical in advancing research and treatment efforts.

SUBMITTER: Haller SP

PROVIDER: S-EPMC7060970 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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The Clinician Affective Reactivity Index: Validity and Reliability of a Clinician-Rated Assessment of Irritability.

Haller Simone P SP Kircanski Katharina K Stringaris Argyris A Clayton Michal M Bui Hong H Agorsor Courtney C Cardenas Sofia I SI Towbin Kenneth E KE Pine Daniel S DS Leibenluft Ellen E Brotman Melissa A MA

Behavior therapy 20191127 2

Irritability is impairing in youth and is the core feature of disruptive mood dysregulation disorder (DMDD). Currently, there are no established clinician-rated instruments to assess irritability in pediatric research and clinical settings. Clinician-rated measures ensure consistency of assessment across patients and are important specifically for treatment research. Here, we present data on the psychometric properties of the Clinician Affective Reactivity Index (CL-ARI), the first semistructure ...[more]

PMID: 32138938

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Project description:BACKGROUND:The distress of patients suffering from a terminal illness can lead to a state of despair and requests for euthanasia and assisted suicide. It is a major challenge for palliative care workers. The Distress Thermometer (DT) is recommended by the National Comprehensive Cancer Network as a means of more easily assessing distress. It is available as a Self-assessment reported Distress Thermometer, but for a wider use in palliative care it should also be implemented in the form of a clinician-reported outcome (clinRO). Clinicians need to rate patient's distress when the patient is not able to do so (subject that cannot be addressed, defensive patient…). The primary aim of the quantitative study was to assess the validity of the Clinician-Rated Distress Thermometer in palliative care. METHOD:The assessments were performed by teams working in three palliative care centres. The primary endpoint was concordance between the patient and clinicians' responses via Lin's concordance coefficient. Eligible patients were aged 18?years or older, suffering from a severe disease in the palliative phase, and with a sufficient level of awareness to consent to participate in the study. A total of 51 patients were recruited, 55% were male, with a mean age of 65.8?years [39-90?years]. RESULTS:Three hundred sixty-four clinician-Rated Distress Thermometer and 467 Self-Reported Distress Thermometer were performed. Only 364 of the 467 Self-Reported Distress Thermometer were used for the study, as investigators did not systematically ask the patient to give an account of his distress. Concordance between patient and clinician responses: The Lin's concordance coefficient with a threshold (alpha) of 5% was 0.46 [0.38; 0.54]. At the first assessment, it was 0.61 [0.44; 0.79]. The Cohen's kappa coefficient was 0.52, with a concordance rate of 79.6%. The sensitivity was 82.9% [66.4-93.4] and the specificity 71.4% [41.9-91.6]. CONCLUSION:The first assessment gave the best results in terms of concordance between Clinician-Rated DT and Self-Reported DT. In the next assessments, the Clinician-Rated DT were less consistent with the patients' Self-Reported DT.

Project description:BackgroundOswestry Disability Index (ODI) is broadly used in clinical and research settings for assessing the disability level in patients with lumbar radiculopathy but it has not been translated into Urdu language according to the pre-established translation guidelines as well as the validity and reliability of ODI Urdu version has not been tested yet. The aim of this study was to translate ODI in native Urdu language (ODI-U) according to recommended guidelines and to measure its psychometric properties in Urdu speaking patients suffering from lumber radiculopathy.MethodsOut of 108 participants, 54 were healthy (who filled ODI-U) and 54 were patients of lumber radiculopathy. The patients were administered through ODI-U, visual analogue scales for disability (VAS disability), pain intensity (VAS pain) and SF-36 at baseline and after 3 days. Reliability was investigated through test-retest method, internal consistency, standard error of measurement (SEM) and smallest detectable change (SDC). ODI-U was assessed for exploratory factor analysis, construct (convergent and discriminative) validity and content validity. Alpha level < 0.05 was considered statistically significant and psychometric standards were evaluated contrary to priori hypothesis.ResultsODI-U revealed excellent test-retest reliability for total score (ICC2,1 = 0.95) and for all item (ICC2,1 = 0.72-0.98). Cronbach's alpha of 0.89 showed excellent internal consistency and moderate correlation between ODI-U total score and each item through spearman's correlation coefficient (r = 0.51-0.76). One factor structure was created, explaining 52.5% variance. There was no floor and ceiling effect of total ODI-U score. Content validity was assessed through conducting interviews with patients and incorporating expert's opinions. The discriminative validity was measured by independent sample t-test, where significant difference between healthy and patients (P < 0.001) was observed. The convergent validity was evaluated through Pearson's correlation showing moderate positive correlation of ODI-U with VAS pain (r = 0.49) and VAS disability (r = 0.51) but moderate negative correlation with all SF-36 domains (r = - 0.43to - 0.63).ConclusionODI-U showed adequate psychometric properties. ODI-U was found to be a reliable and a valid tool to measure the level of disability in Urdu-speaking patients with lumber radiculopathy.

Dataset Information

The Clinician Affective Reactivity Index: Validity and Reliability of a Clinician-Rated Assessment of Irritability.

Publications

The Clinician Affective Reactivity Index: Validity and Reliability of a Clinician-Rated Assessment of Irritability.

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