Ruth Scott

Measuring social relationships The Interview Schedule for Social Interaction

It is generally recognized that social relationships occupy a central position in psychiatry. To examine the role of social relationships in the onset of minor psychiatric morbidity it is necessary to construct an instrument which will meet the need for a valid, reliable and comprehensive index of social relationships. Such an instrument has now been developed and used in a sample of the general population. The Interview Schedule for Social Interaction arose from a research need, and was constructed to assess the availability and perceived adequacy for any individual of a number of facets of social relationships. These consist both of persons and of the provisions obtained through them. Data from a general population sample suggest this instrument to be sufficiently valid and reliable, and also sensitive to predictable variations between sociodemographic groups, to justify its use in clinical and epidemiological studies, both in psychiatry and general medicine.

Performance of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening test for dementia

A 26-item informant questionnaire (IQCODE) and the Mini-Mental State Examination (MMSE) were compared as screening tests for dementia in a sample of 69 patients. Dementia diagnoses were made by both a clinician and a research interview using a computer algorithm to meet DSM-III-R and ICD-10 (Draft) criteria. The IQCODE was found to perform at least as well as the MMSE against all diagnoses and significantly better when judged against the algorithmic ICD-10 diagnoses. Also, the IQCODE was found to be uncontaminated by pre-morbid ability as estimated from the National Adult Reading Test and to have very high test-retest reliability after a delay of a day or more.

Psychiatric disorder in Canberra. A standardised study of prevalence.

A standardised survey of prevalence has been carried out in a general population. The epidemiological method employed is innovative in its use of two established instruments, the GHQ and the PSE, harnessed together in a two‐phase design. 756 persons were interviewed, giving a response rate of 85 % in phase 1. 157 were then interviewed with the PSE in phase 2 within a few days, giving a response rate of 92 % in this weighted subsample.

The Parental Bonding Instrument (PBI): an epidemiological study in a general population sample.

The Parental Bonding Instrument (PBI) was used in a 2-wave community survey of 386 persons. The two factor structure of the instrument was confirmed, as well as the high stability of its scales over time. Respondents who had had children differed significantly from others. No association was found between social desirability, neuroticism or extraversion and either of the scales. No association was observed between the scales and psychiatric disorder, despite using covariance structure analysis to remove the effects of age and attenuation due to measurement error. Estimates of relative risk for affectionless control were low in contrast to estimates calculated from samples with psychiatric disorders. These findings may be characteristic of symptomatic persons in a general population. Because of the importance of the affectionless control construct, the findings invite further investigation in other community and treated samples.

The Psychogeriatric Assessment Scales: a multidimensional alternative to categorical diagnoses of dementia and depression in the elderly

The Psychogeriatric Assessment Scales (PAS) provide an assessment of the clinical changes seen in dementia and depression. Principal components analysis and latent trait analysis were used to develop a set of scales to summarize these clinical changes. There are three scales derived from an interview with the subject (Cognitive Impairment, Depression, Stroke) and three from an interview with an informant (Cognitive Decline, Behaviour Change, Stroke). Results are reported on the reliability and validity of these scales using data from clinical samples in Sydney and Geneva and a population sample from Canberra. The scales were found to have excellent validity when judged against clinical diagnoses of dementia and depression and could distinguish Alzheimers from vascular dementia. Cut-off points were developed to indicate correspondence between scale scores and clinical diagnoses. Percentile rank norms were developed from the Canberra population sample. The PAS is easy to administer and score and can be used by lay interviewers after training. It is intended for application both in research and in services for the elderly.

Adaptation of immigrants: Individual differences and determinants.

This book reports results of a longitudinal study of 307 immigrants to Australia first interviewed in 1979 and re-interviewed in 1982 set in a context of other major studies of immigrants conducted in the UK the US Canada and Australia. It focuses on conclusions that have emerged from 3 decades of research concerning determinants of individual differences in adaptation including demographic characteristics cultural skills personality variables and family relations. Among the questions addressed are: What is the normal course of immigrants reactions to their new country? Are there systematic differences in reaction associated with sex age social class religious commitment previous experience with similar and different cultures? Are subjective reactions (satisfaction with various aspects of their lives) paralleled by objective measures of role performance (adequacy of adaptation in the eyes of other people)? Do members of families migrating together share similar levels of adaptive success? How do members of families migrating together share similar levels of adaptive success? How do inter-member relations affect the adaptation of family members? What are the effects on adaptation of emotional well-being optimism and need for affiliation? Original contributions of the longitudinal study include the assessment of immigrant families both before and after migration the use of measures obtained from other sources other than the focal respondent the examination of relations among 2 dozen different outcomes as distinct measures of adaptation each assessed with multiple-item scales and the simultaneous inclusion of several dozen predictors in multiple-regression analyses applied to each outcome. (authors)

A latent trait analysis of an inventory designed to detect symptoms of anxiety and depression using an elderly community sample.

An 18-item inventory designed by Goldberg et al. (1987) to detect symptoms of anxiety and depression was administered to an elderly general population sample. Latent trait analysis was used to assess the dimensionality of the inventory and the location and discriminatory ability of the symptoms. The items showed different patterns of discrimination in this group compared to the sample of general practice attenders on which the inventory was developed. Overall, the items did define two correlated dimensions of anxiety and depression. In addition, a third dimension of sleep disturbance was detected. Both individual scales and the total symptom scores were sensitive and relatively specific detectors of depressive disorders assessed according to ICD-10 and DSM-III-R criteria. The retention of sleep items on their original scales did not affect the sensitivity of the scales to detect depressive disorders. A two-step administration procedure suggested for use in the administration of the scales was investigated but found to be sensitive to differences between the current sample and the sample on which the inventory was developed. This symptom inventory can be recommended for use in epidemiological investigations as a brief, valid and acceptable method of detecting elevated levels of anxiety and depression in elderly persons.

Neuroticism and self-reported health in an elderly community sample

Abstract Previous research has shown that self-reported health is correlated with the personality trait of neuroticism, but objective measures of health are not. However, much of this research involved narrow samples in which major health problems were uncommon. The present study was based on a survey of persons aged 70 or over who were living in the community. It was found that neuroticism correlated with some self-report measures of health, but not others. Correlations with neuroticism emerged when the self-report measures involved room for personal judgment. Correlations with objective measures were near zero. Correlations between neuroticism and self-reported health were much lower in men than in women. A small correlation was found between neuroticism and use of health services, but only for women. The results support the hypothesis that neuroticism is related to the perception of health rather than to objective health status.

The Elderly who Live Alone Their Mental Health and Social Relationships

In a community survey of the elderly in Hobart, persons who lived alone were compared to those who lived with others. Those who lived alone were more often widows and had had more education. They had markedly fewer close relationships but as much other social interaction. They reported that their personal networks were as adequate as other elderly persons, yet they experienced much more loneliness. They had no higher a prevalence of depressive disorders or dementia on DSM-III criteria, but they did have a higher frequency of neurotic depression and some depressive symptoms, of which loneliness was one. Contrary to what might intuitively be expected, the elderly who live alone may not be a group at increased risk for formal psychiatric morbidity. Instead, they may have a moderate excess of dysphoric symptoms.

ICD-10 mild cognitive disorder : epidemiological evidence on its validity

Criteria for the diagnosis of ICD-10 Mild Cognitive Disorder (MCD) were applied to a sample of 897 community dwelling elderly participants. Criterion A (the presence of a physical disorder) was met by 44%, Criterion B (report of a cognitive disorder) by 17%, Criterion C (an abnormality in quantified cognitive assessments) by 60%, and Criterion D (exclusion on basis of dementia and other conditions) by 74%. A total of 36 cases (4%) met all four criteria. Correlations between Criteria A and B, and B and C were weak (r = 0.18), and the correlation between Criteria A and C was almost zero (r = 0.02). This suggests that no syndrome exists. Membership of MCD was predicted by a report that memory or intelligence interfered with daily life but not by performance on cognitive tests or by a report of physical illness. Cases of MCD had higher anxiety, depression and neuroticism scores than normal elderly, but did not differ substantially on tests of cognitive functioning. These findings call into question the validity of the ICD-10 diagnosis of MCD.