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Elizabeth Brondolo - One of the best experts on this subject based on the ideXlab platform.
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Validation of the Brief Perceived Ethnic Discrimination Questionnaire-Community Version in American Indians.
Cultural diversity & ethnic minority psychology, 2020Co-Authors: Irene V. Blair, Chad Danyluck, Charles M. Judd, Spero M. Manson, Mark L. Laudenslager, Stacie L. Daugherty, Erin L Ratliff, Jacqueline A Gardner, Elizabeth BrondoloAbstract:Objective The Brief Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CVB) is a widely used, multidimensional measure of exposure to ethnic/racial discrimination. The PEDQ-CVB has not been previously validated for use with American Indians, who have endured a unique history of colonization, cultural oppression, and ongoing discrimination. This study examined the measurement invariance of the PEDQ-CVB in American Indians (AIs) and 4 other groups. Additional analyses assessed the scale's convergent and discriminant validity and provided initial evidence of associations with mental and physical health in AIs. Method Primary data were collected from a Community sample of urban-dwelling AIs (n = 222), which included measures of ethnic/racial identity, other life stressors, and mental and physical health, along with the PEDQ-CVB. These were supplemented by secondary analysis of PEDQ-CVB data from African Americans (n = 1176), Latinos (n = 564), East Asian Americans (n = 274), and South Asian Americans (n = 242). Results The PEDQ-CVB demonstrated measurement invariance across the 5 ethnic/racial groups and convergent and discriminant validity in AIs. The PEDQ-CVB was significantly associated with depressive symptoms and physical limitations in AIs, after controlling for relevant demographics. Conclusion This study provides strong evidence that the PEDQ-CVB behaves consistently for AIs and other underrepresented ethnic/racial groups. As such, the PEDQ-CVB allows for documentation of the experiences of different ethnic/racial groups and provides a means to test theoretical models of the antecedents and consequences of perceived discrimination within and across groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Lifetime Racial/Ethnic Discrimination and Ambulatory Blood Pressure: The Moderating Effect of Age
Health Psychology, 2016Co-Authors: Danielle L. Beatty Moody, Shari R Waldstein, Joseph C. Schwartz, Jonathan N. Tobin, Andrea Cassells, Elizabeth BrondoloAbstract:To determine whether the relationships of lifetime discrimination to ambulatory blood pressure (ABP) varied as a function of age in a sample of Black and Latino(a) adults ages 19 - 65.Participants were 607 Black (n = 318) and Latino(a) (n = 289) adults (49% female) who completed the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV), which assesses lifetime exposure to racism/ethnic discrimination. They were outfitted with an ABP monitor to assess systolic and diastolic blood pressure (SBP, DBP) across a 24-hr period. Mixed-level modeling was conducted to examine potential interactive effects of lifetime discrimination and age to 24-hr, daytime, and nighttime ABP after adjustment for demographic, socioeconomic, personality and life stress characteristics, and substance consumption covariates (e.g., smoking, alcohol).There were significant interactions of Age × Lifetime Discrimination on 24-hr and daytime DBP (ps ≤ .04), and in particular significant interactions for the Social Exclusion component of Lifetime Discrimination. Post hoc probing of the interactions revealed the effects of Lifetime Discrimination on DBP were seen for older, but not younger participants. Lifetime discrimination was significantly positively associated with nocturnal SBP, and these effects were not moderated by age. All associations of Lifetime Discrimination to ABP remained significant controlling for recent exposure to discrimination as well as all other covariates.Exposure to racial/ethnic discrimination across the life course is associated with elevated ABP in middle to older aged Black and Latino(a) adults. Further research is needed to understand the mechanisms linking discrimination to ABP over the life course. (PsycINFO Database Record
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Lifetime Racial/Ethnic Discrimination and Ambulatory Blood Pressure: The Moderating Effect of Age
Health psychology : official journal of the Division of Health Psychology American Psychological Association, 2016Co-Authors: Danielle L. Beatty Moody, Shari R Waldstein, Joseph C. Schwartz, Jonathan N. Tobin, Andrea Cassells, Elizabeth BrondoloAbstract:Objective To determine whether the relationships of lifetime discrimination to ambulatory blood pressure (ABP) varied as a function of age in a sample of Black and Latino(a) adults ages 19 - 65. Method Participants were 607 Black (n = 318) and Latino(a) (n = 289) adults (49% female) who completed the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV), which assesses lifetime exposure to racism/ethnic discrimination. They were outfitted with an ABP monitor to assess systolic and diastolic blood pressure (SBP, DBP) across a 24-hr period. Mixed-level modeling was conducted to examine potential interactive effects of lifetime discrimination and age to 24-hr, daytime, and nighttime ABP after adjustment for demographic, socioeconomic, personality and life stress characteristics, and substance consumption covariates (e.g., smoking, alcohol). Results There were significant interactions of Age × Lifetime Discrimination on 24-hr and daytime DBP (ps ≤ .04), and in particular significant interactions for the Social Exclusion component of Lifetime Discrimination. Post hoc probing of the interactions revealed the effects of Lifetime Discrimination on DBP were seen for older, but not younger participants. Lifetime discrimination was significantly positively associated with nocturnal SBP, and these effects were not moderated by age. All associations of Lifetime Discrimination to ABP remained significant controlling for recent exposure to discrimination as well as all other covariates. Conclusions Exposure to racial/ethnic discrimination across the life course is associated with elevated ABP in middle to older aged Black and Latino(a) adults. Further research is needed to understand the mechanisms linking discrimination to ABP over the life course. (PsycINFO Database Record
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Perceived ethnic discrimination and cigarette smoking: examining the moderating effects of race/ethnicity and gender in a sample of Black and Latino urban adults
Journal of Behavioral Medicine, 2015Co-Authors: Elizabeth Brondolo, Jonathan N. Tobin, Andrea Cassells, Angela Monge, John Agosta, Cassandra Stanton, Joseph SchwartzAbstract:Perceived ethnic discrimination has been associated with cigarette smoking in US adults in the majority of studies, but gaps in understanding remain. It is unclear if the association of discrimination to smoking is a function of lifetime or recent exposure to discrimination. Some sociodemographic and mood-related risk factors may confound the relationship of discrimination to smoking. Gender and race/ethnicity differences in this relationship have been understudied. This study examines the relationship of lifetime and recent discrimination to smoking status and frequency, controlling for sociodemographic and mood-related variables and investigating the moderating role of race/ethnicity and gender. Participants included 518 Black and Latino(a) adults from New York, US. Lifetime and past week discrimination were measured with the Perceived Ethnic Discrimination Questionnaire-Community Version. Ecological momentary assessment methods were used to collect data on smoking and mood every 20 min throughout one testing day using an electronic diary. Controlling for sociodemographic and mood-related variables, there was a significant association of recent (past week) discrimination exposure to current smoking. Lifetime discrimination was associated with smoking frequency, but not current smoking status. The association of recent discrimination to smoking status was moderated by race/ethnicity and gender, with positive associations emerging for both Black adults and for men. The association of lifetime discrimination on smoking frequency was not moderated by gender or race/ethnicity. Acute race/ethnicity-related stressors may be associated with the decision to smoke at all on a given day; whereas chronic stigmatization may reduce the barriers to smoking more frequently.
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The Perceived Ethnic Discrimination Questionnaire—Community Version: Validation in a multiethnic Asian sample.
Cultural Diversity & Ethnic Minority Psychology, 2011Co-Authors: Jasmin Kwok, Jennifer Atencio, Jahanara Ullah, Robert Crupi, Alan Roth, William F. Chaplin, Daniel Chen, Elizabeth BrondoloAbstract:This study evaluated the validity and reliability of the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV) Lifetime Exposure scale in a multiethnic Asian sample (N = 509). The 34-item scale measures perceived interpersonal racial/ethnic discrimination and includes four subscales assessing different types of discrimination: Social Exclusion, Stigmatization, Discrimination at Work/School, and Threat/Aggression. The Lifetime Exposure scale demonstrated excellent reliability across the full group and in all major subgroups. Subscales displayed good reliability across the full group and moderate-to-good reliability in each subgroup. The Lifetime Exposure scale was significantly correlated with the depression and anxiety subscales of the SCL-90-R, providing preliminary evidence of construct validity. The data suggest the Lifetime Exposure scale, previously validated in Black and Latino adults, is also appropriate for use with Asian samples, and can be used to examine both within-group and between-groups differences in discrimination.
Chris R. Brewin - One of the best experts on this subject based on the ideXlab platform.
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The treatment of psychiatric disorder in the Community: Report from the Camberwell Needs for Care Survey
Journal of Mental Health, 1999Co-Authors: Paul Bebbington, Lucy Marsden, Chris R. BrewinAbstract:Although the estimation of needs for treatment is a prime function of Community psychiatric surveys, none has so far measured need directly. The Camberwell Needs for Care Survey is the first such attempt. Needs for treatment were identified in a random population sample from a catchment area in inner South London. Information obtained through SCAN, the Social Role Performance Schedule, the Life Events and Difficulties Schedule and a treatment inventory was assessed by a rating panel in relation to an explicit model of care by using the Needs for Care Assessment- Community Version. Subjects with psychotic disorders received good care and treatment. Subjects with depression often rejected the idea of treatment. Treatment was mainly pharmacological and needs were often unmet, particularly for cognitive or supportive psychotherapy. Subjects with anxiety disorders were less likely to reject treatment but still had a high proportion of needs unmet, as was the case for other disorders.
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The need for psychiatric treatment in the general population: the Camberwell Needs for Care Survey.
Psychological medicine, 1997Co-Authors: Paul Bebbington, Lucy Marsden, Chris R. BrewinAbstract:Background, This paper presents the first results of a two-stage psychiatric population survey, which uses a new method of directly evaluating needs for specific psychiatric treatment and the extent to which they have been met.Method, The sample was drawn at random from the population of an area of inner south London with high levels of deprivation. Seven hundred and sixty subjects aged 18-65 completed the GHQ-28. All those scoring > 5 and half of the rest were invited to take part in the second stage, comprising measures of mental state (SCAN), social role performance (SRPS), life events and difficulties (LEDS) and a Treatment Inventory. This information was used to rate the Community Version of the Needs for Care Assessment (NFCAS-C).Results, In all, 408 subjects were interviewed in the second stage. The weighted 1 month prevalence of hierarchically ordered ICD-10 psychiatric disorders was 9.8 %, the 1 year prevalence 12.3 %. The equivalent prevalences for depressive episode were 3.1 % and 5.3 % respectively, while those for anxiety states were both 2.8 %. At interview nearly 10% of the population were identified as having a need for the treatment of a psychiatric condition. This rose to 10.4 % if the whole of the preceding year was assessed. Less than half of all potentially meetable needs were met. There was only partial overlap between diagnosis and an adjudged need for treatment.Conclusion. A majority of people with mental health problems do not have proper treatment; given more resources and greater public and medical awareness, most could be treated by family doctors.
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The reliability of the Community Version of the MRC Needs for Care Assessment
Psychological medicine, 1996Co-Authors: Alain Lesage, Louise Fournier, Mireille Cyr, Jean Toupin, J. Fabian, G. Gaudette, C. Vanier, Paul Bebbington, Chris R. BrewinAbstract:One hundred and nine adults were screened in the Community using the abridged Version of the CIDI (CIDIS). The subjects comprised DSM-III-R current cases (N = 48), lifetime cases (N = 31) and non-cases (N = 30). The interviews with the 109 subjects were conducted by one of two pairs of clinicians and videotaped. Each interviewer-pair included a psychiatrist and a clinical psychologist. They rated the Community Version of the Needs for Care (NFCAS-C) by consensus. The other pair of judges then viewed the video and rated the NFCAS-C independently. The agreement on overall needs was excellent (kappa = 0.75), and very good for four of the seven specific sections (from kappa = 0.61 to 0.81). One section could not be rated because of low prevalence, and agreement was less good for the remaining two sections. Agreement was good on specific interventions (medication, kappa = 0.60; specific psychotherapy, kappa = 0.55), but poor on non-specific interventions. The majority of disagreements were due to differences in clinical judgement rather than to technical errors. A new instruction manual has been produced and should help training as well as stabilizing reliability. In devising reliable and valid instruments based on clinical judgement, a balance must be achieved between enhancing reliability with more precise rules and constraining clinical judgement so tightly that validity is lost.
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Measuring the need for psychiatric treatment in the general population: the Community Version of the MRC Needs for Care Assessment.
Psychological medicine, 1996Co-Authors: Paul Bebbington, Chris R. Brewin, L. Marsden, A. LesageAbstract:The Community Version of the MRC Needs for Care Assessment Schedule (NFCAS-C) is a new instrument designed for the psychiatric conditions seen in general populations. Its principles are based on the original Needs for Care Assessment, although that was developed for the very different population of those with long-standing mental illness (Brewin et al. 1987). The NFCAS-C is designed to reproduce, in an itemized and systematic manner, the functioning of well-organized primary care and psychiatric services. It is primarily intended for research purposes, in particular, the comparison of treatment needs and services in different populations. In this paper we describe the problems of assessing the need for psychiatric care in general populations and the rationale and development of the instrument, while in its companion we present the results of a reliability study (Lesage et al. 1995).
Donna L. Algase - One of the best experts on this subject based on the ideXlab platform.
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risk assessment of wandering behavior in mild dementia
Faculty of Health; Institute of Health and Biomedical Innovation, 2016Co-Authors: Stephen L Luther, Donna L. Algase, Elizabeth Beattie, Ladislav Volicer, Lisa M Brown, Victor Molinari, Heather Moore, Inez JosephAbstract:Objective - This prospective longitudinal study aims to determine the risk factors of wandering-related adverse consequences in Community-dwelling persons with mild dementia. These adverse consequences include negative outcomes of wandering (falls, fractures, and injuries) and eloping behavior. Methods - We recruited 143 dyads of persons with mild dementia and their caregivers from a veteran's hospital and memory clinic in Florida. Wandering-related adverse consequences were measured using the Revised Algase Wandering Scale – Community Version. Variables such as personality (Big Five Inventory), behavioral response to stress, gait, and balance (Tinetti Gait and Balance), wayfinding ability (Wayfinding Effectiveness Scale), and neurocognitive abilities (attention, cognition, memory, language/verbal skills, and executive functioning) were also measured. Bivariate and logistic regression analyses were performed to assess the predictors of these wandering-related adverse consequences. Results - A total of 49% of the study participants had falls, fractures, and injuries due to wandering behavior, and 43.7% demonstrated eloping behaviors. Persistent walking (OR = 2.6) and poor gait (OR = 0.9) were significant predictors of negative outcomes of wandering, while persistent walking (OR = 13.2) and passivity (OR = 2.55) predicted eloping behavior. However, there were no correlations between wandering-related adverse consequences and participants' characteristics (age, gender, race, ethnicity, and education), health status (Charlson comorbidity index), or neurocognitive abilities. Conclusion - Our results highlight the importance of identifying at-risk individuals so that effective interventions can be developed to reduce or prevent the adverse consequences of wandering.
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Risk assessment of wandering behavior in mild dementia
2016Co-Authors: N. Ali, Donna L. Algase, Elizabeth Beattie, Stephen L Luther, Ladislav Volicer, Lisa M Brown, Victor Molinari, Heather Moore, Inez JosephAbstract:Objective - This prospective longitudinal study aims to determine the risk factors of wandering-related adverse consequences in Community-dwelling persons with mild dementia. These adverse consequences include negative outcomes of wandering (falls, fractures, and injuries) and eloping behavior. Methods - We recruited 143 dyads of persons with mild dementia and their caregivers from a veteran's hospital and memory clinic in Florida. Wandering-related adverse consequences were measured using the Revised Algase Wandering Scale – Community Version. Variables such as personality (Big Five Inventory), behavioral response to stress, gait, and balance (Tinetti Gait and Balance), wayfinding ability (Wayfinding Effectiveness Scale), and neurocognitive abilities (attention, cognition, memory, language/verbal skills, and executive functioning) were also measured. Bivariate and logistic regression analyses were performed to assess the predictors of these wandering-related adverse consequences. Results - A total of 49% of the study participants had falls, fractures, and injuries due to wandering behavior, and 43.7% demonstrated eloping behaviors. Persistent walking (OR = 2.6) and poor gait (OR = 0.9) were significant predictors of negative outcomes of wandering, while persistent walking (OR = 13.2) and passivity (OR = 2.55) predicted eloping behavior. However, there were no correlations between wandering-related adverse consequences and participants' characteristics (age, gender, race, ethnicity, and education), health status (Charlson comorbidity index), or neurocognitive abilities. Conclusion - Our results highlight the importance of identifying at-risk individuals so that effective interventions can be developed to reduce or prevent the adverse consequences of wandering.
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risk assessment of wandering behavior in mild dementia
International Journal of Geriatric Psychiatry, 2016Co-Authors: Stephen L Luther, Donna L. Algase, Elizabeth Beattie, Ladislav Volicer, Lisa M Brown, Victor Molinari, Heather Moore, Inez JosephAbstract:OBJECTIVE: This prospective longitudinal study aims to determine the risk factors of wandering-related adverse consequences in Community-dwelling persons with mild dementia. These adverse consequences include negative outcomes of wandering (falls, fractures, and injuries) and eloping behavior. METHODS: We recruited 143 dyads of persons with mild dementia and their caregivers from a veteran's hospital and memory clinic in Florida. Wandering-related adverse consequences were measured using the Revised Algase Wandering Scale - Community Version. Variables such as personality (Big Five Inventory), behavioral response to stress, gait, and balance (Tinetti Gait and Balance), wayfinding ability (Wayfinding Effectiveness Scale), and neurocognitive abilities (attention, cognition, memory, language/verbal skills, and executive functioning) were also measured. Bivariate and logistic regression analyses were performed to assess the predictors of these wandering-related adverse consequences. RESULTS: A total of 49% of the study participants had falls, fractures, and injuries due to wandering behavior, and 43.7% demonstrated eloping behaviors. Persistent walking (OR = 2.6) and poor gait (OR = 0.9) were significant predictors of negative outcomes of wandering, while persistent walking (OR = 13.2) and passivity (OR = 2.55) predicted eloping behavior. However, there were no correlations between wandering-related adverse consequences and participants' characteristics (age, gender, race, ethnicity, and education), health status (Charlson comorbidity index), or neurocognitive abilities. CONCLUSION: Our results highlight the importance of identifying at-risk individuals so that effective interventions can be developed to reduce or prevent the adverse consequences of wandering. Copyright © 2015 John Wiley & Sons, Ltd. Language: en
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Risk assessment of wandering behavior in mild dementia.
International journal of geriatric psychiatry, 2015Co-Authors: N. Ali, Donna L. Algase, Elizabeth Beattie, Stephen L Luther, Ladislav Volicer, Lisa M Brown, Victor Molinari, Heather Moore, Inez JosephAbstract:OBJECTIVE: This prospective longitudinal study aims to determine the risk factors of wandering-related adverse consequences in Community-dwelling persons with mild dementia. These adverse consequences include negative outcomes of wandering (falls, fractures, and injuries) and eloping behavior. METHODS: We recruited 143 dyads of persons with mild dementia and their caregivers from a veteran's hospital and memory clinic in Florida. Wandering-related adverse consequences were measured using the Revised Algase Wandering Scale - Community Version. Variables such as personality (Big Five Inventory), behavioral response to stress, gait, and balance (Tinetti Gait and Balance), wayfinding ability (Wayfinding Effectiveness Scale), and neurocognitive abilities (attention, cognition, memory, language/verbal skills, and executive functioning) were also measured. Bivariate and logistic regression analyses were performed to assess the predictors of these wandering-related adverse consequences. RESULTS: A total of 49% of the study participants had falls, fractures, and injuries due to wandering behavior, and 43.7% demonstrated eloping behaviors. Persistent walking (OR = 2.6) and poor gait (OR = 0.9) were significant predictors of negative outcomes of wandering, while persistent walking (OR = 13.2) and passivity (OR = 2.55) predicted eloping behavior. However, there were no correlations between wandering-related adverse consequences and participants' characteristics (age, gender, race, ethnicity, and education), health status (Charlson comorbidity index), or neurocognitive abilities. CONCLUSION: Our results highlight the importance of identifying at-risk individuals so that effective interventions can be developed to reduce or prevent the adverse consequences of wandering. Copyright © 2015 John Wiley & Sons, Ltd. Language: en
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Validation of the Chinese Revised Algase Wandering Scale-Community Version for persons with dementia in northern Taiwan.
Aging & mental health, 2011Co-Authors: Yi-chen Chiu, Wen-chuin Hsu, Donna L. AlgaseAbstract:Objective: Wandering in persons with dementia is perceived as significant due to its prevalence and negative outcomes. However, lack of a validated wandering measure in Taiwan has limited scientific investigation and clinical practice. Therefore, the purpose of this study was to validate the Chinese Revised Algase Wandering Scale-Community Version (CRAWS-CV) in northern Taiwan. Method: For this cross-sectional study, the sample comprised 180 elders with dementia and their family caregivers (FCs). FCs responded to the CRAWS-CV in interviews with trained research assistants. Results: The structure of CRAWS-CV was examined by exploratory principal component analysis with varimax rotation. This analysis derived nine factors, explaining 71.48% of variance: eloping behavior (EB), mealtime impulsivity/temporal aspects, getting lost inside the house (GLI), pacing, impulsivity, negative outcomes, random pattern (RANDOM), and getting lost outside. The total scale and subscales showed excellent internal consistency....
Paul Bebbington - One of the best experts on this subject based on the ideXlab platform.
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The treatment of psychiatric disorder in the Community: Report from the Camberwell Needs for Care Survey
Journal of Mental Health, 1999Co-Authors: Paul Bebbington, Lucy Marsden, Chris R. BrewinAbstract:Although the estimation of needs for treatment is a prime function of Community psychiatric surveys, none has so far measured need directly. The Camberwell Needs for Care Survey is the first such attempt. Needs for treatment were identified in a random population sample from a catchment area in inner South London. Information obtained through SCAN, the Social Role Performance Schedule, the Life Events and Difficulties Schedule and a treatment inventory was assessed by a rating panel in relation to an explicit model of care by using the Needs for Care Assessment- Community Version. Subjects with psychotic disorders received good care and treatment. Subjects with depression often rejected the idea of treatment. Treatment was mainly pharmacological and needs were often unmet, particularly for cognitive or supportive psychotherapy. Subjects with anxiety disorders were less likely to reject treatment but still had a high proportion of needs unmet, as was the case for other disorders.
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The need for psychiatric treatment in the general population: the Camberwell Needs for Care Survey.
Psychological medicine, 1997Co-Authors: Paul Bebbington, Lucy Marsden, Chris R. BrewinAbstract:Background, This paper presents the first results of a two-stage psychiatric population survey, which uses a new method of directly evaluating needs for specific psychiatric treatment and the extent to which they have been met.Method, The sample was drawn at random from the population of an area of inner south London with high levels of deprivation. Seven hundred and sixty subjects aged 18-65 completed the GHQ-28. All those scoring > 5 and half of the rest were invited to take part in the second stage, comprising measures of mental state (SCAN), social role performance (SRPS), life events and difficulties (LEDS) and a Treatment Inventory. This information was used to rate the Community Version of the Needs for Care Assessment (NFCAS-C).Results, In all, 408 subjects were interviewed in the second stage. The weighted 1 month prevalence of hierarchically ordered ICD-10 psychiatric disorders was 9.8 %, the 1 year prevalence 12.3 %. The equivalent prevalences for depressive episode were 3.1 % and 5.3 % respectively, while those for anxiety states were both 2.8 %. At interview nearly 10% of the population were identified as having a need for the treatment of a psychiatric condition. This rose to 10.4 % if the whole of the preceding year was assessed. Less than half of all potentially meetable needs were met. There was only partial overlap between diagnosis and an adjudged need for treatment.Conclusion. A majority of people with mental health problems do not have proper treatment; given more resources and greater public and medical awareness, most could be treated by family doctors.
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The reliability of the Community Version of the MRC Needs for Care Assessment
Psychological medicine, 1996Co-Authors: Alain Lesage, Louise Fournier, Mireille Cyr, Jean Toupin, J. Fabian, G. Gaudette, C. Vanier, Paul Bebbington, Chris R. BrewinAbstract:One hundred and nine adults were screened in the Community using the abridged Version of the CIDI (CIDIS). The subjects comprised DSM-III-R current cases (N = 48), lifetime cases (N = 31) and non-cases (N = 30). The interviews with the 109 subjects were conducted by one of two pairs of clinicians and videotaped. Each interviewer-pair included a psychiatrist and a clinical psychologist. They rated the Community Version of the Needs for Care (NFCAS-C) by consensus. The other pair of judges then viewed the video and rated the NFCAS-C independently. The agreement on overall needs was excellent (kappa = 0.75), and very good for four of the seven specific sections (from kappa = 0.61 to 0.81). One section could not be rated because of low prevalence, and agreement was less good for the remaining two sections. Agreement was good on specific interventions (medication, kappa = 0.60; specific psychotherapy, kappa = 0.55), but poor on non-specific interventions. The majority of disagreements were due to differences in clinical judgement rather than to technical errors. A new instruction manual has been produced and should help training as well as stabilizing reliability. In devising reliable and valid instruments based on clinical judgement, a balance must be achieved between enhancing reliability with more precise rules and constraining clinical judgement so tightly that validity is lost.
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Measuring the need for psychiatric treatment in the general population: the Community Version of the MRC Needs for Care Assessment.
Psychological medicine, 1996Co-Authors: Paul Bebbington, Chris R. Brewin, L. Marsden, A. LesageAbstract:The Community Version of the MRC Needs for Care Assessment Schedule (NFCAS-C) is a new instrument designed for the psychiatric conditions seen in general populations. Its principles are based on the original Needs for Care Assessment, although that was developed for the very different population of those with long-standing mental illness (Brewin et al. 1987). The NFCAS-C is designed to reproduce, in an itemized and systematic manner, the functioning of well-organized primary care and psychiatric services. It is primarily intended for research purposes, in particular, the comparison of treatment needs and services in different populations. In this paper we describe the problems of assessing the need for psychiatric care in general populations and the rationale and development of the instrument, while in its companion we present the results of a reliability study (Lesage et al. 1995).
Jean Toupin - One of the best experts on this subject based on the ideXlab platform.
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Unmet needs in the Community:can existing services meet them?
Acta psychiatrica Scandinavica, 2000Co-Authors: Johane Lefebvre, Alain Lesage, Louise Fournier, Mireille Cyr, Jean ToupinAbstract:OBJECTIVE This prospective study of Community cases examined: (a) needs for care; (b) whether services meet the needs; and (c) personal factors associated with unmet needs. METHOD Two separate 'Needs for Care Assessment Schedule Community Version' evaluations identified 38 subjects with No Need (NN), 19 with Met Needs (MN) and 25 with Unmet Needs (UNM). Other instruments included the Diagnostic Interview Schedule-Abridged Version (DISSA) and repeated measures of symptoms and social functioning. RESULTS (a) Cases did not equate needs. (b) Services utilization did not equate having met needs. (c) Respondents with UNM were more likely to present high rates of lifetime DSM-II-R disorders, no marital relationship ever, no employment, high rates of life events, and physical or sexual abuse in childhood. They have worse outcome in terms of distress and social functioning. CONCLUSION Personal factors may prevent respondents from seeking, engaging and benefiting from treatment.
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The reliability of the Community Version of the MRC Needs for Care Assessment
Psychological medicine, 1996Co-Authors: Alain Lesage, Louise Fournier, Mireille Cyr, Jean Toupin, J. Fabian, G. Gaudette, C. Vanier, Paul Bebbington, Chris R. BrewinAbstract:One hundred and nine adults were screened in the Community using the abridged Version of the CIDI (CIDIS). The subjects comprised DSM-III-R current cases (N = 48), lifetime cases (N = 31) and non-cases (N = 30). The interviews with the 109 subjects were conducted by one of two pairs of clinicians and videotaped. Each interviewer-pair included a psychiatrist and a clinical psychologist. They rated the Community Version of the Needs for Care (NFCAS-C) by consensus. The other pair of judges then viewed the video and rated the NFCAS-C independently. The agreement on overall needs was excellent (kappa = 0.75), and very good for four of the seven specific sections (from kappa = 0.61 to 0.81). One section could not be rated because of low prevalence, and agreement was less good for the remaining two sections. Agreement was good on specific interventions (medication, kappa = 0.60; specific psychotherapy, kappa = 0.55), but poor on non-specific interventions. The majority of disagreements were due to differences in clinical judgement rather than to technical errors. A new instruction manual has been produced and should help training as well as stabilizing reliability. In devising reliable and valid instruments based on clinical judgement, a balance must be achieved between enhancing reliability with more precise rules and constraining clinical judgement so tightly that validity is lost.