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Assessment of social anxiety in first episode psychosis using the Liebowitz Social Anxiety scale as a self-report measure.

https://arctichealth.org/en/permalink/ahliterature139685
Source
Eur Psychiatry. 2011 Mar;26(2):115-21
Publication Type
Article
Date
Mar-2011
Author
K L Romm
J I Rossberg
A O Berg
C F Hansen
O A Andreassen
I. Melle
Author Affiliation
Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway. k.l.romm@medisin.uio.no
Source
Eur Psychiatry. 2011 Mar;26(2):115-21
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anxiety Disorders - classification - diagnosis - psychology
Factor Analysis, Statistical
Humans
Middle Aged
Norway
Phobic Disorders - classification - diagnosis - psychology
Psychometrics
Reproducibility of Results
Self Concept
Self Report - standards
Social Environment
Social Isolation
Young Adult
Abstract
Social anxiety is a common problem in psychotic disorders. The Liebowitz Social Anxiety Scale, Self-Rating version (LSAS-SR) is a widely used instrument to capture different aspects of social anxiety, but its psychometric properties have not been tested in this patient group. The aims of the present study were to evaluate the psychometric properties of the LSAS-SR in patients with first episode psychosis, to investigate whether it differentiated between active and passive social withdrawal and to test which clinical factors contributed to current level of social anxiety.
A total of 144 first episode psychosis patients from the ongoing Thematically Organized Psychosis (TOP) study were included at the time of first treatment. Diagnoses were set according to the Structured Clinical Interview (SCID-1) for DSM-IV. A factor analysis was carried out and the relationship of social anxiety to psychotic and general symptomatology measured by the Positive and Negative Syndrome Scale (PANSS) was evaluated. Possible contributors to social anxiety were analyzed using multiple hierarchic regression analysis.
The factor analysis identified three subscales: public performance, social interaction and observation. All three subscales showed satisfactory psychometric properties, acceptable convergent and discriminate properties, and confirmed previous findings in social anxiety samples. Self-esteem explained a significant amount of the variance in social anxiety, even after adjusting for the effects of delusions, suspiciousness and depression.
The study shows that the LSAS-SR can be used in this patient group, that social anxiety is strongly related to both behavioral social avoidance and to self-esteem. The results support the use of this measure in assessment of social anxiety in both clinical settings and in research.
PubMed ID
21036553 View in PubMed
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DSM-5 field trials in the United States and Canada, Part II: test-retest reliability of selected categorical diagnoses.

https://arctichealth.org/en/permalink/ahliterature119336
Source
Am J Psychiatry. 2013 Jan 1;170(1):59-70
Publication Type
Article
Date
Jan-1-2013
Author
Darrel A Regier
William E Narrow
Diana E Clarke
Helena C Kraemer
S Janet Kuramoto
Emily A Kuhl
David J Kupfer
Author Affiliation
American Psychiatric Association, Division of Research and American Psychiatric Institute for Research and Education, Arlington, Va, USA. dregier@psych.org
Source
Am J Psychiatry. 2013 Jan 1;170(1):59-70
Date
Jan-1-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anxiety Disorders - classification - diagnosis - psychology
Canada
Child
Comorbidity
Cross-Cultural Comparison
Depressive Disorder, Major - classification - diagnosis - psychology
Diagnosis, Differential
Diagnostic and Statistical Manual of Mental Disorders
Humans
Mental Disorders - classification - diagnosis - psychology
Multicenter Studies as Topic - statistics & numerical data
Patient Care Planning
Prognosis
Psychotic Disorders - classification - diagnosis - psychology
Randomized Controlled Trials as Topic - methods - statistics & numerical data
Reproducibility of Results
Statistics as Topic
Suicidal ideation
Suicide - prevention & control - psychology
United States
Abstract
The DSM-5 Field Trials were designed to obtain precise (standard error,0.1) estimates of the intraclass kappa asa measure of the degree to which two clinicians could independently agree on the presence or absence of selected DSM-5 diagnoses when the same patient was interviewed on separate occasions, in clinical settings, and evaluated with usual clinical interview methods.
Eleven academic centers in the United States and Canada were selected,and each was assigned several target diagnoses frequently treated in that setting.Consecutive patients visiting a site during the study were screened and stratified on the basis of DSM-IV diagnoses or symptomatic presentations. Patients were randomly assigned to two clinicians for a diagnostic interview; clinicians were blind to any previous diagnosis. All data were entered directly via an Internet-based software system to a secure central server. Detailed research design and statistical methods are presented in an accompanying article.
There were a total of 15 adult and eight child/adolescent diagnoses for which adequate sample sizes were obtained to report adequately precise estimates of the intraclass kappa. Overall, five diagnoses were in the very good range(kappa=0.60–0.79), nine in the good range(kappa=0.40–0.59), six in the questionable range (kappa = 0.20–0.39), and three in the unacceptable range (kappa values,0.20). Eight diagnoses had insufficient sample sizes to generate precise kappa estimates at any site.
Most diagnoses adequately tested had good to very good reliability with these representative clinical populations assessed with usual clinical interview methods. Some diagnoses that were revised to encompass a broader spectrum of symptom expression or had a more dimensional approach tested in the good to very good range.
PubMed ID
23111466 View in PubMed
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Physician characteristics and the recognition of depression and anxiety in primary care.

https://arctichealth.org/en/permalink/ahliterature217574
Source
Med Care. 1994 Aug;32(8):795-812
Publication Type
Article
Date
Aug-1994
Author
J M Robbins
L J Kirmayer
P. Cathébras
M J Yaffe
M. Dworkind
Author Affiliation
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
Source
Med Care. 1994 Aug;32(8):795-812
Date
Aug-1994
Language
English
Publication Type
Article
Keywords
Adult
Anxiety Disorders - classification - diagnosis - psychology
Attitude of Health Personnel
Clinical Competence
Cues
Depressive Disorder - classification - diagnosis - psychology
Female
Guilt
Humans
Introversion (Psychology)
Judgment
Male
Motivation
Multivariate Analysis
Nonverbal Communication
Physician-Patient Relations
Physicians, Family - education - psychology - statistics & numerical data
Prejudice
Quebec
Reproducibility of Results
Sensitivity and specificity
Videotape Recording
Abstract
We examined physician characteristics associated with the recognition of depression and anxiety in primary care. Fifty-five physicians treating a total of 600 patients completed measures of psychosocial orientation, psychological mindedness, self-rating of sensitivity to hidden emotions, and a video test of sensitivity to nonverbal communication. Patients were classified as cases of psychiatric distress based on the CES-D scale and the Diagnostic Interview Schedule. Physician recognition was determined by notation of any psychosocial diagnosis in the medical charts over the ensuing 12 months. Of 192 patients scoring 16 or above on the CES-D, 44% (83) were recognized as psychiatrically distressed. Three findings were central to this study: 1) Physicians who are more sensitive to nonverbal expressions of emotion made more psychiatric or psychosocial assessment of their patients and appeared to be over-inclusive in their judgments of psychosocial problems; 2) Physicians who tended to blame depressed patients for causing, exaggerating, or prolonging their depression made fewer psychosocial assessments and were less accurate in detecting psychiatric distress; 3) False positive labeling of patients who had no evidence of psychiatric distress was rare. Surprisingly, more severe medical illness increased the likelihood of labeling and accurate recognition. Physician factors that increased recognition may indicate a greater willingness to formulate a psychiatric diagnosis and an ability notice nonverbal signs of distress.
PubMed ID
8057696 View in PubMed
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Subtypes in bulimia nervosa: the role of eating disorder symptomatology, negative affect, and interpersonal functioning.

https://arctichealth.org/en/permalink/ahliterature124324
Source
Compr Psychiatry. 2012 Nov;53(8):1078-87
Publication Type
Article
Date
Nov-2012
Author
Susanne Lunn
Stig Poulsen
Sarah I F Daniel
Author Affiliation
University of Copenhagen, 2A Oester Farimagsgade, Copenhagen K, Denmark. Susanne.lunn@psy.ku.dk
Source
Compr Psychiatry. 2012 Nov;53(8):1078-87
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Adult
Anxiety Disorders - classification - diagnosis - psychology - therapy
Bulimia Nervosa - classification - diagnosis - psychology - therapy
Cognitive Therapy
Comorbidity
Denmark
Depressive Disorder - classification - diagnosis - psychology - therapy
Female
Humans
Interpersonal Relations
Male
Personality Inventory - statistics & numerical data
Psychoanalytic Therapy
Psychometrics
Reactive Attachment Disorder - classification - diagnosis - psychology - therapy
Young Adult
Abstract
The aim of the study was to investigate whether patients with bulimia nervosa (BN) could be subdivided into clinically meaningful groups reflecting the complex patterns of eating disorder symptoms and personality characteristics that face the clinician.
Seventy patients diagnosed with BN using the Eating Disorder Examination were assessed with measures of negative affect, attachment patterns, and interpersonal problems. An exploratory hierarchical cluster analysis was performed.
The study found two main subtypes differing primarily in terms of symptom severity and level of negative affect, but these subtypes were further subdivided into four clinically relevant subtypes: A dietary restraint/negative affect/high symptomatic group, an emotionally overcontrolled group, a low dietary restraint/emotionally underregulated group, and a high functioning/securely attached group.
The study indicates that cluster-analytic studies, including a broad range of instruments measuring eating disorder symptoms as well as negative affect, relational patterns, and other personality characteristics, may contribute to an integration of previously suggested models of subtypes in BN.
PubMed ID
22591731 View in PubMed
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