The Liebowitz Social Anxiety Scale (LSAS) is a 24-item, self-rated scale used to assess how social anxiety plays a role in your life across a variety of situations. The LSAS was developed by psychiatrist and researcher Dr. Michael R. Liebowitz. The scale might be used in research studies to determine the level of social anxiety experienced by participants, in clinical settings to assess a particular patient’s symptoms, or by people who are concerned that what they are experiencing might be the signs of an anxiety disorder. Experts now recommend routine anxiety screening for all women and girls over the age of 13, so the LSAS is one type of screening tool that you may encounter during a routine doctor’s visit.
Several studies have been conducted to examine the reliability and validity of the scale. Overall, researchers have found that all versions of the scale have excellent internal consistency or reliability. The LSAS measure has also shown to be strongly associated with other current measures of social anxiety, indicating that it has good convergent validity.
Autism Spectrum Disorder
The Cambridge Empathy Quotient (EQ) is a self-report 60-item questionnaire designed to assess high functioning autism, which is believed to be a disorder of empathy and essential for normal social functioning. The EQ gauges empathy using 40 empathy items and 20 filler/control items. The 20 filler/control items were included to distract the respondent from a relentless focus on empathy.
Baron and colleagues validated the EQ with 197 healthy control volunteers and 90 people with high-functioning Autism. The EQ distinguishes reliably between the clinical and control groups (p < .05). The authors also found sex differences in the control group with women scoring significantly higher. In addition, the EQ was found to have high retest reliability over a period of 12 months. The EQ demonstrated strong face validity using the following definition: “Empathy is the drive or ability to attribute mental states to another person/animal and entails an appropriate affective response in the observer to the other person’s mental state.” Each of the 40 empathy items were rated as belonging to this definition by a panel of six experimental psychologists, while five out of six rated all 20 control items as not belonging. Lawrence and colleagues found the EQ possessed strong inter-rater reliability and retest reliability. They also found that the EQ has a moderate correlation with the ’empathetic concern’ and ‘perspective taking’ sub-scales of the Interpersonal Reactivity Index, another measure of empathy which the authors of the EQ considered to be the best empathy measure before creating their own.
Purpose and Meaning
The Meaning in Life Questionnaire (MLQ) is a 10-item questionnaire designed to measure two dimensions of meaning:
The Presence scale measures how much respondents feel their lives have meaning. The Search scale measures how much respondents strive for meaning and understanding in their lives. The MLQ has been identified as a potential mediator of the link between religiousness and psychological health. Meaning in life may be an effective conduit through which counselors and clients can discuss “ultimate” matters, even when they do not share similar perspectives on religion.
The MLQ’s authors used multiple methods and measures of to test their hypothesis that meaning in life mediated the relation between religiousness and life satisfaction, as well as self-esteem and optimism. Their research found that the MLQ has good internal consistency. The presence scale demonstrated coefficient alphas ranging in the low to high .80s, and the search scale yielded alphas in the mid .80s to low .90s. In addition, a multitrait-multimethod matrix demonstrated the convergent and discriminant validity of the MLQ subscales across time and informants, in comparison with 2 other meaning scales. The MLQ offers several improvements over current meaning in life measures, including no item overlap with distress measures, a stable factor structure, better discriminant validity, a briefer format, and the ability to measure the search for meaning.
The Depression Scale for Children – Center for Epidemiological Studies (DSC-CES) is a 20 item self-report questionnaire for young people between the ages of 6 and 17. It asks them to rate how many depressive symptoms they have experienced in the last week. This measure is useful for tracking depressive symptoms over time.
Psychometric characteristics of the DSC-CES were evaluated with 148 child and adolescent psychiatric inpatients. The sample were diagnosed with major depression, dysthymic disorder or another serious mental disorder requiring an inpatient admission. Psychometric properties were adequate, with an internal consistency of .89, and sensitivity was 80% with a cutoff score of 15. However, please note that the DSC-CES was not able to differentiate between inpatients admitted for depression or another mental illness.
Peter Birleson developed a self-rating scale for depression in childhood (DSRS-C) as part of his Master of Philosophy Thesis at the University of Edinburgh in 1978. In its present form, the DSRS-C is an 18-item self-rating scale; significantly shorter than the 37-item inventory from which it emerged. As the DSRS-C (a) does not include the assessment of other symptoms, (b) the developmental status of a child, nor (c) the history of disturbances or its context, it is not intended to be used as a diagnostic tool for depression in children and adolescents. Rather, its intended use is to measure moderate to severe depression in childhood and for health professionals to employ as a quick and cost-effective screener for depression before administering costly diagnostic measures.
Eighteen of the original 37 items were found to separate depressed groups from others in a statistically significant way and now comprise the current DSRS-C. Reliability and validity of the self-rating scale was found to be satisfactory. Individual items had correlations between .65 and .95. Retest reliability of the DSRS-C for the clinical group was .80; showing a highly satisfactory degree of stability. Furthermore, internal consistency using a the split-half method was found to be 0.86. The DSRS-C was tested for clinical validity on an independent population of 155 children between the ages of 8 and 14 who were attending a child psychiatry outpatient clinic. These children were grouped into a depressed population and “others”. Children who scored 15 and over were significantly more likely to have a depressive diagnosis (major depression or dysthymia). The positive predictive value of the total DSRS-C score was almost as good as the global score of the history of depression and appearance of depression evaluated at interview by child psychiatrists. Please note that, while those with a depression diagnosis scored highly, many other children with dysphoric mood also scored over 15, such as those with a conduct disorder, mixed emotional and conduct disorder, and other problems including school refusal.
Postpartum depression is the most common complication of childbearing and rates of help-seeking for postnatal depression are generally low, making screening important. The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item self-report questionnaire designed to identify mothers at risk for prenatal and postnatal depression. The scale indicates how the mother has felt during the previous week. In doubtful cases it may be useful to repeat the tool after 2 weeks. The scale will not detect mothers with anxiety, phobias, or personality disorders.
Cox and his colleagues carried out a validation study on 84 mothers using the Research Diagnostic Criteria for Depressive Illness obtained from Goldberg’s Standardized Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity and was also sensitive to change in the severity of depression over time. In another study, 103 post-partum women completed the EPDS and were interviewed using the Diagnostic Interview Schedule. A cut-off score of 12.5 on the EPDS identified all nine women who reached criteria for major depression. At this threshold the sensitivity (true “cases” identified) of the EPDS was 100%, its specificity (true “non-cases” identified) 95.7%, and its positive predictive value (those who tested as positive and identified as such) was 69.2%.
The Geriatric Depression Scale (GDS) was designed specifically for the elderly as a screening instrument for depression, and it has been tested and used extensively with the older population in many settings, including community, acute care, and long-term care. In its original form, the GDS is 30-items. Participants are asked to respond by answering ‘yes’ or ‘no’ as to how they have felt over the past week. (Sheik & Yesavage created a short form of the GDS in 1986, which contained 15 items.)
The GDS may be used with healthy, medically ill, and mild to moderately cognitively impaired older adults. The GDS is not a substitute for a diagnostic interview by mental health professionals. It is a useful screening tool in the clinical setting to facilitate assessment of depression in older adults, especially when baseline measurements are compared to subsequent scores.
The validity and reliability of the tool have been supported through both clinical practice and research. The GDS has a high degree of internal consistency with a Cronbach’s alpha coefficient and split-half reliability that both = 0.94. The retest reliability is 0.85 for one week apart and 0.85 for one month apart, demonstrating that within these time limits scores remain stable. The GDS is a valid tool for discriminating symptom severity, and the presence vs. absence of depression based on DSM-IV criteria. The GDS has high correlations with the Zung Self-Rating Depression Scale and the Hamilton Rating Scale for Depression (.84 and .83, respectively). Sensitivity (true positives) and specificity (true negatives) at a cutoff of 11 were 84% and 95%, respectively, and at a cutoff of 14 were 80% and 100%, respectively. This provides good evidence that scores of 11 or more should be considered a possible indicator of depression. Note too that the GDS maintains its reliability and validity when administered by phone.
Depression is broadly defined as a mood disorder that has affective, cognitive, and physical signs and symptoms that range from mild to severe and may progress with time. In its most severe form, there may be suicidal thoughts, psychotic features such as hallucinations and delusions, and excessive somatic complaints. The Geriatric Depression Scale (GDS) was designed specifically for the elderly as a screening instrument for depression. The GDS has been tested and used extensively with the older population. It is a 30-item questionnaire in which participants are asked to respond by answering ‘yes’ or ‘no’ about how they felt over the past week. Sheik & Yesavage created a shorter form in 1986 (15 items) called the Geriatric Depression Scale:Short Form (GDS:SF). There are other screening and assessment tools for depression, but the GDS: SF stands out as the best tool to use with older adults.
In a study by Friedman and colleagues of 960 functionally impaired, cognitively intact primary care patients ages 65 and older, they reported moderate internal consistency (a Cronbach a coefficient of 0.75) and that the functional status of the older adult did not significantly affect the scale’s reliability. The GDS showed moderate correlations with measures of depressed mood and life satisfaction, and the GDS:SF accurately identified 89% of those who were not depressed, which varied with the cutoff score: 75% and 65% with cutoff scores of 6 and 5, respectively. In another study, the GDS: SF and the Hamilton Depression Rating Scale were compared in 148 outpatients with Parkinson disease. Although the Hamilton Depression Rating Scale, per its design, provided a more comprehensive evaluation of depressive symptoms, the GDS: SF identified critical symptoms of depression in those with Parkinson disease.
Obsessive-Compulsive and Related Disorders
The Hoarding Rating Scale is a brief 5-item scale that can be given as a semi-structured clinician interview or as a questionnaire. This tool includes 5 questions about clutter, difficulty discarding, excessive acquisition, and the resulting distress and impairment caused by hoarding. The Hoarding Rating Scale-Interview is a psychometrically sound diagnostic instrument for determining the presence and severity of hoarding disorder. Indeed, it showed an excellent internal consistency as well as a high test-retest and cross-context reliability. Both convergent and discriminant validity has been established by the reported correlations between the HRS-I and many of the other hoarding and non-hoarding measures.
The Hogan Drug Attitude Inventory consists of a questionnaire that is completed by the patient. It includes a series of questions, each with true/false answers, pertaining to various aspects of the patient’s perceptions and experiences of treatment. The original scale consists of 30 questions, but a short form consisting of 10 questions has also been validated. Awad, 1993) The patient should be asked to read each statement in the questionnaire (see page 3) and decide whether they believe it to be true or false (or mostly true/false) as applied to their own experience with medications (only those medications used for the patient’s mental health needs). They should circle their answers in ink on the form. Scoring The DAI-30 (page 3) contains 15 items that a patient who is fully adherent to their prescribed medication (and so would be expected to have a ‘positive’ subjective response to medication) would answer as ‘True’, and 15 items such a patient would answer as ‘False’.
Substance-Related and Addictive Disorders
The CAGE questionnaire is used to test for alcohol abuse and dependence in adults. The CAGE-AID version of the tool has been adapted to include drug use. These tools are not used to diagnose diseases, but only to indicate whether a problem might exist. The questions are most effective when used as part of a general health history and should NOT be preceded by questions about how much or how frequently the patient drinks or uses drugs. The reason for this is that denial is quite common among persons abusing alcohol or other drugs; and for the same reason, the CAGE-AID questions focus the discussion on the behavioral effects of drinking or drug use rather than the number of drinks or drugs one uses. The downside of this approach is that questions do not discriminate well between active and inactive drinkers or drug users. This, following positive scores on the CAGE-AID with questions regarding usual consumption patterns such as frequency, quantity, and heaviest consumption will help the clinician discern this distinction.
The CAGE-AID exhibits the following:
Sensitivity and Specificity for One or more Yes responses are 0.79 and 0.77, respectively
Sensitivity and Specificity for Two or more Yes responses are 0.70 and 0.85, respectively
The Drug Abuse Screen Test (DAST-10) was designed to provide a brief, self-report instrument for population screening, clinical case finding and treatment evaluation research. It can be used with adults and older youth. The DAST-10 yields a quantitative index of the degree of consequences related to drug abuse.
Research findings support the DAST as a reliable and valid drug abuse screening instrument that measures a unidimensional construct. The DAST-10 was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r = 0.76) when correlation with the Drug Use Disorders Identification Test was measured and to have a Cronbach’s alpha of 0.92. In addition, a single component accounted for 59.35% of total variance, and the DAST-10 had sensitivity and specificity scores of 0.98 and 0.91, respectively, when using the optimal cut-off score of 4. Additionally, the DAST-10 showed good discriminant validity as it significantly differentiated patients with drug use disorder from those with alcohol use disorder
The CRAFFT is an acronym for Car, Relax, Alone, Forget, Family, Friends, Trouble. This screening tool consists of six questions intended to identify adolescents who may have simultaneous risky alcohol and other drug use disorders. The CRAFFT is a valid means of screening adolescents for substance-related problems and disorders.
The CRAFFT is an efficient and effective health screening tool designed to identify substance use, substance-related riding/driving risk, and substance use disorder among youth ages 12-21. It has been implemented as part of universal screening efforts in thousands of busy medical and community health settings, as it yields information that can serve as the basis for early intervention and patient-centered counseling. The CRAFFT is the most well-studied adolescent substance use screener available and has been shown to be valid for adolescents from diverse socioeconomic and racial/ethnic backgrounds. It is recommended by the American Academy of Pediatrics’ Bright Futures Guidelines for preventive care screenings and well-visits, the Center for Medicaid and CHIP Services’ Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program, and the National Institute of Alcohol Abuse and Alcoholism Youth Screening Guide. The current version of the tool, the CRAFFT 2.1, includes evidence-based revisions to increase the sensitivity and specificity of the tool and includes vaping as a method of administration for marijuana use.
The Leeds Dependence Questionnaire (LDQ) is a 10-item, self completion questionnaire designed to measure dependence upon a variety of substances. The LDQ is capable of measuring change in dependence and can therefore be used to follow treatment progress and evaluate treatment outcomes. It shows sensitivity to change over time through the range of mild to severe dependence. The LDQ measures dependence in abstinent patients as well. Because the LDQ is only 10 questions, it is readily incorporated into everyday practice.
Research shows that the LDQ is a psychometrically sound measure of substance dependence, useful across a variety of substances, and useful in a clinical setting. Young adults (N=300) in residential substance dependence treatment were studied. The LDQ was shown to have concurrent validity: scores obtained from the LDQ were compared to scores obtained at the same time using the Severity of Alcohol Dependence Questionnaire. The LDQ demonstrated construct validity: alpha factoring extraction revealed a single factor accounting for 63% of the variance in reported dependence severity. And the LDQ’s internal consistency was exceedingly high: Cronbach’s alpha was 0.94 and re-test reliability was 0.95.
Bipolar and Related Disorders
Authors of the Bipolar Spectrum Diagnostic Scale (BSDS) conducted a study of the Mood Disorders Questionnaire and concluded that the MDQ had good sensitivity for bipolar I disorder (70%) but a less impressive sensitivity for bipolar II disorder and bipolar disorder not otherwise specified. The goal then of the BSDS was to improve recognition of milder, sub-threshold, forms of the bipolar spectrum and thus be effective across the entire bipolar spectrum severity range. The BSDS consists of a paragraph, 19 sentences in length, describing individuals who have symptoms of bipolar disorder. The individual being examined reads the paragraph and decides how closely it applies to him or her in these two ways: (1) the paragraph, as a whole; and (2) each of the paragraph’s 19 sentences separately and specifically.
The initial study of the BSDS involved 71 patients with major depressive disorder or bipolar disorder. Before conducting the study, the authors intuitively suggested that a cutoff of 12 represented a positive screen. At this cutoff, the sensitivity of the BSDS was 76%, and its specificity was 85%. They examined the performance of the scale at other cutoff points and ultimately recommended a cutoff score of 13 because it yielded the best combination of sensitivity (75%) and specificity (93%) in distinguishing bipolar disorder from major depressive disorder.
The Child Mania Rating Scales (CMRS) are 21-item diagnostic screening measures designed to identify symptoms of mania in children and adolescents ages 9–17 using diagnostic criteria from the DSM-IV as reported by parents and teachers. The measure interviews the child’s mood and behavior symptoms, asking parents and teachers to rate how often the symptoms have caused a problem for the child in the past month.
Clinical studies have found the CMRS-P to be reliable and valid in the assessment of children’s bipolar symptoms. The CMRS has also been found to be useful in differentiating cases of pediatric bipolar disorder from ADHD or no disorder, as well as delineating bipolar subtypes. A meta-analysis comparing the different rating scales available found that the CMRS was one of the three best performing scales in terms of telling cases with bipolar disorder apart from other clinical diagnoses.
Trauma- and Stressor-Related Disorders
An informal caregiver’s (CG) subjective burden is an important aspect of the care she or he provides. It is linked to various outcomes such as health and mortality risk. The Burden Scale for Family Caregivers- Short Form (BSFC-s) measures the subjective burden in informal CGs. The risk of physical psychosomatic complaints, which is a consequence of subjective CG burden, can be determined by using a classification system that was developed (and validated) to deduce the necessity for action and to give concrete recommendations for interventions. The BSFC-s assesses the negative effects of subjective CG burden, which assists healthcare providers in making concrete recommendations to address it. Effective interventions can help to prevent the development of additional health impairments in informal CGs and to reduce medical costs.
Researchers demonstrated that the BSFC-s is a reliable and valid scale for measuring subjective burden in informal CGs. They conducted a cross-sectional study involving 386 informal CGs applying for an initial grade or upgrade in the care they are providing to obtain funds through the health insurance system (in Bavaria, Germany). Researchers analyzed the reliability and the convergent and discriminant validity using the short form of the Giessen Symptom Complaints List-24 (GBB-24), the Caregiver Strain Index, the Patient Health Questionnaire-9, as well as other measures. Results confirmed the convergent and discriminant validity of the BSFC-s with these scales at a p-value < 0.001. To develop a classification system, they compared the percentile ranks of the GBB-24 with the respective BSFC-s sum scores and their distributions and derived three classification categories.
The Big Five Inventory is a self-report inventory designed to measure the Big Five Dimensions: (1) extraversion, (2) agreeableness, (3) conscientiousness, (4) neuroticism, and (5) openness. It is quite brief for a multidimensional personality inventory (44 items total) and consists of short phrases with relatively accessible vocabulary. This assessment is appropriate for people between the age of 16 and 81.
The five domain constructs are:
- Extraversion – The tendency to seek stimulation, talkativeness and related to positive emotions.
- Agreeableness – The tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others.
- Conscientiousness / Intellect – The tendency to show self-discipline, act dutifully, and aim for achievement.
- Emotional Stability – This is the reverse of the “neuroticism” subscale found on the NEO-PIR. Low scores on the Emotional Stability scale indicate the tendency to experience unpleasant emotions easily, such as anger, anxiety, depression, or vulnerability.
- Openness – Reflects the degree of intellectual curiosity, creativity and a preference for novelty and variety.
The Clinical Anger Scale (CAS) is an objective, self-report that measures the psychological symptoms presumed to have relevance in the understanding and treatment of clinical anger. Twenty-one sets of statements were prepared for this purpose; the format of which was chosen from one of Beck’s early instruments was used to design the Clinical Anger Scale. The following symptoms of anger were measured by the CAS items: Several specific analyses were conducted to examine the psychometric properties of the Clinical Anger Scale (CAS). Factor analysis was conducted to examine the factorial validity of the instrument, and reliability coefficients were computed to examine the internal consistency and stability of the CAS. Also, in addition to providing evidence for the convergent and divergent validity of the CAS, an ancillary purpose of the present study was to provide preliminary evidence for its validity by examining some personality, psychopathological symptomotology, behavioral, and family environmental correlates of clinical anger.
Factor analysis of the Clinical Anger Scale confirmed essentially a uni-dimensional item structure; reliability analyses also demonstrated adequate alphas (i.e., internal consistency) and test-retest coefficients (i.e., stability) for the CAS; and other results indicated that the CAS was unrelated to social desirability influences. Additional findings indicated that clinical anger was positively associated with several anger-related concepts (e.g., trait anger, state anger, anger-in, anger-out, anger-control). Other results showed that the Clinical Anger Scale was related in predictable ways to men’s and women’s psychological symptoms, personality traits, and early family environments.
The CORE-10 is a ten item easy-to-use assessment measure for common presentations of psychological distress. It is designed for screening and over the course of treatment to track progress. The measure is a shortened version of the 34 items CORE, both of which ask respondents to self-report symptoms over the past week.
Barkham and his colleagues validated the CORE-10 in primary care patients as well as the general population, finding an internal reliability (Cronbach’s alpha) of 0.9. Based on their analysis it was determined that scores of 11 or above indicated clinically significant psychological distress, and scores above 13 likely indicated depression, with a sensitivity and specificity of .92 and .72, respectively.
The Coping with Problems Experienced – Brief Form (COPE-Brief) is a 24 item self-report questionnaire designed to measure effective and ineffective ways that people cope with stressful life events. “Coping” is defined broadly as an effort used to minimize distress associated with negative life experiences. The scale is often used in health-care settings to ascertain how patients are responding to a serious diagnosis, and it can be used to measure other stressful life events such as assaults, natural disasters, and financial problems.
The Cope-Brief was developed as a short version of the original 60-item COPE scale The Cope-Brief was initially validated on 168 participants who had been impacted by a hurricane. Subsequent factor-analysis with heart failure patients indicated two major factors:
- Avoidant Coping (denial, substance use, behavioral disengagement, self-distraction, and self-blame).
- Approach Coping (active, positive re-framing, planning, acceptance, seeking emotional ad informational support).
The COPE-Brief has good internal consistency when the data is grouped among caregivers of individuals with dementia, r = 0.72 – 0.84, and among caregivers of individuals with acquired brain injury, r = 0.55–0.75. The Brief COPE showed good internal consistency when used with caregivers of individuals with advanced cancer, with Cronbach’s alpha ranging from 0.54–0.91 for both the avoidant and active coping styles. The COPE-Brief also has adequate test–retest reliability for caregivers of individuals with dementia over a 1-year and 2-year period (intraclass correlation coefficient ranges from 0.44–0.72 depending on the scale). The scale also showed adequate criterion validity (predictive) over a 2-year testing period for changes in caregiver burden (0.32–0.33) among caregivers of individuals with dementia. Additionally, dysfunctional coping among caregivers of individuals with acquired brain injury, per the COPE-Brief, was significantly related to increased depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (r = .59).
- DEPRESSION SCALE: dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest/involvement, anhedonia, and inertia
- ANXIETY SCALE: autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect
- STRESS SCALE: difficulty relaxing, nervous arousal, and being easily upset/agitated, irritable/over-reactive and impatient
The Difficulties in Emotion Regulation Scale (DERS) contains 36 items and measures problems related to the regulation of emotion. The DERS helps patients identify areas for emotional growth, especially those with Borderline Personality Disorder, Generalized Anxiety Disorder or Substance Use Disorder. The DERS assesses several factors related to emotional arousal: modulation, awareness, understanding, and acceptance, as well as the ability to act in desired ways regardless of emotional state.
Gratz & Roemer (2003) found that the DERS had high internal consistency, good test–retest reliability, and adequate construct and predictive validity. Based on a sample of 427 adults presenting at an outpatient clinic diagnosed with one or more DSM-5 disorder, this tool showed good internal consistency (Hallion et al., 2018).
The Dyadic Adjustment Scale – Revised (DAS-R) The DAS-R gives a quick snapshot of multiple dynamics within a given relationship as well as an overall assessment of the stability of the relationship. The DAS-R assesses relationships within four overarching categories including.
- Consensus in decision making
- Values and affection
- Satisfaction in the relationship with respect to stability and conflict regulation
- Cohesion as seen through activities and discussion
Construct validity for the DAS-R is supported by its high correlation with a similar measure, the Locke-Wallace Marital Adjustment Test (MAT). The correlation between the DAS-R and the MAT was .68. In addition, the correlation between the DAS-R and the original Dyadic Adjustment Scale (DAS) was .97. In terms of discriminant validity, the DAS-R has been found to successfully differentiate between 81% of distressed and non-distressed cases.
- Bulimia and Food Preoccupation
- Oral Control
This is a brief 8-item measure of the respondent’s self-perceived success in important areas such as relationships, self-esteem, purpose, and optimism. The scale provides a single psychological well-being score and can be used to provide useful feedback for how to improve one’s life and provides useful stimulus for self-reflection. The Flourishing Scale is best used with individuals who have adjustment disorders, or other similarly “mild” conditions, seeking to enhance their lifestyle, not for those whose problems are due to serious mental illness.
The scale was evaluated in a sample of 689 college students from six locations (in the USA and Singapore). It was found to accurately measure subjective well-being. Other well-being measures were administered to determine the convergence of the new scales with established measures, including the Satisfaction with Life Scale, the 4-Item Scale of Happiness, and the Positive and Negative Affect Schedule. Factor analysis revealed one strong factor with an eigenvalue of 4.2, accounting for 53 percent of the variance in the items, and no other eigenvalue above 1.0. The factor loading ranged from .61 to .77. The test has a Cronbach’s alpha of .87 and a temporal stability over one month of .71.
The GAD-7 is a brief measure of symptoms of generalized anxiety disorder as described in DSM-IV. This assessment asks patients to evaluate their level of symptoms over the last two weeks and can be used to track treatment progress over time. Given the GAD-7’s simple language it is appropriate for individuals as young as 14.
Many factor analyses confirm the 1-dimensional structure of the GAD-7. Internal consistency was identical across all subgroups (alpha = 0.89). Inter-correlations with the Patient Health Questinnaire-2 and the Rosenberg Self-Esteem Scale were r = 0.64 and r = – 0.43, respectively. Approximately 5% of subjects had GAD-7 scores of 10 or greater, and 1% had GAD-7 scores of 15 or greater.