Judgmental relativism as a validity threat to standardized psychiatric rating scales

Effects of three types of potentially biasing information on symptom severity judgments for major depressive episode

Two experiments examined the effects of potentially biasing information on judgments of symptom severity pertaining to the diagnosis of major depressive episode (MDE). In both experiments, clinicians viewed videotapes of two actor-simulated patients responding to questions from a standardized diagnostic interview. In Study 1, an expectancy effect was found for both patients such that prior information about a clear-cut history of depression resulted in lower rated severity of current symptoms. In addition, a halo effect was observed for one patient in Study 1 and both patients in Study 2: Clear-cut depressive nonverbal behavior (DNVB) resulted in greater rated severity for symptoms that should not have been affected (e.g., appetite/weight change, suicidal ideation). Clear-cut versus near-threshold information for the two essential criteria for MDE did not affect subsequent judgments in either study. Implications for diagnostic interviewing are discussed.

Measures of impairment for children and adolescents

Measuring the degree of impairment in children and adolescents due to emotional or behavioral disorders is a recent development that will become increasingly important to states and their mental health administrators. A survey of the 50 states was conducted to identify impairment measures that were used on a statewide basis. The results of the survey are presented; five measures were found to be used consistently. The three global measures and two multidimensional measures identified in the survey are reviewed here. Each measure is described and its pertinent psychometric data are presented. The implications for mental health administrators in terms of implementing statewide procedures to assess impairment are considered.

A summary measure of client level of functioning: progress and challenges for use within mental health agencies

A summary measure of clients' level of functioning could assist mental health agencies to better document and evaluate their services. Currently, numerous state mental health authorities collect a level of functioning measure within a management information system on virtually all clients served with state resources. The uses of these data include describing the clientele, defining a priority population for services, preparing performance indicators and measuring contract obligations. However, clearer delineation of the construct of functioning, further exploration of the psychometric properties of the instruments and stricter procedures to ensure the accuracy of data would result in data that are more useful for both management and research.