A Compendium of Psychosocial Measures. Assessment of People with Serious Mental Illnesses in the CommunityRichard Balon, MD
Wayne State University, Detroit, MI, USA
By Dale L. Johnson. New York, NY: Springer Publishing Company; 2010;ISBN 978-0-8261-1818-9; pp 545; $85 (hardcover).
The mental health field has been trying to “objectivize” and measure what we do, and make the information we obtain about our patients and their psychopathology and functioning easily transferable and communicable to others in simple and measurable terms. Therefore, numerous scales, tests, diagnostic assessments, and structured interviews have been created to fulfill this goal. Unfortunately, we have overdone this effort and the field has been flooded with these measures. There are measures for almost everything, even for things nobody would want to measure, and in many cases in duplicate, triplicate, or more. It is quite difficult to navigate through this ever-growing sea, and therefore any effort at compiling these measures into single or multiple volumes should be hailed as a noble one, even if the result is not what one would exactly need.
Compendium of Psychosocial Measures by Dale L. Johnson is the latest effort to compile a reasonable volume of psychosocial measures currently used. As the subtitle states, it is intended for assessing patients in the community; therefore, measures solely used in hospitals are not included. The author states that he selected measures that:
are intended for people with serious mental illness
are available in libraries (including the National Medical Library in Bethesda, MD)
have reliability and validity information available (therefore, commercial measures in which the psychometrics were available only in manuals for purchase are not included).
The Compendium consists of a Foreword by Harriet Lefley, Introduction, listing/standardized discussion of 372 measures, and references. Readers should be aware that the actual measures are not printed in this volume. The Foreword states that we have “nothing like this book in the research armamentarium.” I respectfully disagree because there are other collections of scales and other measures (see one example on p 113). In the Introduction, Dr. Johnson explains the purpose of this compendium and its organization. He also discusses types of reliability (test-retest, interrater), internal consistency of measures, types of validity (face, criterion-related), content, construct, and other considerations in using various measures, such as sensitivity, specificity, positive and negative predictive value, and noncase identification. The final part of the Introduction touches upon the sources of information and assessment of psychosocial measures and also includes a sample assessment set.
The main text clusters 372 scales into 29 sections according to their main purpose: 1. General background information; 2. Functional assessment; 3. Community living; 4. Social functioning; 5. Global assessment; 6. Level of psychopathology; 7. Insight and judgment; 8. Stress; 9. Social problem solving and coping; 10. Social support; 11. Quality of life; 12. Consumer satisfaction scales; 13. Continuity of care; 14. Treatment adherence; 15. Substance abuse; 16. Environmental measures and group processes; 17. Housing; 18. Cultural issues; 19. Special purpose methods (this is a hodgepodge group including measures such as Time Budget Measure and Minnesota Multiphasic Personality Inventory); 20. Agency performance evaluation; 21. Work behaviors; 22. Family measures; 23. Premorbid adjustment; 24. Psychotic symptoms; 25. Depression; 26. Mania; 27. Anxiety; 28. Screening; and 29. Empowerment, recovery, and stigma. The description of each measure consists of a primary source (reference in the literature), purpose, a brief description, reliability, validity, comment (eg, that “some items are ambiguous”), and source (ie, mostly whom to contact to get this measure). The text about each measure is brief, to the point, easy to understand, and helpful in deciding whether one would like to use this measure.
There are many omissions of measures one would like to see here, such as the Hamilton Anxiety Scale (especially as the Hamilton Rating Scale for Depression is listed), Conners Scales, Comprehensive Psychiatric Rating Scale, scales on assessing suicide risk or medication side effects, or any of the many scales evaluating sexual functioning (even persons with serious mental illness have a sex life at times). However, as I noted earlier, no compendium of psychosocial measures will list all measures or satisfy everybody.
One may try to compare this compendium to the Handbook of Psychiatric Measures by Rush and colleagues,1 now in its second edition. Rush’s volume is larger, yet has fewer measures (243) and is more disease-oriented, following the DSM listing of disorders. However, it also includes chapters on diagnostic measures for adults, general psychiatric symptomatology, mental health functioning and disabilities, quality of life measures, adverse effects measures, patient perception of care measures, stress and life events measures, family risk factors, suicide risk, personality disorders, and defense mechanisms and aggression. Similar to the Compendium, each measure includes goals, a description, practical issues, psychometric properties, clinical utility, and references with suggested reading. The Handbook also includes a CD-ROM with some measures that are freely available.
These 2 volumes clearly demonstrate the vastness of psychosocial measures and the difficulty navigating this area. Those individuals and agencies interested in this area should aim to have both volumes and still will not have covered everything available. Many years ago the National Institute of Mental Heath published an assessment manual for psychopharmacology,2 which at the time was considered the definite volume on this topic. Maybe it is time for the National Institutes of Health or Institute of Medicine to address the various measures in the mental health field on a much larger scale and develop a depository of scales available to interested clinicians and researchers.
But what about the Compendium of Psychosocial Measures? It is a useful and valuable volume that many agencies and some clinicians will appreciate, despite the flaws I mentioned.
- Rush JA Jr, First MB, Blacker D. Handbook of psychiatric measures. 2nd ed. Arlington, VA: American Psychiatric Publishing, Inc.; 2008.
- Gay W.. ECDEU assessment manual for psychopharmacology. Rockville, MD: National Institute of Mental Health; 1976.
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