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Test–retest reliability and sensitivity to change of the dimensional anxiety scales for DSM-5

Published online by Cambridge University Press:  08 November 2013

Susanne Knappe ,
Jens Klotsche ,
Franziska Heyde ,
Sarah Hiob ,
Jens Siegert ,
Jürgen Hoyer ,
Anja Strobel ,
Richard T. LeBeau ,
Michelle G. Craske  and
Hans-Ulrich Wittchen
...Show all authors
Susanne Knappe*
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
Jens Klotsche
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
Franziska Heyde
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
Sarah Hiob
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
Jens Siegert
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
Jürgen Hoyer
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
Anja Strobel
Affiliation:
Department of Psychology, Process-Oriented Assessment, Technische Universität Dresden, Dresden, Germany
Richard T. LeBeau
Affiliation:
Department of Psychology, University of California, Los Angeles, California, United States
Michelle G. Craske
Affiliation:
Department of Psychology, University of California, Los Angeles, California, United States
Hans-Ulrich Wittchen
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
Katja Beesdo-Baum
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
*
*Address for correspondence: Susanne Knappe, Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Chemnitzer Str. 46, 01187 Dresden, Germany. (Email: knappe@psychologie.tu-dresden.de)
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Abstract

Objective

This article reports on the test–retest reliability and sensitivity to change of a set of brief dimensional self-rating questionnaires for social anxiety disorder (SAD-D), specific phobia (SP-D), agoraphobia (AG-D), panic disorder (PD-D), and generalized anxiety disorder (GAD-D), as well as a general cross-cutting anxiety scale (Cross-D), which were developed to supplement categorical diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Methods

The German versions of the dimensional anxiety scales were administered to 218 students followed up approximately 2 weeks later (Study 1) and 55 outpatients (23 with anxiety diagnoses) followed-up 1 year later (Study 2). Probable diagnostic status in students was determined by the DIA-X/M-CIDI stem screening-questionnaire (SSQ). In the clinical sample, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses were assessed at Time 1 using the DIA-X/M-CIDI. At Time 2, the patient-version of the Clinical Global Impression—Improvement scale (CGI-I) was applied to assess change.

Results

Good psychometric properties, including high test–retest reliability, were found for the dimensional scales except for SP-D. In outpatients, improvement at Time 2 was associated with significant decrease in PD-D, GAD-D, and Cross-D scores.

Discussion

Major advantages of the scales include that they are brief, concise, and based on a consistent template to measure the cognitive, physiological, and behavioral symptoms of fear and anxiety. Further replication in larger samples is needed. Given its modest psychometric properties, SP-D needs refinement.

Conclusion

Increasing evidence from diverse samples suggests clinical utility of the dimensional anxiety scales.

Keywords

AnxietyassessmentdiagnosticDSMpsychometric

Information

Type
Original Research
Information
CNS Spectrums , Volume 19 , Issue 3 , June 2014 , pp. 256 - 267
Copyright
Copyright © Cambridge University Press 2013 

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Footnotes

This article was generated as part of the DSM-5 Work Group activities, ©2012 by the American Psychiatric Association.

References

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: American Psychiatric Association; 2013: 5–25.Google Scholar
2.Shear, KM, Bjelland, I, Beesdo, K, Gloster, AT, Wittchen, H-U. Supplementary dimensional assessment in anxiety disorders. Int J Methods Psychiatr Res. 2007; 16(Suppl 1): S52–S64.CrossRefGoogle ScholarPubMed
3.LeBeau, RT, Glenn, DE, Hanover, L, etal. A dimensional approach to measuring anxiety for DSM-5. Int J Methods Psychiatr Res. 2012; 21(4): 258–272.Google Scholar
4.Beesdo-Baum, K, Klotsche, J, Knappe, S, etal. Psychometric properties of the dimensional anxiety scales for DSM-5 in an unselected sample of treatment seeking patients. Depress Anxiety. 2012; 29(12): 1014–1024.Google Scholar
5.Möller, E, Majdandzic, M, Craske, MG, Bögels, S. Dimensional assessment of anxiety disorders in parents and children for DSM-5. Int J Methods Psychiatr Res. In press.Google Scholar
6.Knappe, S, Klotsche, J, Strobel, A, etal. Dimensional anxiety scales for DSM-5: sensitivity to clinical severity. Eur Psychiatry. 2013; 28(7): 448–456.CrossRefGoogle ScholarPubMed
7.Beesdo-Baum, K, Knappe, S. Developmental epidemiology of anxiety disorders. Child Adoles Psychiatr Clin N Am. 2012; 21(3): 457–478.CrossRefGoogle ScholarPubMed
8.Fava, GA, Ruini, C, Rafanelli, C. Psychometric theory is an obstacle to the progress of clinical research. Psychother Psychosom. 2004; 73: 145–148.Google Scholar
9.Wittchen, HU, Pfister, H. DIA-X-Interviews: Manual für Screening Verfahren und Interview; Interviewheft Längsschnittuntersuchung (DIA-X-Lifetime); Ergänzungsheft (DIA-X-Lifetime); Interviewheft Querschnittsuntersuchung (DIA-X-12 Monate); Ergänzungsheft (DIA-X-12 Monate); PC-Programm zur Durchführung des Interviews (Längs- und Querschnittsuntersuchung); Auswertungsprogramm. Frankfurt: Swets & Zeitlinger; 1997.Google Scholar
10.Derogatis, LR, Melisaratos, N. The Brief Symptom Inventory: an introductory report. Psychol Med. 1983; 13(3): 595–605.CrossRefGoogle ScholarPubMed
11.Marks, IM, Mathews, AM. Brief standard self-rating for phobic patients. Behav Res Ther. 1979; 17(3): 263–267.Google Scholar
12.Connor, KM, Kobak, KA, Churchill, LE, Katzelnick, D, Davidson, JRT. Mini-SPIN: a brief screening assessment for generalized social anxiety disorder. Depress Anxiety. 2001; 14(2): 137–140.Google Scholar
13.Spitzer, RL, Kroenke, K, Williams, JBW, Lowe, B. A brief measure for assessing generalized anxiety disorder—the GAD-7. Arch Intern Med. 2006; 166(10): 1092–1097.Google Scholar
14.Knappe, S, Hoyer, J. Clinical assessment of anxiety disorders. In: Emmelkamp PMG, Ering T, eds. International Handbook of Anxiety Disorders: Theory, Research and Practice. Vol II: Wiley; In press.Google Scholar
15.Pilkonis, PA, Choi, SW, Reise, SP, etal. Item banks for measuring emotional distress from the Patient-Recorded Outcomes Measurement Information System (PROMIS): depression, anxiety, and anger. Ann Behav Med. 2011; 41: S145–S145.Google Scholar
16.Cella, D, Riley, W, Stone, A, etal. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. J Clin Epidemiol. 2010; 63(11): 1179–1194.Google Scholar
17.Bandelow, B. Panic and Agoraphobia Scale (PAS). Seattle, WA: Hogrefe & Huber Publishers; 1999.Google Scholar
18.Wolpe, J, Lang, PJ. A fear survey schedule for use in behavior therapy. Behav Res Ther. 1964; 2: 27–30.Google Scholar
19.Beck, JG, Carmin, CN, Henninger, NJ. The utility of the fear survey schedule—III: an extended replication. J Anxiety Disord. 1998; 12(3): 177–182.Google Scholar
20.Busner, J, Targum, SD. The clinical global impressions scale: applying a research tool in clinical practice. Psychiatry (Edgmont). 2007; 4(7): 28–37.Google Scholar
21.Berk, M, Ng, F, Dodd, S, etal. The validity of the CGI severity and improvement scales as measures of clinical effectiveness suitable for routine clinical use. J Eval Clin Pract. 2008; 14(6): 979–983.Google Scholar
22.Forkmann, T, Scherer, A, Boecker, M, etal. The clinical global impression scale and the influence of patient or staff perspective on outcome. BMC Psychiatry. 2011; 11: 83.Google Scholar
23. Stata Statistical Software: Release 12 [computer program]. College Station, TX: StataCorp; 2011.Google Scholar
24.Muthen, LK, Muthen, BO. Mplus User's Guide. Vol. 6. Los Angeles, CA: Muthen & Muthen; 1998–2010.Google Scholar
25.Savitz, DA, Olshan, AF. Multiple comparisons and related issues in the interpretation of epidemiologic data. Am J Epidemiol. 1995; 142(9): 904–908.Google Scholar
26.Muthén, B. A general structural equation model with dichotomous, ordered categorical, and continuous latent variable indicators. Psychometrika. 1984; 49(1): 115–132.Google Scholar
27.Hu, L, Bentler, PM. Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychol Methods. 1998; 3(4): 424–453.CrossRefGoogle Scholar
28Meng, XL, Rosenthal, R, Rubin, DB. Comparing correlated correlation-coefficients. Psychol Bull. 1992; 111(1): 172–175.CrossRefGoogle Scholar
29.Carpenter, J, Bithell, J. Bootstrap confidence intervals: when, which, what? A practical guide for medical statisticians. Stat Med. 2000; 19(9): 1141–1164.Google Scholar
30.Kubinger, KD, Rasch, D, Moder, K. Zur Legende der Voraussetzungen des t-Tests für unabhängige Stichproben. Psychologische Rundschau. 2009; 1(60): 26–27.Google Scholar
31.Regier, D. Merging categorical and dimensional diagnoses of mental disorders. Epidemiol Psychiatr Sci. 2012; 21(3): 267–269.CrossRefGoogle ScholarPubMed
32.Balon, R. Measuring anxiety: are we getting what we need? Depress Anxiety. 2005; 22(1): 1–10.Google Scholar
33.McLean, CP, Asnaani, A, Litz, BT, Hofmann, SG. Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res. 2011; 45(8): 1027–1035.CrossRefGoogle ScholarPubMed
34.Reed, V, Gander, F, Pfister, H, etal. To what degree does the Composite International Diagnostic Interview (CIDI) correctly identify DSM-IV disorders? Testing validity issues in a clinical sample. Int J Methods Psychiatr Res. 1998; 7(3): 142–155.Google Scholar
35.Wittchen, H-U, Lachner, G, Wunderlich, U, Pfister, H. Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol. 1998; 33(11): 568–578.Google Scholar
36.Perini, SJ, Slade, T, Andrews, G. Generic effectiveness measures: sensitivity to symptom change in anxiety disorders. J Affect Disord. 2006; 90(2–3): 123–130.Google Scholar