A Multi-Vantaged Approach to Measurement of Behavioral and Affect States for Clinical and Psychobiological Research

Abstract

The development of methods based on the “multivantaged” assessment of behavioral, affect, and cognitive constructs in patients with affective disorders, is reponed. The state and outcome constructs were derived for application in clinical and psychobiological studies, particularly those aimed at testing biobehavioral hypotheses and the evaluation of the effects of drugs. The development of the constructs is based on the combining of scales from established measures which assess the patient in the interview, on the ward, from his self-report, and from a new vantage, through video methodology. Psychometric analyses primarily from data from the NIMH Collaborative Study of the Psychobiology of Depression describe the assembling of the 11 state constructs, and the estimation of their reliabilities, their interrelationships, and their validities. The methods are shown to be capable of characterizing pathologic and “normal” affects, social and expressive behaviors, and impairments in the cognitive and somatic spheres. They differentiated such diverse groups as depressives, manics, and normals, and such behaviorally similar depressive types as the unipolar and bipolar. Preliminary evidence is reported which indicates differential sensitivity to the effects of tricyclic drugs

Onset and Early Behavioral Effects of Pharmacologically Different Antidepressants and Placebo in Depression

“…Other measures of the components of depression, for example, psychomotor performance, derived from our earlier work, are described below. These have been described previously (Katz et al, 1982(Katz et al, , 1984(Katz et al, , 1989.…”

“…In this multivantaged approach (Katz et al, 1984), doctor ratings included the Ham-D, CGI, Schedule for Affective Disorders, and SchizophreniaChange Version (SADS-C, Endicott and Spitzer, 1978), Global Assessment Scale (GAS, Endicott et al, 1976), Video Interview Behavioral Evaluation Scales (VIBES) (Katz and Itil, 1974); nurse ratings: the Affective Disorder Rating Scale (ADRS) (Murphy et al, 1980), NIMH Mood Scale (Raskin et al, 1969), Global Ward Behavior Scale (Raskin et al, 1969); patient self-reports included the Symptoms Checklist (SCL-90; Derogatis et al, 1974); NIMH Mood Scale (Raskin et al, 1969); and the Buss-Durkee Hostility Inventory (Buss and Durkee, 1957). Other measures of the components of depression, for example, psychomotor performance, derived from our earlier work, are described below.…”

“…Following administration of the rating scales at baseline to a broad sample of patients with affective disorders and normal subjects, (Katz et al, 1984), psychometric analyses of scores obtained from the various instruments led to a set of 11 state constructs that measure the major components of depression. These studies included tests of discriminant and construct validity (Katz et al, 1984(Katz et al, , 1987.…”

Enhancing the Technology of Clinical Trials and the Trials Model to Evaluate Newly Developed, Targeted Antidepressants

“…Discovering how these methods can be combined to meet the objective of devising primary outcome indices and measures of the major components requires psychometric analysis of large sample data in which the methods have been applied alongside the conventional severity rating scales. Examples of systems based on combining several diverse test procedures are found in Raskin et al (1967), and in Katz et al (1984). The values of the componential approach in meeting current problems of evaluation are further examined in the section on measuring onset and speed of action of the new drugs.…”

Psychopharmacology and the Etiology of Psychopathologic States: Are We Looking in the Right Way?

“…Examination in the previous study (Maas et al 1980;Katz et al 1979) of the average componential prohle for a severely depressed sample of 104 patients indicated that the level of anxiety in those patients was almost as high as the level of depressed mood and that hostil ity was signiftcantly higher than in healthy controls (Katz et al 1984).…”