Evaluation of a new screening instrument for psychological distress in postacute rehabilitation in older person

Grund, Stefan; Kilb, Michael; Breitinger, Eva; W, Hundsdörfer; Schäfer, Hans Günter; Schols, Jos M. G. A.; Gordon, Adam L; Bauer, Jürgen; Alpers, Georg W.

doi:10.1007/s41999-021-00554-9

Cited by 1 publication

(1 citation statement)

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“…In recent years, there has been a reappraisal of the major clinical implications related to the process of assessment of psychological distress (e.g., the number of studies exceeds 40,714 on Web of Science, accessed on June 30, 2022), yet simple reference to psychological distress without providing a clear conceptualization of this construct is no longer acceptable (Burnette et al, 2020; Grund et al, 2022; Kusi-Appiah et al, 2021; Phillips, 2009). The clinimetric approach (Fava, 2022) and its CLIPROM criteria (Carrozzino et al, 2021) may provide an innovative methodological framework for a substantial revision of the clinical conceptualization and assessment of psychological distress.…”

Section: Discussionmentioning

confidence: 99%

The concept of psychological distress and its assessment: A clinimetric analysis of the SCL-90-R.

Carrozzino¹,

Patierno²,

Pignolo³

et al. 2023

International Journal of Stress Management

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Many studies have been conducted on psychological distress but the question of how to conceptualize and assess this phenomenon still remains a controversial issue. Clinimetrics, the science of clinical measurements, may pave the ground for a substantial revision of the clinical conceptualization and assessment of this construct. A Rasch analysis was performed to evaluate whether the Symptom Checklist-90-Revised (SCL-90-R) and its subscales were valid indices of underlying dimensions of psychological distress. Based on the clinimetric validation of the SCL-90-R, as well as on a critical review of the available literature, a concept analysis of psychological distress was performed. The SCL-90-R total score misfitted the Rasch model but it was found to have a Person Separation Reliability Index of 0.94. Model fit was achieved after the exclusion of six misfitting items. Paired t tests indicated that all the subscales of the SCL-90-R were unidimensional. Psychological distress was defined as a subjective, unifying, dimensional, and transdiagnostic construct consisting in a unique experience of discomfort, which may involve a sense of demoralization, the experience of feeling broken or mental pain, a sense of anguish, symptoms of somatization and attention deficit hyperactivity disorder (ADHD), feelings of anger, self-perceived lack of control, and self-criticism. Our findings also showed that the SCL-90-R could reliably differentiate healthy stress from psychological distress, and identify individuals at risk of psychiatric disorders. The total score of the 84-item version of the SCL-90-R may be used as an overall indicator of psychological distress. The subscales are recommended to assess the severity of specific symptomatic manifestations of psychological distress.

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