Multidimensional assessment of psychosis: A factor-analytic validation study of the routine assessment of patient progress

Ehmann, Tom; Holliday, Stephen G.; MacEwan, G. William; Smith, G.

doi:10.1053/comp.2001.16557

Cited by 4 publications

(8 citation statements)

References 10 publications

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“…The inter-rater reliability and split-half reliability and the Cronbach's alpha were high. These findings are similar to other studies carried out using the instrument (Ehmann et al, 1995(Ehmann et al, , 2001. The principal component analysis revealed that the latent variable related to life skills had a high eigen value and explained a significant proportion of the variance.…”

Section: Discussionsupporting

confidence: 89%

“…The Routine Assessment of Patient Progress (RAPP) is designed for nurses to combine observations with interview-based ratings in order to assess the presence and their severity of multiple domains of patient functioning and to overcome the limitations of the existing scales (Ehmann et al, 1995;Ehmann et al, 2001). The RAPP consists of 21 scoreable items (for example, diet, sleep, elimination, safety, movement, anxiety, mood, activity, delusions, hallucinations, speech, hostility, memory, hygiene, cooperation, socialization, budgeting, sexual expression, leisure, problem solving, nurse's attention) and a seven-part descriptive section (for example, patients strengths, use of as needed medication, use of seclusion/restraint, special nursing concerns, nursing care plan).…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Routine Assessment of Patient Progress (RAPP) in patients with psychosis in South India

Charles

John

Chandy

et al. 2003

Int J Methods Psych Res

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The aim of the study was to validate the Routine Assessment of Patient Progress (RAPP), an instrument for assessment by nurses, among patients with psychosis in South India. One hundred consecutive patients with psychosis admitted to the Department of Psychiatry, Christian Medical College, Vellore, India, were assessed on day five and day 19 using the RAPP, the PANSS, and the CGI scales. The correlation of the RAPP with the other scales, its change over time, the inter-rater reliability, and factor structure were assessed. The subscales of RAPP correlated significantly with those of the other scales at intake and at follow-up. The RAPP scores changed significantly after treatment. Its inter-rater reliability as measured by the intra-class correlation coefficient was 0.98. The Cronbach's alpha, used to measure the internal consistency of the scale, was 0.87. The split-half reliability (Spearman-Brown) was 0.89. Principal component analysis with varimax rotation revealed six factors, which explained 67.4% of the variance. Items related to life skills explained a major proportion of the variance. The good psychometric properties, concurrent validity, high inter-rater reliability and sensitivity to change make it a useful instrument for nurses to employ to assess patients with psychoses.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Validation of the Routine Assessment of Patient Progress (RAPP) in patients with psychosis in South India

Charles

John

Chandy

et al. 2003

Int J Methods Psych Res

View full text Add to dashboard Cite

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“…Three other studies not reporting an affective dimension chose to focus on nonaffective symptoms in their analyses [17,37,39]. Of the studies reporting affective dimensions, all but 7 found separate manic and depressive dimensions [31,33,38,41–43,45]. McGrath et al [31] included limited coverage of affective symptoms, which resulted in a single inclusive affective dimension.…”

Section: Resultsmentioning

confidence: 99%

“…McGrath et al [31] included limited coverage of affective symptoms, which resulted in a single inclusive affective dimension. Ehmann et al [33] used the Routine Assessment of Patient Progress, which does not include items specific to depression or mania and reported anxiety/somatization and aggression dimensions. In fact, the item “mood/affect” fell under the aggression dimension.…”

Section: Resultsmentioning

confidence: 99%

“…Cuesta et al [21,22] reported an insight dimension, which included 3 items with high factor loadings but obvious overlap: lack of feeling of illness, lack of insight, and refusal of treatment. Two studies reported an independent anxiety dimension [22,33], whereas other studies either have found anxiety symptoms to load under a depression or mania dimension or did not address anxiety in their assessments. Several studies reported dimensions typically characterized as nonspecific symptoms: ( a ) cognitive functioning or cognition [36,38,43], ( b ) hostility [38,40,43], and ( c ) behavioral/social disturbance [20,36,42].…”

Section: Resultsmentioning

confidence: 99%

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Categorical vs dimensional classifications of psychotic disorders

Potuzak

Ravichandran

Lewandowski

et al. 2012

Comprehensive Psychiatry

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Objective Both categorical and dimensional methods appear relevant to classifying psychotic disorders; however, there is no clear consensus on the most appropriate categories and dimensions or on the best approach for constructing nosologic criteria that integrate these 2 methods. This review examines the evidence on specific dimensions and categories that would best characterize psychoses. Method Entries in the MEDLINE database between 1980 and 2011 were searched for studies of the dimensional and/or categorical structure of psychosis. Studies were included if samples represented a spectrum of psychotic disorders and dimensions/categories were empirically derived using principal components analysis, factor analysis, or latent class analysis. Results Most dimensional studies observed 4 or 5 dimensions within psychosis, with positive, negative, disorganization, and affective symptom domains most frequently reported. Substance abuse, anxiety, early onset/developmental, insight, cognition, hostility, and behavioral/social disturbance dimensions appeared in some studies. Categorical studies suggested 3 to 7 major classes within psychosis, including a class similar to Kraepelin’s dementia praecox and one or more classes with significant mood components. Only 2 studies compared the relative fit of empirically derived dimensions and categories within the same data set, and each had significant limitations. Conclusion There is relatively consistent evidence on appropriate categories and dimensions for characterizing psychoses. However, the lack of studies directly comparing or combining these approaches provides insufficient evidence for definitive conclusions about their relative merits and integration. The authors provide specific recommendations for designing future studies to identify valid dimensions and/or categories of the psychoses and investigate hybrid approaches to model the structure of the underlying illnesses.

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Outcome Measurement in Pharmacological Trials: Validity of the Routine Assessment of Patient Progress (RAPP)

Ts¹,

Kragelj²,

Gn³

et al. 2003

J Psychopharmacol

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The assessment of outcomes after treatment with antipsychotic medication is fundamental to clinical care and research. The Routine Assessment of Patient Progress (RAPP) is a reliable multidimensional scale that employs nurses' ratings of symptoms and functioning in psychiatric inpatients. The present study sought to extend validity evidence for the RAPP by examining its ability to reflect changes associated with treatment by antipsychotic medications. The use of a different sample in this study also provided the opportunity to replicate earlier validity data collected on the original set of patients. Ninety-seven separate trials were conducted, involving 65 consecutive admissions to a unit that specializes in the assessment and treatment of patients with long standing severe psychiatric disorders. The RAPP, along with the Positive and Negative Syndrome Scale and global measures of severity, were administered at baseline and at the end of each trial. Both factor scores and clinically-derived subscales were analysed for sensitivity to change. Patients were globally rated as improved, unchanged or worsened at the end of the medication trial. Results indicated that the RAPP factor, clinical scale and total scores compared favourably to other outcome measures in patients rated as improved or worse. In patients rated as unchanged, RAPP scores displayed significantly less change than did the PANSS scores. These findings support the validity of the RAPP as an outcome measure in treatment trials.

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Multidimensional assessment of psychosis: A factor-analytic validation study of the routine assessment of patient progress

Cited by 4 publications

References 10 publications

Validation of the Routine Assessment of Patient Progress (RAPP) in patients with psychosis in South India

Validation of the Routine Assessment of Patient Progress (RAPP) in patients with psychosis in South India

Categorical vs dimensional classifications of psychotic disorders

Outcome Measurement in Pharmacological Trials: Validity of the Routine Assessment of Patient Progress (RAPP)

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