Psychometric properties of the Treatment-Emergent Activation and Suicidality Assessment Profile (TEASAP) in youth with OCD

Abstract

This study evaluated the psychometric properties of the treatment-emergent activation and suicidality assessment profile (TEASAP) in a clinical sample of 56 youth ages 7 to 17 with obsessive compulsive disorder (OCD) who participated in a double-blind randomized controlled trial. The 38-item TEASAP demonstrated good internal consistency for its total score (α = 0.93) and adequate to good performance for its five subscale scores (α = 0.65 to 0.92). One week test-retest stability (N = 18) was adequate (Intraclass correlation coefficient [ICC] = 0.68 to 0.80) except for Self-Injury (ICC = 0.46). Construct validity was supported by total and subscale TEASAP score relationships with related constructs, including irritability, hyperactivity, externalizing behaviors, manic symptoms, and suicidal ideation, and the absence of relationships with unrelated constructs. Predictive validity was established for the Disinhibition subscale through significant associations with subsequent activation events. Furthermore, TEASAP sensitivity to change in activation scores over time was supported by longitudinal associations of TEASAP scores with clinician ratings of activation over the course of treatment. Findings indicate that the TEASAP has acceptable psychometric properties in a clinical sample of youth with OCD and merits further study in larger samples for additional refinement of its measurement approaches.

A pilot study of actigraphy as an objective measure of SSRI activation symptoms: Results from a randomized placebo controlled psychopharmacological treatment study

“…Echoing similar analyses reported by Bussing and colleagues (2013), number of comorbidities was not significantly associated with TEASAP ratings (0.11, p = 0.25) in the entire sample. A higher number of comorbidities was weakly associated with higher daytime activity levels (0.35, p < 0.05), but not night-time activity levels (−0.01, p = 0.97), which aligned findings that showed that number of comorbidities had no association with any sleep variables.…”

“…The TEASAP (Bussing et al, 2013) is a parent-rated assessment of activation symptom severity that captures five identified symptom clusters related to Activation Syndrome: (1) Irritability (9 items), (2) Akathisia/Hyperkinesis/Somatic Anxiety (6 items), (3) Disinhibition/Impulsivity (7 items), (4) Mania (10 items), and (5) Self-injury/Suicidality/Harm to others (6 items). Parents rate the child’s behavior in the past week, considering frequency and impairment associated with the behavior on a 4-point Likert-style scale (0 = none; 1 = mild; 2 = moderate; and 3 = severe).…”

“…The five subscales are summed to create a Total Score of activation symptom severity used for all analyses in this study. The TEASAP has strong psychometric properties, including the ability to capture week-to-week fluctuation in activation symptom severity (Bussing et al, 2013). …”

“…The U.S. Food and Drug Administration (FDA) described a symptom set consisting of anxiety, agitation, panic attacks, insomnia, irritability, hostility (aggressiveness), impulsivity, akathisia (psychomotor restlessness), hypomania, and mania that might be linked to worsening depression and suicidal ideation development (FDA, 2010). Reid et al (2010) proposed organizing the most common activation symptoms into five symptom clusters (i.e., irritability, akathisia, disinhibition, mania, and self-harm) and, in combination with work by Bussing and colleagues (2013), psychometrically validated the first dimensional parent-report measure for activation symptoms called the Treatment Emergent Activation Syndrome Assessment Profile (TEASAP). The TEASAP uniquely measures these symptom clusters, producing five subscale scores and an overall activation score.…”

Side-effects of SSRIs disrupt multimodal treatment for pediatric OCD in a randomized-controlled trial

“…The variability of this estimate is largely due to an absence of any comprehensive assessment measure of AS. Recently, the Treatment-Emergent Activation and Suicidality Assessment Profile (TEASAP) was developed to remedy this problem, providing a psychometrically validated method to comprehensively assess AS in children and adolescents receiving SSRI treatment (Bussing et al, 2013). The measure identifies five clusters of SSRI-induced side effects, including irritability, akathisia, disinhibition, mania, and self-harm.…”