Versions
 | This section is empty. You can help by adding to it. (May 2022) |
The Anorectic Behavior Observation Scale (ABOS) is a thirty-item diagnostic questionnaire devised to be answered by the parents, spouse or other family member of an individual suspected of having an eating disorder. It was developed by Vandereyken et al. in 1992. [1] The ABOS is useful for evaluations of patients with anorexia nervosa (AN) and bulimia nervosa (BN) before, during, and after clinical treatments. It can also be a significant tool for the screening of subjects in early-stage ED. [2]
The validity and reliability of the ABOS have been confirmed by Vandereycken, [3] and the scale shows good internal consistency with Cronbach's α of .81. [4]
Gathering data from parents and caregivers is extremely important because patients with ED often tend to deny or minimize their disorder. [5] [1] The early stage of ED is often not immediately identifiable by the relatives, as the first signals can be misinterpreted as a form of self-control or willpower. [4] People with ED, indeed, tend to adopt secret attitudes, hiding eating behaviours and body shape. [4] That is the reason why a detailed observation of the patient by their caregivers is crucial in the early stage of the disorder. [6] [7]
The ABOS consists of 30 items with three possible answers provided per question: "yes" (2 points), "no" (0 points), and "don't know" (1 point). [4] The caregivers should base their rating of the 30 items on observations of the patient during the past month. [1] [5] The score ranges from 0 to 60, with a higher score indicating a higher level of pathology, and the cut-off point is 21. [4]
The questions address three factors: [2] [4] [5] [8]
Cross-cultural differences have been noticed with regard to the content of each factor. [2] [8]
The ABOS is a strong tool in the diagnosis of patients with ED, but there are some limitations to consider. [4]
The first main issue has to do with the objectivity of the ABOS. The information provided by the informant with regard to the suspected patient can be influenced by several factors, such as the context or the implicit characteristics of both the parent and the subject. For instance, intra-family conflicts or complex parent-child relationships can impact the information provided by the caregivers. [4] [9] The psychopathology of the parents can also be a misleading factor, especially if they have anxiety and depression. [2] [9]
A second key issue concerns the ABOS as a measurement system. The scale, in fact, indicates the absence or presence of a certain behaviour, but it does not address the frequency of the observed behaviour. [4]
Other issues have emerged from the samples of the studies, in particular with regard to cross-cultural differences. Slightly distinct behaviours, indeed, have been noticed across countries. Consequently, a larger randomizing sample comprehensive of patients from different countries is needed in order to make reliable generalizations. [8]
Evidently, considering the abovementioned limitation, the ABOS should be used together with self-report questionnaires and interviews that assess the patient directly. [5] [8]
| | This section is empty. You can help by adding to it. (May 2022) |
The validity of the German-language version of ABOS was tested with 101 females, in- and outpatients recruited from the Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité Berlin. Sixty-three patients had AN restricting subtype (ANR), 17 from AN binge-purge subtype (ANBP), and 21 from BN. All ED patients met the DSM-IV criteria for ED and were aged between 12 and 18 years. A control group of 134 people with matching age and socio-economic backgrounds completed the ABOS, which was translated into German by an independent translator. [5]
Two analyses were conducted to evaluate the scale. Firstly, internal consistency was tested using Cronbach's alpha; secondly, confirmatory factor analysis was conducted to test whether the German data fitted the original version by Vandereycken. [5]
The results reported a high internal consistency for the total sample and confirmed that the original model fits the German data well. Consequently, the German-language version can be a valid and reliable tool in the diagnosis of eating disorders. [5]
The validity of the Japanese-language version of ABOS was tested with 102 family members of eating disorder patients, completing the questionnaire. The patients were 80 females and one male, who came out of clinics for the first time. Among them, 21 patients had AN restrictive type (ANR), 42 had AN binge-purge subtype (ANBP), 12 had BN, and 6 had not-specified ED. All ED patients met the DSM-IV criteria for ED and the mean age of patients was 20.8. The questionnaire was translated into Japanese by the back-translation method. [8]
Two analyses where conducted to test the data. Firstly, a Scree test was applied to determine the number of factors in the Japanese sample; secondly, a confirmatory factor analysis was conducted to observe whether the Japanese data fitted the original version of the ABOS. [8]
The results illustrated that the original three-factor model fits the Japanese data well. Consequently, the Japanese-language version of the ABOS can be a useful tool in the diagnosis of eating disorders. [8]
However, cross-cultural differences were noted as compared to the original version with regard to the content of each factor. For instance, chopping food in small pieces is not considered a pathological behaviour in Japan because of the ordinary use of chopsticks. [8]
The validity of the Spanish-language version of the ABOS was tested with 239 caregivers of 143 outpatients diagnosed with and treated for an ED in the Eating Disorders Outpatient Clinic of the Psychiatric Services at the Galdakao-Usansolo Hospital and the Ortuella Mental Health Centre in Bizkaia, Spain. Patients were aged between 16 and 65 and they had AN or BN, according to the DSM-IV criteria. Socio-demographic data were gathered from both the patients and the caregivers and the ABOS was translated into Spanish. Moreover, in the Spanish version, the caregivers also completed the ABOS after 1 year, to observe the changes in the patients' ED over time. [2]
Three analyses were conducted to test the data. Firstly, a confirmatory factor analysis tested whether the Spanish data fitted the original model; secondly, a Scree test was assessed to determine the number of factors; thirdly, Cronbach's alpha coefficients were computed to evaluate internal consistency. Furthermore, after one year, the newly completed ABOS was compared to the initial one. [2]
The results showed that the original version fitted the Spanish data well, the three-factor model was confirmed as the most suitable, and the Cronbach's alpha coefficients confirmed internal consistency. In addition, the comparison with the ABOS completed one year later illustrated non-significant changes. A longer follow-up period might therefore be needed.
Overall, however, the Spanish-language version of the ABOS can be a useful tool in the diagnosis of eating disorders. [2]
The Eating and Activity Questionnaire for Parents (EAQP) is a short form of the ABOS utilizing 10 items from the original version. It was designed to solve some psychometric issues that had been identified in the ABOS, with regard to variance and distribution. The EAQP reflects the three-factor structure of the ABOS, but the third factor has been changed from "Hyperactivity" to "Level of activity/fitness".
The EAQP is utilized as a screening tool of parents' assessment of their child's eating behavior. [10]
An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Types of eating disorders include binge eating disorder, where the patient eats a large amount in a short period of time; anorexia nervosa, where the person has an intense fear of gaining weight and restricts food or overexercises to manage this fear; bulimia nervosa, where individuals eat a large quantity (binging) then try to rid themselves of the food (purging); pica, where the patient eats non-food items; rumination syndrome, where the patient regurgitates undigested or minimally digested food; avoidant/restrictive food intake disorder (ARFID), where people have a reduced or selective food intake due to some psychological reasons; and a group of other specified feeding or eating disorders. Anxiety disorders, depression and substance abuse are common among people with eating disorders. These disorders do not include obesity. People often experience comorbidity between an eating disorder and OCD. It is estimated 20–60% of patients with an ED have a history of OCD.
Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. This activity aims to expel the body of calories eaten from the binging phase of the process. Binge eating refers to eating a large amount of food in a short amount of time. Purging refers to the attempts to get rid of the food consumed. This may be done by vomiting or taking laxatives.
The Barratt Impulsiveness Scale (BIS) is a widely used measure of impulsiveness. It includes 30 items that are scored to yield six first-order factors and three second-order factors.
The Liebowitz Social Anxiety Scale (LSAS) is a short questionnaire developed in 1987 by Michael Liebowitz, a psychiatrist and researcher at Columbia University and the New York State Psychiatric Institute. Its purpose is to assess the range of social interaction and performance situations feared by a patient in order to assist in the diagnosis of social anxiety disorder. It is commonly used to study outcomes in clinical trials and, more recently, to evaluate the effectiveness of cognitive-behavioral treatments. The scale features 24 items, which are divided into two subscales. 13 questions relate to performance anxiety and 11 concern social situations. The LSAS was originally conceptualized as a clinician-administered rating scale, but has since been validated as a self-report scale.
Attachment measures refer to the various procedures used to assess the attachment system in children and adults. Researchers have developed various ways of assessing self-protective strategies and patterns of attachment. Some methods work across the several models of attachment and some are model-specific.
The Eating Attitudes Test, created by David Garner, is a widely used 26-item, standardized self-reported questionnaire of symptoms and concerns characteristic of eating disorders. The EAT is useful in assessing "eating disorder risk" in high school, college and other special risk samples such as athletes. EAT has been extremely effective in screening for anorexia nervosa in many populations.
Child and adolescent psychiatry is a branch of psychiatry that focuses on the diagnosis, treatment, and prevention of mental disorders in children, adolescents, and their families. It investigates the biopsychosocial factors that influence the development and course of psychiatric disorders and treatment responses to various interventions. Child and adolescent psychiatrists primarily use psychotherapy and/or medication to treat mental disorders in the pediatric population.
The Body Attitudes Test (BAT) was developed by Probst et al. in 1995. It was designed for the assessment of multiple eating disorders in women. The BAT measures an individual's subjective body experience and attitudes towards one's own body. It is a questionnaire composed of twenty items which yields four different factors that evaluate the internal view of the patient's own body.
The Eating Disorder Diagnostic Scale (EDDS) is a self-report questionnaire that assesses the presence of three eating disorders; anorexia nervosa, bulimia nervosa and binge eating disorder. It was adapted by Stice et al. in 2000 from the validated structured psychiatric interview: The Eating Disorder Examination (EDE) and the eating disorder module of the Structured Clinical Interview for DSM-IV (SCID)16.
The Patient Health Questionnaire (PHQ) is a multiple-choice self-report inventory that is used as a screening and diagnostic tool for mental health disorders of depression, anxiety, alcohol, eating, and somatoform disorders. It is the self-report version of the Primary Care Evaluation of Mental Disorders (PRIME-MD), a diagnostic tool developed in the mid-1990s by Pfizer Inc. The length of the original assessment limited its feasibility; consequently, a shorter version, consisting of 11 multi-part questions - the Patient Health Questionnaire was developed and validated.
The Quality of Life In Depression Scale (QLDS), originally proposed by Sonja Hunt and Stephen McKenna, is a disease specific patient-reported outcome which assesses the impact that depression has on a patient's quality of life. It is the most commonly used measure of quality of life in clinical trials and studies of depression. The QLDS was developed as a measure to be used in future clinical trials of anti-depressant therapy.
The Somatic Symptom Scale - 8 (SSS-8) is a brief self-report questionnaire used to assess somatic symptom burden. It measures the perceived burden of common somatic symptoms. These symptoms were originally chosen to reflect common symptoms in primary care but they are relevant for a large number of diseases and mental disorders. The SSS-8 is a brief version of the popular Patient Health Questionnaire - 15 (PHQ-15).
The Mood Disorder Questionnaire (MDQ) is a self-report questionnaire designed to help detect bipolar disorder. It focuses on symptoms of hypomania and mania, which are the mood states that separate bipolar disorders from other types of depression and mood disorder. It has 5 main questions, and the first question has 13 parts, for a total of 17 questions. The MDQ was originally tested with adults, but it also has been studied in adolescents ages 11 years and above. It takes approximately 5–10 minutes to complete. In 2006, a parent-report version was created to allow for assessment of bipolar symptoms in children or adolescents from a caregiver perspective, with the research looking at youths as young as 5 years old. The MDQ has become one of the most widely studied and used questionnaires for bipolar disorder, and it has been translated into more than a dozen languages.
The Child Mania Rating Scales (CMRS) is a 21-item diagnostic screening measure designed to identify symptoms of mania in children and adolescents aged 9–17 using diagnostic criteria from the DSM-IV, developed by Pavuluri and colleagues. There is also a 10-item short form. The measure assesses the child's mood and behavior symptoms, asking parents or teachers to rate how often the symptoms have caused a problem for the youth in the past month. Clinical studies have found the CMRS to be reliable and valid when completed by parents in the assessment of children's bipolar symptoms. The CMRS also can differentiate cases of pediatric bipolar disorder from those with ADHD or no disorder, as well as delineating bipolar subtypes. A meta-analysis comparing the different rating scales available found that the CMRS was one of the best performing scales in terms of telling cases with bipolar disorder apart from other clinical diagnoses. The CMRS has also been found to provide a reliable and valid assessment of symptoms longitudinally over the course of treatment. The combination of showing good reliability and validity across multiple samples and clinical settings, along with being free and brief to score, make the CMRS a promising tool, especially since most other checklists available for youths do not assess manic symptoms.
The General Behavior Inventory (GBI) is a 73-question psychological self-report assessment tool designed by Richard Depue and colleagues to identify the presence and severity of manic and depressive moods in adults, as well as to assess for cyclothymia. It is one of the most widely used psychometric tests for measuring the severity of bipolar disorder and the fluctuation of symptoms over time. The GBI is intended to be administered for adult populations; however, it has been adapted into versions that allow for juvenile populations, as well as a short version that allows for it to be used as a screening test.
Christopher James Alfred Granville Fairburn is a British psychiatrist and researcher. He is Emeritus Professor of Psychiatry at the University of Oxford. He is known for his research on the development, evaluation and dissemination of psychological treatments, especially for eating disorders.
The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) is a semi-structured interview aimed at early diagnosis of affective disorders such as depression, bipolar disorder, and anxiety disorder. There are different versions of the test that have use different versions of diagnostic criteria, cover somewhat different diagnoses and use different rating scales for the items. All versions are structured to include interviews with both the child and the parents or guardians, and all use a combination of screening questions and more comprehensive modules to balance interview length and thoroughness.
The nine-item Patient Health Questionnaire (PHQ-9) is a depressive symptom scale and diagnostic tool introduced in 2001 to screen adult patients in primary care settings. The instrument assesses for the presence and severity of depressive symptoms and a possible depressive disorder. The PHQ-9 is a component of the larger self-administered Patient Health Questionnaire (PHQ), but can be used as a stand-alone instrument. The PHQ is part of Pfizer's larger suite of trademarked products, called the Primary Care Evaluation of Mental Disorders (PRIME-MD). The PHQ-9 takes less than three minutes to complete. It is scored by simply adding up the individual items' scores. Each of the nine items reflects a DSM-5 symptom of depression. Primary care providers can use the PHQ-9 to screen for possible depression in patients.
The Cambridge Behavioural Inventory (CBI) and its revised version, Cambridge Behavioural Inventory-Revised (CBI-R), are informant-based questionnaires that evaluate the emergence of behavioural symptoms in neurodegenerative brain disorders, including Alzheimer's disease (AD), Huntington's disease (HD), Parkinson's disease (PD), and frontotemporal dementia (FTD).