Assessing Psychopathology And Behavior Problems In Persons With Mental Retardation

239 Pages·2007·6.66 MB·English

DOCUMENT RESUME
ED 342 801 TM 017 968
AUTHOR Aman, Michael G.
TITLE Assessing Psychopathology and Behavior Problems in
Persons with Mental Retardation: A Review of
Available Instruments.
INSTITUTION National inst. on Alcohol Abuse and Alcoholism
(DHHS), Rockville, Md.
REPORT NO DHHS-ADM-91-1712
PUB DATE 91
NOTE 241p.
PUB TYPE Reference Materials - Bibliographies (131) -- Reports
- Research/Technical (143)
EDRS PRICE MF01/PC10 Plus Postage.
DESCRIPTORS *Behavior Disorders; Developmental Disabilities;
*Diagnostic Tests; Evaluation Methods; Interviews;
*Measures (Individuals); Medical Evaluation; Mental
Disorders; Mental Health; *Mental Retardation;
*Psychological Testing; *Psychopathology; Surveys
ABSTRACT
This survey of the instruments and methods that are
currently available for assessing mental health problems in persons
with mental retardation lists formalized instruments and interview
techniques and evaluates them from a methodological perspective.
Emphasis is on the assessment and classification of disorders rather
than on the evaluation of adaptive behaviors or treatment effects.
Information was solicited from several professional organizations
with an interest in behavior, psychopathology, and developmental
disabilities through letters sent to 50 prominent researchers and
through computer searches of the literature. Approximately 40
relevant instruments were identified. These are described in three
sections: (1) the more established instruments, most of which have
been published, with detailed descriptions and thorough critiques;
(2) relatively new or unpublished instruments, with brief summaries
and critiques; and (3) relevant instruments considered peripheral to
assessment of behavior disorders, with brief descriptions and no
appraisal of psychometric characteristics. Eight tables summarize
information about the instruments. Three appendices provide
supplemental information about the survey process and the instruments
reviewed. (SLD)
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ASSESSING PSYCHOPATHOLO I
AND BEHAVIOR PROBLEMS
IN PERSONS WITH MENTAL RETARDATION:
A REVIEW OF AVAILABLE INSTRUMENTS
Report Prepared for the National Institute
of Mental Health
Michael G. Aman
The Nisonger Center for
Mental Retardation and Developmental Disabilities
The Ohio State University
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Alcohol, Drug Abuse, and Mental Health Administration
National Institute of Mental Health
5600 Fishers Lane
Rockville, Maryland 20857
Acknowledgements
This review was funded by a Professional Services Contract from the
National Institute of Mental Health (NIMH) to Michael Aman, Ph.D. The author
would like to acknowledge the important role of Dr. Eleanor Dibble of the NIMH
who first envisaged the need for such a review, who initiated the funding of
the project, and who provided many useful suggestions on how the review
might be structured. The author would like to thank the following workers for
professional advice and critical comments on aspects of this research:
Drs. Fred Damarin, David Hammer, Johannes Rojahn, Donald Smeltzer (Ohio
State University), Dr. Stephen Schroeder (University of Kansas), and
Dr. Nirbhay Singh (Medical College of Virginia). The author is grateful to
Peggy Smith (Virginia Treatment Center for Children) for her many useful
editorial suggestions and, as always, to Marsha Aman for a great deal of moral
support and practical help including substantial editorial advice and word
processing of this document.
Suggested citation: Aman, M.G. (1991). Assessing psychopathology and
behavior problems in persons with mental retardation: A review of
available instruments. Rockville MD: U.S. Department of Health and
Human Services.
iii
4
Table of Contents
iii
Acknowledgements
1
Introduction
3
Survey Methods Employed
4
Selection Criteria for Instruments
5
Instruments Not Included
Other Instruments Relevant to the Assessment of Psychopathology 7
8
Evaluation Criteria
9
Acceptable Ranges
10
Review Format
10
Some Caveats
12
The Nature of Psychopathology in Mental Retardation
21
Part I
AAMD Adaptive Behavior Scale: Residential and Community
23
Edition
AAMD Adaptive Behavior Scale: School Edition 30
35
Aberrant Behavior Checklist
41
Adolescent Behavior Checklist
Balthazar Scales of Adaptive Behavior: II. Scales of Social Adaptation 46
51
Behaviour Disturbance Scale
55
Client Development Evaluation Report
59
Clinical Interview Schedule
Devereux Adolescent Behavior Rating Scale 65
70
Devereux Child Behavior Rating Scale
Diagnostic Assessment of the Severely Handicapped (DASH) 75
Emotional Disorders Rating Scale: Developmental Disabilities so
Minnesota Developmental Programming System (MDPS):
84
Behavior Management Assessment
89
Preschool Behavior Questionnaire
Prout-Strohmer Personality Inventory 93
v
Psychopathology Instnunent for Mentally Retarded Adults (PIMRA) 97
Reiss Screen for Maladaptive Behavior 103
Schedule of Handicaps, Behaviour, and Skills kfIBS) Revised 107
Self-Report Depression Questionnaire 113
Strohmer-Prout Behavior Rating Scale 117
Vineland Adaptive Behavior Scale 121
Part II
125
Attention Checklist 127
Behavior Development Survey 128
Behavior Evaluation Rating Scale (BeERS) 130
Behavior Inventory for Rating Development (BIRD) 131
Behavior Problems Inventory 133
Communication Style Questionnaire 135
Developmentally Delayed Children's Behaviour Checklist 137
Fairview Maladaptive Behavior Survey 139
Gilson-Levitas Diagnostic Criteria 141
Motivation Assessment Scale 143
Pqchosocial Behaviour Scale 145
Revised Children's Manifest Anxiety Scale 147
Social and Emotional Behavior Inventory 150
Social Judgment Scale 152
Social Participation Rating Scale 154
Standardized Assessment of Personality 156
Structured Clinical Interview 158
Zung Self-Rating Anxiety Scale (Adapted) 159
Part III 161
Cognitive Diagnostic Battery 163
Maladaptive Behavior Scale (MABS) 164
Paroxysmal Behavior Scale 165
vi
166
Seizure and Related Behavior Checklist
167
Shortened Stockton Rating Scale
168
Social Performance Survey Schedule
169
Vocational Problem Behavior Inventory
171
Conclusions and Recommendations
173
Characterization of Existing Scales
174
State of the Field
178
Recurring Problems with Available Instruments
and Behavior Disorders in Mental Retardation 179
Toward a Valid Taxonomy of Emotional
181
Recommended 1nstrwnents
183
Recommendations for Future Research
187
Tables
Reliability Correlations for
Tab lel: Magnitude of Interrater
187
Different Types of Informant
Addressed in Reviewed Instruments (Part I) 188
Table 2: Psychometric Futures
190
Table 3: Instruments in Parts I and II Classified by Type of Rater
191
Table 4: Instruments in Parts I and II Classified by Age Group Covered
192
Table 5: Instruments in Parts I and II Classified by Method of Derivation
193
Table 6: Instruments in Parts I and II Classified by Number of Subsea les
Table 7: Instruments in Pans I and II Classified by Level of Mental
194
Retardation Covered
195
Factors from Factor Analytic Reseaith
Table 8: Commonalities among
197
Appendices
Whose Memberships Were Notified
Appendix A: Societies and Associations
197
Regarding the Review
198
Characteristics of Reviewed Scales
Appendix B: Summary of Psychometric
for Abbreviations Used in Tables 3 Through 7 238
Appendix C: Full Instrument Names
vii
Y-
Introduction
1
interest, both in the United States and in other
In recent years, there has been gnat
appropriate methods for assessing mental health problems in
countries, in the nature and
retardation. This has led to a number of activities such as the
persons with mental
National Institute of Mental Health (NIMH) convened a
following. In May 1986 the
problems in treatment tesearch with
special workshop on the topic of "Methodological
also mentally ill" (see Special Feature on Treatment
mentally retarded populations who arc
N1MH-sponsored workshop was held in February 1987 on
Research, 1986). A second
retardation." In addition,
psychiatric disorders in mental
"Assessment and treatment of
meetings of the National
during 1986 and 1987 in national
related presentations were made
The American Association for Mental Retardation,
Association of the Dually Diagnosed,
Conference on Mental Health Aspects of Mental Retardation
and an International Research
of these workshops and
opinion that emerged repeatedly at many
(see Reiss, 1989). An
instruments has hampered
conferences was that a lack ofuniform or adequate assessment
individualized methods of
have employed idiosyncratic or
clinical research. Many studies
investigations. However, it was not
assessment, and this has hindered comparison across
impression was of the actual need for better diagnostic instmments.
clear how accurate this
considerable need for a systematic survey of the instruments
Thus, there appeamd to be a
health problems in persons
and methods that are currently available for assessing mental
with mental retardation.
requirement. One objective
carried out to help meet this
The present project was
was to collect all formalized instruments and interview techniques for evaluating
retardation. The second
psychopathology and behavior disorders in persons with mental
principal objective was to describe these instruments and to evaluate them from a
methodological perspective. It is hoped that this will help to inform interested workers
techniques and their relative merits. It should be
about the available pool of assessment
this project has been on assessment and classification of
noted that the emphasis in
evaluation of adaptive behavior or treatment effects.
disorders per se rather than on the
adaptive behavior or treatment effects could come
Thus, instruments developed to measure
necessarily was directed to diagnostic
under the terms of this review, but the evaluation
precision.
Survey Methods Employed
appropriate rating and
A variety of methods was used to identify and locate
3
diagnosdc instruments. Extensive efforts were made to inform workers
in the field that the
assessment was underway and to seek submissions of all relevant materials, whetner
published or not. These efforts included the following:
1. Notices were sent to a number of societies and organizatiolis
whose membership
was known to have an interest in behavior problems,
psychopathology, and
developmental disabilities. In each case, a notice described the objectives of the
review project and asked that all relevant materials be sent
to the author. The
organizations that were contacted are listed in Appendix A.
2. Computer searches were conducted to examine the literature for relevant
publications on the assessment of behavior problems and/or dual diagnosis.
These
included Med line, BRS (Psych Info), and BRS Health Instruments
File Database
searches.
3 . Personal letters were sent
to 50 prominent researchers who were known to be
interested in assessment research in the mental retardation field. This
was expedited
by the literature search discussed above and by suggestions provided
by colleagues
in the field. The individuals who were contacted resided in eight
different regions
including the United States, Australia, Canada, England, the
Netherlands,
Scotland, Sweden, and Wales.
Selection Criteria for Instruments
As noted previously, the emphasis of this review was
on standardized scales and
interviews that could differentiate between various forms of psychopathclogy
or behavior
disorders in persons with mental retardation. The computer search, and
more specifically
the key word diagnosis, produced a very large number of
articles that were deemed not to
be relevant to this review. These included numerous research
papers concerned with
identification of various physiological,
genetic, metabolic, or other pathological disorders,
such as Rett syndrome, phenylketonuria,
and so forth. Such publications were excluded
from the present review. Also excluded were articles and instruments
that attempted to
formulate subgroups on the basis of IQ test profiles or neuropsychological
profiles.
Vocational adaptation and readiness scales were excluded unless
specifically relevant to the
dual diagnosis question. Finally, scales that were designed
to screen for a single disorder,
such as the several autism scales,
were not included in this review. These criteria were
somewhat arbitrary, but it was necessary to put boundaries on the
survey so that its major
objectives could be achieved.
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