Psychological tests typically include a response scale whose purpose it is to organize and constrain the options available to respondents and facilitate scoring. One such response scale is the Likert ...scale, which initially was introduced to have a specific 5-point form. In practice, such scales have varied considerably in the nature and number of response options. However, relatively little consensus exists regarding several questions that have emerged regarding the use of Likert-type items. First, is there a "psychometrically optimal" number of response options? Second, is it better to include an even or odd number of response options? Finally, do visual analog items offer any advantages over Likert-type items? We studied these questions in a sample of 1,358 undergraduates who were randomly assigned to groups to complete a common personality measure using response scales ranging from 2 to 11 options, and a visual analog condition. Results revealed attenuated psychometric precision for response scales with 2 to 5 response options; interestingly, however, the criterion validity results did not follow this pattern. Also, no psychometric advantages were revealed for any response scales beyond 6 options, including visual analogs. These results have important implications for psychological scale development.
Public Significance Statement
We studied several aspects of questionnaire response scales and their impact on the reliability and validity of a personality measure. We found that smaller numbers of response options have a negative impact on the measurement precision of a scale, which has important implications how psychological measures should be developed and used in practice.
Highlights • We compared several DSM-5 PTSD models in a large psychiatric sample. • Patients reported symptoms referencing a Criterion-A trauma or stressful life event. • A novel 6-factor dysphoria ...and 7-factor hybrid model outperformed other models. • Criterion-A qualification did not alter structural results. • The 6-factor dysphoria model emerged as the most parsimonious solution.
We examine fear and anxiety in the context of structural models of personality (the five-factor model, or FFM) and psychopathology (the Hierarchical Taxonomy of Psychopathology, or HiTOP); we also ...highlight important issues related to their assessment. Anxiety is a sustained, future-oriented response to potential threat. Trait measures of anxiety represent a core facet within the broader domain of neuroticism in the FFM. Anxiety-related symptoms are indicators of the distress subfactor within the internalizing spectrum in HiTOP. In contrast, fear is a brief, present-focused response to an acute threat. We distinguish between two ways of assessing individual differences in fear. The first type assesses phobic responses to specific stimuli. Phobia measures are moderately correlated with measures of neuroticism in the FFM and define the fear subfactor of internalizing in HiTOP. The second type assesses individual differences in harm avoidance versus risk taking. Measures of risk taking (i.e., low fear) are moderately related to disinhibition/low conscientiousness and antagonism/low agreeableness in the FFM and are indicators of the externalizing superspectrum in HiTOP.
Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research ...and utility in clinicalpractice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on structural evidence. It addresses problems of diagnostic heterogeneity, comorbidity, and unreliability. We review the HiTOP model, supporting evidence, and conceptualization of psychopathology in this hierarchical dimensional framework. The system is not yet comprehensive, and we describe the processes for improving and expanding it. We summarize data on the ability of HiTOP to predict and explain etiology (genetic, environmental, and neurobiological), risk factors, outcomes, and treatment response. We describe progress in the development of HiTOP-based measures and in clinical implementation of the system. Finally, we review outstanding challenges and the research agenda. HiTOP is of practical utility already, and its ongoing development will produce a transformative map of psychopathology.
The Pathological Narcissism Inventory (PNI) has enjoyed widespread use in the study of the narcissism. However, questions have been raised about whether the PNI’s grandiosity scale adequately ...captures narcissistic grandiosity as well as other popular measures do. Specifically, some have noted that PNI grandiosity shows a pattern of external associations that diverges from patterns for narcissistic grandiosity predicted by experts, and is more similar to the predictions for the vulnerability scale than is desirable. Previous research driving these critiques has relied on patterns of zero-order correlations to examine the nomological networks of these scales. The present study reexamines the nomological networks of PNI grandiosity and vulnerability scales using hierarchical regression. Results indicate that once accounting for overlapping variance of vulnerability and grandiosity, the unique variance in the PNI’s grandiosity scale closely matches contemporary expert conceptualizations of narcissistic grandiosity based on expected associations with other personality variables.
Objective: Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high ...comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alternative to traditional classifications that conceptualizes psychopathology as a set of dimensions organized into increasingly broad, transdiagnostic spectra. Prior work has shown that using a dimensional approach improves reliability and validity, but translating a model like HiTOP into a workable system that is useful for health care providers remains a major challenge. Method: The present work outlines the HiTOP model and describes the core principles to guide its integration into clinical practice. Results: Potential advantages and limitations of the HiTOP model for clinical utility are reviewed, including with respect to case conceptualization and treatment planning. A HiTOP approach to practice is illustrated and contrasted with an approach based on traditional nosology. Common barriers to using HiTOP in real-world health care settings and solutions to these barriers are discussed. Conclusions: HiTOP represents a viable alternative to classifying mental illness that can be integrated into practice today, although research is needed to further establish its utility.
What is the public health significance of this article?
Redefining a taxonomy of psychopathology according to data results in dimensions, not categories, that can be organized hierarchically-with at least six higher level spectra near the top of the model and more specific lower level components and traits at the bottom. This approach may improve case conceptualizations and align more closely with transdiagnostic treatments, while also specifying more narrow targets for intervention. A case illustration shows how the HiTOP model can be used in clinical practice today, although additional research is needed to fully assess the utility of this approach for providers and patients.
•Personality traits interacted when predicting some disorders in a psychiatric sample.•High extraversion, conscientiousness reduced the risk conferred by high neuroticism.•The most consistent effects ...were for symptoms of major depression.•There was also evidence of trait interactions for PTSD and GAD symptoms.
It is well-established that neuroticism, extraversion, and conscientiousness are individually associated with internalizing disorders, but research suggests that these main effects may be qualified by a three-way interaction when predicting depression. The current study was the first to examine this three-way interaction in a psychiatric sample (N=463) with a range of internalizing symptoms as the outcomes. Using two omnibus personality inventories and a diagnostic interview, the expected three-way interaction emerged most consistently for symptoms of major depression, and there was also evidence of synergistic effects for post-traumatic stress disorder and generalized anxiety disorder. Findings indicate that, even in a clinically-distressed and currently-disordered sample, high levels of extraversion and conscientiousness protect against distress disorders for those with high levels of neuroticism.
Narrative coherence serves as an index of the unity in an individual's sense of self-integrating their past self with their present self and allowing them to pursue meaningful goals for their future. ...It has been assessed using the Life Story Interview. Personality functioning is used to describe an individual's ability to develop stable and integrated representations of the self and others as well as their ability to develop and maintain stable, intimate, and affiliative relationships and meaningfully empathize with others. We studied the links between narrative coherence (based on Life Story Interviews) and personality functioning (as indexed by clinician ratings using the Levels of Personality Functioning Scale) in a psychiatric sample (N = 134) and more generally studied the nomological net surrounding narrative coherence. Contrary to predictions, results revealed that narrative coherence does not serve as a marker of personality functioning. However, we found evidence of an association between narrative coherence and measures of extraversion and psychosocial functioning. This study represents an important step in integrating narrative identity with empirically derived structural models of personality pathology and psychopathology. Implications for future research are discussed.
The authors describe a new self-report instrument, the Inventory of Depression and Anxiety Symptoms (IDAS), which was designed to assess specific symptom dimensions of major depression and related ...anxiety disorders. They created the IDAS by conducting principal factor analyses in 3 large samples (college students, psychiatric patients, community adults); the authors also examined the robustness of its psychometric properties in 5 additional samples (high school students, college students, young adults, postpartum women, psychiatric patients) who were not involved in the scale development process. The IDAS contains 10 specific symptom scales: Suicidality, Lassitude, Insomnia, Appetite Loss, Appetite Gain, Ill Temper, Well-Being, Panic, Social Anxiety, and Traumatic Intrusions. It also includes 2 broader scales: General Depression (which contains items overlapping with several other IDAS scales) and Dysphoria (which does not). The scales (a) are internally consistent, (b) capture the target dimensions well, and (c) define a single underlying factor. They show strong short-term stability and display excellent convergent validity and good discriminant validity in relation to other self-report and interview-based measures of depression and anxiety.
This article introduces the rationale for developing a special issue on methodological and statistical advancements in clinical assessment, which will appear approximately 25 years after a similar ...1995 issue that produced many seminal and highly cited articles. We commissioned articles from a range of expert scholars in important areas of psychometrics (reliability, validity, scale construction, item response theory, and factor analysis) and assessment methodology in specific contexts (multicultural, clinical prediction, response bias, experience-sampling, and neuroscience) in addition to a lead article that considers clinical assessment research in the broader open science framework. We briefly summarize these contributions and their impact.
Public Significance Statement
This article summarizes the articles included in a special issue of the Journal focused on methodological and statistical advancements in clinical assessment. These articles present a range of topics related to the modern science and practice of psychological assessment.