Magnetic resonance (MR) imaging has been described as the most important medical innovation in the last 25 years. Over 80 million MR procedures are now performed each year and on average 2.3%(95% confidence interval: 2.0 to 2.5%) of all patients scheduled for MR imaging suffer from claustrophobia. Thus, prevention of MR imaging by claustrophobia is a common problem and approximately 2,000,000 MR procedures worldwide cannot be completed due to this situation. Patients with claustrophobic anxiety are more likely to be frightened and experience a feeling of confinement or being closed in during MR imaging. In these patients, conscious sedation and additional sequences (after sedation) may be necessary to complete the examinations. Further improvements in MR design appear to be essential to alleviate this situation and broaden the applicability of MR imaging. A more open scanner configuration might help reduce claustrophobic reactions while maintaining image quality and diagnostic accuracy. We propose to analyze the rate of claustrophobic reactions, clinical utility, image quality, patient acceptance, and cost-effectiveness of an open MR scanner in a randomized comparison with a recently designed short-bore but closed scanner with 97% noise reduction. The primary aim of this study is thus to determine whether an open MR scanner can reduce claustrophobic reactions, thereby enabling more examinations of claustrophobic patients without incurring the safety issues associated with conscious sedation. In this manuscript we detail the methods and design of the prospective "CLAUSTRO" trial. This randomized controlled trial will be the first direct comparison of open vertical and closed short-bore MR systems in regards to claustrophobia and image quality as well as diagnostic utility. ClinicalTrials.gov: NCT00715806.

Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments, treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological, experimental, and genetic data were collected and will be integrated.

In this investigation, the authors examined the effect of attributional processes concerning medication taking on return of fear following exposure-based treatment. Participants (87% undergraduate students and 13% community volunteers) displaying marked claustrophobic fear (N = 95) were randomly allocated to a waitlist condition, a psychological placebo condition, a 1-session exposure-based treatment, or the same exposure treatment given in conjunction with an inactive pill. Attributions concerning medication taking were manipulated by further randomly assigning participants in the exposure-based treatment plus pill condition to 1 of 3 instructional sets immediately following treatment completion and posttreatment assessment:(1) The pill was described as a sedating herb that likely made exposure treatment easier;(2) the pill was described as a stimulating herb that likely made exposure treatment more difficult; or (3) the pill was described as a placebo that had no effect on exposure treatment. Return of fear rates for the 3 conditions were 39%, 0%, and 0%, respectively. Moreover, the deleterious effects of the sedation instructions were mediated by reduced self-efficacy. These findings highlight the importance of assessing patient attributions regarding the improvements achieved with combined exposure-based and pharmacological treatments for anxiety disorders.

The present case series with two patients explored whether virtual reality (VR) distraction could reduce claustrophobia symptoms during a mock magnetic resonance imaging (MRI) brain scan. Two patients who met DSM-IV criteria for specific phobia, situational type (i.e., claustrophobia) reported high levels of anxiety during a mock 10-min MRI procedure with no VR, and asked to terminate the scan early. The patients were randomly assigned to receive either VR or music distraction for their second scan attempt. When immersed in an illusory three-dimensional (3D) virtual world named SnowWorld, patient 1 was able to complete a 10-min mock scan with low anxiety and reported an increase in self-efficacy afterwards. Patient 2 received "music only" distraction during her second scan but was still not able to complete a 10-min scan and asked to terminate her second scan early. These results suggest that immersive VR may prove effective at temporarily reducing claustrophobia symptoms during MRI scans and music may prove less effective.

Standing participants were passively restrained and exposed to oscillating visual motion. Thirty-nine percent of participants reported motion sickness. Despite passive restraint, participants exhibited displacements of the center of pressure, and prior to the onset of motion sickness the evolution of these displacements differed between participants who later became sick and those who did not. Claustrophobia occurred during restraint, but only among participants who became motion sick. The results are consistent with the postural instability theory of motion sickness. We discuss the possible relation between claustrophobia symptoms, postural movements and motion sickness incidence.

The Vancouver Obsessional-Compulsive Inventory (VOCI) and the Symmetry Ordering and Arranging Questionnaire (SOAQ) are self-report measures that assess a wide variety of symptoms and features of obsessive-compulsive disorder (OCD) including checking, contamination, obsessions, hoarding,"just right", indecisiveness, and symmetry, ordering and arranging obsessions and compulsions. The original English versions of the VOCI and SOAQ have been shown to demonstrate excellent psychometric properties. The present study examined the reliability and validity of French translations of these measures in a non-clinical sample, and also involved the collection of supplementary psychometric information about the English versions of the scales from a new sample. Volunteer undergraduate students completed questionnaire packages including the VOCI and SOAQ, as well as measures of obsessive-compulsive, phobic and depressive symptomatology in their native language of either French or English. Results indicate that the French versions of the VOCI and SOAQ demonstrate similar and excellent psychometric properties to the English versions and that these measures are highly valid and reliable assessment tools for use in clinical and research applications in both languages.

We exposed standing participants to optic flow in a moving room. Motion sickness was induced by motion that simulated the amplitude and frequency of standing sway. We identified instabilities in displacements of the center of pressure among participants who became sick; these instabilities occurred before the onset of subjective motion sickness symptoms. Postural differences between Sick and Well participants were observed before exposure to the nauseogenic stimulus. During exposure to the nauseogenic stimulus, sway increased for participants who became sick but also for those who did not. However, at every point during exposure sway was greater for participants who became motion sick. The results reveal that motion sickness is preceded by instabilities in displacements of the center of pressure.

Data from two large undergraduate samples were used to develop the phobic stimuli response scales (PSRS). Factor analyses of data from the first sample (N = 380) led to the creation of several scales, two of which (Social and Blood-Injection Fears) demonstrated good reliability and convergent validity. Analyses of data from a second sample (N = 330) were used to modify the three remaining scales (Animal, Bodily Harm, and Physical Confinement Fears), which also showed sound psychometric properties. As predicted, the PSRS were differentially correlated with neuroticism and extraversion, which may represent predisposing factors for these phobic responses. These new scales improve our understanding of the individual differences that are associated with various fears.

The primary aim of the current study was to further investigate the deleterious effects of safety-seeking behaviors on fear reduction by disentangling the effects of perceived availability of threat-relevant safety behaviors during treatment versus their actual use. Participants (N=72) displaying marked claustrophobic fear were randomly assigned to 1 of 5 conditions:(a) exposure only (EO),(b) exposure with phobic safety-behavior availability (SBA),(c) exposure with safety-behavior utilization (SBU),(d) credible placebo treatment (PL), or (e) wait list (WL). High end-state functioning rates at posttreatment were as follows: EO = 94%, SBA = 45%, SBU = 44%, PL = 25%, and WL = 0%. Findings suggest that it is the perception of the availability of safety aids as opposed to their actual use that exerts a disruptive effect on fear reduction. Clinical implications are discussed.

Compulsive ordering and arranging, and a preoccupation with symmetry are features of obsessive-compulsive disorder (OCD) that have not been examined experimentally. Three connected studies were conducted to examine this phenomenon: a self-report measure of this behaviour was developed and validated, participants were asked to engage in tasks designed to assess preferences for order, and to assess the interference of disorderly surroundings in the completion of a stressful activity. The self-report measure has sound psychometric properties and validity. Participants with a strong preference for order were made more anxious by having to complete a difficult task in a disorganized environment. Participants without this preference did not show this effect. The results are discussed in terms of the phenomenology of compulsive ordering and arranging, and its relationships with both OCD and normal human behaviour. It is suggested that compulsive ordering and a drive for symmetry are extreme manifestations of the common preference for order and symmetry.

Episodes of panic are self-limiting--they all come to an end. However, it has not been explained how and why they end. Neither the cognitive nor the biological theory of panic deals with this phenomenon. As a first step toward an understanding of what stops a panic, we collected evidence about the self-limiting nature of these episodes. A semistructured interview was developed and conducted with 25 participants who had received a diagnosis of panic disorder. Participants reported a variety of triggers of panic, signs that a panic was ending, and strategies used to terminate panic episodes. A substantial proportion of participants indicated that there was a refractory period following panic episodes. The theoretical and therapeutic significance of this self-limiting feature of panic episodes is considered, as is the probable occurrence of a postpanic refractory period.

We examined fear induced by the magnetic resonance imaging (MRI) procedure in 80 adult patients who were undergoing the procedure for the first time. Participants completed self-report measures of claustrophobia, anxiety sensitivity, thoughts about the scan, and pain. Participants were assessed pre- and postscan, and at 1-month follow-up. Twenty-five percent of the participants experienced moderate to severe anxiety during the MRI scan. Prescan scores on the Claustrophobia Questionnaire (CLQ: Rachman and Taylor, 1993) significantly predicted participants' distress during the scan: pain and anxeity sensitivity did not. Furthermore, CLQ scores discriminated between participants who reported panic during the scan and participants who did not report panic. A brief screening instrument consisting of six items from the 29-item CLQ is suggested. This brief screening instrument administered prior to the scan may help identify in advance those people who are most likely to experience claustrophobic fear and, in particular, those who panic during the MRI procedure.

Compulsive ordering and arranging, and a preoccupation with symmetry are features of obsessive-compulsive disorder (OCD) that have not been examined experimentally. Three connected studies were conducted to examine this phenomenon: a self-report measure of this behaviour was developed and validated, participants were asked to engage in tasks designed to assess preferences for order, and to assess the interference of disorderly surroundings in the completion of a stressful activity. The self-report measure has sound psychometric properties and validity. Participants with a strong preference for order were made more anxious by having to complete a difficult task in a disorganized environment. Participants without this preference did not show this effect. The results are discussed in terms of the phenomenology of compulsive ordering and arranging, and its relationships with both OCD and normal human behaviour. It is suggested that compulsive ordering and a drive for symmetry are extreme manifestations of the common preference for order and symmetry.

Recent research suggests that there is a positive memory bias for threatening information in compulsive cleaners. However, the relationship between OCD and memory is likely to be more complex when the compulsive behaviour is checking. Hence, we decided to explore this relationship in a clinical sample of people who check compulsively. Participants completed a diagnostic interview and were then asked to complete a standard 'baseline' check which normally causes distress/discomfort. Two additional checks were then completed--one under conditions of high responsibility and one under low responsibility. The order of responsibility manipulation was randomized across participants. After each check, participants completed a Memory and Confidence Interview which assessed memory for threat-relevant and threat-irrelevant aspects of the check, and also confidence in memory for the check. One week later, participants came into the laboratory to complete additional Memory and Confidence Interviews after watching a videotape of the checks completed earlier in their own homes. These videotaped checks were taken as conditions of 'no responsibility'. Results show a positive memory bias for threat-relevant information. As responsibility was inflated, this positive memory bias was amplified. Under conditions of no responsibility, no memory bias was detectable. Also, responsibility appears to have had a greater impact on confidence in memory than on memory itself in OCD. The results are discussed in terms of the mnestic deficit theory of OCD and in terms of cognitive-behavioural approaches to understanding the disorder.

There is a memory bias associated with depression, and good reason to expect a memory bias associated with anxiety. However, the results of studies reported to date have been ambiguous. Accordingly, an experiment was conducted to assess memory for contamination in people with different types of anxiety. Memory for contaminated stimuli among participants who met DSM-IV criteria for obsessive-compulsive disorder (OCD) and indicated a fear of contamination (n = 10) was compared to memory in a group of anxious controls (n = 10), and in undergraduate students (n = 20). Participants were shown 50 objects, 25 of which were contaminated by the experimenter and 25 which were touched but not contaminated. They then completed a neuropsychological memory assessment, after which the participants were asked to recall all of the objects touched by the experimenter. They were then asked to approach each object and to rate their anxiety about touching it. Finally, participants were asked about their perceptions of the cleanliness of each object. The OCD group had better memory for contaminated objects than for clean ones. Neither control group showed such a bias. Neuropsychological test scores indicated that this bias is not the result of differences in general memory ability. The results are discussed in terms of the memory-deficit theory of OCD and of behavioural and cognitive approaches to understanding the role of information processing in fear and anxiety.

OBJECTIVES: The primary objective of this study was to describe and investigate a cognitive distortion associated with eating psychopathology. This distortion, termed 'thought-shape fusion', is said to occur when merely thinking about eating a forbidden food increases the person's estimate of their shape or weight, elicits a perception of moral wrongdoing and makes the person feel fat. DESIGN: Two studies were conducted. The first was a psychometric study and the second utilized a within-participants experimental design. METHODS: In Study 1, thought-shape fusion was assessed in a sample of 119 undergraduate students using a questionnaire. In Study 2, 30 students with high thought-shape fusion scores participated in an experiment designed to elicit the distortion. RESULTS: Thought-shape fusion was found to be significantly associated with measures of eating disorder psychopathology. The questionnaire used to measure thought-shape fusion had high internal consistency, a good factor structure accounting for 46.2% of the variance and predictive validity. The results from Study 2 indicated that the distortion can be elicited under experimental conditions, produces negative emotional reactions and prompts the urge to engage in corrective behaviour (e.g. neutralizing/checking). This corrective behaviour promptly reduces the negative reactions. CONCLUSION: The results of the two studies indicate that the concept of thought-shape fusion is coherent, unifactorial and measurable. It is associated with eating disturbance and elicits negative emotional and behavioural responses.

Given the postulated significance of inflated responsibility in obsessive compulsive disorder (OCD), there is a need for clarification of the concept itself and a means for measuring such responsibility. Two psychometric studies were conducted in order to develop a reliable self-report scale. In the first study 291 students completed the specially constructed Responsibility Appraisal Questionnaire (RAQ). Four factors emerged: responsibility for harm, responsibility in social contexts, a positive outlook towards responsibility, and thought-action fusion (TAF). In the second study, 234 students completed a revised RAQ. Four comparable factors emerged, and the TAF subscale correlated significantly with measures of obsessionality, guilt, and depression. The correlations between TAF and obsessionality and guilt remained significant even after BDI scores were controlled. It is concluded that the broad concept of inflated responsibility needs to be qualified; the connection between inflated responsibility and OCD appears to be situation-specific and idiosyncratic. There is more inflated responsibility than there is OCD. The measured concept of inflated responsibility is multifactorial (harm, social, positive, and TAF), not unitary. The TAF factor appears to be particularly significant in OCD.

The features of severe health anxiety, intense and persistent anxiety about one's present and future health, are described. In common with other anxiety disorders such as GAD, PTSD and OCD, the core of HAD is distressing, uncontrollable anxiety, and is classifiable as an Anxiety Disorder, Health Anxiety Disorder (HAD). The cognitive construal of HAD proposes that health anxiety is caused by catastrophic misinterpretations of the significance of sensations and/or changes in bodily functions and appearance (such as swellings, pain, loss of energy, dizzy spells). The nature, causes, triggers, persistence, assessment and treatment of HAD are reviewed, and the present status of the cognitive model is appraised. Suggestions are made for future research and clinical applications, and the need for incisive evaluations of the main premises of the model is emphasized.

In order to test the proposition that imagining carrying out an unacceptable non-consensual act can evoke contamination-related feelings in the perpetrator, 4 connected experiments were carried out involving male students. The effects of the experimental procedure were enhanced by the introduction of a theme of betrayal which boosted the feelings of contamination and urges to wash. The non-consensual scenarios were followed by substantial increases in negative emotions, notably shame, disgust and guilt, and these increases were boosted over successive enhancements of the procedure. Overall the results show that perpetrators of (imagined) unacceptable acts report a range of negative emotions and feelings of dirtiness. The main conclusion of this research is that imagining an unacceptable, non-consensual act can produce feelings of contamination. It is an experimental illustration of mental contamination, that is, contamination which is evoked by a mental event without any contact with a tangible contaminant.

BACKGROUND AND OBJECTIVES It has been proposed that the judicious use of safety behaviour can facilitate improvements in the acceptability of cognitive behaviour therapy (CBT). It was decided to explore the possibility of facilitating CBT by introducing a form of safety behaviour. We sought to assess the degree to which Exposure plus Safety Behaviour (E + SB) is an effective intervention for contamination fears. METHODS A comparison was made between the effects of a control condition (Exposure and Response Prevention; ERP) and an experimental condition (Exposure plus Safety Behaviour; E + SB) in which each exposure to a contaminant was followed by the use of a hygienic wipe in a sample of (n = 80) undergraduate students. In session one, each participant touched a confirmed contaminant 20 times. After each exposure participants were asked to report their feelings of contamination, fear, disgust, and danger. In the second session, two weeks later, the same procedure was carried out for a further 16 trials. RESULTS The ERP and the E + SB conditions both produced large, significant and stable reductions in contamination. Significant reductions in fear, danger and disgust were also reported in both conditions. LIMITATIONS The treatment was provided to an analogue sample and over two sessions. CONCLUSIONS The use of hygienic wipes, the safety behaviour used in this experiment, did not preclude significant reductions in contamination, disgust, fear and danger. If it is replicated and extended over a longer time-frame, this finding may enable practitioners to enhance the acceptability of cognitive behavioural treatments and boost their effectiveness.

AIM To examine the psychometric properties of a novel anxiety rating scale, the Geriatric Anxiety Inventory (GAI) in Parkinson's disease (PD). METHOD The predictive validity of the GAI was tested against the presence of any DSM-IV anxiety disorders in 58 PD patients using receiver operating curve analysis. The concurrent validity of this scale was also studied against the state half of the Spielberger State Trait Anxiety Inventory (STAI). The internal consistency and test-retest reliability of the GAI were also examined. RESULTS The GAI displayed good concurrent validity against the STAI and the DSM-IV. It also showed good internal consistency and test-retest reliability. CONCLUSIONS This study suggested that the GAI is an appropriate scale to use in non-demented PD patients.

OBJECTIVES To produce a robust measure of social inclusion [Social and Community Opportunities Profile (SCOPE)] that is multidimensional and captures multiple life domains; incorporates objective and subjective indicators of inclusion; has sound psychometric properties including responsiveness; facilitates benchmark comparisons with normative general population and mental health samples [including common mental disorder (CMD) and severe mental illness groups]; can be used with people with mental health problems receiving support from mental health services or not; and can be used across a range of community service settings. DESIGN Phase I: conceptual framework developed from a review of the literature and concept mapping. Phase II: questionnaire developed including UK national population surveys and other normative data. Pre-testing using cognitive appraisal and evaluation then pilot testing in a small convenience sample. Preliminary testing (following modification) in community (n = 252) and mental health service users (MHSUs) samples (n = 43). Data reduction including factor analysis and Mokken scaling for polytomous item response analysis then psychometric evaluation, including internal consistency and discriminant and construct validity. Test-retest reliability assessed in a convenience sample of students (n = 119). Final testing in clinical services including psychometric evaluation and responsiveness testing. SETTING The community sample was set in participants' households across the UK. The MHSU sample was set in a south Wales resource centre. The student sample was set in a university. PARTICIPANTS The community sample was randomly selected from the postal address file in five areas in England and Wales. Forty people in this sample were subgrouped as having a CMD based on their responses to the Mental Health Index five items. Two MHSU samples were obtained from existing services. RESULTS Psychometric testing on the field data from the SCOPE long version demonstrated good internal consistency of all scales (alpha ≥ 0.7), good construct validity, with SCOPE scales correlating highly with each other sharing between 40% and 61% of variance and a close but lesser association with community participation and social capital. Chi-squared tests on objective items and analysis of variance between groups on SCOPE scales demonstrated good discriminant validity between different mental health groups (and better than the Mokken scaling results). Acceptability was good, with 77% of the service user sample finding the SCOPE domains relevant. The number of items in SCOPE decreased from 121 to 48 following data reduction. Scales in the short version of SCOPE retained reasonable internal consistency (alpha between 0.60 and 0.75). Test-retest reliability demonstrated reliability over time, with strong associations between all items over a 2-week period. Repeating the discriminant validity tests on the short version demonstrates good discriminant validity between the mental health groups. Acceptability improved, with 90% of the sample describing questions as relevant to them. CONCLUSIONS The main aim of producing an instrument with good psychometric properties for use in research and clinical settings, namely the SCOPE short version, was achieved. Ongoing data collection will enable responsiveness testing in the future. Further research is needed including larger samples of minority and disadvantaged groups, including those with physical illnesses and disabilities, and specific mental health diagnostic groups. FUNDING The National Institute for Health Research Health Technology Assessment programme.

The authors describe the development and psychometric properties of a new measure called the Skills of Cognitive Therapy (SoCT) in depressed adults and their cognitive therapists. The 8-item SoCT assesses patients' understanding and use of basic cognitive therapy (CT) skills rated from the perspectives of both observers (SoCT-O; therapists in this report) and patients (SoCT-P). Ratings of patients' skill usage are made on 5-point Likert-type scales ranging from 1 (never) to 5 (always or when needed). Higher scores reflect greater patient skill in applying cognitive therapy principles and coping strategies. To develop this scale, a 33-item pool was used, rated by both patients and their therapists at the middle and end of CT (Ns = 359-416), and evaluated the reliability and concurrent and predictive validity of both versions of the scale. The SoCT has excellent internal consistency reliability and moderate correlations between the observer and patient versions. It is important to note that the SoCT showed good predictive validity for response when collected at the midpoint of acute phase CT. Considering both patients' self-ratings and clinicians' SoCT ratings, the odds ratio for responding to CT was 2.6. The practical utility of the SoCT is discussed, as well as its theoretical importance in research of patient CT skills (e.g., acquisition, comprehension, and generalization) as putative moderators or mechanisms of symptom change in the therapy.(PsycINFO Database Record (c) 2011 APA, all rights reserved).

There is a lack of normative data on broadband omnibus types of personality tests with medical populations. In fact, the only two tests normed on medical populations are the Millon Behavioral Medicine Diagnostic (MBMD) and the Millon Behavioral Health Inventory (MBHI). The internal consistency, test-retest reliabilities, and validity studies of these instruments are reviewed and compared in an effort to aid clinicians in discerning their relative psychometric strengths and weaknesses. Due to the lack of validity studies with the MBMD and the fact that reliability limits the ceiling of validity coefficients, the MBMD has yet to meet the challenges it was designed to meet. Implications for practice are addressed.

Fear of suffocation and fear of restriction are thought to underlie claustrophobia and can be assessed with the Claustrophobia Questionnaire (CLQ; Radomsky et al., 2001). A first study tested the psychometric properties of a Dutch version of the CLQ. Students (N=363) completed a Dutch translation of the CLQ and a set of other questionnaires assessing other specific fears, anxiety or depression. Results confirmed the two-factor structure and showed that the Dutch version of the CLQ has good psychometric properties. A second study tested the predictive validity of the Dutch CLQ. Participants (N=23) were exposed each to nine claustrophobic situations with elements of suffocation, restriction or both. The Dutch CLQ was found to be a significant predictor of fear and respiratory reactivity during claustrophobic exposure. It can be concluded that the Dutch version of the CLQ is a reliable and valid instrument to assess claustrophobic fear.

This study investigated reliability and factor validity of a Farsi version of the Positive and Negative Perfectionism Scale in 606 undergraduate students (257 men, 349 women) from the University of Tehran. All participants were asked to complete the scale, along with the General Health Questionnaire (Goldberg, 1972) and the Coopersmith Self-Esteem Inventory (Coopersmith, 1967). Findings indicated good internal consistency, test-retest reliability, and construct validity of the two-factor structure of the Farsi version of the Positive and Negative Perfectionism Scale. These factors were similar to the factors found in previous studies and were accordingly labeled Positive Perfectionism and Negative Perfectionism. The results provide evidence for applicability of the scale and its cross-cultural validity.

This study examines reliability and validity and establish Danish norms for the Danish version of the Beck Youth Inventories (BYI)(Beck, Beck & Jolly, 2001), which consists of five self-report scales; Self-Concept (BSCI), Anxiety (BAI), Depression (BDI), Anger (BANI) and Disruptive Behavior (BDBI). A total of 1,116 school children and 128 clinical children, aged 7-14, completed BYI. Internal consistency coefficients were high. Most test-retest correlations were >0.70. A test-retest difference was found for BAI. Exploratory and confirmatory factor analysis indicated that the five factor structure of the instrument was justified. The BSCI, BAI and BDI discriminated moderately between the norming sample and the clinical group, and the latter group included more children who exceeded the 90th percentile of the norming sample. Diagnostic groups scored higher on relevant scales than norms. Only BSCI and BDI differentiated between diagnostic groups. The BYI showed acceptable internal consistency and test-retest stability, except for BAI. The BYI did not adequately differentiate between internalizing disorders.

BACKGROUND The Strengths and Difficulties Questionnaire (SDQ) has become one of the most widely used measurement tools in child and adolescent mental health work across the globe. The SDQ was originally developed and validated within the UK and whilst its reliability and validity have been replicated in several countries important cross cultural issues have been raised. We describe normative data, reliability and validity of the Chinese translation of the SDQ (parent, teacher and self report versions) in a large group of children from Shanghai. METHODS The SDQ was administered to the parents and teachers of students from 12 of Shanghai's 19 districts, aged between 3 and 17 years old, and to those young people aged between 11 and 17 years. Retest data was collected from parents and teachers for 45 students six weeks later. Data was analysed to describe normative scores, bandings and cut-offs for normal, borderline and abnormal scores. Reliability was assessed from analyses of internal consistency, inter-rater agreement, and temporal stability. Structural validity, convergent and discriminant validity were assessed. RESULTS Full parent and teacher data was available for 1965 subjects and self report data for 690 subjects. Normative data for this Chinese urban population with bandings and cut-offs for borderline and abnormal scores are described. Principle components analysis indicates partial agreement with the original five factored subscale structure however this appears to hold more strongly for the Prosocial Behaviour, Hyperactivity - Inattention and Emotional Symptoms subscales than for Conduct Problems and Peer Problems. Internal consistency as measured by Cronbach's alpha coefficient were generally low ranging between 0.30 and 0.83 with only parent and teacher Hyperactivity - Inattention and teacher Prosocial Behaviour subscales having alpha > 0.7. Inter-rater correlations were similar to those reported previously (range 0.23 - 0.49) whilst test retest reliability was generally lower than would be expected (range 0.40 - 0.79). Convergent and discriminant validity are supported. CONCLUSION We report mixed findings with respect the psychometric properties of the Chinese translation of the SDQ. Reliability is a particular concern particularly for Peer Problems and self ratings by adolescents. There is good support for convergent validity but only partial support for structural validity. It may be possible to resolve some of these issues by carefully examining the wording and meaning of some of the current questions.

The Symptom Assessment-45 Questionnaire (SA-45) is a 45-item self-report instrument of psychiatric symptomatology derived from the original SCL-90. The SA-45 consists of nine 5-item scales assessing each of the same symptom domains as its parent instrument with no item overlap across domains. This paper provides preliminary validation of the Spanish version of the questionnaire in an undergraduate sample. Exploratory and confirmatory factor analyses supported a 9-factor structure, which corresponds to the nine proposed scales. Normative data, reliability (internal consistency) and validity were also examined, finding support for sound psychometric properties.

The Comprehensive Assessment of Prospective Memory (CAPM) is a questionnaire designed to evaluate frequency of prospective memory (PM) failures in people with brain injury. The aims of this study were to investigate the psychometric properties of the CAPM, including test-retest reliability and internal consistency, and to establish normative data by comparing CAPM scores between groups on the basis of sex, age, and education. Data were collected on 95 people aged 15-60 years living in the community, with no history of brain injury, using the CAPM. The results showed that the test-retest reliability and internal consistency for the CAPM were within acceptable ranges, indicating that the CAPM provides a stable and homogenous measure of an individual's self-report of PM failures. Normative data are presented in two age groups based on the significant difference found between the age groups 15-30 years and 31-60 years. These established norms can be used to describe perceived or observed behaviours indicative of PM failure in patients with brain injury by comparing CAPM ratings from significant others with the norms. The CAPM questionnaire provides researchers or clinicians with a stable and reliable assessment option that specifically focuses on PM for individuals with brain injury.