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Some methodological issues in using aggression rating scales in intervention studies among institutionalized elderly.

A Shah1

  • 1Imperial College School of Medicine, London, England, UK. a.k.shah@ic.ac.uk

International Psychogeriatrics
|January 13, 2000
PubMed
Summary

Aggressive behavior in elderly psychiatric patients naturally decreases over time. Studies using the Staff Observation Aggression Scale (SOAS) should include a 4-week run-in period to account for this spontaneous decline.

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Area of Science:

  • Geriatric Psychiatry
  • Behavioral Science
  • Clinical Psychology

Background:

  • Aggressive behavior is a concern in geriatric psychiatry settings.
  • Spontaneous decline in aggression is observed over time with repeated assessments.

Purpose of the Study:

  • To examine the spontaneous decline of aggressive behavior in geriatric psychiatry inpatients over a 6-week period.
  • To compare the utility of the Staff Observation Aggression Scale (SOAS) and the Rating Scale for Aggressive Behavior in the Elderly (RAGE) in detecting this decline.

Main Methods:

  • A 6-week observational study was conducted on a continuing-care geriatric psychiatry ward.
  • The Staff Observation Aggression Scale (SOAS) and the Rating Scale for Aggressive Behavior in the Elderly (RAGE) were used for serial measurements.

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Main Results:

  • The RAGE scale and its subitems showed no significant spontaneous decline.
  • The SOAS total score, total aggressive incidents, and most subitems declined spontaneously after Week 4, stabilizing by Week 5.
  • The SOAS results subitem did not show a significant decline.

Conclusions:

  • A minimum 4-week "run-in" period is recommended for intervention studies utilizing the SOAS.
  • This "run-in" period helps mitigate the confounding effect of spontaneous decline in aggressive behavior.
  • Findings highlight the importance of considering natural behavioral changes in study design.