The premorbid adjustment scale structured interview (PAS-SI): preliminary findings.

Area of Science:

• Psychiatry
• Psychometrics
• Clinical Assessment

Background:

• The Premorbid Adjustment Scale (PAS) is a key tool for retrospective assessment of premorbid functioning.
• Existing PAS use lacks a standardized structured interview (SI) schedule, raising questions about its reliability.
• Limited data exists on the reliability of the PAS instrument.

Purpose of the Study:

• To develop and validate a structured interview schedule for the PAS, termed the PAS-SI.
• To evaluate the cross-cultural reliability of the newly developed PAS-SI.
• To enhance the standardization and reliability of premorbid functioning assessment.

Main Methods:

• Developed the PAS-SI by adapting PAS items and response options into a structured question format.
• Incorporated skip instructions and guidelines for determining the onset of psychotic symptoms to focus on premorbid functioning.
• Translated the PAS-SI into 12 languages and assessed inter-rater reliability with 84 psychiatrists across 10 countries using role-play training and native language ratings.

Main Results:

• The weighted intra-class correlation coefficient for absolute agreement and consistency was calculated.
• A reliability score of .77 was achieved, indicating good agreement and consistency.
• The study successfully tested the PAS-SI across multiple languages and cultural contexts.

Conclusions:

• The PAS-SI is a reliable and consistent instrument for assessing premorbid functioning.
• The structured interview format enhances the usability and dependability of the PAS.
• The cross-cultural validation supports the global applicability of the PAS-SI.