Reply to "Further issues in determining the readability of self-report items: comment on McHugh and Behar (2009)"

In his commentary on our previously published article "Readability of Self-Report Measures of Depression and Anxiety," J. Schinka (2012) argued for the importance of considering readability of patient materials and highlighted limitations of existing methodologies for this assessment. Schinka's commentary articulately described the weaknesses of readability assessment and emphasized the importance of the development of improved strategies for assessing readability to maximize the validity of self-report measures in applied settings. In our reply, we support and extend Schinka's argument, highlighting the importance of consideration of the range of factors (e.g., use of reverse-scored items) that may increase respondent difficulty with comprehension. Consideration of the readability of self-report symptom measures is critical to the validity of these measures in both clinical practice and research settings.