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SCL 90-R interpretation and brain tumour: a correction factor?
1Division of Neurosurgery, Ohio State University College of Medicine, USA.
Objective:
Determine whether spurious SCL 90-R profiles resulting from endorsement of neurologic treatment items can be corrected and still retain ecological validity.
Design:
The proportion of subjects' item endorsement was compared with the adult non-patient norm group. Items with discriminative power (chi 2 > 25, p < 0.001 and endorsement by at least 25% of subjects) underwent principal-components analysis with somatic treatment and psychiatric factors identified. Items in the somatic treatment factor were extracted as the corrective factor. The resultant corrected T scores were plotted against original SCL 90-R profiles.
Setting:
University medical centre.
Patients:
Thirty community dwelling adults with biopsy confirmed malignant brain tumours referred by their treating physician for evaluation prior to aggressive treatment.
Interventions:
The SCL 90-R was part of a neuropsychological test battery.
Main Outcome Measure:
The SCL 90-R was selected prior to data collection because it is the second most frequently used psychosocial instrument in medical settings, yet has demonstrated attenuated validity with neurologic patients.
Results:
Extraction of 10 somatic treatment items resulted in lower profiles on Somatization, OBSESSIVE: Compulsive, Depression, and Anxiety dimensions and the global indicators. However, clinical caseness for individuals remained greater than indicated by clinical interview.
Conclusion:
Correction for SCL 90-R neurologic treatment items resulted in reduced sensitivity and poorer ecological validity.