Podcast Beta
Questions and Answers
What is the primary purpose of the DSM-5 Level 1 Cross-Cutting Symptom Measure?
How many psychiatric domains are assessed in the adult version of the DSM-5 Level 1 Cross-Cutting Symptom Measure?
Who may complete the Level 1 Cross-Cutting Symptom Measure if the individual is unable to do so?
Which of the following is NOT one of the psychiatric domains included in the Level 1 measure?
Signup and view all the answers
What type of rating does the DSM-5 Level 1 Cross-Cutting Symptom Measure use?
Signup and view all the answers
How long is the time frame for assessing symptoms in the Level 1 measure?
Signup and view all the answers
What was a primary finding regarding the implementation of the measure in clinical settings?
Signup and view all the answers
Which population was specifically mentioned as part of the studies evaluating the adult self-rated version of the measure?
Signup and view all the answers
How many questions are included in the parent/guardian-rated version of the measure for children?
Signup and view all the answers
What is one psychiatric domain assessed by the parent/guardian-rated version of the measure?
Signup and view all the answers
What aspect of communication did individuals find the measure facilitated during clinical encounters?
Signup and view all the answers
In terms of psychometric evaluation, which property was confirmed in studies involving the adult self-rated version?
Signup and view all the answers
Which psychiatric symptoms are included in the measure's assessment?
Signup and view all the answers
What is the main time frame used for assessing symptoms in children?
Signup and view all the answers
What additional version of the measure may be considered for children aged 11-17?
Signup and view all the answers
In what context was the measure found to be clinically useful?
Signup and view all the answers
Where can the child-rated version of the measure be found online?
Signup and view all the answers
How is a rating of 'mild' defined on the adult self-rated version of the measure?
Signup and view all the answers
In what situation should a clinician particularly review the score on an item within a domain?
Signup and view all the answers
Which of the following items indicates a severity of symptoms based on the recommended scale?
Signup and view all the answers
Which type of symptom assessment is suggested to be reviewed when a score of mild or greater is noted in certain domains?
Signup and view all the answers
Which specific symptoms should not be included when a clinician reviews scores of mild or greater in the domains?
Signup and view all the answers
What score indicates the need for further inquiry in the substance use domain?
Signup and view all the answers
How are items pertaining to suicide attempts and substance abuse rated?
Signup and view all the answers
Which statement is true regarding the threshold score for inattention?
Signup and view all the answers
What is the scoring scale for most items on the mental health measure?
Signup and view all the answers
Which item scores on the 'Don't Know' scale require further inquiry?
Signup and view all the answers
What does the Level 2 cross-cutting symptom assessment provide?
Signup and view all the answers
Which domains are assessed in the Level 2 cross-cutting symptom assessment?
Signup and view all the answers
What should clinicians focus on when scores are mild or greater in specific domains?
Signup and view all the answers
What is the purpose of indicating the highest score in the 'Highest Domain Score' column?
Signup and view all the answers
Which characteristic differentiates the child-rated version from the parent/guardian-rated version?
Signup and view all the answers
What additional action may be required when a substance use item indicates a high score?
Signup and view all the answers
What does Table 2 provide guidance on?
Signup and view all the answers
In which age group are substance use items particularly relevant according to the guidelines?
Signup and view all the answers
What is the primary function of the Level 2 Cross-Cutting Symptom Measures?
Signup and view all the answers
How should Level 1 and Level 2 measures be used to track changes in symptom presentation over time?
Signup and view all the answers
What should high scores on a Level 1 domain indicate to a clinician?
Signup and view all the answers
For which group is it preferred for the Level 2 measures to be completed by the same informant at follow-ups?
Signup and view all the answers
What is indicated by a clinician's review of the 'Highest Domain Score' column?
Signup and view all the answers
What characteristic differentiates the child-rated version from the parent/guardian-rated version?
Signup and view all the answers
What is the main purpose of the Clinician-Rated Dimensions of Psychosis Symptom Severity measure?
Signup and view all the answers
Which symptom domains are included in the Clinician-Rated Dimensions of Psychosis Symptom Severity measure?
Signup and view all the answers
How many items are included in the Clinician-Rated Dimensions of Psychosis Symptom Severity?
Signup and view all the answers
What aspect of psychotic disorders does the severity of mood symptoms indicate?
Signup and view all the answers
During what timeframe should symptom severity be rated by the clinician?
Signup and view all the answers
What kind of cognitive issues are frequently observed in individuals with psychotic disorders?
Signup and view all the answers
What does a score of 3 indicate on the rating scale?
Signup and view all the answers
When should the measure be completed to track changes in symptom severity?
Signup and view all the answers
What might consistently high scores in a symptom domain indicate?
Signup and view all the answers
Which statement is true regarding the clinician's role in scoring?
Signup and view all the answers
What is the lowest score on the 5-point scale?
Signup and view all the answers
What does the clinician indicate for each item in the 'Score' column?
Signup and view all the answers
Study Notes
DSM-5 Level 1 Cross-Cutting Symptom Measure
- A self- or informant-rated measure assessing domains important across psychiatric diagnoses
- Helps clinicians identify additional areas of inquiry impacting treatment and prognosis
- Tracks changes in symptom presentation over time
Domains Assessed
- 13 psychiatric domains, including:
- Depression
- Anger
- Mania
- Anxiety
- Somatic Symptoms
- Suicidal Ideation
- Psychosis
- Sleep Problems
- Memory
- Repetitive Thoughts and Behaviors
- Dissociation
- Personality Functioning
- Substance Use
Measure Composition
- 23 questions in the adult version
- Each domain consists of 1-3 questions
- Items inquire about the level of bother or frequency of symptoms during the past 2 weeks
Administration
- Can be completed by the individual or a knowledgeable adult informant if the individual has impaired capacity (e.g., major neurocognitive disorder)
Measure's Reliability and Usefulness
- The measure was found to be clinically useful and reliable in the DSM-5 Field Trials conducted in adult clinical samples across the United States and Canada.
- Individuals' symptom ratings were shared with the clinician before meeting, facilitating communication during the clinical encounter.
- Clinicians in both major academic-medical research institutions and routine clinical practice settings found the measure clinically useful and feasible for integration into everyday clinical care and specialty clinical settings.
- Multiple studies have evaluated the psychometric properties of the adult self-rated version of the cross-cutting symptom measure in various populations.
- A large study of non-treatment-seeking college students across the United States demonstrated acceptable internal consistency and internal validity.
Parent/Guardian-Rated Version
- The parent/guardian-rated version of the measure is designed for children ages 6-17 and consists of 25 questions.
- The questions assess 12 psychiatric domains, including:
- Depression
- Anger
- Irritability
- Mania
- Anxiety
- Somatic symptoms
- Inattention
- Suicidal ideation/attempt
Psychiatric Symptom Measure
- Assessments include psychosis, sleep disturbance, repetitive thoughts and behaviors, and substance use.
- Ratings are based on the frequency or severity of symptoms over the past 2 weeks.
- The measure has been found to be clinically useful and reliable in pediatric clinical samples across the United States.
Administration
- Parent/guardian ratings are required for children of all ages.
- For children ages 11-17, clinicians may consider obtaining self-ratings from the child using the child-rated version of the measure.
- The child-rated version of the measure is available online at www.psychiatry.org/dsm5.
Scoring of Self-Rated Measures
- Each item is rated on a 5-point scale: 0 (none or not at all), 1 (slight or rare, less than a day or two), 2 (mild or several days), 3 (moderate or more than half the days), and 4 (severe or nearly every day)
- Clinicians should review scores on each item within a multi-item domain to identify the most problematic symptom
- A rating of mild (2) or greater on any item within a domain (except substance use, suicidal ideation, and psychosis) indicates the need for further assessment
Scoring Guidelines for Child Mental Health
Overview
- The guidelines describe how to use scores from a parent/guardian-rated mental health measure to determine if a more detailed assessment is necessary.
- The measure includes 25 items rated on a 5-point scale, with the exception of three items that are rated on a "Yes, No, or Don't Know" scale.
Scoring and Interpretation
- Most items are rated on a 5-point scale, ranging from 0 (none or not at all) to 4 (severe or nearly every day).
- Scores on the substance use, suicidal ideation, and psychosis domains are used to determine the need for further inquiry.
- A rating of 1 (slight or rare) or greater on any item within these domains may indicate a need for further assessment.
- For inattention and psychosis, scores are interpreted differently, with a rating of 1 (slight or rare) or greater used as an indicator for further inquiry.
- Suicide Attempt and Substance Abuse items are scored on a "Yes, No, or Don't Know" scale, with a rating of "Don't Know" indicating a need for further inquiry.
Threshold Scores
- Threshold scores for further inquiry are outlined in a table, indicating scores of 1+ for substance use, suicidal ideation, psychosis, and inattention, and "Don't Know" for suicide attempt and substance abuse.
Additional Assessment
- Depending on the score, a Level 2 cross-cutting symptom assessment may be needed, providing a more detailed evaluation of possible mental health concerns.
- Level 2 assessment includes domains such as substance use, suicidal ideation, psychosis, inattention, suicide attempt, and substance abuse.
Substance Use Items for Children
- Use of substance use items for children aged 11-17 years may lead to further probing of issues with the child
- This includes using the child-rated Level 2 Cross-Cutting Symptom Measure for the relevant domain
Clinician Guidance
- Clinicians should indicate the highest score on any item within a domain in the "Highest Domain Score" column
- Table 2 provides threshold scores that guide further inquiry for remaining domains
Child-Rated Version Guidelines
- Clinician instructions and guidelines for the child-rated version are similar to those of the parent/guardian-rated version
- Exception: "Don't Know" response categories are not present in the child-rated version
- Refer to www.psychiatry.org/dsm5 for more information
Level 2 Cross-Cutting Symptom Measures
- Threshold scores on Level 1 measures indicate a possible need for detailed clinical inquiry
- Level 2 measures provide in-depth information on potentially significant symptoms to inform diagnosis, treatment planning, and follow-up
- Level 2 measures are available online at www.psychiatry.org/dsm5
- Adult and pediatric versions are available online for most Level 1 symptom domains
Frequency of Use of the Cross-Cutting Symptom Measures
- Level 1 and relevant Level 2 measures can be completed at regular intervals to track change in symptom presentation over time
- Measures should be completed by the same knowledgeable informant for individuals with impaired capacity
- Measures should be completed by the same parent or guardian for children ages 6-17 years
- Consistently high scores on a particular domain may indicate significant and problematic symptoms that warrant further assessment, treatment, and follow-up
- Clinical judgment should guide decision making in using the cross-cutting symptom measures
Psychotic Disorders and Symptom Severity
- Psychotic disorders are heterogeneous, and symptom severity can predict aspects of the illness, such as cognitive and/or neurobiological deficits.
- Dimensional assessments capture meaningful variation in symptom severity, helping with treatment planning, prognostic decision-making, and research on pathophysiological mechanisms.
Clinician-Rated Dimensions of Psychosis Symptom Severity Measure
- The measure provides scales for dimensional assessment of primary symptoms of psychosis, including: • Hallucinations • Delusions • Disorganized speech • Abnormal psychomotor behavior • Negative symptoms
- The measure also includes a scale for dimensional assessment of cognitive impairment, which predicts functional abilities and prognosis.
- Scales for dimensional assessment of depression and mania are provided to identify co-occurring mood pathology.
Assessment and Rating
- The Clinician-Rated Dimensions of Psychosis Symptom Severity is an 8-item measure completed by the clinician during clinical assessment.
- Each item asks the clinician to rate the severity of each symptom as experienced by the individual when it was at its most severe during the past 7 days.
Scoring and Interpretation
- Ratings for each item on the measure are done on a 5-point scale with the following levels:
- 0: none
- 1: equivocal
- 2: present, but mild
- 3: present and moderate
- 4: present and severe
- Each rating level has a symptom-specific definition to guide the clinician's judgment
- Clinicians review all available information and select the level that best describes the symptom severity based on clinical judgment
Frequency of Use
- The measure can be completed at regular intervals to track changes in symptom severity over time
- The frequency of use depends on the individual's symptom stability and treatment status
- Consistently high scores on a particular domain may indicate significant problems that require further assessment, treatment, and follow-up
- Clinical judgment should guide decision making when interpreting results
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
A self- or informant-rated measure that assesses domains important across psychiatric diagnoses, helping clinicians identify areas for further inquiry and track symptom changes.
