Concordance of the mini-Psychiatric Assessment Schedule for Adults who have Developmental Disabilities (PASADD) and the Brief Symptom Inventory.
Mini-PASADD and BSI line up well for general distress in adults with ID, but both stumble on obsessive-compulsive items.
01Research in Context
What this study did
The team gave the adults with ID two quick mental-health checklists. One was the Mini-PASADD, a 20-item carer interview. The other was the Brief Symptom Inventory, a 53-item self-report.
They wanted to know if the two screens picked out the same people as distressed. They also checked if carers and clients answered similar questions in the same way.
What they found
Overall, the two tools agreed 80-90 % of the time on general distress. Agreement was lowest on the obsessive-compulsive items.
Neither tool gave clean yes/no answers for specific disorders. They worked best as first-step red-flag screens.
How this fits with other research
Rojahn et al. (2012) did the same kind of head-to-head study. They shortened the 49-item BPI-01 to 30 items and still kept 0.96-0.99 agreement. Freeman et al. (2015) now shows you can also shorten mental-health screening without losing much signal.
Tsakanikos et al. (2011) looked at the DAS behavior scale in the same adult-ID group. They found two clear factors, while N et al. found weaker obsessive-compulsive agreement. The difference is method: Elias used factor math on one tool; N et al. used simple agreement across two tools.
Linaker (1991) cross-checked the PIMRA against DSM-III and got only moderate kappa (0.62). N et al. got higher agreement, suggesting newer screens have improved since 1991.
Why it matters
If you need a fast mental-health screen for adults with ID, either the Mini-PASADD or the BSI will do. Pick the one that fits your setting: carer interview for non-speakers, self-report for verbal clients. Do not rely on either tool for firm OCD diagnosis—follow up with a full clinical interview.
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02At a glance
03Original abstract
BACKGROUND: When assessing the mental health needs of people who have intellectual disabilities (ID) it is important to use measures that have good validity and reliability to ensure accurate case recognition and reliable and valid outcome data. Measures developed for this purpose tend to be self-report or by informant report. Multi-trait screening tools developed to identify psychological and psychiatric disorders in people who have ID tend to be informant based. Research examining the concordance of different tools has found this to be high but not for specific diagnoses. Multi-trait self-report measures are fewer and have not been compared with informant approaches. This study aims to examine the concordance between two multi-trait measures of mental health used with people who have ID. One administered to informants [the Mini-Psychiatric Assessment Schedule for Adults who have Developmental Disabilities (PASADD)] and one self-report [Brief Symptom Inventory (BSI)] METHOD: The measures were completed with 109 adults who have ID and with someone who knows them well. RESULTS: Level of agreement across the four scales in common was good for three. The poorest convergence was for the obsessive compulsive disorder sub-scales. However, a high level of concordance was found between most sub-scales. CONCLUSION: The BSI and the PASSAD seem to be good indicators of psychiatric problems and psychological distress; however, similar to other multi-trait measures they did not demonstrate appropriate specificity for particular disorders.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12073