Psychometric characteristics of the adult scale of hostility and aggression: reactive/proactive (A-SHARP) and relation to psychiatric features of adults with developmental disabilities.
The A-SHARP reliably separates severity from provocation of aggression in adults with IDD—use it to track both dimensions.
01Research in Context
What this study did
The team checked if the Adult Scale of Hostility and Aggression: Reactive/Proactive (A-SHARP) really works. They gave the scale to caregivers of adults with intellectual or developmental disabilities. Then they compared the scores to other well-known behavior and psychiatric measures.
What they found
The A-SHARP held up. It showed good internal consistency, meaning its items hang together. Two raters usually scored the same adult about the same. The scale also lined up with the Behavior Problems Inventory and with DSM psychiatric diagnoses.
How this fits with other research
Matlock et al. (2011) built the A-SHARP first; Smith et al. (2014) now give it a full psychometric check-up and pass it for field use.
Jones et al. (2010) did the same job for kids with the C-SHARP. Both studies find the reactive/proactive split is solid across the lifespan.
Matson et al. (2013) offer the CAPs-IDD checklist to pick any psychiatric tool for adults with IDD. Their framework says to weigh cost, training time, and validity; the 2014 data show A-SHARP meets those criteria.
Why it matters
You now have a free, caregiver-friendly scale that separates how severe an aggressive act is from what provoked it. Use the A-SHARP at intake and every six months. Track both dimensions to see if your behavior plan lowers severity, provocation, or both.
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02At a glance
03Original abstract
Recently, we described the development of the Adult Scale of Hostility and Aggression: Reactive/Proactive (A-SHARP) (Matlock & Aman, 2011). The A-SHARP was derived by factor analysis of ratings of 512 adults with intellectual and developmental disabilities (IDD), and its resulting five subscales were designated as (1) Verbal Aggression, (2) Physical Aggression, (3) Hostile Affect, (4) Covert Aggression, and (5) Bullying. The items on each subscale are rated first for severity (the Problem scale) and second for "origin" (i.e., to reflect extent to which behaviors are planned or reactive; "Provocation scale"). This study evaluated psychometric characteristics of the A-SHARP in the developmental sample of 512 adults. Mean item-whole subscale correlations ranged from .67 (Physical Aggression) to .78 (Verbal Aggression) on the Problem scale. Interrater reliability (n=39) ranged from .59 to .78 on the Problem subscales and from .54 to .78 on the Provocation subscales. For the entire sample, the correspondence between the Problem and Provocation subscales was low (-0.04 to 0.28), indicating independence between the scales. The A-SHARP Physical subscale was strongly correlated with Behavior Problems Inventory (BPI) Aggression frequency ratings (n=512, r=0.79), and strongly with BPI severity ratings (r=.86). We examined congruent validity between A-SHARP subscale scores on the one hand and four DSM-IV categories and Down syndrome on the other. A number of significant associations were observed between the A-SHARP subscales and diagnostic group, supporting the A-SHARP's congruent validity. Likewise, we examined the correspondence between use of psychoactive medicines and A-SHARP scores and found a number of associations between medication use and higher subscale scores. Overall, these results support the reliability and validity of the A-SHARP, and, as intended, the problem and provocation subscales appear to assess different constructs. However, much more work is needed to determine fully how well each of the subscales performs psychometrically.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.07.029