Reliability and validity of the PAS-ADD Checklist for detecting psychiatric disorders in adults with intellectual disability.
The PAS-ADD Checklist is a quick, reliable way for staff to spot psychiatric disorders in adults with intellectual disability.
01Research in Context
What this study did
The team tested a 29-item staff checklist called PAS-ADD. They wanted to know if it could spot psychiatric disorders in adults with intellectual disability.
They checked three things: does the checklist hang together, do different raters agree, and does it match real clinical diagnoses.
What they found
The PAS-ADD Checklist passed the tests. Items grouped into clean factors, raters agreed, and screen-positive cases lined up with doctor diagnoses.
In plain words: staff can trust the tool to flag who needs a mental-health referral.
How this fits with other research
Matson et al. (2004) built on this work by giving us norms. They showed that about 20% of adults with ID screen positive, so you know what to expect in your caseload.
Hawley et al. (2004) reviewed many tools and reached the same bottom line: brief checklists like PAS-ADD work best when you pair them with direct observation.
Bachman et al. (1988) did a similar psychometric job on an older scale, the PIMRA. The methods match, but PAS-ADD is shorter and now has fresher evidence behind it.
Why it matters
If you serve adults with ID, keep a stack of PAS-ADD Checklists at the nurses' station. A five-minute rating can tell you who needs a full mental-health evaluation before problem behavior escalates. Use the 20% norm to set realistic caseload expectations and justify referral budgets.
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02At a glance
03Original abstract
The PAS-ADD Checklist is a screening instrument specifically designed to help staff recognize mental health problems in the people with intellectual disability for whom they care, and to make informed referral decisions. The instrument consists of a life-events checklist and 29 symptom items scored on a four-point scale. Scores are combined to provide three threshold scores. The crossing of any of these thresholds indicates the need for a fuller assessment. The items are worded in everyday language, making the Checklist suitable for use by individuals who do not have a background in psychopathology. The present paper presents the results of a number of studies evaluating the reliability and validity of the Checklist. Factor analysis of Checklists completed on a community sample of 201 individuals yielded eight factors, of which seven were readily interpretable in diagnostic terms. Internal consistency of the scales was generally acceptable. Inter-rater reliability in respect to individual items gave a fairly low average Kappa of 0.42. However, agreement on case identification, the main purpose of the Checklist, was quite good, with 83% of the decision being in agreement. Validity in relation to clinical opinion was also satisfactory, case detection rising appropriately with the clinically judged severity of disorder. The PAS-ADD Checklist is published and distributed by the Hester Adrian Research Centre, Manchester, England, from where further information and order forms are available on request.
Journal of intellectual disability research : JIDR, 1998 · doi:10.1046/j.1365-2788.1998.00116.x