Cognitive and somatic aspects of depression among a rehabilitation sample: Reliability and validity of SCL-90—R research subscales.

Abstract

Although research subscales have been developed (Buckelew, DeGood, Schwartz, & Kerler, 1986) to assess the cognitive and somatic item patterning among chronic pain patients using the SCL-90-R, no information is available concerning the reliability or validity of those subscales. This study was designed to assess the internal consistency of these experimental subscales, evaluate the validity of these scales using standardized clinical scales measuring similar constructs, and to further examine the item response patterning with a new pain clinic sample and a rehabilitation center patient sample. The SCL-90-R was administered to 78 patients with chronic pain, 52 patients with spinal cord injury, and a control group of 145 college students. Estimates of internal consistency, represented by coefficient alpha, were .69 for the Somatic Depression subscales and .91 for the Cognitive Depression subscales. Data suggestive of construct validity included differential correlations of r=.78 between the experimental Cognitive Depression scale and the SCL-90-R Obsessive Compulsive scale, r=.66 between the experimental Somatic Depression scale and the SCL-90-R Somatization scale. Similar evidence of divergent validity was not clearly demonstrated with the remaining SCL-90-R subscales. Multivariate analysis of variance revealed that previously found item response patterning was replicated with a new chronic pain sample and with a spinal cord injured sample. Refinement of the research subscales and implications for clinical use among medical/rehabilitation samples is discussed.Reports on the prevalence of clinical depression among persons presenting at chronic pain clinics have varied from 10% (Pilowsky, Chapman, & Bonica, 1977) to 100% (Lascelles, 1966). Psychological tests such as the MMPI or SCL-90-R, which are often used in the psychological evaluation of pain patients, provide global scores on depression scales. However, such scales include items reflecting both cognitive and somatic symptoms. It is possible that pain patients may obtain elevated scores on depression scales by endorsing predominantly somatic symptoms of psychopathology while denying psychological distress. Differences in cognitive vs somatic symptom pattern-

How Gender Affects Psychological Adjustment One Year After Coronary Artery Bypass Graft Surgery

“…Test-retest correlation coefficients for the subscales of this measure range from .78 to .90, and internal consistency alpha coefficients from .77 to .90. The reported coefficient alphas were .69 for the Somatic Depression and .91 for the Cognitive Depression subscales (Buckelew et al, 1988). The Downloaded by [University of Liverpool] at 11:37 09 October 2014 score of the SCL-90-R is positively correlated with that of the Social Adjustment Scale-Self Report and the General Hospital Questionnaire (Derogatis, 1983).…”

Mediating effect of anxiety and depression on the relationship between Attention-deficit/hyperactivity disorder symptoms and smoking/drinking

“…Anxiety and Depression: Symptom Checklist -90-Revised (SCL-90-R) was used to assess depression and anxiety. The SCL-90-R is a screening measure of general psychiatric symptomatology 55 . Two dimensions measuring anxiety (10 items) and depression (13 items) were used in the study.…”

The Classification of Patients with Chronic Pain: Age and Sex Differences

“…The SCL-90R and its predecessor (SCL-90) have been used extensively as clinical and research measures with chronic pain patients (33,34), and for identifying chronic pain patient typologies based on hierarchical cluster analyses (16,17). Chronic pain patients have been found to have different response patterns on the SCL-90R compared with psychiatric patients and nonpatients ('normals') (34); therefore, empirically based scoring methods for chronic pain patients have been developed (33,34). The scale scores developed by Shutty et al (33) based on exploratory and confirmatory factor analyses with chronic pain patients were used in this study.…”