CORE-OM as a routine outcome measure for adolescents with emotional disorders: factor structure and psychometric properties

Abstract

Background: Instruments for monitoring the clinical status of adolescents with emotional problems are needed. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) according to theory measures problems/ symptoms, well-being, functioning and risk. Documentation of whether the theoretical factor structure for CORE-OM is applicable for adolescents is lacking. Methods: This study examined the factor structure and psychometric properties of the CORE-OM based on two samples of adolescents (age 14-18): youths seeking treatment for emotional problems (N = 140) and high school students (N = 531). A split half approach was chosen. An exploratory factor analysis (EFA) was performed on the first half of the stratified samples to establish the suitability of the model. A Confirmatory Factor Analysis (CFA) with the chosen model from the EFA was performed on the second half. Internal consistency and clinical cutoff scores of the CORE-OM were investigated. Results: The best fitting model only partially confirmed the theoretical model for the CORE-OM. The model consisted of five factors: 1) General problems, 2) risk to self, 3) positive resources 4) risk to others and 5) problems with others. The clinical cutoff score based on the all-item total was higher than in an adult sample. Both the all-item total and general problems cutoff scores showed gender differences. Conclusion: The factor analysis on CORE-OM for adolescents resulted in a five-factor solution, and opens up for new subscales concerning positive resources and problems with others. A 17-item solution for the general problems/ symptoms scale is suggested. We advise developers of self-report instruments not to reverse items, if they do not intend to measure a separate factor, since these seem to affect the dimensionality of the scales. Comparing means for gender in non-clinical samples should not be done without modification of the general emotional problem and the positive resources scales. Slightly elevated CORE-OM scores (up to 1.3) in adolescents may be normal fluctuations.

Long-term effectiveness and trajectories of change after treatment with SMART, a transdiagnostic CBT for adolescents with emotional problems

“…CORE-OM has shown good psychometric properties [ 58 , 62 ], but also has some methodological challenges [ 60 ]. In the present study a 17-item general problem scale score was used, based on the results of a validation of the CORE-OM in Norwegian adolescents; a community sample from junior and senior high-school, and the clinical sample in the present study [ 66 ]. The CORE General problem scale score reports symptoms and problems, both psychologically and in relation to others, and can be interpreted as a measure of general psychological distress [ 66 ].…”

Clinical Outcomes in Routine Evaluation Measures for Patients Discharged from Acute Psychiatric Care: Four-Arm Peer and Text Messaging Support Controlled Observational Study

“…Patients with mental health disorders are particularly vulnerable for suicidality or homicidal propensity [ 5 , 7 , 8 ]. Clinical Outcomes in Routine Evaluation—Outcome Measure (CORE-OM) is a well-recognized and validated tool that measures psychological distress and can be administered at several time points to detect changes in mental health parameters [ 9 , 10 ]. The instrument is designed to provide a feasible outcome measure.…”

“…Monitoring changes in patients’ psychological parameters over time is of key importance for assessing the success and effectiveness of mental health services [ 9 , 30 ].…”

Measurement properties of the Swedish clinical outcomes in routine evaluation outcome measures (CORE-OM): Rasch analysis and short version for depressed and anxious out-patients in a multicultural area

“…It has been translated into 54 languages and dialects [ 15 ]. Most psychometric studies have been conducted in primary health care settings with depressed or anxious adult patients, but the scale has also been validated in adolescents [ 16 ] and in people with learning disabilities [ 17 ], eating disorders [ 18 ], tinnitus [ 19 ] and substance misuse [ 20 ]. A shorter 10-item version has shown high acceptability in terms of readability, high reliability and high convergent validity with the full CORE-OM [ 21 ].…”