The ESDQ: A New Method of Assessing Emotional and Social Dysfunction in Patients Following Brain Surgery

Abstract

The Emotional and Social Dysfunction Questionnaire (ESDQ) has been designed to overcome some of the difficulties of inappropriately applying psychiatric based questionnaires to brain-damaged populations. Two-hundred and twenty-five patients were assessed following brain surgery (BS) using a self-rating patient version of the ESDQ and 211 of these patients were rated by their partner. A factor analysis using a varimax rotation and principal components analysis found the partner results to show eight factors including, Anger, Helplessness, Emotional Dyscontrol, Indifference, Inappropriateness, Fatigue, Maladaptive behaviour, and Insight. The analysis of the Self-rating questions revealed a similar profile, Anger, Emotional Dyscontrol, Helplessness, Inertia, Fatigue, Indifference, Inappropriate, and Euphoria. The scales based on the factors were subjected to discriminant analysis in which the BS patients were compared with a combination control group of neurosurgical outpatients and terminally-ill cancer patients, all of which were without cerebral complaints. The brain surgery results for the partner-rated and the Self-rated version of the ESDQ were compared with control ratings of 42 partners and 54 self-ratings, respectively. The analysis showed a significant discrimination for the Partner-rated version on each of the eight scales individually with an overall significant overall separation (Wilks Lambda=.903, chi=21.1, df=8, p=<.005). The Self-rated version showed less separation on an individual scale basis the Emotional Dyscontrol scale failing to show a significant separation. The overall difference on the Self-rating version was significant [Wilks Lambda=.908, chi=26.2, df=8, p=<.001). The levels of internal consistency of the questionnaire scales were found to be satisfactory (Alpha,.78 -.94). Also the relationship between ESDQ scales and standardised measures of aggression, anxiety, depression, and vigour (STAXI, HADS, and POMS) gave an indication of acceptable levels of concurrent validity.

The mediating effect of psychological distress on functional dependence in stroke patients

“…The original Emotional and Social Dysfunction Questionnaire (ESDQ) was developed as a 51‐item instrument to assess various types of psychological distress in brain damage patients (Andrewes et al . ). We revised the ESDQ to create the ESDQ_C, which is a 28‐item instrument with six factors, anger, emotional dyscontrol, helplessness, inertia, indifference and euphoria, to examine the various forms of psychological distress in stroke patients.…”

“…, Andrewes et al . ). Bogousslavsky () examined the emotional and behavioural problems prevalent among 300 stroke patients and observed the proportions of emotional and behavioural problems such as sadness (72%), disinhibition (56%), lack of adaptation (44%), environmental withdrawal (24%), crying (27%), lack of awareness of disability (anosognosia) (24%), passivity (24%) and aggressiveness (11%).…”

Predicting Compliance With Treatment Following Stroke: A New Model of Adherence Following Rehabilitation

“…Internal consistency of the HADS produced satisfactory results (α = .90) for the depression scale in the original scale development study. The Emotional and Social Dysfunction Questionnaire (ESDQ; Andrewes et al, 2003a;Andrewes, Kaye, Murphy, & Harris, 2003b) was used to assess anger, emotional dyscontrol, helplessness, inertia, indifference, fatigue, inappropriateness, and euphoria. The ESDQ has verified internal reliability demonstrating Cronbach Alpha values of .80 or higher for the PQ and .79 or higher for the SQ or higher for each of the scales (Andrewes et al, 2003a, pp.…”

Development and Evaluation of Information Resources for Patients, Families, and Healthcare Providers Addressing Behavioral and Cognitive Sequelae Among Adults With a Primary Brain Tumor

“…In addition, there are a growing number of accounts of behavioral challenges in patients with PBT (Andrewes et al, 2003;Catt, Chalmers, & Fallowfield, 2008;Kelly, Brown, Todd, & Kremer, 2008;Salander, 1996;Salander, Bergenheim, Hamberg, & Henriksson, 1999). Challenging behaviors after acquired brain impairment have been defined as spanning verbal or physical aggression, sexually inappropriate behavior, wandering/absconding, perseveration (repetitive behaviors), socially inappropriate behavior (including illegal behaviors, noncompliant behaviors), and adynamia (lack of initiation; Sabaz et al, 2014).…”