Validation of the Recent Life Changes Questionnaire (RLCQ) for stress measurement among adults residing in urban communities in Pakistan

Abstract

BackgroundRecent Life Changes Questionnaire (RLCQ) developed by Richard Rahe has enabled quantification of stress by analyzing life events. The overall aim of the study was to create a reliable version of the Rahe’s RLCQ for measuring stress in individuals living in developing countries and assess its validity. This paper discusses criterion validation of the adapted RLCQ in urban communities in Pakistan.MethodsThis is a criterion validation study. Four urban communities of Karachi, Pakistan were selected for the study in which households were randomly chosen. Two data collectors were assigned to administer the adapted RLCQ to eligible participants after obtaining written informed consent. Following this interaction, two psychologists interviewed the same participants with a diagnostic gold standard of Mini International Neuropsychiatric Interview (MINI) which is utilized in usual practice within Pakistan to confirm the presence of stress related mental disorders such as Depression, Anxiety, Dysthymia, Suicide, Phobia, OCD, Panic Disorder, PTSD, Drug abuse and dependence, Alcohol abuse and dependence, Eating Disorders and Antisocial Personality Disorder to validate the accuracy of the adapted RLCQ. We generated the ROC curves for the adapted RLCQ with suggested cut-offs, and analyzed the sensitivity and specificity of the adapted RLCQ.ResultsThe area under the receiver operating characteristic curve (ROC) of common mental disorders such as depression and anxiety was 0.64, where sensitivity was 66%, specificity was 56% and the corresponding cut off from the adapted RLCQ was 750. Individuals scoring ≥750 were classified as high stress and vice versa. In contrast, the area under the ROC curve for serious mental disorder and adverse outcomes such as suicide, bipolar and dysthymia was 0.75, where sensitivity was 72% and specificity was 60% at the cut off of 800 on the adapted RLCQ. Individuals scoring ≥800 were classified as high stress and vice versa. The rate of agreement between the two psychologists was 94.32% (Kappa = 0.84).ConclusionThe adapted and validated RLCQ characterizes common mental disorders such as depression and anxiety with moderate accuracy and severe mental disorders such as suicide, bipolar and dysthymia with high accuracy.Trial registrationClinicaltrials.gov NCT02356263. Registered January 28, 2015. (Observational Study Only).

Sensitivity and specificity of a brief scale to evaluate psychological violence at work in Peruvian health professionals

“…b) The ROC curve results in other areas [3,19] provide conclusive support for the SPV-Health due to its discriminative capacity (AUC = 0.89 versus the limit of AUC > 0.80) [19] and its randomness of selection, which are adequate in both cases [3,19]. c) Regarding the Pakistani stress questionnaire (AUC = 0.64; kappa = 0.84 [6] versus AUC = 0.89; k = − 0.766 in the present study), the value of the SPV-Health is reinforced in clinical and legal environments, given the convergence of stress as an underlying factor [6]. A decrease in JS negatively affects organizational commitment [5] and increases the levels of stress and exhaustion in health workers [2,10], and PVW becomes a reason for leaving the job [12].…”

“…To the best of our knowledge, this is the first study to evaluate the practical application of and prospects for using the SPV-Health, which uses uniform criteria to classify PVW [3,4] and makes it possible to collect baseline and follow-up responses within the framework of clinical psychology and organizational psychology [3,6].…”

“…Psychological violence at work (PVW) refers to an intentional action in which workers are verbally assaulted, threatened and/or humiliated during their professional practice [1,2] in ways that do not involve physical violence [3]. PVW is exacerbated in the health sector due to the precariousness of working conditions, which commonly involve psychosocial risk factors [4][5][6]. There are no differences in the rates of PVW between developed and underdeveloped countries, between health groups, or between stable and temporary work conditions [7][8][9][10]; however, at the individual level, the effects of PVW can vary according to the individual's resilience [6,11].…”

“…PVW is exacerbated in the health sector due to the precariousness of working conditions, which commonly involve psychosocial risk factors [4][5][6]. There are no differences in the rates of PVW between developed and underdeveloped countries, between health groups, or between stable and temporary work conditions [7][8][9][10]; however, at the individual level, the effects of PVW can vary according to the individual's resilience [6,11].…”

Proceedings. Rangahau: Te Mana o te Mahi Kotahitanga / Research: The Power of Collaboration. Unitec/MIT Research Symposium 2022, December 8 and 9

“…It can, for example, be viewed as a threat or an opportunity. Artani et al (2019) define stress as the "perceived loss of an individual's ability to adapt with evolving changes in life. "…”