Apathy can manifest in various neuropsychiatric conditions, as well as in individuals who experience significant stressful life events or suffer from underlying internal medical conditions. The Starkstein Apathy Scale (SAS) is recognized as a reliable screening tool, besides being endorsed by the International Parkinson and Movement Disorder Society to assess apathy in patients with Parkinson’s disease. Recently, the Italian version of this scale (SAS-I) has been introduced. Furthermore, normative data have been provided on a large sample of Italian healthy individuals. Here we present the official Italian translation of the SAS, along with clarifications regarding its administration. Also, we supply details concerning the scale’s factorial structure, inter-item conditional associations and item performance by using EFA, Network analysis, and IRT modelling for polytomous items.
LevyRDuboisB. Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cereb Cortex. 2006;16(7):916-928. DOI: 10.1093/cercor/bhj043
2.
RobertPLanctôtKLAgüera-OrtizL, et al.Is it time to revise the diagnostic criteria for apathy in brain disorders? The 2018 international consensus group. Eur Psychiatry. 2018;54:71-76. DOI: 10.1016/j.eurpsy.2018.07.008
3.
TerashiHUetaYKatoHMitomaHAizawaH. Characteristics of apathy in treatment-naïve patients with Parkinson’s disease. Int J Neurosci. 2019;129(1):16-21. DOI: 10.1080/00207454.2018.1503184
4.
HongistoKHallikainenISelanderTet al.Quality of life in relation to neuropsychiatric symptoms in Alzheimer’s disease: 5-year prospectiveALSOVAcohort study. Int J Geriatr Psychiatr. 2018;33(1):47-57. DOI: 10.1002/gps.4666
5.
LiemburgEJDlabac-De LangeJJBaisLKnegteringHvan OschMJRenkenRJAlemanA. Neural correlates of planning performance in patients with schizophrenia–relationship with apathy. Schizophr Res. 2015;161(2-3):367-375. DOI: 10.1016/j.schres.2014.11.028
6.
BrodatyHAltendorfAWithallASachdevP. Do people become more apathetic as they grow older? A longitudinal study in healthy individuals. Int Psychogeriatr. 2010;22(3):426-436. DOI: 10.1017/S1041610209991335
7.
PardiniMCordanoCGuidaSet al.Prevalence and cognitive underpinnings of isolated apathy in young healthy subjects. J Affect Disord. 2016;189:272-275. DOI: 10.1016/j.jad.2015.09.062
8.
RadakovicRAbrahamsS. Developing a new apathy measurement scale: Dimensional apathy scale. Psychiatr Res. 2014;219(3):658-663. DOI: 10.1016/j.psychres.2014.06.010
9.
SantangeloGRaimoSSicilianoMet al.Assessment of apathy independent of physical disability: Validation of the Dimensional Apathy Scale in Italian healthy sample. Neurol Sci. 2017;38(2):303-309. DOI: 10.1007/s10072-016-2766-8
10.
AngYSLockwoodPAppsMAMuhammedKHusainM. Distinct subtypes of apathy revealed by the apathy motivation index. PLoS One. 2017;12(1):e0169938. DOI: 10.1371/journal.pone.0169938
11.
AltieriMMaggiGRippaVSantangeloG. Evaluation of apathy in non-clinical populations: Validation, psychometric properties, and normative data of the Italian version of Apathy-Motivation Index (AMI). Neurol Sci. 2023;44(9):3099-3106. DOI: 10.1007/s10072-023-06774-0
12.
StarksteinSEMaybergHSPreziosiTAndrezejewskiPLeiguardaRRobinsonRG. Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 1992;4(2):134-139. DOI: 10.1176/jnp.4.2.134
13.
MarinRSBiedrzyckiRCFirinciogullariS. Reliability and validity of the apathy evaluation scale. Psychiatr Res. 1991;38(2):143-162. DOI: 10.1016/0165-1781(91)90040-v
14.
LeentjensAFDujardinKMarshLet al.Apathy and anhedonia rating scales in Parkinson's disease: Critique and recommendations. Mov Disord. 2008;23(14):2004-2014. DOI: 10.1002/mds.22229
15.
PedersenKFAlvesGLarsenJPTysnesOBMøllerSGBrønnickK. Psychometric properties of the Starkstein Apathy Scale in patients with early untreated Parkinson disease. Am J Geriatr Psychiatr. 2012;20(2):142-148. DOI: 10.1097/JGP.0b013e31823038f2
16.
GarofaloEIavaroneAChieffiSet al.Italian version of the Starkstein Apathy Scale (SAS-I) and a shortened version (SAS-6) to assess “pure apathy” symptoms: Normative study on 392 individuals. Neurol Sci. 2021;42(3):1065-1072. DOI: 10.1007/s10072-020-04631-y
17.
BeckATWardCHMendelsonMMockJErbaughJ. An inventory for measuring depression. Arch Gen Psychiatr. 1961;4:561-571. DOI: 10.1001/archpsyc.1961.01710120031004
18.
BrodatyHConnorsMH. Pseudodementia, pseudo-pseudodementia, and pseudodepression. Alzheimers Dement. 2020;12(1):e12027. DOI: 10.1002/dad2.12027
19.
AielloEND'IorioAMontemurroS, et al.Psychometrics, diagnostics and usability of Italian tools assessing behavioural and functional outcomes in neurological, geriatric and psychiatric disorders: A systematic review. Neurol Sci. 2022;43(11):6189-6214. DOI: 10.1007/s10072-022-06300-8
20.
HuLTBentlerPM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model: A Multidiscip J. 1999;6(1):1-55. DOI: 10.1080/10705519909540118
21.
BorsboomDDesernoMKRhemtullaM, et al.Network analysis of multivariate data in psychological science. Nature Reviews Methods Primers. 2021;1(1):58. DOI: 10.1038/s43586-021-00055-w
22.
HeveyD. Network analysis: A brief overview and tutorial. Health Psychol Behav Med. 2018;6(1):301-328. DOI: 10.1080/21642850.2018.1521283
FriedmanJHastieTTibshiraniR. Sparse inverse covariance estimation with the graphical lasso. Biostatistics. 2008;9(3):432-441. DOI: 10.1093/biostatistics/kxm045
25.
BakerFB. The Basics of Item Response Theory. 2nd ed.College Park: ERIC Clearinghouse on Assessment and Evaluation; 2001.
26.
BaylorCHulaWDonovanNJDoylePJKendallDYorkstonK. An introduction to item response theory and Rasch models for speech-language pathologists. Am J Speech Lang Pathol. 2011;20(3):243-259. DOI: 10.1044/1058-0360(2011/10-0079
27.
ZhangDWangCYuanT, et al.Psychometric properties of the coronavirus anxiety scale based on classical test theory (CTT) and item response theory (IRT) models among Chinese front-line healthcare workers. BMC Psychol. 2023;11(1):224. DOI: 10.1186/s40359-023-01251-x
28.
EpskampSBorsboomDFriedEI. Estimating psychological networks and their accuracy: A tutorial paper. Behav Res Methods. 2018;50(1):195-212. DOI: 10.3758/s13428-017-0862-1
29.
HusainMRoiserJP. Neuroscience of apathy and anhedonia: A transdiagnostic approach. Nat Rev Neurosci. 2018;19(8):470-484. DOI: 10.1038/s41583-018-0029-9
30.
MaggiGVitaleCDelle CurtiAAmboniMSantangeloG. Unawareness of apathy in Parkinson's disease: The role of executive dysfunction on symptom recognition. Brain Sci. 2023;13(6):964. DOI: 10.3390/brainsci13060964
31.
PenningtonCDuncanGRitchieC. Altered awareness of cognitive and neuropsychiatric symptoms in Parkinson's disease and Dementia with Lewy Bodies: A systematic review. Int J Geriatr Psychiatr. 2021;36(1):15-30. DOI: 10.1002/gps.5415
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
