Problem Severity Among Outpatient Mental Health Clients: Development and Validation of the South Shore Problem Inventory-Revised

Abstract

The use of global instruments has been recommended as a viable strategy for clinical assessment and outcome measurement in mental health practice. The current study examined the validity, reliability, and utility of the South Shore Problem Inventory-Revised (SSPI-R), a multidimen sional global client self-report scale based on a biopsychosocial framework Data collectedfrom 376 clients newly admitted to an adult outpatient community mental health program were submitted to principal components analysis and varimax rotation. Three major factors emerged reflecting an underlying factor structure similar to that of the original SSPI. The three factors were defined as: psychophysiological (Factor 1), community/health (Factor 2), and family pathol ogy (Factor 3). Overall, the scale accounted for about 43% of the variance, internal consistency ratings were good to excellent, and subscale correlations revealed good separation among the three factors. Matters concerning validity, reliability, and utility are discussed as are implica tions for the use of the scale in agency-based clinical assessment and outcome evaluation.

Get full access to this article

View all access options for this article.

References

American Psychiatric Association. (1987). The diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.

Bandura, A.A. (1977). Social learning theory Englewood Cliffs, NJ: Prentice-Hall.

Berlin, S.B. (1982). Cognitive-behavioral interventions for social work practice Social Work, 27, 218-226.

Comrey, A.L. (1988). Factor analytic methods of scale development in personality and clinical psychology Journal of Consulting and Clinical Psychology, 56, 754-761.

Derogatis, L.R. (1977). SCL-90: Administration, scoring and procedures manual-I for the r(evised) version Baltimore, MD: Clinical Psychometrics Research.

Dohrenwend, B.P. , & Dohrenwend, B.S. (1976). Sex differences in psychiatric disorders American Journal of Sociology , 81, 1447-1454.

Endicott, J. , Spitzer, R.L. , Fleiss, J.L. , & Cohen, J. (1976). The global assessment scale Archives of General Psychiatry, 33, 766-771.

Germain, C.B. (1991). Human behavior in the social environment: An ecological view New York: Columbia University Press.

Gibelman, M. , & Demone, H.W., Jr. (1989). The evolving contract state In H. W. Demone, Jr. & M. Gibelman (Eds.), Services for sale : Purchasing health and human services (pp.17-57). New Brunswick, NJ: Rutgers, The State University of New Jersey.

10.

Goldstein, E.G. (1984). Ego psychology and social work practice New York: Free Press.

11.

Hurley, D. (1991). Women, alcohol and incest: An analytical review Journal of Studies on Alcohol, 52, 253-268.

12.

Hudson, W. (1982). The clinical measurement package: A field manual Homewood, IL: Dorsey.

13.

Jayratne, S. (1990). Clinical significance: Problems and new developments In L. Videka-Sherman & W. J. Reid (Eds.), Advances in clinical social work research (pp.271-285). Silver Spring, MD: NASW Press.

14.

Jenkins, S. , & Mattaini, M. (1992). The center for study of social work practice Research on Social Work Practice, 2, 133-142.

15.

Kaiser, H.F. (1960). The application of electronic computers to factor analysis Educational and Psychological Measurement , 20, 141-151.

16.

Kim, J.O. , & Mueller, C.W. (1978). Factor analysis: Statistical methods and practical issues Beverly Hills, CA: Sage .

17.

Lautenschlager, G.J. (1989). A comparison of alternatives to conducting Monte Carlo analyses for determining parallel analysis criteria Multivariate Behavioral Research, 24, 365-395.

18.

Mackey, R.A. (1985). Ego psychology and clinical practice New York: Gardner.

19.

McConnaughy, E.A. , DiClemente, C.C. , Prochaska, J.O. , & Velicer, W.F. (1989). Stages of change in psychotherapy: A follow-up report Psychotherapy, 26, 494-503.

20.

McFarland, B.H. (1989). Overview of mental health services research In J. D. Bloom (Series Ed.) & H. R. Lamb (Vol. Ed.), State university collaboration: The Oregon experience: Vol. 44. New Directions for Mental Health Services. San Francisco, CA: Jossey-Bass.

21.

Morrow-Bradley, C. , & Elliot, R. (1986). Utilization of psychotherapy research by practicing psychotherapists American Psychologist , 41, 188-197.

22.

National Institute of Mental Health. (1986 ). Ideal criteria for development, selection and use of client outcome measures In J. A. Ciarlo, T. R. Brown, D. W. Edwards, T. J. Kiresuk, & F. L. Newman (Eds.), Assessing mental health treatment outcome measurement techniques (Series FN No.9, DHHS Publication No. ADM 86-1301). Washington, DC: U.S. Government Printing Office.

23.

Newman, F.L. , Hunter, R.H. , & Irving, D. (1987). Simple measures of progress in the evaluation of mental health services Evaluation and Program Planning , 10, 209-218.

24.

Norusis, M.J. (1985). SPSS-X: Advanced statistics guide Chicago: SPSS, Inc.

25.

O'Hare, T. (1993). Alcohol consumption and presenting problems in an outpatient mental health clinic Addictive Behaviors , 18, 1857-1865.

26.

Overall, J.E. , & Gorham, D.R. (1962). The brief psychiatric rating scale Psychological Reports, 10, 799-812.

27.

Proctor, E. (1990). Evaluating clinical practice: Issues of purpose and design Social Work Research and Abstracts , 26, 32-40.

28.

Schneider, L.C. , & Struening, E.L. (1983). SLOF: A behavioral rating scale for assessing the mentally ill Social Work Research and Abstracts, 19(3), 9-21.

29.

Weissman, M.M. , & Bothwell, S. (1976). Assessment of social adjustment by patient self report Archives of General Psychiatry , 33, 1111-1115.