A new, female-specific irritability rating scale

A new, female-specific irritability rating scale

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J Psychiatry Neurosci 2008;33(4):344-54

Leslie Born, PhD, MSc; Gideon Koren, MD; Elizabeth Lin, PhD; Meir Steiner, MD, PhD

Born — Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont.; Koren — The Motherisk Program, The Hospital for Sick Children, the Departments of Pediatrics, Pharmacology, Pharmacy, and Medicine and Medical Genetics, University of Toronto, Toronto, Ont., and The Ivey Chair in Molecular Toxicology, University of Western Ontario, London, Ont.; Lin — Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto, Toronto, Ont.; Steiner — Departments of Psychiatry and Behavioral Neurosciences and Obstetrics and Gynecology, McMaster University, Brain–Body Institute, Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Department of Psychiatry and Institute of Medical Sciences, University of Toronto, The Hospital for Sick Children, Toronto, Ont.

Abstract

Objective: Irritability is a prominent symptom in the spectrum of female-specific mood disorders, and in some women, irritability is serious enough to disrupt their lives and warrant treatment. The objective of this research was to develop a new, female-specific state measure of irritability.

Methods: We constructed self-rating and observer rating scales using items derived from spontaneous descriptions of irritability by women with mood disturbances related to the menstrual cycle, childbearing or menopause. Following a pretest, the scales were shortened to the core items of irritability (annoyance, anger, tension, hostility, sensitivity to noise and touch) and tested on a new cohort of patients.

Results: The 14-item Self-Rating Scale and the 5-item Observer Rating Scale showed evidence for internal consistency (Self-Rating: n = 36 patients, Cronbach’s α = 0.9257, mean interitem correlation = 0.4690; Observer Rating: Cronbach’s α = 0.7418, mean interitem correlation = 0.3616), Self-Rating test–retest reliability (n = 29 patients, rs = 0.704, p = 0.01) and interrater reliability (n = 20 patients; τb = 1.000, p = 0.001).

Conclusion: This new, female-specific scale for rating irritability has the potential to further the evaluation of this prominent symptom cluster and increase specificity in clinical assessments of emotional disturbances related to reproductive cyclicity in women.

Résumé

Objectif : L’irritabilité est un symptôme important dans le spectre des troubles thymiques particuliers aux femmes et, chez certaines, elle est assez sérieuse pour perturber leur vie et justifier un traitement. Cette recherche visait à mettre au point une nouvelle mesure de l’irritabilité spécifique à la femme.

Méthodes : Nous avons construit des échelles d’autoévaluation et d’évaluation par observateur au moyen de questions dérivées de descriptions spontanées de l’irritabilité données par des femmes atteintes de troubles thymiques liés au cycle menstruel, à l’accouchement ou à la ménopause. À la suite d’un prétest, on a raccourci les échelles pour les ramener aux éléments de base de l’irritabilité (agacement, colère, tension, hostilité, sensibilité aux bruits et au toucher) et nous en avons fait l’essai sur une nouvelle cohorte de patientes.

Résultats : L’échelle d’autoévaluation à 14 questions et l’échelle d’évaluation par observateur à 5 questions ont démontré une uniformité interne (autoévaluation : n = 36 patientes, α de Cronbach = 0,9257, corrélation moyenne entre questions = 0,4690; évaluation par observation : α de Cronbach = 0,7418, corrélation moyenne entre questions = 0,3616), rapidité du test-retest d’autoévaluation (n = 29 patientes, rs = 0,704, p = 0,01) et fiabilité entre évaluateurs (n = 20 patientes; τb = 1,000, p = 0,001).

Conclusion : Cette nouvelle échelle d’évaluation de l’irritabilité spécifique à la femme pourrait pousser plus loin l’évaluation de cette grappe de symptômes importants et accroître la spécificité des évaluations cliniques des troubles émotionnels liés au cycle de la reproduction chez la femme.


Presented at the 2nd World Congress of Women’s Mental Health, Washington, Mar. 17–21, 2004.

Medical subject headings: women’s health; irritable mood.

Competing interests: None declared.

Contributors: All authors designed the study. Drs. Born and Steiner acquired and analyzed the data and wrote the article, which Drs. Koren and Lin reviewed. All authors gave final approval for the article to be published.

Submitted July 19, 2007; Revised Nov. 6, Dec. 27, 2007; Accepted Dec. 27, 2007

Correspondence to: Dr. M. Steiner, Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, 301 James St. S., Hamilton ON L8P 3B6; fax 905 521-6098; mst@mcmaster.ca