Validity and severity thresholds for the depression subscale of the affective self rating scale: An equipercentile equating study using classical test theory.

BACKGROUND: The Affective Symptoms Scale (ASRS) is a unique instrument designed to separately measure depressive and manic symptoms in mood disorders. We validated the ASRS against the Patient Health Questionnaire (PHQ-9) and the Quick Inventory of Depressive Symptomatology (QIDS-16). METHODS: A retrospective study of 258 patients who completed the PHQ-9, QIDS-16 and ASRS as part of routine clinical care. To establish meaningful clinical thresholds for the depression subscale of the ASRS, it was equated with the QIDS and the PHQ-9. RESULTS: The depression subscale of the ASRS had significant positive correlations with the QIDS-16 and the PHQ-9 (respectively, r= 0.8, t[253] = 19.8, p < 0.001, and r= 0.8, t[245] = 28.2, p < 0.001). The equipercentile equating method with the PHQ-9 indicated that the thresholds corresponded to ASRS depression subscale scores of 5.4, 10.6, 16.1, and 23. Equating with the QIDS indicated that thresholds corresponded to ASRS depression subscale scores of 5.1, 11, 18.4, and 27.5. LIMITATIONS: Limitations include a small sample size that did not allow more detailed statistical analysis, such as Item Response Theory. The population is a heterogenous population at a university outpatient setting. CONCLUSIONS: The ASRS depression subscale significantly correlated with the PHQ-9 and QIDS-16. Our proposed threshold scores for the ASRS are 5, 11, 16 and 23 to indicated mild, moderate, severe and very severe depression respectively.

Stories of relative privilege: power and social change in feminist community psychology.

Stories about community work in New Zealand and Scotland are presented to describe and reflect on issues central to feminist community psychology. Organizing a lesbian festival, Ingrid Huygens describes feminist processes used to equalize resources across Maori (indigenous) and Pakeha (white) groups. Heather Hamerton presents her experiences as a researcher using collective memory work to reflect on adolescent experiences related to gender, ethnicity, and class. Sharon Cahill chronicles dilemmas and insights from focus groups about anger with women living in public housing in Scotland. Each story chronicles experiences related to oppression and privilege, and describes the author's emotions and reflections. Individually and collectively, the stories illustrate the potential offered by narrative methods and participatory processes for challenging inequalities and encouraging social justice.

Strengthening parent-community member relations on agency boards: comparative case study.

Relations between parents of children with developmental disabilities and other community members on agency boards can be difficult to negotiate. In this comparative study of the boards of three community agencies, we examined the forces that influence the quality of parent-community member relations. The results suggest that when differences between groups are acknowledged and respected at the same time that similarities are recognized and valued, board operations are more likely to be successful and focused on providing effective services. The case descriptions included here suggest that an organization's ability to manage the tension between intergroup differences and similarities is influenced by (a) organizational history of intergroup relations, (b) group identification, and (c) organizational practices that bridge group differences. Action implications are discussed.

A history of women and feminist perspectives in community psychology.

Using an historical framework, we document and assess efforts to include women, women's issues, and feminism in community psychology and in the Society for Community Research and Action (SCRA). Initiatives of the SCRA Task Force/Committee on Women are traced from its inception to present. We also chronicle the dilemmas and difficulties of moving toward a feminist community psychology. The history is divided into five phases. Each phase is described in terms of women's involvement in the field and efforts to integrate feminist content into research and practice of the field. Reflections on the qualities of contexts that have both supported and inhibited inclusion are identified. We look to this history to try to understand the observation that while women have been increasingly visible in leadership roles and women's professional development has been encouraged, less progress has been made toward building a feminist community psychology.

Gender, race, and class in organizational contexts.

Creating settings that support diversity has been a long-standing concern of community psychology. In this paper, I propose two qualities as important aspects of organizational contexts that support the meaningful participation of diverse groups: (a) a culture of connection and (b) recognition of multiple "realities." For each theme, I first examine countervailing values that can undermine meaningful participation of nondominant groups. I suggest that organizational values for independence and a press for sameness can contribute to settings where members of traditionally oppressed groups will be prevented from meaningful participation. I also suggest that fostering a culture of connectedness that actively legitimizes multiple realities is a constructive alternative. To illustrate these points, I share observations based on experiences in manufacturing, educational, and community-based settings. Then, I explore two dynamics that are important when confronting the countervailing values and building more inclusive contexts: (a) accountability for impact and (b) privilege dynamics. Last, I turn to some possibilities for change through a stance of connected disruption.

Health promotion and disease prevention in kidney transplant recipients.

Patients with end-stage renal disease have a critical need for health maintenance. Due to the shortage of donor organs, kidney transplant--the treatment of choice for end-stage renal disease--is not available to all individuals listed on the national waiting list. Therefore, treatment must be optimal to maximize graft survival and length of life in this high-risk population. Transplant recipients are exposed to the inherent risks of immunosuppression. Chronic use of pharmocologic agents to maintain graft survival is associated with conditions such as coronary artery disease, stroke, infection, and malignancy. A needs assessment revealed that many identified risks were modifiable through proper education and intervention. Therefore, health promotion and disease prevention--namely cancer screening and prevention, cardiovascular risk factors, and dietary guidelines--were identified as educational priorities. In an environment of fiscal constraint and priority setting, transplant centers are obligated to provide quality outcomes with cost-containment. Transplant teams must therefore focus on minimizing risks and preventing diseases to reduce costs and produce positive long-term outcomes.

The multitextured lives of women of color.

In this commentary, I suggest that our work with women of color should be held together by three primary threads: (a) appreciation for history as we decipher and interpret the adaptive strategies of women of color; (b) recognition of the intersections of race, gender, and class as central to our work; and (c) self-critical examination of the meanings we attach to "difference". The papers in the current special issue provide good examples regarding the importance of each thread. I argue that attention to these three themes should help us to keep our focus on contextually driven questions and to move forward our appreciation for the lives of women of color.

Family reactions to institutional closure.

Determinants of families' reactions to their relatives' relocation (from a large developmental disability institution that was closing to smaller institutions) were examined. Ninety-four families responded to two surveys sent during closure and one year later asking about (a) reactions to the closure, (b) relative's medical status, (c) involvement with their relative, (d) appraisal of the situation, and (e) social support. Over time, families reported less stress and dissatisfaction with closure. Family reactions during closure were related to the relative's medical status, involvement with their relative, and appraisal of the situation, whereas family reactions one year later were related to appraisal, involvement with their relative, and social support.