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Google Drive

[edit]

Here is the link to the HCL-32 google drive. Please put your articles and resources here.

A note that there is an existing page of the HCL-32 and your edits could build upon the existing framework.

Jules Angst, MD
Known forAuthoring the Hypomania Checklist; President of the European Bipolar Forum


Introduction

[edit]
    • What are the acronyms? What do they stand for?
    • What is the purpose of the measure?
    • What is the intended population of the measure?
    • How long does it take to take/administer the assessment?
    • Who wrote the measure?
    • How many items does the measure contain?
    • What kind of impact did the measure have?
      • Ex: is it more sensitive than existing measures?
    • What kinds of settings is the measure most typically used?
      • Ex: research, clinical

The Hypomania Checklist (HCL-32) is a questionnaire developed by Dr. Jules Angst to identify hypomanic features in patients with major depressive disorder in order to help recognize bipolar II disorder and other bipolar spectrum disorders[1] in people seeking help in primary care and other general medical settings. It was originally used in clinical settings with depressed patients, but has gained popularity as a screening tool for hypomanic features in non-clinical adult populations.[2] It asks about 32 behaviors and mental states that are either aspects of hypomania or features associated with mood disorders, and uses short phrases and simple language, making it easy to read. The University of Zurich holds the copyright, and the HCL-32 is available for use at no charge. More recent work has focused on validating translations and testing whether shorter versions still perform well enough to be helpful clinically.[3] Recent meta-analyses find that it is one of the most accurate assessments available for detecting hypomania, doing better than other options at recognizing bipolar II disorder.[4][5]

Versions

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The original 32-item version of the HCL has been reduced to a 13 and 16 item versions (HCL-13; HCL-16), which still perform well clinically to help differentiate bipolar disorder from major depressive disorder.[6][3] The original version has also been modified/ extended into the HCL-32-R1, the HCL-32-R2, and the HCL-33. The HCL-32-R1contains 31 items, and was originally validated in a transcultural sample of 12 countries across 5 geographical regions.[7] It was then further developed into the HCL-32-R2, with 34 items.[7] From here, two of the items from the HCL-32-R2 were merged together, resulting in the HCL-33. In addition to the 33 item symptom list on the HCL-33, this version of the measure contains additional items assessing impairment, others' reactions to the "highs" of hypomania, and duration of the "highs" of hypomania.

  • How many versions of the measure are there?
  • What is the intended population for each version?
  • How many items are in each version of the measure?
  • What are the acronyms for each version?

Reliability

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Reliability

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Reliability refers to whether the scores are reproducible. Unless otherwise specified, the reliability scores and values come from studies done with a United States population sample. Here is the rubric for evaluating the reliability of scores on a measure for the purpose of evidence based assessment.

  • What were the norms from the measure’s first publication?
    • IE what was the demographics of the population used to first validate this measure?
  • What is the internal consistency?
    • Internal consistency: how well the items relate/correlate to one another
    • Normally reported as an alpha or Cronbach's alpha
  • What is the inter-rater reliability?
    • Inter-rater reliability: how consistently the measure gives the same results across different raters (*not applicable for self-report*)
    • Normally reported as kappa
  • What is the test-retest reliability?
    • Test-retest: how consistently the measure gives the same result after the same person takes the test multiple times
Rubric for evaluating norms and reliability for the General Behavior Inventory (table from Youngstrom et al., extending Hunsley & Mash, 2008; *indicates new construct or category)
Criterion Rating (adequate, good, excellent, too good*) Explanation with references
Norms Excellent 8123 patients were gathered from 21 studies. Fourteen studies (66.7%) included exclusively outpatients while six studies (28.6%) had inpatients and outpatients, and one study did not specify this information. On average 63.9% of the participants were female. The estimated weighted mean age of the participants for the studies which provided this information was 42.80 (SD = 12.49).[7]
Internal consistency (Cronbach’s alpha, split half, etc.) Good The median of alphas from this study was .88[7]
Inter-rater reliability Not applicable Designed originally as a self-report scale; parent and youth report correlate about the same as cross-informant scores correlate in general[8]
Test-retest reliability (stability Excellent rtt = .90 over 30 days was first estimated by Vieta et. al.[7]
Repeatability Not published No published studies formally checking repeatability

Validity

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Validity describes the evidence that an assessment tool measures what it was supposed to measure. There are many different ways of checking validity. For screening measures, diagnostic accuracy and discriminative validity are probably the most useful ways of looking at validity. Unless otherwise specified, the validity scores and values come from studies done with a United States population sample. Here is a rubric for describing validity of test scores in the context of evidence-based assessment.

  • What is the content validity?
    • Content validity: how much the items relate to what you are trying to measure
  • What is the construct validity?
    • Construct validity: how well the assessment is able to measure the abstract concept  it is trying to measure
    • Ex: An ADHD assessment with good construct validity correlates very highly with ADHD diagnoses
  • What is the discriminative validity?
    • Discriminative validity: how well the measure does NOT measure what it is NOT supposed to measure
    • Ex: An ADHD assessment with high discriminative validity would not measure severity of schizophrenic symptoms
  • What is the prescriptive validity?
    • Prescriptive validity: Refers to the capacity of an assessment to inform which intervention will have the best outcomes for a client
  • What is the validity generalization?
    • Validity generalization: how well the validity of the measure holds true across different populations
    • Ex: a measure that has been validated in multiple languages and has high validity with college students, as a self-report, and as a caregiver report would have good validity generalization
  • Is the measure sensitive to treatment? How sensitive?
    • IE: can you use this measure throughout the course of a treatment to see if the treatment is working?
  • What is the clinical utility of the measure?
    • IE: does this measure ultimately help clinicians and clients?
    • Ex: if the measure costs a lot of money to take, is long, cumbersome, and has low validity/reliability, then it would have low clinical utility
Evaluation of validity and utility for the General Behavior Inventory (table from Youngstrom et al., unpublished, extended from Hunsley & Mash, 2008; *indicates new construct or category)
Criterion Rating (adequate, good, excellent, too good*) Explanation with references
Content validity Excellent Covers both DSM diagnostic symptoms and a range of associated features[9]
Construct validity (e.g., predictive, concurrent, convergent, and discriminant validity) Excellent Shows convergent validity with other symptom scales, longitudinal prediction of development of mood disorders,[10][11][12] criterion validity via metabolic markers[9][13] and associations with family history of mood disorder.[14] Factor structure complicated;[9][15] the inclusion of “biphasic” or “mixed” mood items creates a lot of cross-loading
Discriminative validity Excellent Multiple studies show that GBI scores discriminate cases with unipolar and bipolar mood disorders from other clinical disorders[9][16][17] effect sizes are among the largest of existing scales[18]
Validity generalization Good Used both as self-report and caregiver report; used in college student[15][19] as well as outpatient[16][20][21] and inpatient clinical samples; translated into multiple languages with good reliability
Treatment sensitivity Good Multiple studies show sensitivity to treatment effects comparable to using interviews by trained raters, including placebo-controlled, masked assignment trials[22][23] Short forms appear to retain sensitivity to treatment effects while substantially reducing burden[23][24]
Clinical utility Good Free (public domain), strong psychometrics, extensive research base. Biggest concerns are length and reading level. Short forms have less research, but are appealing based on reduced burden and promising data

Development and history

[edit]
  • Why was the instrument developed? What need did this instrument meet? When?
  • How was the scale developed? What was the theoretical background behind it?
  • If there were previous versions, when were they published?

The Hypomania Checklist was built as a more efficient screening measure for hypomania, to be used both in epidemiological research and in clinical use. Existing measures for bipolar disorder focused on identifying personality factors and symptom severity instead of the episodic nature of hypomania or the possible negative consequences in behavioral, affective, or cognitive changes associated.[25] These measures were mostly used in non-clinical populations to identify individuals at risk and were not used as screening instruments. The HCL-32 is a measure intended to have high sensitivity to direct clinicians from many countries to diagnosing individuals in a clinical population with bipolar disorder, specifically bipolar II disorder.

Initially developed by Jules Angst and Thomas Meyer in German, the questionnaire was translated into English and translated back to German to ensure accuracy. The English version of the HCL has been used as the basis for translation in other languages through the same process. The original study that used the HCL in an Italian and a Swiss sample noted the measure's high sensitivity and a lower sensitivity than other used measures.

The scale includes a checklist of 32 possible symptoms of hypomania, each rated yes or no. The rating "yes" would mean the symptom is present or this trait is "typical of me," and "no" would mean that the symptom is not present or "not typical" for the person.[25]

Impact

[edit]
  • What was the impact of this assessment? How did it affect assessment in psychiatry, psychology and health care professionals?
  • What can the assessment be used for in clinical settings? Can it be used to measure symptoms longitudinally? Developmentally?

Use in other populations

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The HCl - 32 has been translated into over 15 different languages.[26] These include Spanish, German, Italian, Chinese, Russian, and Swedish, among others.[27][28][29][30][31][32]

Research

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  • Any recent research done that is pertinent?

Limitations

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    • What are some of the measure’s limitations? Be thorough in your explanation.
      • Ex: does it have low reliability? Is it a self-report measure?
    • Is the measure copyrighted?

The HCL suffers from the same problems as other self-report inventories, in that scores can be easily exaggerated or minimized by the person completing them. Like all questionnaires, the way the instrument is administered can influence the final score. If a patient is asked to fill out the form in front of other people in a clinical environment, for instance, social expectations may elicit a different response compared to administration via a postal survey.[33]

Similar reliability scores were found when only using 16 item assessments versus the traditional 32-item format of the HCL-32[citation needed]. A score of at least 8 items was found valid and reliable for distinguishing Bipolar Disorder and Major Depressive Disorder[citation needed]. In a study, 73% of patients who completed the HCL-32 R1 were true bipolar cases identified as potential bipolar cases. However, the HCL-32 R1 does not accurately differentiate between Bipolar I and Bipolar II.[34] However, the 16-item HCL has not been tested as a standalone section in a hospital setting. In addition, while the HCL-32 is a sensitive instrument for hypomanic symptoms, it does not distinguish between bipolar I and bipolar-II disorders[citation needed]. The HCL-32 has not been compared with other commonly used screening tools for bipolar disorder, such as the Young Mania Rating Scale, Young Mania Rating Scale and the General Behavior Inventory. The online version of the HCL has been shown to be as reliable as the paper version.[34]

See also

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  • Are there any relevant Wikipedia pages to the article? If so, link them here.
  • Are there free pdf versions of the questionnaire (if not copyrighted)? If so, link them here.

For instance:

[edit]
    • Find author/publisher and link their bio page here
    • Link any relevant resources (if applicable)

Example page

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References

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  1. ^ Bowling A (2005). "Mode of questionnaire administration can have serious effects on data quality". Journal of Public Health. 27 (3): 281–91. doi:10.1093/pubmed/fdi031. PMID 15870099.
  2. ^ "The use of Mood Disorder Questionnaire, Hypomania Checklist-32 and clinical predictors for screening previously unrecognised bipolar disorder in a general psychiatric setting". www.sciencedirect.com. Retrieved 2017-04-07.
  3. ^ a b Forty L, Kelly M, Jones L, Jones I, Barnes E, Caesar S, Fraser C, Gordon-Smith K, Griffiths E, Craddock N, Smith DJ (2010). "Reducing the Hypomania Checklist (HCL-32) to a 16-item version". Journal of Affective Disorders. 124 (3): 351–6. doi:10.1016/j.jad.2010.01.004. PMID 20129673.
  4. ^ Carvalho, André F.; Takwoingi, Yemisi; Sales, Paulo Marcelo G.; Soczynska, Joanna K.; Köhler, Cristiano A.; Freitas, Thiago H.; Quevedo, João; Hyphantis, Thomas N.; McIntyre, Roger S. (2015-02-01). "Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies". Journal of Affective Disorders. 172: 337–346. doi:10.1016/j.jad.2014.10.024. ISSN 0165-0327. PMID 25451435.
  5. ^ Takwoingi, Yemisi; Riley, Richard D.; Deeks, Jonathan J. (2015-11-01). "Meta-analysis of diagnostic accuracy studies in mental health". Evidence Based Mental Health. 18 (4): 103–109. doi:10.1136/eb-2015-102228. ISSN 1468-960X. PMC 4680179. PMID 26446042.
  6. ^ Singh, Sukhmeet; Scouller (2017). "Evaluation of the 13-item Hypomania Checklist and a brief 3-item manic features questionnaire in primary care". BJ Psych Bulletin. 41.
  7. ^ a b c d e Angst, Jules; Meyer (2010). "Hypomania: A transcultural perspective". World Psychiatry. 9: 41–49. Cite error: The named reference ":5" was defined multiple times with different content (see the help page).
  8. ^ Achenbach, TM; McConaughy, SH; Howell, CT (March 1987). "Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity". Psychological Bulletin. 101 (2): 213–32. PMID 3562706.
  9. ^ a b c d Depue, Richard A.; Slater, Judith F.; Wolfstetter-Kausch, Heidi; Klein, Daniel; Goplerud, Eric; Farr, David (1981). "A behavioral paradigm for identifying persons at risk for bipolar depressive disorder: A conceptual framework and five validation studies". Journal of Abnormal Psychology. 90 (5): 381–437. doi:10.1037/0021-843X.90.5.381. {{cite journal}}: |access-date= requires |url= (help)
  10. ^ Klein, DN; Dickstein, S; Taylor, EB; Harding, K (February 1989). "Identifying chronic affective disorders in outpatients: validation of the General Behavior Inventory". Journal of consulting and clinical psychology. 57 (1): 106–11. PMID 2925959. {{cite journal}}: |access-date= requires |url= (help)
  11. ^ Mesman, Esther; Nolen, Willem A.; Reichart, Catrien G.; Wals, Marjolein; Hillegers, Manon H.J. (May 2013). "The Dutch Bipolar Offspring Study: 12-Year Follow-Up". American Journal of Psychiatry. 170 (5): 542–549. doi:10.1176/appi.ajp.2012.12030401. {{cite journal}}: |access-date= requires |url= (help)
  12. ^ Reichart, CG; van der Ende, J; Wals, M; Hillegers, MH; Nolen, WA; Ormel, J; Verhulst, FC (December 2005). "The use of the GBI as predictor of bipolar disorder in a population of adolescent offspring of parents with a bipolar disorder". Journal of affective disorders. 89 (1–3): 147–55. PMID 16260043. {{cite journal}}: |access-date= requires |url= (help)
  13. ^ Depue, RA; Kleiman, RM; Davis, P; Hutchinson, M; Krauss, SP (February 1985). "The behavioral high-risk paradigm and bipolar affective disorder, VIII: Serum free cortisol in nonpatient cyclothymic subjects selected by the General Behavior Inventory". The American journal of psychiatry. 142 (2): 175–81. PMID 3970242. {{cite journal}}: |access-date= requires |url= (help)
  14. ^ Klein, DN; Depue, RA (August 1984). "Continued impairment in persons at risk for bipolar affective disorder: results of a 19-month follow-up study". Journal of abnormal psychology. 93 (3): 345–7. PMID 6470321. {{cite journal}}: |access-date= requires |url= (help)
  15. ^ a b Pendergast, Laura L.; Youngstrom, Eric A.; Brown, Christopher; Jensen, Dane; Abramson, Lyn Y.; Alloy, Lauren B. (2015). "Structural invariance of General Behavior Inventory (GBI) scores in Black and White young adults". Psychological Assessment. 27 (1): 21–30. doi:10.1037/pas0000020. {{cite journal}}: |access-date= requires |url= (help)
  16. ^ a b Danielson, CK; Youngstrom, EA; Findling, RL; Calabrese, JR (February 2003). "Discriminative validity of the general behavior inventory using youth report". Journal of abnormal child psychology. 31 (1): 29–39. PMID 12597697. {{cite journal}}: |access-date= requires |url= (help)
  17. ^ Findling, RL; Youngstrom, EA; Danielson, CK; DelPorto-Bedoya, D; Papish-David, R; Townsend, L; Calabrese, JR (February 2002). "Clinical decision-making using the General Behavior Inventory in juvenile bipolarity". Bipolar disorders. 4 (1): 34–42. PMID 12047493. {{cite journal}}: |access-date= requires |url= (help)
  18. ^ Youngstrom, Eric A.; Genzlinger, Jacquelynne E.; Egerton, Gregory A.; Van Meter, Anna R. (2015). "Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania". Archives of Scientific Psychology. 3 (1): 112–137. doi:10.1037/arc0000024. {{cite journal}}: |access-date= requires |url= (help)
  19. ^ Alloy, LB; Abramson, LY; Hogan, ME; Whitehouse, WG; Rose, DT; Robinson, MS; Kim, RS; Lapkin, JB (August 2000). "The Temple-Wisconsin Cognitive Vulnerability to Depression Project: lifetime history of axis I psychopathology in individuals at high and low cognitive risk for depression". Journal of abnormal psychology. 109 (3): 403–18. PMID 11016110. {{cite journal}}: |access-date= requires |url= (help)
  20. ^ Klein, Daniel N.; Dickstein, Susan; Taylor, Ellen B.; Harding, Kathryn (1989). "Identifying chronic affective disorders in outpatients: Validation of the General Behavior Inventory". Journal of Consulting and Clinical Psychology. 57 (1): 106–111. doi:10.1037/0022-006X.57.1.106. {{cite journal}}: |access-date= requires |url= (help)
  21. ^ Youngstrom, EA; Findling, RL; Danielson, CK; Calabrese, JR (June 2001). "Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory". Psychological assessment. 13 (2): 267–76. PMID 11433802. {{cite journal}}: |access-date= requires |url= (help)
  22. ^ Findling, RL; Youngstrom, EA; McNamara, NK; Stansbrey, RJ; Wynbrandt, JL; Adegbite, C; Rowles, BM; Demeter, CA; Frazier, TW; Calabrese, JR (January 2012). "Double-blind, randomized, placebo-controlled long-term maintenance study of aripiprazole in children with bipolar disorder". The Journal of clinical psychiatry. 73 (1): 57–63. PMID 22152402. {{cite journal}}: |access-date= requires |url= (help)
  23. ^ a b Youngstrom, E; Zhao, J; Mankoski, R; Forbes, RA; Marcus, RM; Carson, W; McQuade, R; Findling, RL (March 2013). "Clinical significance of treatment effects with aripiprazole versus placebo in a study of manic or mixed episodes associated with pediatric bipolar I disorder". Journal of child and adolescent psychopharmacology. 23 (2): 72–9. PMID 23480324. {{cite journal}}: |access-date= requires |url= (help)
  24. ^ Ong, ML; Youngstrom, EA; Chua, JJ; Halverson, TF; Horwitz, SM; Storfer-Isser, A; Frazier, TW; Fristad, MA; Arnold, LE; Phillips, ML; Birmaher, B; Kowatch, RA; Findling, RL; LAMS, Group (1 July 2016). "Comparing the CASI-4R and the PGBI-10 M for Differentiating Bipolar Spectrum Disorders from Other Outpatient Diagnoses in Youth". Journal of abnormal child psychology. PMID 27364346. {{cite journal}}: |access-date= requires |url= (help); |first14= has generic name (help)
  25. ^ a b Angst J, Adolfsson R, Benazzi F, Gamma A, Hantouche E, Meyer TD, Skeppar P, Vieta E, Scott J (2005). "The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients". Journal of Affective Disorders. 88 (2): 217–33. doi:10.1016/j.jad.2005.05.011. PMID 16125784.
  26. ^ "Hypomania/Mania Symptom Checklist (HCL-32) | PsychEducation". psycheducation.org. Retrieved 2017-04-07.
  27. ^ Mosolov, S. N.; Ushkalova, A. V.; Kostukova, E. G.; Shafarenko, A. A.; Alfimov, P. V.; Kostyukova, A. B.; Angst, J. (2014-02-01). "Validation of the Russian version of the Hypomania Checklist (HCL-32) for the detection of Bipolar II disorder in patients with a current diagnosis of recurrent depression". Journal of Affective Disorders. 155: 90–95. doi:10.1016/j.jad.2013.10.029. ISSN 1573-2517. PMID 24230917.
  28. ^ Meyer, Thomas D.; Bernhard, Britta; Born, Christoph; Fuhr, Kristina; Gerber, Sonja; Schaerer, Lars; Langosch, Jens M.; Pfennig, Andrea; Sasse, Johanna (2011-02-01). "The Hypomania Checklist-32 and the Mood Disorder Questionnaire as screening tools--going beyond samples of purely mood-disordered patients". Journal of Affective Disorders. 128 (3): 291–298. doi:10.1016/j.jad.2010.07.003. ISSN 1573-2517. PMID 20674032.
  29. ^ Vieta, E.; Sánchez-Moreno, J.; Bulbena, A.; Chamorro, L.; Ramos, J. L.; Artal, J.; Pérez, F.; Oliveras, M. A.; Valle, J. (2007-08-01). "Cross validation with the mood disorder questionnaire (MDQ) of an instrument for the detection of hypomania in Spanish: the 32 item hypomania symptom check list (HCL-32)". Journal of Affective Disorders. 101 (1–3): 43–55. doi:10.1016/j.jad.2006.09.040. ISSN 0165-0327. PMID 17189651.
  30. ^ "Hypomania Checklist-33--Chinese Version: EBSCOhost". web.a.ebscohost.com. Retrieved 2017-04-07.
  31. ^ Carta, Mauro Giovanni; Hardoy, Maria Carolina; Cadeddu, Mariangela; Murru, Andrea; Campus, Andrea; Morosini, Pier Luigi; Gamma, Alex; Angst, Jules (2006-01-01). "The accuracy of the Italian version of the Hypomania Checklist (HCL-32) for the screening of bipolar disorders and comparison with the Mood Disorder Questionnaire (MDQ) in a clinical sample". Clinical Practice and Epidemiology in Mental Health. 2: 2. doi:10.1186/1745-0179-2-2. ISSN 1745-0179. PMC 1420280. PMID 16524481.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  32. ^ "Elsevier: Article Locator". www.sciencedirect.com. Retrieved 2017-04-07.
  33. ^ Bowling A (2005). "Mode of questionnaire administration can have serious effects on data quality". Journal of Public Health. 27 (3): 281–91. doi:10.1093/pubmed/fdi031. PMID 15870099.
  34. ^ a b Angst (June 2007). "Hypomania Check List (HCL-32 R1) Manual" (PDF). Retrieved 23 November 2015.


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