Instruments are available for the following disorders. Click on each disorder to view the instruments available, a brief description, and the scoring algorithm. Please read the remainder of this page before accessing or using any of the instruments in order to become more familiar with the spectrum model and concepts.

Many instruments were developed as structured clinical interviews and later converted to a patient self-report format. We believe the structured clinical interview format is useful for clinicians to learn the content and range of response on each instrument. We suggest you administer the structured clinical interview a few times until you are comfortable with questioning patients in this manner. Only then should you opt to use the self-report version in its place. Then decide which method works best for you, your patients, and your situation.

Why should I use spectrum instruments?

The spectrum instruments have the potential to help health care professionals better understand their patients and patients feel better understood. The spectrum instruments are:

Easy to complete, score, and understand
Acceptable and useful by both patients and clinicians
Flexibly administered as clinical interviews or self-reports
Available to assess symptoms over the lifetime, the past month or the past week
Validated
Useful in predicting clinical outcomes
Helpful for health care professionals to distinguish symptoms of physical illnesses that may also be expressions of mental or emotional disturbances
Useful in the initial stages of treatment planning
Useful for monitoring change (the weekly and monthly versions)

Example of an application for a medical practitioner

A patient presents with unexplained hand dermatitis. After a thorough exam, you prescribe certain lotions to be used daily. When the patient returns one month later for a follow-up, she is no better and you cannot determine the reason. You administer the Obsessive-Compulsive Spectrum Lifetime Self-Report and learn that she endorses many of the items, including contamination fears and frequent hand washing. You refer her to a colleague who diagnoses and treats the obsessive-compulsive symptoms and subsequently the dermatological condition remits.

Example of an application for a mental health practitioner

A patient presents himself for treatment of major depressive disorder. He has a history of an inability to tolerate (“is allergic to”) medications. You suspect the patient might have panic-agoraphobic spectrum so you administer the Panic-Agoraphobic Spectrum Lifetime Self-Report. He endorses many items including typical panic symptoms and substance sensitivity. You explain to the patient the concept of panic spectrum and convince him to try another medication beginning with a very low dose and increasing the dosage gradually. The patient is relieved that you understand his concerns and is willing to consider that he’s not allergic.

How long are the spectrum instruments?

Instruments vary in length from 100 to 160 items.

How are the spectrum instruments scored?

Spectrum instruments can be scored in a variety of ways, depending on the needs of the user. Scoring can be either dimensional or categorical. When used dimensionally, scores can constitute a profile of the individual items or of domain subscales. Total spectrum score can also be used as a severity index. Alternatively, a cut-score for spectrum total scores can be used to identify a categorical disorder.

Have these instruments are validated?

Many of the instruments have been validated in psychiatric and non-psychiatric patient populations. Please refer to each individual instrument for this information.

What are the procedures for the development of the instruments?

The work of the Spectrum Collaborative Project consisted of converting clinical observations into a systematic inquiry to elicit lifetime symptoms, traits and behaviors occurring commonly in patients with mood, panic-agoraphobia, social phobia, obsessive-compulsive and eating disorders. Structured clinical interviews were developed during a series of meetings, with additional input from experts in each area as needed. Both DSM criterion symptoms and non-DSM criteria of the five disorders were included.

Italian and English versions of the instruments were developed in parallel at meetings of the spectrum group. Based on our combined clinical experience and the bilingual expertise of several members of the group, the translations were deemed adequate (Rucci & Maser, 2000]. Before validation studies were conducted, instruments were pilot-tested with appropriate patient populations and language was adjusted as needed. Multi-center validation studies were then conducted in Italy for each instrument. A separate SCI-PAS validation study was conducted in Pisa, Italy, and Pittsburgh, PA, U.S., to examine further aspects of validity and reliability and to explore cross-cultural differences (Frank et al, 2005). After conducting the validation studies of the structured clinical interviews, which covered symptoms and behaviors over the lifetime, investigators developed lifetime self-report instruments that could be completed by the patients themselves. These easily completed instruments ask patients to answer 'yes' or 'no' to 100-160 questions per spectrum instrument. Then, in order to assess current features of each disorder spectrum, versions were developed for the assessment of symptoms and behaviors over the past month and the past week.

Rucci P, Maser JD: Instrument development in the Italy-USA collaborative spectrum project. Epidemiologia e Psichiatria Sociale, 9:249-256, 2000.