SCL 90-R interpretation and brain tumour: a correction factor?

OBJECTIVE

Determine whether spurious SCL 90-R profiles resulting from endorsement of neurologic treatment items can be corrected and still retain ecological validity.

DESIGN

The proportion of subjects' item endorsement was compared with the adult non-patient norm group. Items with discriminative power (chi 2 > 25, p < 0.001 and endorsement by at least 25% of subjects) underwent principal-components analysis with somatic treatment and psychiatric factors identified. Items in the somatic treatment factor were extracted as the corrective factor. The resultant corrected T scores were plotted against original SCL 90-R profiles.

SETTING

University medical centre.

PATIENTS: Thirty community dwelling adults with biopsy confirmed malignant brain tumours referred by their treating physician for evaluation prior to aggressive treatment.

INTERVENTIONS: The SCL 90-R was part of a neuropsychological test battery.

MAIN OUTCOME MEASURE: The SCL 90-R was selected prior to data collection because it is the second most frequently used psychosocial instrument in medical settings, yet has demonstrated attenuated validity with neurologic patients.

RESULTS

Extraction of 10 somatic treatment items resulted in lower profiles on Somatization, OBSESSIVE: Compulsive, Depression, and Anxiety dimensions and the global indicators. However, clinical caseness for individuals remained greater than indicated by clinical interview.

CONCLUSION

Correction for SCL 90-R neurologic treatment items resulted in reduced sensitivity and poorer ecological validity.