Methodology respecting the recommendation of standardized measurement instruments

This appendix presents the steps that led to the recommendation of the most appropriate instruments to conduct surveys of mental health status, its determinants and possible consequences by means of population-based surveys (section 6).

Committee of experts

A committee of experts was established to pinpoint and recommend the standardized instruments. The committee, chaired by Dr. Pierre Gosselin and coordinated by Magalie Canuel, comprised three experts in the realm of mental health or population-based mental health surveillance: Dr. Alain Brunet (Douglas Mental Health University Institute), Dr. Arnaud Duhoux (Université de Montréal) and Dr. Alain Lesage (INSPQ). The experts were recruited by invitation based on their CVs. Each committee member filled out a conflict of interest disclosure form. No conflict of interest was reported.

Their mandate was to:

  • comment on the list of indicators initially selected;
  • verify that the list of instruments identified during the first stage of selection was complete;
  • evaluate the standardized measurement instruments according to a list of criteria;
  • revise and comment on the recommendations.

Indicators studied

Initially, only indicators that allow for the evaluation of mental health status were to be selected. Accordingly, emphasis was placed mainly on such indicators. However, it may be equally important to monitor the determinants of mental health status and certain other possible consequences in the wake of a disaster. Based on the experts’ recommendation, a number of instruments were proposed to measure certain of the indicators. Table 1 presents the list of indicators, which the committee of experts revised.

It should be noted that this toolkit mainly covers only one dimension of mental health, i.e. mental health problems. It covers to a limited extent positive mental health in the Well-being section.

Table 1 - List of categories of indicators selected that are related to mental health status, its determinants and possible consequences
Indicators
  • Anxiety symptoms
  • Depressive symptoms
  • Post-traumatic stress disorder symptoms
  • Psychological distress
  • Immediate impact of the trauma (peritraumatic reactions)
  • Well-being
  • Functioning and disability
  • Quality of life
  • Social support
  • Alcohol use
  • Drug use
  • Medication use
  • Use of mental health services

Selection of the measurement instruments

The list of standardized measurement instruments was based on targeted research in two databases (PubMed and EBSCOhost), instrument databases such as PILOTS, the website of psychometric instruments in French, published books and the grey literature. Research in the two databases proved arduous given the difficulty of clearly defining the search criteria, which generated results not confined to standardized measurement instruments. Accordingly, it is mainly the other search engines that were used to establish the list of instruments.
 

First stage in the selection

For the tools to be selected in the first stage, they had to satisfy the following criteria:

  • instruments in the public domain or protected by copyright but without charge;
  • instruments written in or translated into French;
  • instruments that use a self-report questionnaire.

Table 2 presents the list of instruments that satisfy these criteria.

Table 2  - Standardized instruments that satisfy the first selection criteria, depending on the indicators selected
Standardized measurement instruments*
Anxiety symptoms
  • Catastrophic Cognitions Questionnaire – Modified (CCQ-M)
  • Composite International Diagnostic Interview – Short Form (CIDI-SF)
  • Composite International Diagnostic Interview (CIDI)
  • De Bonis Anxiété Trait-État (BATE)
  • Depression Anxiety Stress Scales (DASS)
  • Diagnostic Interview Schedule for Adult and for Children (DISC)
  • Diagramme de Ferreri (FARD)
  • Échelle de Covi (COVI)
  • Generalized Anxiety Disorder – 7 items (GAD-7)
  • Generalized Anxiety Disorder – Questionnaire-IV (GAD-Q-IV)
  • Hamilton Anxiety Rating Scale (HAM-A)
  • Hopkins Symptom Checklist – 25 items (HSCL-25)
  • Mini-International Neuropsychiatric Interview (MINI)
  • Overall Anxiety Severity and Impairment Scale (OASIS)
  • Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales (PHQ-SADS)
  • Penn State Worry Questionnaire (PSWQ)
  • Revised Children's Anxiety and Depression Scale – Youth and Parent Version (RCADS)
  • Screen for Child Anxiety Related Emotional Disorders (SCARED)
  • Spence Children's Anxiety Scale (SCAS)
  • World Health Organization World Mental Health Composite International Diagnostic Interview (WHO WMH-CIDI)
  • Zung Self-Rating Anxiety Scale (SAS)
Depressive symptoms
  • Adolescent Depression Rating Scale (ADRS)
  • Attributional Style Questionnaire (ASQ)
  • Beck Depression Inventory (BDI)
  • Center for Epidemiologic Studies – Depression Scale (CES-D)
  • Center for Epidemiologic Studies – Depression Scale for Children (CES-DC)
  • Clinically Useful Depression Outcome Scale (CUDOS)
  • Columbia Depression Scale (CDS)
  • Composite International Diagnostic Interview – Short Form(CIDI- SF) CIDI-SF
  • Composite International Diagnostic Interview (CIDI)
  • Depression Anxiety Stress Scales (DASS)
  • Depression Self-Rating Scale for Children (DSRS)
  • Diagnostic Interview Schedule for Adult and for Children (DISC)
  • Diagnostic Inventory for Depression (DID)
  • Échelle de ralentissement dépressif (ERD)
  • Geriatric Depression Scale – Short form (GDS-SF)
  • Geriatric Depression Scale (GDS)
  • Harvard National Depression Screening Scale (HANDS)
  • Hopkins Symptom Checklist – 25 items (HSCL-25)
  • Mini-International Neuropsychiatric Interview (MINI)
  • MOS Depression Questionnaire (MOS-DQ)
  • Patient Health Questionnaire (PHQ)
  • Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales (PHQ-SADS)
  • Questionnaire QD-2A (QD-2A)
  • Quick inventory of Depressive Symptomatology (QIDS)
  • Revised Children's Anxiety and Depression Scale – Youth and Parent Version (RCADS)
  • World Health Organization World Mental Health Composite International Diagnostic Interview (WHO WMH-CIDI)
  • Zung Self-Rating Depression Scale (SDS)
Post-traumatic stress disorder symptoms
  • Child Posttraumatic Stress Reaction Index (CPTS-RI)
  • Child PTSD Symptom Scale (CPSS)
  • Children's Impact of Traumatic Events Scale – Revised (CITES-2)
  • Children's Revised Impact of Event Scale (CRIES)
  • Composite International Diagnostic Interview (CIDI)
  • Diagnostic Interview Schedule for Adult and for Children (DISC)
  • Impact of Event Scale – Revised (IES-R)
  • Impact of Event Scale (IES)
  • Los Angeles Symptom Checklist (LASC)
  • Mini-International Neuropsychiatric Interview (MINI)
  • Modified PTSD Symptom Scale (MPSS-SR)
  • Pediatric Emotional Distress Scale (PEDS)
  • Posttraumatic Stress Disorder Checklist (PCL-S; PCL-C; PCL-M; PCL-5)
  • Primary Care PTSD Screen (PC-PTSD)
  • Short Posttraumatic Stress Disorder Rating Interview (SPRINT)
  • Structured Interview for Posttraumatic Stress Disorder (SI-PTSD)
  • Structured Trauma-Related Experiences and Symptoms Screener (STRESS)
  • Traumatic Events Screening Inventory for Children (TESI-C)
  • World Health Organization World Mental Health Composite International Diagnostic Interview (WHO WMH-CIDI)
Immediate impact of the trauma
  • Peritraumatic Dissociative Experiences Questionnaire (PDEQ) PDEQ
  • Peritraumatic Distress Inventory (PDI)
  • Shortness of Breath, Tremulousness, Racing Heart and Sweating Rating Scale (STRS-A3)
Psychological distress
  • Hassles scale
  • Indice de détresse psychologique de Santé Québec – 14 items (IDPSQ-14)
  • Kessler Psychological Distress Scale (K6; K10)
  • Mental Health Inventory (MHI)
  • Mesure de stress psychologique (MSP)
  • Perceived Stress Scale (PSS)
  • Question « Stress quotidien perçu » (dans l’ESCC)
  • Self Reporting Questionnaire (SRQ)
Well-being
  • Affect Balance Scale (ABS)
  • Échelle de mesure des manifestations du bien-être psychologique – version courte (ÉMMBEP)
  • General Well-Being Schedule (GWB)
  • Mental Health Continuum (MHC)
  • Personal Wellbeing Index – Adult/School Children (PWI-A/PWI-SC)
  • Positive and Negative Affect Schedule (PANAS)
  • Psychological General Well-Being Index (PGWBI)
  • Ryff’s Scales of Psychological Well-Being – 18 items (RPWB-18)
  • Well-Being Questionnaire – 12 items (W-QB12)
  • World Health Organization Well-Being Index (WHO-5)
Functioning and disability
  • Bristol Activites of Daily Living Scale (BADLS)
  • Échelle d’adaptation sociale II (EAS-II)
  • Functional Independence Measure (FIM)
  • Module « Activités de la vie quotidienne » (dans l’ESCC)
  • Social functioning questionnaire (SFQ)
  • World Health Organization Disability Assessment Schedule (WHODAS 2.0)
Quality of life
  • Échelle de qualité de vie (SEP-59)
  • EuroQol-5-Dimension (EQ-5D-5L)
  • Health-Related Quality of Life (HRQOL)
  • Life Satisfaction Index (LSI)
  • McGill Quality of Life Questionnaire – Revised (MQOL)
  • Quality of life Enjoyment and Satisfaction Questionnaire – Short form (Q-LES-Q)
  • Quality of life Questionnaire; Quality of life Interview (Bigelow, Douglas, A.)
  • Quality of Life Scale (QOLS)
  • Question « État de santé mentale perçue » (dans l’ESCC)
  • Question « État de santé perçu » (dans l’ESCC)
  • Question « Satisfaction à l'égard de la vie » (dans l’ESCC)
  • Rand 36-item Health Survey (Rand-36)
  • Satisfaction with Life Scale (SWLS)
  • Schalock and Keith Quality of Life Questionnaire (QOL-Q)
  • Short Form 36 Health Survey (SF-36)
  • Short-Form SF-12v2 Health Survey
  • Temporal Satisfaction with Life Scale (TSWLS)
  • World Health Organization Quality of Life (WHOQOL-BREF)
Social support
  • 3-Item Oslo Social Support Scale (O3SS)
  • Duke Social Support Index/Abbreviated Duke Social Support Index (DSSI)
  • Duke-UNC Functional Social Support Questionnaire (DUFSS)
  • Échelle de la qualité des relations interpersonnelles (EQRI)
  • Échelle de solitude de UCLA
  • Interpersonal Support Evaluation List (ISEL)
  • Inventory of Socially Supportive Behaviors (ISSB)
  • Lubben Social Network Scale (LSNS)
  • Medical Outcome Study Social Support Survey (MOS)
  • Mesure du fonctionnement social
  • Module « Échelle de provisions sociales » (dans l’ESCC – Santé mentale)
  • Module « Échelle de provisions sociales » (dans l’ESCC – Santé mentale)
  • Multidimensional Scale of Perceived Social Support (MSPSS)
  • Perceived Social Support from Family and from Friends (PSS-Fa; PSS-Fr)
  • Question « Satisfaction à l'égard de sa vie sociale » (EQSP)
  • Social Support Questionnaire (SSQ)
  • Soutien social dans l'environnement familial (dans le California Healthy Kids Survey)
  • Soutien social dans l'environnement scolaire (dans le California Healthy Kids Survey)
  • Soutien social des amis (dans le California Healthy Kids Survey)
Alcohol use
  • Adolescent Alcohol and Drug Involvement Scale (AAIDS)
  • Alcohol Use Disorders Identification Test (AUDIT)
  • Alcohol, Smoking and Substance Involment Screening Test (ASSIST)
  • Brief COPE
  • CAGE Questionnaire
  • Composite International Diagnostic Interview – Short form (CIDI-SF)
  • CRAFFT Screening Tool for Adolescent Substance Abuse (CRAFFT)
  • Dépistage/évaluation du besoin d'aide – Alcool (DÉBA-A)
  • Grille de dépistage de consommation problématique d'alcool et de drogues chez les adolescents et adolescentes (DEP-ADO)
  • Michigan Alcoholism Screening Test – Revised (MAST)
  • Patient Health Questionnaire (PHQ) – Alcohol Abuse and Dependence module
  • Penn Alcohol Craving Scale (PACS)
  • Rapid Alcohol Problems Screen 4 (RAPS4)
  • T-ACE Questionnaire
  • Temptation and Restraint Inventory (TRI)
  • TWEAK Questionnaire
  • Two-Item Conjoint Screen (TICS)
Drug use
  • Alcohol, Smoking and Substance Involment Screening Test (ASSIST)
  • Brief COPE
  • CAGE Questionnaire – Adapted to include drugs (CAGE-AID)
  • Consommation de drogues (dans l’EQSJS)
  • Consommation de drogues (dans l’EQSP)
  • CRAFFT Screening Tool for Adolescent Substance Abuse (CRAFFT)
  • Dépistage/évaluation du besoin d'aide – Drogues (DÉBA-D)
  • Drug Abuse Screening Test – 10 items (DAST-10)
  • Grille de dépistage de consommation problématique d'alcool et de drogues chez les adolescents et adolescentes (DEP-ADO)
  • Usage de drogues illicites (dans l’ESCC)
  • World Health Organization World Mental Health Composite International Diagnostic Interview (WHO WMH-CIDI)
Medication use
  • Consommation de médicaments (dans l’ESCC)
  • World Health Organization World Mental Health Composite International Diagnostic Interview (WHO WMH-CIDI)
Use of mental health services
  • Besoins de santé non comblés (dans l’ESCC)
  • Consultations chez des médecins ou avec certains professionnels de la santé (dans l’ESCC)
  • Projet dialogue (adaptation des questions de l'ESCC)

*    The name of the instruments are identified in English when they have been developed in English.

Second stage in the selection

The experts were to assess the 166 preselected measurement instruments (Table 2) according to a list of criteria. They were to assign a score of 0 to 10 to each one. The scores were attributed subjectively and were based on the experts’ knowledge of the instruments. A score of 0 to 4 meant that the tool satisfied the criterion “not at all”, “very little” or “little.” A score of 5 to 10 meant that the tool satisfied the criterion “well” or “very well.” The experts were not to write anything if they were unfamiliar with the tool. An average score was then calculated of all the scores that the experts attributed.

The following selection and evaluation criteria applied to the instruments:

  • a small number of items (or short administration period of the questionnaire);
  • the sound metrological quality of the French and English versions;
  • a validated French version;
  • ease of use and interpretation by non-experts, e.g. the presence of threshold scores for interpretation;
  • the availability of reference data for comparison purposes.

Third stage in the selection

Following the second stage of the selection, five to six instruments with the best scores were selected and prioritized. The committee then reached a consensus to recommend one instrument among those selected and to suggest one or two others with equally sound potential.