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Assessment Instruments

I am retaking this class this is the previous assignment that was done please redo the assignment using tis a s a guide. The instructor will run assignment though the plagiarism checker. All work must be original

Anxiety and Related Disorders

Week X

DSM:

Schizophrenia

Instrument:

PANSS (Positive and Negative Syndrome Scale). According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) criteria, the tool is used to evaluate and diagnose Schizophrenia Spectrum, a psychotic disorder.

Article:

Lim, K., Peh, O. H., Yang, Z., Rekhi, G., Rapisarda, A., See, Y. M., … & Lam, M. (2021). Large-scale evaluation of the Positive and Negative Syndrome Scale (PANSS) symptom architecture in schizophrenia. 
Asian Journal of Psychiatry, 
62, 102732.

The article provides an analysis of the PANSS, examining its development, credibility, and reliability as an assessment instrument for Schizophrenia. The text points out the extensive utilization of the tool in both research and clinical facilities, thereby emphasizing its reliability and significance.

Appropriateness for Dx:

The PANSS is widely recognized as the predominant tool for assessing symptom severity in individuals diagnosed with Schizophrenia. The usage of this scale, consisting of 30 items, is typically conducted by clinicians who have received specialized training (Lim,
et
al., 2021). These clinicians evaluate the intensity of each symptom (referred to as an item) by choosing one of seven options (referred to as weights), which are numbered from 1 to 7. PANSS has demonstrated robust internal reliability, sound validity of constructs, and exceptional sensitivity to changes.

Response to Therapy/Treatment:

PANSS is predominantly employed in the evaluation and identification of psychotic symptoms for the purpose of assessment and diagnosis. This measurement tool does not possess a specific design for assessing patient response to therapy or treatment. However, this tool has the potential to monitor fluctuations in the intensity of symptoms over a period, thereby serving as an indirect measure of the efficacy of treatment interventions (Lim,
et
al., 2021). The tool demonstrates efficacy in the identification of schizophrenic symptoms in patients, both prior to and after the treatment. PANSS classifies symptoms into distinct categories, namely positive, negative, cognitive, and general psychopathology. The process of classifying aids in the assessment of the effectiveness of a given treatment or therapy. Nonetheless, it is important to point out that PANSS is not designed to be utilized as a solitary diagnostic instrument. The utilization of this tool should be combined with a thorough clinical evaluation to establish a diagnosis.

Psychometrics:

The PANSS instrument comprises a comprehensive symptom assessment, encompassing 30 items that are rated on a scale ranging from one to seven. The total average symptom score is derived from these items, yielding a range of 30 to 210. Higher test scores are indicative of worsened Schizophrenia symptom severity. Every category in the instrument is assigned a score ranging from 1 to 7 (Lim,
et
al., 2021), which reflects the extent and intensity of symptoms experienced: (1 = no presence, 2 = minimal presence, 3 = mild presence, 4 = moderate presence, 5 = moderately severe presence, 6 = severe presence, 7 = extremely severe presence). Strong reliability and validity are among the PANSS’s numerous desirable psychometric qualities, with 7 gauging positive symptoms, 7 gauging negative ones, and 16 gauging the overall psychopathology.

Reliability: The PANSS has been demonstrated to have excellent levels of internal consistency, as seen by the high Cronbach’s alpha coefficients that have been recorded for the positive, negative, and general psychopathology subscales. Additionally, there is a high level of inter-rater reliability, which indicates that various raters came to similar conclusions on the ratings given.

Validity: The Positive and Negative Syndrome Scale for the assessment of Schizophrenia (PANSS) has been shown to have strong synchronous validity by positively correlating with other well-established measures of the severity of Schizophrenia symptoms. It has further been confirmed to have strong distinctive validity, meaning that it can differentiate between those who have Schizophrenia and those who have other mental illnesses. In addition, the PANSS demonstrated sensitivity to change, which provides evidence of its responsiveness in identifying treatment effects.

Limitations:

Although PANSS holds significant value as an assessment tool, it is not without certain limitations. Firstly, there is a significant dependence on clinician ratings, which has the potential to create subjective aspects and variations in the scoring process. To effectively tackle this issue, it is advisable to implement training and provide continuous supervision to guarantee the consistent and dependable execution of tasks. The limited number of elements, which may be mostly treatment-responsive, is another major constraint. It is possible that the psychopathological aspects of Schizophrenia that are most common would not be assessed through simple PANSS (Lim,
et
al., 2021). Moreover, it is important to note that the instrument primarily emphasizes the assessment of symptom severity, potentially limiting its ability to fully capture the comprehensive extent of functional impairment encountered by individuals diagnosed with Schizophrenia. It may be imperative to implement supplementary measures to evaluate areas like social functionality and life quality. It should be noted that the PANSS is predominantly intended for implementation in adult cohorts, and its suitability and dependability may be limited when employed in the assessment of psychosis in children and adolescents.

References

Lim, K., Peh, O. H., Yang, Z., Rekhi, G., Rapisarda, A., See, Y. M., … & Lam, M. (2021). Large-scale evaluation of the Positive and Negative Syndrome Scale (PANSS) symptom architecture in schizophrenia. 
Asian Journal of Psychiatry, 
62, 102732.