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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2002, Number 6

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Salud Mental 2002; 25 (6)

Estudio de validez y confiabilidad de la escala de agresividad explícita enpacientes psiquiátricos

Páez F, Licon E, Fresán A, Apiquian R, Herrera-Estrella M, García-Anaya M, Robles-García R, Pinto T

Language: Spanish
References: 35
Page: 21-26
PDF size: 360.15 Kb.


ABSTRACT

Introduction
Human aggressiveness is a complex phenomenon. Several epidemiological studies have shown an increased rate of aggressiveness and violence among individuals with a psychiatric disorder in comparison to general population.
Many of the scales designed to measure rage, anger and violence are self-report questionnaires which have several disadvantages, since patients whose cognitive abilities are impaired by a psychotic disorder or an organic mental disease cannot reliably complete questionnaires since they do not reliably recall or admit violent events. Other few objective scales used in rating aggressive behaviors do not rate the severity of the aggressive behaviors and do not have the capacity to describe the types of aggressive behaviors. The Overt Aggression Scale is an specific instrument with high sensitivity. Objective
The aim of this study was to translate into Spanish language the Overt Aggression Scale, to determine its validity and reliability, and to examine the correlation between symptom severity and the number and severity of aggressive episodes in a sample of psychiatric patients.
Method
Thirty nine patients were referred due to the presence of aggressive behavior, and recruited at the emergency service of the Psychiatric Hospital Fray Bernardino Alvarez. Demographic characteristics were recorded for each patient. The Positive and Negative Syndrome Scale (PANSS) were used for the assessment of clinical characteristics of the patients at baseline and after four weeks. The Overt Aggression Scale (OAS) was used for the evaluation of aggressiveness. This instrument is designed to measure the type and severity of the aggressive behaviors and the intervention used by the medical staff for the aggressive episode.
Clinical evaluations with the OAS were performed in the baseline by two independent raters to obtain the reliability of the instrument, during four weeks to determine the changes in aggression.
Results
There were no significant differences in demographic characteristics or the severity of psychotic symptoms between subjects diagnosed during the study.
The concordance between raters with the Overt Aggression Scale showed an intraclass correlation coefficient of 0.96. All patients showed a reduction on psychotic symptom severity and in the number of aggressive episodes during their hospitalization and a decrease in the total score of the Overt Aggression Scale. There were no significant differences in psychotic symptomatology, the number of aggressive episodes or the total score of the OAS between diagnoses.
There were no significant associations between aggressiveness and demographic characteristics of the sample. There was a positive correlation with positive symptoms rated with the PANSS and the global severity of the OAS.
Discussion In this study, the intraclass correlation coefficient was similar to that of the english version study. As in previous reports there were no difference in the severity of aggressive behaviors between patients with schizophrenia and patients with other diagnoses. A positive correlation between the severity of aggressive behaviors and the severity of positive symptoms suggested concurrent validity. Predictive validity was confirmed by the OAS decrease after 4 weeks of treatment. Further studies examining the correlation between the OAS with specific items of the PANSS rating scale will be helpful in finding the validity of the scale. In conclusion the Spanish version of OAS showed good reliability and validity for the measurement of aggression.


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