User:Hjlucero/HCL-32

Google Drive
Here is the link to the HCL-32 google drive. Please put your articles and resources here.

A note that there is an existing page of the HCL-32 and your edits could build upon the existing framework.

Introduction
The Hypomania Checklist (HCL-32) is a questionnaire developed by Dr. Jules Angst to identify hypomanic features in patients with major depressive disorder in order to help recognize bipolar II disorder and other bipolar spectrum disorders in people seeking help in primary care and other general medical settings. It was originally used in clinical settings with depressed patients, but has gained popularity as a screening tool for hypomanic features in non-clinical adult populations. It asks about 32 behaviors and mental states that are either aspects of hypomania or features associated with mood disorders, and uses short phrases and simple language, making it easy to read. The University of Zurich holds the copyright, and the HCL-32 is available for use at no charge. More recent work has focused on validating translations and testing whether shorter versions still perform well enough to be helpful clinically. Recent meta-analyses find that it is one of the most accurate assessments available for detecting hypomania, doing better than other options at recognizing bipolar II disorder.
 * What are the acronyms? What do they stand for?
 * What is the purpose of the measure?
 * What is the intended population of the measure?
 * How long does it take to take/administer the assessment?
 * Who wrote the measure?
 * How many items does the measure contain?
 * What kind of impact did the measure have?
 * Ex: is it more sensitive than existing measures?
 * What kinds of settings is the measure most typically used?
 * Ex: research, clinical

Versions
The original 32-item version of the HCL has been reduced to a 13 and 16 item versions (HCL-13; HCL-16), which still perform well clinically to help differentiate bipolar disorder from major depressive disorder. The original version has also been modified/ extended into the HCL-32-R1, the HCL-32-R2, and the HCL-33. The HCL-32-R1contains 31 items, and was originally validated in a transcultural sample of 12 countries across 5 geographical regions. It was then further developed into the HCL-32-R2, with 34 items. From here, two of the items from the HCL-32-R2 were merged together, resulting in the HCL-33. In addition to the 33 item symptom list on the HCL-33, this version of the measure contains additional items assessing impairment, others' reactions to the "highs" of hypomania, and duration of the "highs" of hypomania.
 * How many versions of the measure are there?
 * What is the intended population for each version?
 * How many items are in each version of the measure?
 * What are the acronyms for each version?

Reliability
Reliability refers to whether the scores are reproducible. Unless otherwise specified, the reliability scores and values come from studies done with a United States population sample. Here is the rubric for evaluating the reliability of scores on a measure for the purpose of evidence based assessment.


 * What were the norms from the measure’s first publication?
 * IE what was the demographics of the population used to first validate this measure?
 * What is the internal consistency?
 * Internal consistency: how well the items relate/correlate to one another
 * Normally reported as an alpha or Cronbach's alpha
 * What is the inter-rater reliability?
 * Inter-rater reliability: how consistently the measure gives the same results across different raters (*not applicable for self-report*)
 * Normally reported as kappa
 * What is the test-retest reliability?
 * Test-retest: how consistently the measure gives the same result after the same person takes the test multiple times

Validity
Validity describes the evidence that an assessment tool measures what it was supposed to measure. There are many different ways of checking validity. For screening measures, diagnostic accuracy and discriminative validity are probably the most useful ways of looking at validity. Unless otherwise specified, the validity scores and values come from studies done with a United States population sample. Here is a rubric for describing validity of test scores in the context of evidence-based assessment.


 * What is the content validity?
 * Content validity: how much the items relate to what you are trying to measure
 * What is the construct validity?
 * Construct validity: how well the assessment is able to measure the abstract concept  it is trying to measure
 * Ex: An ADHD assessment with good construct validity correlates very highly with ADHD diagnoses
 * What is the discriminative validity?
 * Discriminative validity: how well the measure does NOT measure what it is NOT supposed to measure
 * Ex: An ADHD assessment with high discriminative validity would not measure severity of schizophrenic symptoms
 * What is the prescriptive validity?
 * Prescriptive validity: Refers to the capacity of an assessment to inform which intervention will have the best outcomes for a client
 * What is the validity generalization?
 * Validity generalization: how well the validity of the measure holds true across different populations
 * Ex: a measure that has been validated in multiple languages and has high validity with college students, as a self-report, and as a caregiver report would have good validity generalization
 * Is the measure sensitive to treatment? How sensitive?
 * IE: can you use this measure throughout the course of a treatment to see if the treatment is working?
 * What is the clinical utility of the measure?
 * IE: does this measure ultimately help clinicians and clients?
 * Ex: if the measure costs a lot of money to take, is long, cumbersome, and has low validity/reliability, then it would have low clinical utility

Development and history
The Hypomania Checklist was built as a more efficient screening measure for hypomania, to be used both in epidemiological research and in clinical use. Existing measures for bipolar disorder focused on identifying personality factors and symptom severity instead of the episodic nature of hypomania or the possible negative consequences in behavioral, affective, or cognitive changes associated. These measures were mostly used in non-clinical populations to identify individuals at risk and were not used as screening instruments. The HCL-32 is a measure intended to have high sensitivity to direct clinicians from many countries to diagnosing individuals in a clinical population with bipolar disorder, specifically bipolar II disorder.
 * Why was the instrument developed? What need did this instrument meet? When?
 * How was the scale developed? What was the theoretical background behind it?
 * If there were previous versions, when were they published?

Initially developed by Jules Angst and Thomas Meyer in German, the questionnaire was translated into English and translated back to German to ensure accuracy. The English version of the HCL has been used as the basis for translation in other languages through the same process. The original study that used the HCL in an Italian and a Swiss sample noted the measure's high sensitivity and a lower sensitivity than other used measures.

The scale includes a checklist of 32 possible symptoms of hypomania, each rated yes or no. The rating "yes" would mean the symptom is present or this trait is "typical of me," and "no" would mean that the symptom is not present or "not typical" for the person.

Impact

 * What was the impact of this assessment? How did it affect assessment in psychiatry, psychology and health care professionals?
 * What can the assessment be used for in clinical settings? Can it be used to measure symptoms longitudinally? Developmentally?

Use in other populations
The HCl - 32 has been translated into over 15 different languages. These include Spanish, German, Italian, Chinese, Russian, and Swedish, among others.

Research

 * Any recent research done that is pertinent?

Limitations
The HCL suffers from the same problems as other self-report inventories, in that scores can be easily exaggerated or minimized by the person completing them. Like all questionnaires, the way the instrument is administered can influence the final score. If a patient is asked to fill out the form in front of other people in a clinical environment, for instance, social expectations may elicit a different response compared to administration via a postal survey.
 * What are some of the measure’s limitations? Be thorough in your explanation.
 * Ex: does it have low reliability? Is it a self-report measure?
 * Is the measure copyrighted?

Similar reliability scores were found when only using 16 item assessments versus the traditional 32-item format of the HCL-32. A score of at least 8 items was found valid and reliable for distinguishing Bipolar Disorder and Major Depressive Disorder. In a study, 73% of patients who completed the HCL-32 R1 were true bipolar cases identified as potential bipolar cases. However, the HCL-32 R1 does not accurately differentiate between Bipolar I and Bipolar II. However, the 16-item HCL has not been tested as a standalone section in a hospital setting. In addition, while the HCL-32 is a sensitive instrument for hypomanic symptoms, it does not distinguish between bipolar I and bipolar-II disorders. The HCL-32 has not been compared with other commonly used screening tools for bipolar disorder, such as the Young Mania Rating Scale, Young Mania Rating Scale and the General Behavior Inventory. The online version of the HCL has been shown to be as reliable as the paper version.

Example page

 * General Behavior Inventory