Introduction
Basic Concepts
90 Symptom Checklist (SymptomChecklist90, SCL-90), also known as Self-reporting Inventory (Self-reportingInventory), sometimes It is called Hopkin's Symptom List (HSCL, compiled earlier than SCL-90, authored by the same person, HCSL first edition compiled in 1954). It was compiled in 1975 and its author is L.R. Derogatis. The scale has a total of 90 items, including a wide range of psychiatric symptoms, ranging from feelings, emotions, thinking, consciousness, behavior to living habits, interpersonal relationships, diet and sleep, etc., and uses 10 factors to reflect them separately Psychological symptoms in 10 areas.
Characteristics of the scale
1. The mental health symptom self-rating scale has the characteristics of large capacity, abundant symptoms, and more accurate description of the subject's conscious symptoms. It contains a wide range of psychiatric symptoms, from feelings, emotions, thinking, behaviors to living habits, interpersonal relationships, eating and sleeping.
2. Each of its items is scored from 1 to 5, and the specific instructions are as follows:
No: Consciously there is no such problem (symptom);
< p>Very mild: Consciously have the problem, but it does not happen frequently and severely;Moderate: Consciously have the symptom, and its severity is mild to moderate;
Severe: Consciously often have this symptom, and its degree is moderate to severe;
Severe: Consciously the frequency and intensity of this symptom are very serious.
As a self-assessment scale, the specific meaning of "light, medium, and heavy" here should be understood by the self-evaluator, and there is no need to make hard and fast rules.
3. The scale can be used for the diagnosis of mental health conditions, as well as for psychiatric research. It can be used for other evaluations or self-evaluation.
Evaluation of test utility
1, in psychiatry and psychological counseling clinics, as an assessment tool to understand the mental health problems of the patient or the counselee;
< p>2. In general hospitals, this scale is often used to understand the mental symptoms of people seeking help from physical diseases, and the results are satisfied;3, SCL-90 is used to investigate the mental health problems of different occupational groups, Reflect the mental health problems of various occupational groups from different aspects.
Scope of application
This test is suitable for adults (over 16 years old). The purpose of this test is to assess whether a person has certain psychological symptoms and their severity from a variety of perspectives such as feelings, emotions, thinking, consciousness, behavior, lifestyle habits, interpersonal relationships, diet and sleep. It has good distinguishing ability for people who have psychological symptoms (that is, they may be on the edge of psychological disorder or psychological disorder). It is suitable for testing who may have a psychological disorder in a certain population, what kind of psychological disorder a certain person may have and how severe it is. Not suitable for mania and schizophrenia. This test can not only self-test, but also other people (such as their abnormal behaviors, the possibility of mental or mental illness). If the score is found to be higher, further screening should be performed.
Included content
There are a total of 90 self-assessment items in this quiz. The nine factors tested are: somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, horror, paranoia and psychosis.
Mental Health Symptom Self-Rating Scale Operation Manual
The mental health symptom self-rating scale is used to assess the individual’s feelings, emotions, thinking, behaviors, life habits, interpersonal relationships, diet Designed for mental health symptoms such as sleep.
The scale includes 90 items and a total of 9 subscales, namely somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, horror, paranoia, and psychosis.
(1) Somatization: including 1, 4, 12, 27, 40, 42, 48, 49, 52, 53, 56 and 58, a total of 12 items. This factor mainly reflects subjective physical discomfort.
(2) Obsessive-compulsive symptoms: 3, 9, 10, 28, 38, 45, 46, 51, 55 and 65, a total of 10 items, reflecting the clinical obsessive-compulsive symptom group.
(3) Interpersonal relationship sensitivity: including 6, 21, 34, 36, 37, 41, 61, 69 and 73, a total of 9 items. Mainly refers to certain personal feelings of uncomfortableness and low self-esteem, especially when compared with others.
(4) Depression: including 5, 14, 15, 20, 22, 26, 29, 30, 31, 32, 54, 71 and 79, a total of 13 items. Reflects a wide range of concepts associated with clinically depressive symptoms.
(5) Anxiety: Including 2, 17, 23, 33, 39, 57, 72, 78, 80 and 86, a total of 10 items. Refers to psychiatric symptoms and experiences that are clinically clearly associated with anxiety symptom clusters.
(6) Hostility: Including 11, 24, 63, 67, 74 and 81, a total of 6 items. It mainly reflects the patient's hostile performance from three aspects: thinking, emotion and behavior.
(7) Horror: including 13, 25, 47, 50, 70, 75 and 82, a total of 7 items. It is basically consistent with the content reflected in the traditional state of terror or square terror.
(8) Paranoia: including 8, 18, 43, 68, 76 and 83, a total of 6 items. Mainly refers to suspicion and relationship delusion.
(9) Psychiatric: Including 7, 16, 35, 62, 77, 84, 85, 87, 88 and 90, a total of 10 items. Among them, auditory hallucinations, dissemination of thoughts, and feelings of insight are items that reflect schizophrenia-like symptoms.
(10) 19, 44, 59, 60, 64, 66, and 89 are 7 items that cannot be included in the above factors. They mainly reflect sleep and diet. In our analysis of some data, Classify it as a factor of 10 "other".
Steps
1. Before starting the assessment, the staff should first explain the overall scoring method and requirements to the examinee. Then let them make an independent self-assessment that is not influenced by anyone, and fill it out with a pencil.
Each item of SCL-90 adopts a 5-level grading system, as follows:
(1) No: Consciously no such problem;
( 2) Very mild, consciously having this symptom, but has no actual effect on the subject, or the effect is slight;
(3) Moderate: consciously having this symptom, and has a certain effect on the subject Influence;
(4) Heaviness: Consciously have the symptom, which has a considerable influence on the subjects;
(5) Severe: Consciously the frequency and intensity of the symptom Both are very serious and have a serious impact on the subjects.
The "influence" here includes pain and annoyance caused by symptoms, as well as damage to psychosocial function caused by symptoms. The specific definitions of "light, moderate, and heavy" should be experienced by the subjects themselves, and there is no need to make hard and fast rules.
The evaluation time is the actual feeling of "now" or "the last week".
2. For self-evaluators with low levels of education, the staff can read to him item by item, and tell him the meaning of the problem in a neutral, without any hint or bias.
3, The time range of the assessment is the actual feeling of "now" or "the last week".
4. At the end of the evaluation, I or the clinical consultant will check one by one. If there is any omission or re-evaluation, the self-evaluator should be reminded to reconsider the evaluation, so as not to affect the accuracy of the analysis Sex.
Test score
SCL-90 has two main statistical indicators, namely total score and factor score.
Total score items
(1)Total score: The sum of the individual scores of 90 items can reflect the severity of the disease.
(2) Total average score: Total score/90, which means that from the overall situation, the subject’s self-perception is located at the level of 1-5.
(3) Number of positive items: The number of items with a single item score ≥2, which indicates how many items the subject has "sickness".
(4) Number of negative items: The number of items with single item score=1, which indicates how many items are "asymptomatic" in the subject.
(5) Average score of positive symptoms: (total score-number of negative items)/number of positive items, representing the average score of the subject in the "symptomatic" item. What scope is the severity of the items that reflect the subject’s poor self-perception?
Factor score
Factor score includes 10 factors, that is, all 90 items are divided into 10 categories. Each factor reflects a certain aspect of the examinee, so the distribution characteristics of the examinee's symptoms can be understood through factor scores, and profile analysis can be made.
Scoring results
Basic explanation
The author of the scale did not propose a cut-off value. According to the results of the national norm, the total score exceeds 160 points, or the number of positive items exceeds 43 items, or any factor score of more than 2 points, need to be considered for screening positive, and further examination is required.
Detailed explanation of scoring symptoms
Total Symptom Index
In general, the participants’ self-symptom evaluation is between " There is no "serious" level. The score of the total symptom index is between 1 and 1.5, indicating that the subjects feel that they do not have the symptoms listed in the scale; between 1.5 and 2.5, it indicates that the subjects feel a little symptom, but they occur infrequently; between 2.5 and 2.5. Between 3.5, it indicates that the participant feels symptoms, and the severity is mild to moderate; between 3.5 and 4.5, it indicates that the participant feels symptoms, and the degree is moderate to severe; between 4.5 and 5, it indicates that the participant feels symptoms. I feel there, and the frequency and intensity of the symptoms are very serious.
Number of positive items
It refers to the number of items rated as 2-5 points. It indicates how many items the subject feels " Have symptoms".
Number of negative items
refers to the number of items rated as 1 point, and it indicates how many items are "asymptomatic".
Positive symptom average score
refers to the level of the individual’s poor self-perception. Its meaning is the same as that of the total symptom index.
Factor score
SCL-90 includes 9 factors. Each factor reflects a certain aspect of the individual’s symptoms. The distribution of symptoms can be understood through factor scores. Features. The factor score is equal to the total score of the items that make up a factor divided by the number of items that make up a factor. When an individual's score on a certain factor is greater than 2, that is, beyond the normal average score, the individual is likely to have mental health problems in this aspect.
⑴. Somatization
mainly reflects physical discomfort, including cardiovascular, gastrointestinal, respiratory and other system discomforts, and headache, back pain, muscle aches, and anxiety and other physical discomforts.
The score of this subscale is between 12-60 points. A score of 36 points or more indicates that the individual has obvious physical discomfort, and is often accompanied by symptoms such as headaches and muscle aches. The score is less than 24 points, and the physical symptoms are not obvious. In general, the higher the score, the stronger the physical discomfort; the lower the score, the less obvious the experience of symptoms.
⑵. Obsessive-compulsive symptoms mainly refer to meaningless thoughts, impulses, and behaviors that are knowingly unnecessary but can’t get rid of. There are also some general behavioral signs of cognitive impairment that are also reflected in this factor.
The score of this subscale is between 10-50 points. Scores above 30 points, obsessive-compulsive symptoms are more obvious. Scores below 20 points, obsessive-compulsive symptoms are not obvious. Generally speaking, the higher the score, the less the individual is unable to get rid of some meaningless behaviors, thoughts and impulses, and may show some signs of cognitive impairment. The lower the score, the less obvious the individual has on this symptom, and there is no compulsive behavior.
⑶. Interpersonal sensitivity
mainly refers to some interpersonal uncomfortable and low self-esteem, especially when compared with others. Inferiority complex in interpersonal communication, restlessness, obvious uncomfortableness, and bad self-suggestion and negative expectations in interpersonal communication are the typical causes of symptoms in this area.
The score of this subscale is between 9-45 points. A score above 27 points indicates that the individual’s interpersonal relationship is more sensitive, and the inferiority complex in interpersonal communication is strong, accompanied by behavioral symptoms (such as restlessness, withdrawal, etc.). A score below 18 points indicates that the individual is relatively normal in interpersonal relationships. In general, the higher the score, the more problems the individual has in interpersonal communication, the more prominent the inferiority and self-centeredness, and the more negative expectations the individual has. The lower the score, the more easily the individual can cope with interpersonal relationships, self-confidence in interpersonal communication, know-how, and positive expectations.
⑷. Depression
Depression and mood are typical symptoms, and are also characterized by diminished interest in life, lack of motivation, and loss of vitality. It also shows disappointment, pessimism, and the cognitive and physical feelings associated with depression. In addition, it also includes thoughts about death and suicidal ideas.
The score of this subscale is between 13-65 points. A score of 39 points or more indicates that the individual has a strong degree of depression, lacks sufficient interest in life, lacks exercise vitality, and in extreme cases, there may be thoughts of wanting to die and notions of suicide. A score of 26 points or less indicates that the individual has a weak degree of depression, an optimistic and positive attitude towards life, full of vitality, and a happy mood. In general, the higher the score, the more obvious the degree of depression, and the lower the score, the less obvious the degree of depression.
⑸. Anxiety
Generally refers to those irritability, restlessness, nervousness, nervousness and the resulting physical signs such as tremor.
The score of this subscale is between 10-50 points. A score of more than 30 points indicates that the individual is more anxious, prone to irritability, restlessness and nervousness, and may cause panic attacks in extreme cases. A score of less than 20 points indicates that the individual is not easy to be anxious and easy to show a stable state. In general, the higher the score, the more obvious the anxiety performance. The lower the score, the less anxiety it will cause.
⑹. Hostility
Mainly reflect the performance of hostility from three aspects: thoughts, feelings and behaviors. The items include feelings of boredom, throwing objects, arguing, and uncontrollable tempers.
The score of this subscale is between 6-30 points. A score of 18 points or more indicates that the individual is prone to show hostile thoughts, emotions, and behaviors. A score below 12 indicates that the individual is prone to show friendly thoughts, emotions and behaviors. In general, the higher the score, the more likely the individual is to be hostile, controversial, and difficult to control. The lower the score, the milder the individual’s temper, the friendliness of others, and the dislike of arguing and non-disruptive behavior.
⑺. Horror
The objects of fear include traveling, open spaces, crowds or public places and vehicles. In addition, there is social horror.
The score of this subscale is between 7-35 points. A score of 21 points or more indicates that the individual’s horror symptoms are more obvious, often showing social, square, and crowd fear, and a score of less than 14 points indicates that the individual’s horror symptoms are not obvious. In general, the higher the score, the more likely an individual is to fear some places and objects, accompanied by obvious physical symptoms. The lower the score, the less likely it is for an individual to develop a sense of terror, and the more normal communication and activities will be.
⑻. Paranoia
mainly refers to projective thinking, hostility, suspicion, delusion, passive experience and exaggeration.
The score of this subscale is between 6-30 points. A score of 18 points or more indicates that the individual has obvious symptoms of paranoia and is more likely to be suspicious and hostile. A score of less than 12 points indicates that the individual's paranoid symptoms are not obvious. In general, the higher the score, the more easily the individual is paranoid, showing projective thinking and delusions, and the lower the score, the less likely it is for the individual to go to extremes.
⑼. Psychotic
Reflects a variety of acute symptoms and behaviors, that is, the symptom manifestations of a less restrictive psychotic process.
The score of this subscale is between 10-50 points. A score of more than 30 points indicates that the individual's psychotic symptoms are more obvious, and a score of less than 20 points indicates that the individual's psychotic symptoms are not obvious. In general, the higher the score, the more psychotic symptoms and behaviors are shown. The lower the score, the less these symptoms and behaviors will be exhibited.
(10) Other items (sleep, diet, etc.)
As additional items or others, they are treated as the tenth factor so that the sum of the points of each factor is equal to the total score.
Reference Norm
Reference Norm Application
Previously, a simple explanation of the test results is provided. It should be said that this explanation is rather rough, mainly It is for subjects or students who are not familiar with psychometric knowledge. To further understand the significance of the test results, the test scores must be compared with the norm to find out how much the test scores differ from the general level. Only in this way can we accurately determine the meaning of the subjects' scores. For this scale, the grading principles for the scores of the subjects’ subscales are as follows: ①Anything within one standard deviation above or below the average is considered "medium level symptom performance"; ②Two standard deviations above or below the average Those that are within are "higher or lower levels of symptoms"; ③ those that exceed two standard deviations above or below the average are "high or low symptoms." Therefore, it is not enough to look at the scores of the subjects on the surface. It depends on their level in the same group to determine the true degree of their symptoms. For example, although the scores of the subjects on some subscales are relatively high, if the average score of the subscales in the norm is also relatively high, and after calculation, it is found that the score of the subject does not exceed one standard deviation, then it indicates that the subject is in The symptoms in this area are only at a moderate level, so don't worry too much!
Suggestions
The self-rating scale for mental health symptoms includes a wide range of psychiatric symptoms, such as thinking, emotions, interpersonal relationships, and living habits.
The scale examines the individual’s mental health from 9 aspects from the perspective of physical and mental symptoms. If the score on certain symptoms is higher, the frequency and intensity of certain symptoms are felt If they are all serious, we should pay attention to the students’ problems in this area.
Since the self-rating scale measures the severity of symptoms felt by an individual over a period of time, the interpretation of scale scores should be cautious. It does not necessarily mean that the individual has a high score. For serious psychological problems, the higher scores on certain subscales may just be due to the fact that the individual encountered some difficulties at the time, such as being broken in love, facing exams, and getting sick. Therefore, it is necessary to further understand the reasons for the high scores of students.
If the individual feels that these symptoms are more serious in multiple dimensions, mental health education should be strengthened, and in severe cases, they should go to a more authoritative psychological counseling and treatment institution for further examination and diagnosis.
Precautions
1. The application in the group of patients with mania or schizophrenia has been limited-the scale items are not comprehensive enough, lack of "emotional elevation", "Thinking erratic" and other projects.
2. It can only be possible, and it cannot be said that there must be a mental illness. To make a diagnosis, it is necessary to conduct an interview and refer to the diagnostic criteria of the corresponding disease.
Specific format
Symptom self-rating scaleSCL-90
Guidelines : The following table lists the symptoms or problems that some people may have. Please read each one carefully, and then according to the degree to which the sentence matches your own actual situation(the last week or now ), choose an appropriate number and fill in the answer box at the back:
1—none, 2—very light, 3—medium, 4 —Heavy, 5—Severe |
Sequence | Question | Options |
1 | Headache | 1 1 |
2 | Nervous, not at ease | 3 |
| 3 | There are unnecessary thoughts or words circling in the mind | < p>3 |
4 | Dizziness Or faint | 1 |
5 | Less interest in the opposite sex | 1 td> |
6 | Reproach others for completeness td> | 4 |
7 | < td width="357">3 | |
8 | Blaming others for causing trouble | 3 |
9 | Forgetfulness | 3 |
10 | Worry about the neatness of your clothes and the correct manners | 4 |
11 | Easily annoyed and excited | 4 11 |
12 | Chest pain | 2 |
13 | Fear of empty places or streets | 3 |
14 | I feel my energy drops and my activities slow down | 3 14 |
15 | I want to end my life | 4 |
16 | Hear sounds that other people can’t hear | 216 |
17 | trembling | 3< /p> |
18 | I feel that most people Not trusted | 4 |
19< /p> | Poor appetite | 4 19< /p> |
20 | Crying easily | 4 |
21 td> | I feel shy and uncomfortable when getting along with the same sex | 5 | < /tr>
22 | Feeling deceived, caught in a trap or someone wants to catch you< /p> | 3 |
23 | Suddenly feeling scared for no reason | 3 | < /tr>
24 | I lose my temper because I can’t control it td> | 4 24 |
25< /p> | Afraid to go out alone | 2 | < /tr>
26 | I often blame myself | 3 |
27 | Low back pain | 3 |
| 28 | I feel difficult to complete the task | 5 |
29 | feel lonely < /td> | 4 |
30 | Feeling bored | 4 |
31 | Too much worry | 4 |
32 | Not feeling for things Interests | 3 32 |
33 | feeling scared | 3 |
34 | Your feelings are easily hurt< /p> | 4 |
35 | Others can know your private thoughts | 3 |
36 | Feeling that others don’t understand you and are different Love you | 4 |
37< /p> | Feel that people are unfriendly to you and dislike you | 5 p> |
38 | You must do things very slowly To ensure it is done correctly | 2 |
39 | Heartbeat is very strong | 3 < /td> |
40 | Nausea or stomach upset | 3 |
41 td> | I feel inferior to others | 4 |
42 | Muscle soreness | 3 |
43 | < p>I feel someone is watching and talking about you | 3 |
44 | Difficult to fall asleep | 2 p> 44 |
45 | < p>You must double check when doing things | 2 |
| < p>4 6 | Difficult to make a decision | 3 td> |
47 | Fear of taking tram, bus, subway or train | 2 |
48 | Difficulty breathing | 1 |
49 | Shorts of cold or heat | < td width="78">|
50 | Avoid something, occasion, or event because you are afraid | 3 | tr>
51 | The brain is empty | 4 |
52 | Tingling or tingling in the body | 2 |
53 | There is a sense of blockage in the throat | 2 |
54 | Feel the future There is no hope | 5 |
55< /p> | Can’t concentrate | 3 | tr>
56 | feeling a part of the body weak | 3 56 |
57 p> | Feeling nervous or easily nervous | 4 |
58 | Feeling heavy hands or feet td> | 3 |
59 | < td width="357">5 | |
Eat too much | 3 | |
61 | Feel uncomfortable when others look at you or talk about you | 4 |
62 | There are some ideas that are not yours | 3 |
63 | < p>Have the urge to hit or hurt others | 4 |
64 | Wake up too early | 1 |
65 | You must wash your hands repeatedly , Points | 2 |
66 p> | Unsteady sleepiness | 2 |
67 | I want to break or destroy something | p>4 |
68 < /td> | There are some ideas that others don’t have | 3 | tr>
69 | Feeling nervous to others | < td width="78">|
70 | I feel uncomfortable in crowded places such as shops or movie theaters | 4 |
71 | I feel that everything is difficult | < td width="78">|
72 | Blasts of fear or panic | 3 |
73 | I feel uncomfortable eating in public | 3 |
74 | < p>Always argue with people | 3 |
75 | I'm nervous when I'm alone | 3 |
76 | The grades are not properly evaluated | 3 |
| 77 | I feel lonely even with others | 4 |
78 | I feel restless Indefinite | 4 |
79 p> | I feel worthless | 5 |
80 | Feeling familiar things become strange or unfamiliar Of | 3 |
81 p> | Yelling or throwing something | 2 |
82 | Fear of fainting in public < /td> | 1 |
83 | Feel that others want to take advantage of you | 3 |
84 | I am troubled by some sexual thoughts < /td> | 4 |
85 | You think you should be punished for your fault | 4 | < /tr>
86 | I feel I want to finish things quickly < /td> | 2 |
87 | I feel a serious problem with my body | 4 |
88 | Never feel close to other people | 4 |
89 | Feel guilty | 3 |
90 | I feel something wrong with my brain | < p>4 |
Evaluation
Many articles use SCL-90 to measure the mental health of the population. From the content of the scale, SCL-90 is just a 90-question symptom checklist. Its items mainly come from psychiatric symptomology, involving feelings, thinking, emotions, behaviors, interpersonal relationships, living habits, diet, sleep and so on. The main purpose is to assess whether a person has certain psychological symptoms and how serious they are. It is often used as a screening scale in psychiatry and consultation clinics in clinical practice. It is a bit inappropriate to use it as a test of the overall mental health of a certain population. First of all, because the concept of mental health is not limited to the presence or absence of psychological symptoms, of course one can be considered unhealthy if there are psychological symptoms, but the absence of psychological symptoms does not mean that one is mentally healthy. Therefore, some people have suggested that it is only suitable for testing which people in a certain group of people may have psychological disorders, and it is not suitable for comparing the differences in the level of mental health among ordinary people.
The other reason is that SCL-90 measures a person’s symptom level for a certain period of time (in the past week), which reflects a person’s psychological well-being at a certain period of time. Affected by many factors, especially life events. For students facing important exams, high anxiety scores should be normal, and they may have psychological problems if they are not at all anxious. Therefore, if someone has a high SCL-90 score, we only need to say that he may have some psychological symptoms, but we cannot say that he has a psychological problem or a psychological disorder based on the SCL-90 alone. There is a time limit for the diagnosis of any mental illness or mental disorder, and it can be diagnosed not only lasting for a week. In addition, the psychological measurement itself has a large error, and the reliability of this self-rating scale is lower, and the error may be greater.
