Symptom Checklist 90 Revised (SCL-90-R)

The SCL-90-R is a measure of psychological distress, appropriate for both adolescents and adults. It is a revised form (two items were replaced and seven were modified) of the SCL-90, an unnormed version. Other precursors include the Hopkins Symptom Check List-58 (HSCL-58) and the HSCL-90. (Ref: 1) It consists of 90 items total, with 83 items representing nine subscales: somatization (SOM), obsessive-compulsive, interpersonal sensitivity (I-S), depression (DEP), anxiety (ANX), hostility (HOS), phobic anxiety (PHOB), paranoid ideation (PAR) and psychoticism (PSY). In addition to these nine symptoms, the SCL-90-R also contains seven items which relate to appetite and sleep disturbances. It utilizes three global distress indices: Global Severity Index (GSI), Positive Symptom Distress Index (PSDI), Positive Symptom Total (PST). It may be used in screening or as a measure of patient progress.

Price varies by package. Order through Pearson Assessments

12-15 minutes

1975

Flesch-Kincaid 7th grade level score. Phrases are short and easy to comprehend for someone with at least a 7th grade level reading ability.

5-point Likert, ranging from “not at all distressing” (0) to “extremely distressing” (4).

Self-administered, computer-administered, audiocassette, or online assessment available.

Raw scores are converted to T-scores and plotted on a profile showing the centile equivalent for each subscale. Subscale scores are found by summing item scores for the entire instrument and dividing by the total number of items on each subscale. The PST score is found by adding all items not scored zero. PSDI is found by dividing the grand total by the PST score. The GSI is found by summing the scores for the 90 items and dividing by 90. (Ref: 2) The author suggests that the GSI is the best indicator of the current degree of distress when one simple summary score is needed.

Spanish and French (Canada) language versions are available.

Leonard R. Derogatis
This instrument may be purchased from Pearson Assessments online at http://www.pearsonassessments.com/tests/scl90r.htm.

Johns Hopkins University School of Medicine
Baltimore, Maryland

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www.derogatis-tests.com

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In the development of the scale, nine factors were found by varimax rotation. However, only four of the ten items deemed to represent “psychoticism” loaded on this factor. It was reported that those items would be adjusted, however, they were not. (Ref: 1) Principal components analysis produced a first factor that accounted for 27% of the total variance, while the second factor accounted for only 5.1% of the variance. Varimax rotation was performed and a six-factor solution was chosen: 1) Depression, 2) Somatization, 3) Anger-Hostility, 4) Paranoid-Psychoticism, 5) Phobic Anxiety, and 6) Obsessive-Compulsive. These included 73 items of sufficient loading (>=0.40). Correlations among the 6 factors ranged from 0.48 to 0.70, while correlations with the total score ranged from 0.74 to 0.91. (Ref: 3) Two significant canonical correlations were found for the SCL-90-R in a sample of adolescents. All SCL-90-R scales had correlations >=0.69 with their first canonical variable, except for Phobic Anxiety and Paranoid Ideation. The highest correlations were for Depression (r=0.96), Anxiety (r=0.92) and Interpersonal Sensitivity (r=0.89). (Ref: 4)

Normative information is gathered from the SCL-90-R publisher’s website: www.ncs.com. Normative information is available for samples of:

For a postdisaster bereaved group, test retest coefficient alphas ranged from 0.47 to 0.69 and were significant at p<0.001. In the control group, the Interpersonal Sensitivity subscale test-retest coefficient alpha was significant at the p<0.001 level (r=0.50), while the Obsessive-Compulsive subscale (r=0.43), the Global Severity Index (r=0.40) and the Positive Symptom Total were significant at the p<0.01 level. (Ref: 2)

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For a postdisaster bereaved group at 11- (T1) and 35-month (T2) follow-ups, all subscale coefficient alphas ranged from 0.74 to 0.91, except for the Psychoticism scale, which was 0.67 at T2. For the control group, all subscale coefficient alphas ranged from 0.72 to 0.91, except for Phobic Anxiety (0.62 at T1 and 0.44 at T2), Psychoticism (0.68 at T1), and Paranoid Ideation (0.65 at T2). The Global Severity Index coefficient alpha=0.97 across both groups at T1 and T2. Both groups at both times had identical coefficient alphas for the Depression, Anxiety, and Interpersonal Sensitivity subscales (all >=0.86). (Ref: 2)

In another study, split-half reliability for the entire test was 0.94. (Ref: 3) Coefficient alphas for the scales and the Global Severity Index range from 0.78 to 0.97 (Ref: 7,9), while coefficient alphas for a computer-administered version were similar at 0.74-0.97. (Ref: 9)

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In one study, discriminant validity was not supported: all nine dimensions of the SCL-90-R correlated significantly with the Beck Depression Inventory, ranging from 0.46 to 0.73 (p<0.0001). The Depression subscale had the highest correlation with r=0.73. (Ref: 3) Convergent validity, however, was supported: the SCL-90-R subscales were each correlated with a similar MMPI clinical scale, except for the Masculine-feminine interests scale and the Mania scale. The Hypochondriasis scale of the MMPI and Somatization scale of the SCL-90-R showed the highest correlation at r=0.64. (Ref: 3) Also, each dimension of the SCL-90-R correlated with several MMPI scales (the Somatization and Depression dimensions were significantly correlated with nine scales of the MMPI). (Ref: 3)

The Depression, Interpersonal Sensitivity, Anxiety, and Global Severity Index dimensions of the SCL-90-R are correlated significantly with the Children’s Depression Inventory at 0.70-0.74. Other dimensions correlated at 0.40-0.64. (Ref: 4)

The SCL-90-R correlates at 0.45 with the Brief Psychiatric Rating Scale (Ref: 5) and 0.64 with the General Health Questionnaire-12. (Ref: 7) It has a correlation of 0.33 with the Impairment Scale (IS), used for making clinical diagnoses. (Ref: 9) The SCL-90-R correlates with the Beck Depression Inventory at 0.66 in a group of depressed inpatients and 0.69 in a group of inpatients with depression and other disorders. (Ref: 5)

In a ROC analysis, the Anxiety and Depression subscales showed acceptable concurrent validity for those two diagnostic groups (AUC=0.86 and 0.81) as determined by DSM-III-R (ROC curve far above the diagonal). (Ref: 7) Further ROC analysis produced the following values: (Ref: 10)

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Sensitivity is reported for various cut-off scores: (Ref: 7)

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Yes. (Ref: 2-10)