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Research Paper

A new, female-specific irritability rating scale

Leslie Born, Gideon Koren, Elizabeth Lin and Meir Steiner
J Psychiatry Neurosci July 01, 2008 33 (4) 344-354;
Leslie Born
Born — Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont.; Koren — The Motherisk Program, The Hospital for Sick Children, the Departments of Pediatrics, Pharmacology, Pharmacy, and Medicine and Medical Genetics, University of Toronto, Toronto, Ont., and The Ivey Chair in Molecular Toxicology, University of Western Ontario, London, Ont.; Lin — Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto, Toronto, Ont.; Steiner — Departments of Psychiatry and Behavioral Neurosciences and Obstetrics and Gynecology, McMaster University, Brain–Body Institute, Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Department of Psychiatry and Institute of Medical Sciences, University of Toronto, The Hospital for Sick Children, Toronto, Ont.
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Gideon Koren
Born — Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont.; Koren — The Motherisk Program, The Hospital for Sick Children, the Departments of Pediatrics, Pharmacology, Pharmacy, and Medicine and Medical Genetics, University of Toronto, Toronto, Ont., and The Ivey Chair in Molecular Toxicology, University of Western Ontario, London, Ont.; Lin — Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto, Toronto, Ont.; Steiner — Departments of Psychiatry and Behavioral Neurosciences and Obstetrics and Gynecology, McMaster University, Brain–Body Institute, Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Department of Psychiatry and Institute of Medical Sciences, University of Toronto, The Hospital for Sick Children, Toronto, Ont.
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Elizabeth Lin
Born — Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont.; Koren — The Motherisk Program, The Hospital for Sick Children, the Departments of Pediatrics, Pharmacology, Pharmacy, and Medicine and Medical Genetics, University of Toronto, Toronto, Ont., and The Ivey Chair in Molecular Toxicology, University of Western Ontario, London, Ont.; Lin — Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto, Toronto, Ont.; Steiner — Departments of Psychiatry and Behavioral Neurosciences and Obstetrics and Gynecology, McMaster University, Brain–Body Institute, Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Department of Psychiatry and Institute of Medical Sciences, University of Toronto, The Hospital for Sick Children, Toronto, Ont.
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Meir Steiner
Born — Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont.; Koren — The Motherisk Program, The Hospital for Sick Children, the Departments of Pediatrics, Pharmacology, Pharmacy, and Medicine and Medical Genetics, University of Toronto, Toronto, Ont., and The Ivey Chair in Molecular Toxicology, University of Western Ontario, London, Ont.; Lin — Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto, Toronto, Ont.; Steiner — Departments of Psychiatry and Behavioral Neurosciences and Obstetrics and Gynecology, McMaster University, Brain–Body Institute, Women’s Health Concerns Clinic, St. Joseph’s Healthcare Hamilton, Department of Psychiatry and Institute of Medical Sciences, University of Toronto, The Hospital for Sick Children, Toronto, Ont.
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    Fig. 1

    Born–Steiner Irritability Scale: Self-Rating.

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    Fig. 2

    Born–Steiner Irritability Scale: Observer Rating

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    Table 1

    Demographic characteristics of pretest and test samples

    CharacteristicsSample time; no. (and %) of subjects
    PretestTest
    Female-specific mood disorder, patients/control subjects
     Premenstrual syndrome11/38/0
     Antepartum depression12/312/0
     Postpartum depression10/310/0
     Perimenopause6/36/0
    Born in Canada41 (80)27 (75)
    English mother tongue29 (80)29 (80)
    White49 (96)29 (80)
    Married30 (59)18 (50)
    College or university education37 (72)22 (60)
    Currently employed41 (80)22 (60)
    Taking an antidepressant at presentation17 (33)9(25)
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    Table 2

    Range of severity and frequency of scores for each item

    ItemRange of severity; no. of endorsements% of scores above 0
    0123
    Self-Rating Scale (n = 36)
    1. Feeling mad4236388.8
    2. Ready to explode10175472.2
    3. Yelled at others9204375.0
    4. Irritable when touched8187377.7
    5. Flying off the handle61611383.3
    6. Cloud of anger16116355.5
    7. Been rather sensitive9109875.0
    8. Quicktocriticize9175575.0
    9. Noises seemed louder1589458.3
    10. Getting annoyed51310886.1
    11. Lost control2555130.5
    12. Flood of tension6197483.3
    13. Said nasty things1986347.2
    14. Things bother me7147880.5
    Observer Rating Scale (n = 30)
    1. Annoyance4145786.6
    2. Anger1225296.6
    3. Tension2881293.3
    4. Hostile behaviour798676.6
    DisagreeAgree
    5a. Touch sensitivity201033.3
    5b. Noise sensitivity181240.0
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    Table 3

    Self-Rating Scale: item–total score correlations (n = 36)

    Item no.rsp value
    10.5870.001
    20.8340.001
    30.6850.001
    40.2920.042
    50.8350.001
    60.7920.001
    70.7410.001
    80.6770.001
    90.8670.001
    100.8440.001
    110.5990.001
    120.7700.001
    130.6810.001
    140.6160.001
    150.1940.26
    160.3060.07
    170.5480.001
    180.6240.001
    190.5090.002
    200.5500.001
    • rs = Spearman rank-order correlation coefficient for correlation between item score and total self-rating score at first clinic visit.

    • View popup
    Table 4

    Observer Rating Scale: item–total score correlations (n = 30)

    Item no.rsp value
    10.8630.001
    20.6930.001
    30.6510.001
    40.8010.001
    5a0.3010.053
    5b0.7630.001
    • rs = Spearman rank-order correlation coefficient for correlation between item score and total observer rating score at first clinic visit.

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    Table 5

    Observer Rating Scale: interrater agreement

    ItemRater A and rater B1Rater A and rater B2Rater A and rater B3
    No. of patients% agreeτp valueNo. of patients% agreeτp valueNo. of patients% agreeτp value
    Annoyance101001.0000.00151001.0000.00151001.0000.001
    Anger101001.0000.0015100c5100c
    Tension10900.9580.0015800.6670.01351001.0000.001
    Hostile behaviour101001.0000.00151001.0000.00151001.0000.001
    Sensitivity
     Jumpy when touched101001.0000.00151001.0000.00151001.0000.001
     Voices were much louder101001.0000.00151001.0000.00151001.0000.001
    VAS: irritability10—0.6890.0015—0.8000.0015—0.8000.001
    VAS: quality of life10—0.5840.0015—0.8000.0015—0.8000.001
    • % agree = % raw agreement; τ = Kendall’s Tau-b coefficient (α = 0.05); p = significance (1-tailed); c = constant (no statistics were computed because rater A/B1/B2/B3 were constants); VAS = visual analog scale; — = no data.

    • Note: Rater A = author; B1 = psychiatrist; B2 = psychiatric social worker; B3 = psychiatric nurse.

    • View popup
    Table 6

    Interrater reliability: visual analog scales

    RaterScale; mean rating (and SD)
    Irritability*Quality of life†
    A50.90(26.30)52.80(26.30)
    B159.60(25.95)61.50(25.47)
    B256.00(26.99)55.40(28.41)
    B336.60(30.28)32.40(28.86)
    • A = author; B1 = psychiatrist; B2 = psychiatric social worker; B3 = psychiatric nurse; SD = standard deviation.

    • ↵* Kruskal–Wallis χ2 = 2.211; p = 0.33.

    • ↵† Kruskal–Wallis χ2 = 3.111; p = 0.21.

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Journal of Psychiatry and Neuroscience: 33 (4)
J Psychiatry Neurosci
Vol. 33, Issue 4
1 Jul 2008
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A new, female-specific irritability rating scale
Leslie Born, Gideon Koren, Elizabeth Lin, Meir Steiner
J Psychiatry Neurosci Jul 2008, 33 (4) 344-354;

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A new, female-specific irritability rating scale
Leslie Born, Gideon Koren, Elizabeth Lin, Meir Steiner
J Psychiatry Neurosci Jul 2008, 33 (4) 344-354;
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