Have you ever noticed how much information your physician has on you before he or she even enters the exam room to greet you? All the information on that clipboard – vital signs and other important medical data – was collected in advance in order to maximize the limited time you have with your physician. Back in 1997, with a busy counseling practice and the need for a doctoral dissertation topic, I asked myself the following question: What if we therapists had data on our clients’ “psychological vital signs” – depression, anger, and anxiety -- at the very start of each session? Immediately, I saw how a brief self-report instrument on these three important emotional dimensions of psychopathology -- administered before sessions in my waiting area -- could greatly reduce the time required for assessing clients, and thereby provide more time for actual therapy. Moreover, it would offer a convenient way to track progress, screen for psychopathology, and provide symptom documentation in support of diagnoses and treatment interventions, which, could have relevance to third party payers and therapist’s legal protection.
As I learned at the time, there were (and still are) a number of very good instruments measuring depression, anxiety, and anger. However, these instruments were developed independently, meaning the assembly of a lengthy, cumbersome and expensive test battery would be required. So, in 1998, with the approval of my doctoral dissertation committee at Northern Illinois University, “the development and validity of an accurate self-report instrument for conveniently measuring depression, anxiety, and anger” became my dissertation topic.
Considering the potential such an instrument may have in assessing psychopathology on a wide scale, both the accuracy and the convenience of the instrument became very important factors to me in its development. So immediately I ran into the following problem: Making the instrument accurate required the collection of a large amount of self-report data on each of these three emotions. On the other hand, making the instrument convenient required limiting the administrative time of the instrument to about 10 minutes or so, about the length of time a client might sit in a waiting room. Therefore, in order achieve both goals -- accuracy and convenience -- I developed, in 1999, a new testing format called quick-flow. The quick-flow format involves using economically worded items (such as “sad”) presented in parcels (consisting of items “sad,” “tired,” “lonely”) under a simple item heading (such as “Feeling . . .”). To my pleasant surprise, the new quick-flow format not only enabled me to collect a large amount of data on depression, anxiety and anger in record time, but also allowed me to add a separate section to the instrument – later called the Red Flag Section -- to help clinicians screen for substance abuse, eating disorders, suicidality, potential for violence, and other mental health concerns.
After a 167-item pilot version of the instrument, based on an extensive review of the literature, was administered to 386 outpatients across the United States by a team of over 40 colleagues recruited online, statistical analysis of that data resulted into the psychometrically refined 105-item instrument eventually called the Quick Psychoaffective Symptoms Scan (Qpass). In 2000, in a separate sample of 82 outpatients, Qpass was found to be a reliable and valid measure not only of depression, anxiety, and anger, but also of Global Psychopathology (that is, overall psychological distress), Psychoticism, Obsessive Compulsivity, Phobic Avoidance, Suicide Risk, and Violence Risk and 14 sub-constructs of depression, anxiety, and anger. This meant that the 10- minute instrument could now measure 23 constructs of interest to mental health professionals.
After earning my doctorate in 2001, I made Qpass available to colleagues in various mental health settings across the United States who had offered much positive feedback on the usefulness of the instrument in their settings. Many of them have commented on how useful and convenient Qpass is in quickly assessing the symptoms and constructs that are relevant to them. Whether you are a clinician or researcher, my sincere hope is that Qpass will prove to be a very useful and convenient tool for you. If you have any questions that are not sufficiently answered at our website (see Qpasslive.com) or the Qpass manual, please feel free to contact me directly. Also, I would also greatly appreciate any feedback you have to offer on the use of Qpass in your setting!
Scott Lownsdale, Ed.D., LCPC
5589 Guilford Road,