1. PSYCHOMETRIC PROPERTIES OF CIS
Understanding crisis: First step towards validation of « Crisis Integration Scale » (CIS) J.P. Bacchetta, A. Zanello, M. Varnier, A. Zinetti Bertschy, A. Fredenrich-Mühlebach and M.C.G. Merlo Department of Psychiatry, HUG University Hospitals, Geneva, Switzerland
INTRODUCTION
Crisis is a psychic reaction to stress with the potential to produce psychiatric symptoms. It is also considered as a transition phase which may change attitudes and interpersonal functioning (1). Special psychotherapeutic interventions have been developed in order to promote these changes. Brief crisis intervention centres (CIC) provide an alternative to hospital treatments and preserve as much as possible social relations and functioning.
In this study, we present the “Crisis Integration Scale” (CIS) and its psychometric properties. 
CIS PRESENTATION
CIS is a new, brief self-rating scale developed to measure whether or not a patient integrates his/her crisis as a constructive experience of his/her live. This scale is in French language (EIC: “Echelle d’Intégration de la Crise”) and is based on the concept of “integration versus sealing-over” proposed by T. McGlashan (2). CIS contains 18 items rated from 1= I totally disagree to 4= I totally agree.
Examples of CIS item:
Item 3: To speak about my crisis scares me.
Item 7: This crisis has destroyed my life.
Item 11: This crisis is part of my life.
PARTICIPANTS
70 recently admitted patients to our CIC suffering of major depression or anxiety disorders participated to this study. Their characteristics are presented in Table 1 .
Table 1. Demographic and clinical characteristics of the sample
Gender (female/male): 46/24
Age in years m(SD): 37.7 (10) F
Diagnosis (CIM-10)*: F F F
* F20-29: Schizophrenia, Schyzotypal and Delusions disorders, F30-39: Affective disorders, F40-48:Neurotic, stress-related and somatoforms disorder, F60-69: Disorders of Adult Personality and Behaviour
METHOD and PROCEDURE
The severity of psychiatric symptoms was assessed with the Brief Psychiatric Rating Scale (BPRS) and the Symptom Check List (SCL-90-R) while crisis integration was evaluated with the Recovery Style Questionnaire (RSQ) and CIS. Concurrently, we assessed also the social functioning with Global Assessment of Functioning (GAF). Assessment were proposed at intake (during the first week) and after 2 months. CIS were also administered after one week.
STATISTICAL ANALYSIS
Following psychometrics characteristics of EIC were calculated: internal consistence (Cronbach ⍺ ), test-retest reliability (ICC: Intra Class Correlation), convergent/divergent validity (Pearson correlation) and sensibility to change (Student t test).
PSYCHOMETRIC PROPERTIES OF CIS
Internal consistence (N=70; Cronbach ⍺ =0.57) and test-retest reliability at one week (N=61; ICC = 0.62) are acceptable.
As shown in Table 2, CIS is associated to RSQ suggesting that convergent validity is good. CIS, being not related to symptoms, has a excellent divergent validity. The trend found between CIS and GAF (actual) suggests that crisis integration is related to social functioning and probably to social relationships.
CIS appears not sensibility to change as shows in Table 3.
Table 2: Covergent and divergent validity (N=70)
Table 3: Sensibility to change (N=24)
RSQ
SCL-90 SR
GSI
BPRS
positive
negative
Manic/hostility
Anxio/depressive
GAF
Actual
CIS
0.26
0.11
-0.05
-0.08
-0.07
0.14
0.24 p
0.04
0.39
0.70
0.56
0.61
0.29
0.06
Intake
Follow-up t p
CIS: mean (SD)
55.8 (5.5)
56.3 (6.9)
-0.37
0.72
DISCUSSION
The first statistical analysis shows encouraging results according to reliability (internal consistency, test-retest). However no significant correlations were found between CIS and validity measures (e.g. BPRS items).
The next step for the validation of CIS is to study further the external and internal validities. All these results will then be compared with those concerning a different clinical population (patients with psychotic symptoms) admitted in a specialised outpatient unit.
BIBLIOGRAPHY
1) Rosen A. Crisis management in the community. In MJA Practice Essentials – Mental Health. Sydney: Australasian Medical Publishing Company, 1998, pp
2) McGlashan T.H. and Levy S.T. Sealing-over in a therapeutic community. Psychiatry, 40, 55-65, 1977.
Poster presented at AEP Congres, march 2007, Madrid/ Spain