Rehab Measures Instrument
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  2. Spinal Cord Injury – Quality of Life Depression

Spinal Cord Injury – Quality of Life Depression

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Purpose

The SCI-QOL Depression instrument assess symptoms of depression in individuals with spinal cord injury.

Link to Instrument

Instrument Details

Acronym SCI-QOL Depression

Area of Assessment

Depression
Quality of Life
Mental Health

Assessment Type

Patient Reported Outcomes

Administration Mode

Computer

Cost

Free

Cost Description

Paper copies of short forms are available. PDFs can be requested through emails to sci-qol@udel.edu and tbi-qol@udel.edu

Electronic versions can be found in the NIH Toolbox or the PROMIS app. Either app is $500/yr, and covers up to 10 iPads on a single license. The SCI-QOL and TBI-QOL CATs can be administered directly through these apps. It is important to note that using the app requires you to be physically with the participant or read the questions aloud by interview over the phone - there is no way to send a link to have someone complete the measures at home.

Free electronic versions are available. If your institution has REDCap, the CATs and short forms can be accessed through the REDCap instrument library by searching for the specific measure you want and adding them to your REDCap project. For non-REDCap alternatives, the SCI-QOL and TBI-QOL short forms can be imported into an alternative electronic administration platform such as Qualtrics, SurveyMonkey, Google Forms, etc. Email sci-qol@udel.edu or tbi-qol@udel.edu to request PDF versions.

Diagnosis/Conditions

  • Spinal Cord Injury

Populations

Spinal Injuries

Key Descriptions

  • The SCI-QOL Depression measure is an item response theory (IRT)-calibrated item bank with 28 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or short form (SF). Many items are shared with the PROMIS (18 of 28 items) and Neuro-QOL (23 of 28 items) Depression item banks.

Number of Items

28
Short: 10
CAT: 4-12

Equipment Required

  • The Short Form requires only the printed form and a pencil. A CAT administration requires a desktop, laptop, or tablet computer with internet connection and login to AssessmentCenter.net
  • Access to the short form, and administration of CATs through Assessment Center, is available through SCI-QOL@udel.edu.

Time to Administer

Less than 5 minutes

Required Training

Reading an Article/Manual

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Review completed by Pamela Kisala, M.A. and Matthew Cohen, Ph.D.

ICF Domain

Body Function

Measurement Domain

Emotion

Considerations

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Spinal Injuries

back to Populations

Standard Error of Measurement (SEM)

Depends on the mode of administration:

  • Full Item Bank: Mean SEM= 2.1
  • 8-Item Fixed-Length CAT: Mean SEM= 2.7
  • Variable-length CAT (Min 4): Mean SEM= 3.0
  • Variable-length CAT (Min 8): Mean SEM= 3.1
  • 4-Item Fixed-length CAT: Mean SEM= 3.4

Minimal Detectable Change (MDC)

Calculated from SEM

  • Full Item Bank: MDC= 4.9
  • 8-Item Fixed-Length CAT: MDC= 6.3
  • Variable-length : MDC= 7.2

Cut-Off Scores

Holdnack et al. (in preparation) created a "cross-walk" table to transform SCI-QOL Depression scores to scores on the PHQ-9, a gold standard measure of depression with well-established cut scores. The SCI-QOL Depression scores below are the equivalent of PHQ-9 cutoff scores.

  • Mild Depression: T-score from 52-58
  • Moderate Depression: T-score from 60-64
  • Moderate-severe Depression: T-score from 65-67
  • Severe Depression: T-score 68+

Normative Data

General population (2000 U.S. Census). The normative data reference the calibration sample from PROMIS, which matches the demographics of the 2000 U.S. Census.

(n=716, mean age = 43.0(15.3); time post injury = 7.1 years (10.0); 45% paraplegia, 54% tetraplegia).

Test/Retest Reliability

Traumatic SCI (Tulsky et al., 2015)

  • Excellent: (Pearson's r= 0.80)
  • Excellent: (ICC= 0.80)

Internal Consistency

Traumatic SCI (Tulsky et al., 2015)

  • Excellent: (Cronbach's alpha= .96)

Criterion Validity (Predictive/Concurrent)

Traumatic SCI (Tulsky et al., 2015)

  • Excellent concurrent validity predicating the PHQ-9 (r= .76)

Construct Validity

Traumatic SCI (Tulsky et al., in preparation)

The SCI-QOL Depression item bank demonstrated good convergent validity by correlating strongly with measures of:

  • Anxiety (GAD-7 r= .59)
  • Life Satisfaction: (Satisfaction with Life Scale r= -.62)
  • Resilience (SCI-QOL Resilience r = -.73)
  • Positive affect (SCI-QOL Positive Affect r= -.68).

The SCI-QOL Depression item bank demonstrated good discriminant validity by weakly correlating with measures of:

  • Fine motor functioning (SCI-QOL Fine Motor r= -.16)

Content Validity

Some SCI-QOL items were derived from the focus groups and cognitive interviews that founded the PROMIS and/or Neuro-QOL measurement systems. The Neuro-QOL focus groups comprised patients with neurological illness (n=64) and caregivers (n= 19). Other SCI-QOL items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI (n=42).

Face Validity

Not statistically assessed, but content was generated from individuals with SCI and expert clinicians, so face validity is believed to be strong.

Floor/Ceiling Effects

Traumatic SCI (Tulsky et al., 2015)

 

Full Item Bank:

  • Floor Effect: Excellent (0.1%)

  • Ceiling Effect: Adequate to Excellent (3.1%)

8-Item Fixed-length CAT:

  • Floor Effect: Adequate to Excellent (4.7%)

  • Ceiling Effect: Excellent (0.1%)

Variable-length CAT (Max 12):

  • Floor Effect: Adequate to Excellent (3.5%)

  • Ceiling Effect: Excellent (0.1%)

Variable-length CAT (Max 8):

  • Floor Effect: Adequate to Excellent (4.7%)

  • Ceiling Effect: Excellent (0.1%)

4-Item Fixed-length CAT:

  • Floor Effect: Adequate to Excellent (7.4%)

  • Ceiling Effect: Excellent (0.1%)

Bibliography

Tulsky et al. (2015). Measuring depression after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Depression item bank and linkage with PHQ-9. Journal of Spinal Cord Medicine, 38(3), 335-346.

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