On the Validity of the Symptom Check List-90 (Scl90): a Comparison of Diagnostic Self-Ratings in General Practice Patients and 'Normals', Based On the Hebrew Version

The short clinical diagnostic self-rating scale for emotional and somatic concerns — Symptom Check List-90 (SCL-90) - was translated into everyday Hebrew and tested on 131 subjects for: 1. Construct validity, using item analysis. 2. Discriminating validity on a gradient of general practice patients and 'normal' controls. The Hebrew SCL-90 was found to retain its validity and to be easily administered and scored in non-treatment situations. It was also used as a tool for generating and substantiating hypotheses on psychosomatic and psychosocial interrelationships. The success of anxiolytic drugs in the treatment of neurotic patients depends, in part, on factors that are not drug-related. Among these factors is the nature of the neurotic complaint, or the composition of the symptom syndrome. Therefore, as part of its larger study on anxiolytic drugs, the Community Mental Health Centre of Northern Jerusalem, Israel, sought a self-diagnostic psychometric instrument that could differentiate among subjects in terms of symptom syndromes, and that could also reflect change as a result of drug treatment. The Middlesex Hospital Questionnaire (MHQ) was the first questionnaire considered for this purpose(2): A validation study of the Hebrew version showed that the Hebrew MHQ was 'a valid scale enabling accurate segregation of sub-populations differing in their clinical status'.(3) But the MHQ subscales were not sufficiently specific, since three of them showed some overlapping. Moreover there were only 48 items, and the questionnaire allowed only 'yes/no' answers. These two factors, therefore, tended to lower the reliability of the questionnaire. Consequently the search for a self-diagnostic instrument continued, and the SCL-90 was considered(4). The SCL-90 is a self-report clinical rating scale that is longer than the MHQ (90 items, which reflect nine primary symptom dimensions) and has a range of five answers for each item. According to its authors the 'SCL-90 has been designed as a general measure of psychiatric outpatient symptomatology for use in both clinical and research situations, and was developed with primary emphasis on validity as a criterion measure in clinical drug trials where the principal focus is on the relative efficacy of psychotherapeutic agents'.(5) It was, therefore, decided to conduct a pilot study attempting to validate a Hebrew version of the SCL-90. No inter-country or interlingual comparisons are intended. In the present study, the Hebrew version of the SCL-90 is investigated for its construct and discriminatory validity. An item analysis will be presented.