2.3 Evaluations
Datasets concerning socio-demographic parameters, such as gender, age,
marital status, educational and employment details were evaluated
through a questionnaire developed by two psychiatrists having a minimum
of three years’ clinical and research background.
UHR individuals were enrolled using SIPS(McGlashan, Walsh, & Woods,
2010). SIPS contains five components: Scale of Prodromal Symptoms
(SOPS), Presence of psychosis scale (POPS), COPS, Global assessment for
functioning of a modified scale (GAF-M), and the schizotypal personality
disorder diagnostic criteria. Among them, SOPS assesses the type and
severity of at-risk symptoms. The SOPS contains 19 entries and consists
of four subscales: positive symptoms (5 bars), negative symptoms (6
bars), disintegration symptoms (4 bars), and general symptoms (4 bars).
A diagnosis of psychiatric risk syndrome was made, which was mainly
adjudicated according to the positive symptom scale (P1: unusual thought
content/delusions; P2: doubtful/harmful ideas; P3: exaggerated thoughts;
P4: perceptual abnormalities/hallucinations; P5: disordered speech)
scores in SOPS. The criteria of judgment were graded on a scale of 0 to
6, with 0: none, 1 to 5 representing that the positive symptoms were non
psychotic, and 6 indicating that the positive symptoms reached the level
of psychotic. The SIPS/SOPS scale has good reliability and can be widely
used in clinical setting (Woods, Walsh, Powers, & McGlashan, 2019).
Symptomatology was evaluated through Chinese version of positive and
negative syndrome scale (PANSS)(Kay, Opler, & Lindenmayer, 1988). The
primary aim of the PANSS was to rank abundance in psychiatric symptom
manifestation/s together with individual symptom severity, consisting in
30 items, which are scored on a 1-7 scale segregated across three
sub-scales: positive (7 items), negative (7 items), together with a
scale for general psychopathology (16 items). A higher score reflects
more severe symptoms.
Depressive symptoms were defined through the Chinese version for
Montgomery-Åsberg Depression Rating Scale (MADRS) (Liu et al., 2009;
Montgomery & Asberg, 1979). This scale had 10 items, with individual
items graded (0-6). A total score of 12 is used as a cut-off, with a
score greater than or equal to 12 indicating depressive symptoms. Raised
scorings reflected increased severity of depressive symptoms.
Overall function was evaluated through global assessment for functioning
scale (GAF)(Hall, 1995). This scale is based on the assessment tool of
Axis II in DSM-III-R, which mainly rates three dimensions of social
function, psychological symptoms, and occupational/learning function.
The total score is divided into nine grades, ranging from 1-100 points,
with higher scores indicating better function.
Coping styles have been extensively studied in the 1970s, but have
resulted in a diversity of choice of coping style assessment tools due
to differences in research perspectives. Internationally, there is no
uniform regulation of coping styles, so there are also a variety of
assessment tools. Coping Style Questionnaire (CSQ), commonly used in
China, was employed for this investigation. CSQ was developed by Xiao
and Xu in 1996 referring to theories and questionnaires used in studies
on coping and defense in other countries (Xiao and Xu, 1996). The tool
has 62 entries, each with two responses with 1 “yes” and 2 “no”. It
consists of 6 subscales, which are problem-solving, self-blame, help
seeking, fantasy, repression, and rationalization. Problem-solving as
well as help seeking were positive coping styles, whereas self-blame,
fantasy together with repression were the negative coping styles,
rationalized to be the mixed type of coping styles. This questionnaire
has satisfactory robustness and relevance and is widely used in China
with regard to the evaluation of coping styles.
Self-esteem was performed through self-esteem scale by Rosenberg
(Rosenberg, 1978), which was translated into a Chinese version in 1993
and has been tested for extensive validity . The scale contains 10 items
across a 4-point Likert scale (1=very strongly disagreement, 4=very
strongly agreement). Total scores reflect overall individual
self-esteem, increased scorings reflected increased self-esteem.