This study evaluated the psychometric properties of a newly developed instrument, the Social Anxiety Scale (SAS) within a non-clinical Swedish adult population (n: 384), in which psychophysical (SAS-cMax) and categorical (SAS-C) scaling methods were compared. Unlike many common rating scales, the SAS items were designed to align with the perceived intensity of symptom severity. With a reduced number of items, both scaling methods (SAS11-cMax and SAS13-C) demonstrated robust conceptual validity, with a three-factor model encompassing “fear of interaction in groups and with strangers”, “fear of speaking in front of others and being in the center of attention”, and “fear of performing tasks while being observed”. In addition, the SAS showed an excellent internal consistency (SAS11-cMax, α = 0.93 and SAS13-C, α = 0.93), as well as good to satisfactory convergent and discriminant validity. ROC-analyses revealed an excellent accurcay of both scaling methods to distinguish between high and low social anxiety levels. A score of 25.3 cM (“moderate social anxiety”) yielded the most optimal sensitivity (0.80) and specificity (0.80) of the SAS11-cMax. A score of 18.5 points yielded the most optimal sensitivity (0.85) and specificity (0.87) of the SAS13-C. Overall, its concluded that the SAS exhibits sound psychometric properties regardless of scaling method. Further validation with other social anxiety scales and within a clinical population, is needed to establish its effectiveness as a screening tool for social anxiety.

Most research showing results of psychotherapy come from efficacy studies or effectiveness studies from university counselling centers, or therapy clinics at universities. This study is an effectiveness study that aims to investigate the results of psychological treatment in psychiatric clinics for outpatients under naturalistic conditions. The study contributes unique insights regarding the outcomes of psychological treatment for patients with severe psychiatric problems in the complex real environment where many influencing variables exist. Patients were recruited from 2012 to 2016 from psychiatric clinics in Sormland, Sweden in the regular service. They received psychological treatment lasting between 1 and 50 months. The entire period of assessment took place between 2012 and 2021. A total of 325 patients received treatment from 59 participating therapists. Patients completed symptom assessment instruments regarding anxiety, depression, and quality of life at the start of therapy, upon the completion of therapy and, at follow-up one year after completion. Analyses indicated a significant improvement in all outcome instruments between start and completion of therapy. The improvement was largely maintained until follow-up. The effect sizes were moderate. Between 49.1% and 62.9% of patients “improved” or “recovered” as measured by the symptom assessment instruments at completion of therapy. The proportion of improved/recovered on the quality-of-life instrument was 37.4%. In a naturalistic cohort with comparatively severe psychiatric problems, substantial and stable improvements were achieved. The outcomes were respectable considering the population. The study provides external validity to efficacy studies on how psychological treatment works in a real-life context.

The COVID-19 pandemic precipitated numerous changes in daily life, including the cancellation and restriction of sports globally. Because sports participation contributes positively to the development of student-athletes, restricting these activities may have led to long-term mental health changes in this population. Using a repeated cross-sectional study design, we measured rates of depression using the Patient Health Questionnaire-2 and anxiety using the Generalized Anxiety Disorder-2 scale in student-athletes attending elite sport high schools in Sweden during the second wave of the pandemic (February 2021; n = 7021) and after all restrictions were lifted (February 2022; n = 6228). Depression among student-athletes decreased from 19.8% in 2021 to 17.8% in 2022 (p = .008, V = .026), while anxiety screening did not change significantly (17.4% to 18.4%, p > .05). Comparisons between classes across years revealed older students exhibited decreases in depressive symptoms, while younger cohorts experienced increases in symptoms of anxiety from 2021 to 2022. Logistic regressions revealed that being female, reporting poorer mental health due to COVID-19, and excessive worry over one’s career in sports were significant predictors of both depression and anxiety screenings in 2022. Compared to times when sports participation was limited, the lifting of restrictions was associated with overall reduced levels of depression, but not anxiety.

The Borg centiMax Scale, is a psychophysically composed general intensity ratio scale, which could enable more precise inter‐ and intraindividual comparisons of the intensity of depressive symptoms. In the present study, the properties of the centiMax scale were examined in 38 patients with clinical depression and 109 students. Additionally, preliminary centiMax cut‐off scores for mild, moderate and severe depression were estimated. The psychometric properties of the centiMax were found to be satisfactory regarding internal consistency, convergent, discriminative and predictive validity. Moreover, the centiMax was demonstrated to provide meaningful comparisons of symptom intensity, which makes it possible to evaluate the relative importance of individual symptoms in a profile and make more precise comparisons within and between individuals. With regard to intraindividual comparisons, patients rated , for example, the intensity of feeling “guilt” twice as strong as feelings of “being punished,” and the intensity of “loss of pleasure” almost three times as strong as “being punished.” With regard to interindividual comparisons, patients rated e.g., the intensity of “being punished” as 12 times stronger than controls, and the intensity of “worthlessness” about nine times stronger. In conclusion, the centiMax was shown to be reliable and valid for assessing depressive symptoms. The centiMax with level anchored ratio data, appears to be highly advantageous as it permits rather precise values of symptom intensity for intra‐ and interindividual comparisons that could be useful in the diagnostic process and in treatment planning.

The Borg centiMax scale is a psychophysically constructed general intensity scale with verbal anchors placed in congruence with the numerical scale (0–100); thus, ratio data are obtained. With ratio data, quantitative relationships among perceptions and feelings can be determined in a statistically more solid way. The purpose of this pilot study was to explore the utility of using the Borg CR Scale® (centiMax®, CR100) for measuring depressive symptoms in a pilot study of 50 students, who completed the centiMax along with the Beck Depression Inventory (BDI). Convergent validity and reliability were examined by correlation analyses (Pearson, Spearman, and Split-half with Spearman–Brown correction), and group and individual symptom profiles were constructed to illustrate the possible advantage of level anchored ratio data. The strong correlation 0.75 (p < .001) between the instruments supports an acceptable convergent validity of the centiMax and indicates a common underlying construct. Additionally, the reliability was high (cM = 0.96; BDI = 0.90). With symptom profiles, it was demonstrated that level anchored ratio data can show both how intense (level) and how many times more intense (relation) the feelings of separate symptoms are. In conclusion, the centiMax appears to be a valid and reliable instrument; however, further studies in larger samples including clinically depressed participants are needed for evaluating its diagnostic importance.

In many sports, for example in diving, figure skating, or ski jumping, judges subjectively score the performance on a category scale. The level-anchored ratio Borg centiMax (R) Scale (CR100), a general intensity scale from 0 to 100 commonly used for self-appraisal of exertion, is an interesting and valuable alternative. The aim was to explore the possibility of using the Borg centiMax (R) Scale (CR100), for performance evaluation in diving. In Study 1, 16 participants used the centiMax scale and the traditional diving scale (FINA) during a judicial training course on pre-recorded material; and in Study 2, six professional judges used the two scales during qualifying, semi-finals, and finals in the Swedish Championships in orebro, 2012. Strong and significant correlations were obtained between judged performances with the two scales (r >=.8), as well as with contest results (r >=.6). The continuous and finely graded centiMax scale has promising possibilities of improving measurement with both level determinations (how good) and ratio relationships (how much better). With a Borg CR scale, more interesting comparisons can be made, for example, direct comparisons between performance measures and perceptual variables (e.g., perceived exertion and motivation). This is of importance in training and coaching of athletes.

The aim of this study was to investigate if different scale formats affect what conclusion one can draw about the prevalence of a specific trait in a sample. More specifically, we compared the original scale format of Need for cognition (1-5) and Behavioral Inhibition/Approach (1-4) with an 11-point scale (0-10), and a psychophysical scale originally developed to measure physical exertion, Borg centiMax Scale®. Forty-eight psychology undergraduate students participated in return for course credit. In a within-subjects design, all participants completed both questionnaires in all three versions. Results revealed that the mean was consistently reaching ceiling effects when using the original scale formats, and the variation was relatively low compared to the other scales. In sum, the results revealed that the scale format plays a significant role in how prevalent a specific trait becomes in a sample.

For many years, psychologists have developed instruments for assessing disorders based on ordinal scales. These scales, despite being widely used, easy to apply, and producing good results, have some imperfections. By bringing the knowledge acquired by the psychophysics field during the last century, it is possible to improve psychological assessment creating new instruments based in psychophysical methods of measurement like ratio scaling.

Auditory-perceptual assessment has been criticized because of its inherent subjectivity. However, perceptual judgments are the primary tool in the clinical assessment of voice and resonance parameters and a key task for the speech–language pathologist/therapist (SLP/T). Decision on treatment or further examination is based on the perceptual speech assessment which need to be reliable. Of all perceptual dimensions used to distinguish normal from abnormal speech the most difficult to judge reliably is hypernasality (Watterson et al., 2017). Nevertheless, the final decision regarding whether an individual has nasality or other speech problems is based on the listener’s subjective measurement (Moll, 1λ64). Nasality is present in normal voice production and refers to perceived nasal sounds arising from the coupling of the oral and nasal resonating cavities. Nasal consonants are common in the languages. Normal nasal resonance has a range of acceptability and is perceived along a continuum, while nasal resonance disorders are associated with defects or dysfunction in the palate. In the current study the reliability of perceptual assessment of hypernasality with three different methods were compared. Standardised audio recordings of 5-year-old Swedish-speaking children with repaired cleft palate consisting of 73 stimuli in three different randomised orders were perceptually assessed by four experienced speech-language pathologists using three different methods: a sort and rate procedure (VISOR) allowing comparison between and ordering stimuli along a visual analogue scale; a 2- step method beginning with determination whether the speech resonance is within normal range or not. If not, the stimulus is rated along a 3 point ordinal category scale; a combined category-ratio scale (Borg centiMax®(cM)), where verbally well-defined categories are levelanchored to a ratio scale. Each listener completed a total of 657 hypernasality ratings (73 stimuli in 3 orders by 3 methods) for the rating task. Good to excellent intra-rater reliability was found within each listener for all methods. The highest inter-rater reliability was demonstrated for VISOR and the Borg cM. High consistency within each method was found with the highest for the Borg cM. In conclusion, both the VISOR and the Borg centiMax® seem appropriate for auditory-perceptual assessment of hypernasality with similar and high reliability. However, the Borg cM showed slightly better consistency and seems easiest to use in a clinical setting. Further research should aim for valid definitions of how hypernasality corresponds to the categories along the scale.

Objective: To compare reliability in auditory-perceptual assessment of hypernasality for 3 different methods and to explore the influence of language background.

Design: Comparative methodological study.

Participants and Materials: Audio recordings of 5-year-old Swedish-speaking children with repaired cleft lip and palate consisting of 73 stimuli of 9 nonnasal single-word strings in 3 different randomized orders. Four experienced speech-language pathologists (2 native speakers of Brazilian-Portuguese and 2 native speakers of Swedish) participated as listeners. After individual training, each listener performed the hypernasality rating task. Each order of stimuli was analyzed individually using the 2-step, VISOR and Borg centiMax scale methods.

Main Outcome Measures: Comparison of intra- and inter-rater reliability, and consistency for each method within language of the listener and between listener languages (Swedish and Brazilian-Portuguese).

Results: Good to excellent intra-rater reliability was found within each listener for all methods, 2-step:kappa = 0.59-0.93; VISOR: intraclass correlation coefficient (ICC) = 0.80-0.99; Borg centiMax (cM) scale: ICC = 0.80-1.00. The highest inter-rater reliability was demonstrated for VISOR (ICC = 0.60-0.90) and Borg cM-scale (ICC = 0.40-0.80). High consistency within each method was found with the highest for the Borg cM scale (ICC = 0.89-0.91). There was a significant difference in the ratings between the Swedish and the Brazilian listeners for all methods.

Conclusions: The category-ratio scale Borg cM was considered most reliable in the assessment of hypernasality. Language background of Brazilian-Portuguese listeners influenced the perceptual ratings of hypernasality in Swedish speech samples, despite their experience in perceptual assessment of cleft palate speech disorders.