Repetitive behaviors are commonly observed in clinical settings, yet mental health practitioners still understand very little about them and the role they play in someone’s life.
Measure development analyses are outlined for the purpose of determining the psychometric properties of a new assessment tool intended to assist mental health practitioners in understanding what motivates and sustains repetitive behavior in their clients.
Participants consisted of 82 total subjects. Of those subjects 70 were male and 12 were female. Diagnostically, 25 were in a group meeting criteria for OCD only, 23 were in a group meeting criteria for an ASD only, and 34 were in a group meeting criteria for both OCD and an ASD. The research site was a clinical setting at a diagnostic and treatment center located in the Northeastern United States.
Measures. The self-developed assessment tool-form 1 was administered and scored by the PI with each subject. This tool is intended to determine whether a particular repetitive behavior (i.e., stereotypy, obsession, compulsion, perseveration, preoccupation) is characterized by one of the possible functional characteristics of repetitive behavior identified for study (i.e., risk-avoiding, pleasure-seeking, soothing, distressing, adaptive, disruptive, metaphoric, concrete, internalized, and/or intrusive).
The self-developed assessment tool- form 2 was provided to the parents or caregivers and primary therapists for each individual in the study. This tool utilized the same items as form 1, but presented in a manner that the individual subject’s parents or other caregivers and therapists could easily understand and respond to (e.g., instead of “It makes it difficult to concentrate,” the item read: Do you think that this behavior makes it difficult for him/her to concentrate?).
The Yale-Brown Obsessive Compulsive Scale, Adaptive Behavior Assessment System-Second Edition, and Gilliam Autism Rating Scale-Second Edition were also provided to each subject and/or his/her parent or caregiver. For the purposes of this study, it was used to examine patterns of association between the self-developed assessment tool and standard measures of functioning.
Exploratory factor analyses were conducted separately in data collected from parents, therapists, and individuals using a self-developed repetitive behavior scale. When the structural coefficients from these analyses were compared across the three sources of information, four larger factors emerged demonstrating reasonable consistency across the three types of informants. These assessed: 1) intrusive effects; 2) soothing effects; 3) level of distress, and; 4) pleasure-seeking qualities. Reliability for the new scales was then calculated separately for each source of information revealing high internal consistency as evidenced by Cronbach’s alpha scores mostly in the 0.7 and higher range. Validity Analyses were completed, first by examining bi-variate correlations among the new scales and then by examining correlations between the new scales and established measures of functioning.
A more comprehensive, functional model of repetitive behavior including links with other symptoms would go a long way toward helping mental health professionals better understand the purpose of repetitive behavior and how to better address it.
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