Psychometric Property Study of the Affective Lability Scale-short Form in Chinese Patients with Mood Disorders

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2023 Apr 21

PMID 37082759

Authors

Mohan Ma

Chuman Xiao

Wenwen Ou

Guanyi Lv

Mei Huang

Xiaotian Zhao

Yaqi Qin

Yumeng Ju

Yan Zhang

Affiliations

Soon will be listed here.

Abstract

Introduction: This study aimed to investigate the psychometric properties of the Affective Lability Scale-short form (ALS-SF) among Chinese patients with mood disorders, and to compare ALS-SF subscale scores between patients with major depressive disorder (MDD) and patients with bipolar disorder (BD) depression.

Methods: A total of 344 patients with mood disorders were included in our study. Participants were measured through a set of questionnaires including the Chinese version of ALS-SF, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), and NEO-Five Factor Inventory (NEO-FFI). Exploratory factor analysis and confirmatory factor analysis were applied to examine the psychometric properties of ALS-SF. Besides, correlation and regression analyses were performed to explore the relationship between affective lability and depression, anxiety, and neuroticism. Independent samples -tests were used to compare the subscale scores of ALS-SF between the MDD and BD depression groups.

Results: Results of factor analysis indicated that the model of ALS-SF was consistent with ALS-SF. The ALS-SF showed a solid validity and high internal consistency (Cronbach's alpha = 0.861). In addition, each subscale of ALS-SF was significantly correlated with PHQ-9, GAD-7, and NEO-FFI neuroticism subscale, except for the anger subscale showed no significant correlation with PHQ-9. Besides, the depression/elation and anger factor scores in patients with BD depression were higher than in patients with MDD.

Conclusion: Our study suggests that the Chinese version of ALS-SF has good reliability and validity for measuring affective lability in Chinese patients with mood disorders. Assessing affective lability would assist clinicians to distinguish between MDD and BP depression and may decrease the risks of misdiagnosis.

References

Contardi A, Imperatori C, Amati I, Balsamo M, Innamorati M . Assessment of Affect Lability: Psychometric Properties of the ALS-18. Front Psychol. 2018; 9:427. PMC: 5885065. DOI: 10.3389/fpsyg.2018.00427. View

Mesbah R, de Bles N, Rius-Ottenheim N, van der Does A, Penninx B, van Hemert A . Anger and cluster B personality traits and the conversion from unipolar depression to bipolar disorder. Depress Anxiety. 2021; 38(6):671-681. PMC: 8248435. DOI: 10.1002/da.23137. View

Hoegh M, Melle I, Aminoff S, Haatveit B, Olsen S, Huflatten I . Characterization of affective lability across subgroups of psychosis spectrum disorders. Int J Bipolar Disord. 2021; 9(1):34. PMC: 8566621. DOI: 10.1186/s40345-021-00238-0. View

Zwicker A, Drobinin V, MacKenzie L, Howes Vallis E, Patterson V, Cumby J . Affective lability in offspring of parents with major depressive disorder, bipolar disorder and schizophrenia. Eur Child Adolesc Psychiatry. 2019; 29(4):445-451. DOI: 10.1007/s00787-019-01355-z. View

Perlis R, Fava M, Trivedi M, Alpert J, Luther J, Wisniewski S . Irritability is associated with anxiety and greater severity, but not bipolar spectrum features, in major depressive disorder. Acta Psychiatr Scand. 2009; 119(4):282-9. PMC: 3312008. DOI: 10.1111/j.1600-0447.2008.01298.x. View

Aas M, Pedersen G, Henry C, Bjella T, Bellivier F, Leboyer M . Psychometric properties of the Affective Lability Scale (54 and 18-item version) in patients with bipolar disorder, first-degree relatives, and healthy controls. J Affect Disord. 2014; 172:375-80. DOI: 10.1016/j.jad.2014.10.028. View

Xu S, Chen Y, Li Y, Yang S, Lu Y, Li L . Factor structure and psychometric properties of the affective lability scale-short form in Chinese adolescents. Front Psychiatry. 2022; 13:881541. PMC: 9713808. DOI: 10.3389/fpsyt.2022.881541. View

Kamen C, Pryor L, Gaughan E, Miller J . Affective lability: separable from neuroticism and the other big four?. Psychiatry Res. 2010; 176(2-3):202-7. DOI: 10.1016/j.psychres.2008.08.002. View

Sun X, Li Y, Yu C, Li L . [Reliability and validity of depression scales of Chinese version: a systematic review]. Zhonghua Liu Xing Bing Xue Za Zhi. 2017; 38(1):110-116. DOI: 10.3760/cma.j.issn.0254-6450.2017.01.021. View

10.

Flint J . The genetic basis of neuroticism. Neurosci Biobehav Rev. 2004; 28(3):307-16. DOI: 10.1016/j.neubiorev.2004.01.004. View

11.

McCrae R, Costa Jr P . Validation of the five-factor model of personality across instruments and observers. J Pers Soc Psychol. 1987; 52(1):81-90. DOI: 10.1037//0022-3514.52.1.81. View

12.

Look A, Flory J, Harvey P, Siever L . Psychometric properties of a short form of the Affective Lability Scale (ALS-18). Pers Individ Dif. 2010; 49(3):187-191. PMC: 2893358. DOI: 10.1016/j.paid.2010.03.030. View

13.

Sparding T, Palsson E, Joas E, Hansen S, Landen M . Personality traits in bipolar disorder and influence on outcome. BMC Psychiatry. 2017; 17(1):159. PMC: 5415752. DOI: 10.1186/s12888-017-1332-0. View

14.

Verdolini N, Menculini G, Perugi G, Murru A, Samalin L, Angst J . Sultans of Swing: A Reappraisal of the Intertwined Association Between Affective Lability and Mood Reactivity in a Post Hoc Analysis of the BRIDGE-II-MIX Study. J Clin Psychiatry. 2019; 80(2). DOI: 10.4088/JCP.17m12082. View

15.

Widaman K . Common Factor Analysis Versus Principal Component Analysis: Differential Bias in Representing Model Parameters?. Multivariate Behav Res. 2016; 28(3):263-311. DOI: 10.1207/s15327906mbr2803_1. View

16.

Marwaha S, Balbuena L, Winsper C, Bowen R . Mood instability as a precursor to depressive illness: A prospective and mediational analysis. Aust N Z J Psychiatry. 2015; 49(6):557-65. DOI: 10.1177/0004867415579920. View

17.

Taylor R, Ulrichsen A, Young A, Strawbridge R . Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review. Int J Bipolar Disord. 2021; 9(1):33. PMC: 8558129. DOI: 10.1186/s40345-021-00237-1. View

18.

Marwaha S, Gordon-Smith K, Broome M, Briley P, Perry A, Forty L . Affective instability, childhood trauma and major affective disorders. J Affect Disord. 2015; 190:764-771. DOI: 10.1016/j.jad.2015.11.024. View

19.

Li H . Affective Instability, Depression, and Anxiety Symptoms in a Community Sample of Pregnant and Postpartum Women: A Cross-Sectional Study. Int J Environ Res Public Health. 2022; 19(6). PMC: 8951286. DOI: 10.3390/ijerph19063171. View

20.

Perlis R, Smoller J, Fava M, Rosenbaum J, Nierenberg A, Sachs G . The prevalence and clinical correlates of anger attacks during depressive episodes in bipolar disorder. J Affect Disord. 2004; 79(1-3):291-5. DOI: 10.1016/S0165-0327(02)00451-2. View