Monday, May 27, 2019

Post-Traumatic Stress Disorder Checklist and DSM-5 (PCL-5)

The PCL-5 is a 20-item self-report checklist of symptoms that can help clinicians screen patients for PTSD (Post-Traumatic Stress Disorder). The scale can assist in making a diagnosis and in monitoring change during and after treatment.

The VA site suggests the scale can be completed in 5-10 minutes.

The scores range from 0 to 80.

The items are organized according to DSM-5 clusters.

Scale availability link

Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at

Web link detail:

Applied Statistics for Counselors:  Buy on Amazon

References (PCL-5)

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489-498. doi: 10.1002/jts.22059
Bovin, M. J., Marx, B. P., Weathers, F. W., Gallagher, M. W., Rodriguez, P., Schnurr, P. P., & Keane, T. M. (2015). Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in Veterans. Psychological Assessment, 28, 1379-1391. doi: 10.1037/pas0000254
Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., Foa, E. B., Young-McCaughan, S., Yarvis, J., Hembree, E. A., Mintz, J., Peterson, A. L., & Litz, B. T. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28, 1392-1403. doi: 10.1037/pas0000260
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Monday, April 15, 2019

Charting Death and Thinking about Epidemics

What are the leading causes of death in the United States?

Based on what you have read or learned from news sources, what did you expect to see in the top five? If you thought of one that is missing, perhaps it is in the top 10. Still, when you look at the numbers, you may be surprised to learn how few people die in a given year, given the size of the US population.

My point in this post is that we ought to examine total data instead of being guided by the headlines of news stories and misleading charts when we want to understand a health or social condition.

According to the Centers for Disease Control and Prevention, the five leading causes of death in 2017 were heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke. The report includes more causes, but I chose the top five based on the deaths per 100,000 U.S. standard population.

When you add the numbers for the five causes, you find the top five causes of death accounted for 445 people out of 100,000 people. Thus, less than 1% of the population died from the top five causes.

The chart illustrates a helpful way to report data. Instead of reporting percentages, just give the numbers of people for any condition in relationship to a population value. In this case, the relevant population value is Americans (actually an estimate of the U.S. population based on the 2010 census).

It is usually better to report data in terms of how many people with a condition out of 100 people, but as you can see, out of a sample of 100 people, we might have no dead people! And, fewer than 2 people died of these causes out of 1,000 people! So, it is important to select a population size that makes sense in terms of all the available data.

About Totals

I would like to know how many people died in the United States. It just seems to make sense. If you are going to tell me how many people died out of some portion of the population, why not tell me the total figure?

Interestingly, there is a total death figure for 2016, which is 2,744,248. That gives us a death rate of 849.3 people out of 100,000 population. The total population estimate for 2016 is 323,071,342. So, less than 1% of the population died in 2016.

I would also like to know how many people died out of 100,000 people in 2017. The online figure is 731.9 per 100,000 so I will fix that fraction of a person and say 732 people out of 100,000. The 2018 CDC report tells us that 2,813, 503 deaths were registered. I see that they only know about registered deaths. Presumably, people could die and not be registered. so, it is good to pay attention to the details.

They don't tell us how many people are in their estimate of the population-- the last census was in 2010. But they did write that they estimated the 2017 population based on 2010 census data. I did a search and found a census table estimate for 2017 = 327, 147, 121, according to the website.

The statisticians are pretty good, but it is important to know that we are dealing with estimates. We really don't know how many people died in the USA in 2017. Still, I bet the numbers are good estimates.

I don't require absolute certainty when it comes to data about human beings. Anyway, if you are interested, you could estimate the number of people who died in 2017 or, you can wait until the data are provided.


Another useful lesson to note here is the lack of scary headlines. We just have the facts reported in a responsible way. There are no news media telling us about this epidemic or another in an effort to sell a story.

We know that less than 1 out of 100 people died in 2016 (849 out of 100,000 rounded). If a person had 1,000 friends on social media then, 8 or 9 might have died if, and only if, the friends were similar in age and other relevant variables to people in the general U.S. population. My guess is, any friendship group probably does not represent a proportionate sample of the US population so, we will need to be careful in generalizing about all people based on our friendship groups.

It is truly sad for loving family members when people die of any cause. When we look at the total population, we see that even for the leading causes, not many of us die every year. Of course, healthcare personnel and other decision-makers ought to pay attention to trends--especially when we can do something about a particular cause of death.

If you were going to write that we have an epidemic based on the number of people dying, what figure would you say is worthy of the term epidemic? The dictionaries are not helpful because they refer to an epdemic as a "widespread" problem such as a disease. Truly, 1% of almost 330 million people is a lot of human beings. The number of people who did not die is of course the reverse so, more than 99% did not die.

We are wise to keep total figures in mind when we want to truly understand the scope of a particular cause of death or other social concern.


The death rate increased 100% when two people die this year compared to one person who died last year.

Perhaps you already know this? It is a deceptive practice. Suppose one person died after taking drug XYZ this year. Then, next year two people died after taking the same drug. Two people out of thousands or millions is a very small number, but the increase in deaths equals 100%! We do not know how many people took drug XYZ and are living quite happily! It's good to be careful how people are reporting data. We really need to know all the relevant data when making informed decisions.

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Corrections and helpful comments are welcome.


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Tuesday, April 2, 2019

7 Tips for Writing Better Survey Items

So many people are creating surveys in schools, government agencies, and major corporations. Some are better than others.

Here are seven tips.

1  Stay focused on your goal. 
Avoid asking everything you can think of on a subject. Unfortunately, I've been on project teams that would not heed this advice. Participants get frustrated and leave surveys incomplete.

2  Ask only one question at a time.
Have someone look at your items to see if they are confused about what you are asking.

3  Use easy-to-understand language.
Know your audience and how they use language. Again, ask a few people to check your wording.

4  Write well.
Some participants will drop out of your survey when they identify misspelled words, common punctuation errors, and problems of grammar.

5  Cover all possible answers.
If you aren't sure you have listed every option, then add an "other" option with a place to write in another response. This may lessen the frustration of participants who don't agree with the available options.

6  Provide a reason and time information for long surveys.
Justify why it is important for people to spend a long time answering your questions. And give them a time estimate based on how long others have taken to complete your survey.

7  Build Trust
Provide contact information and a link to your school or business so people have a way of verifying your credibility. People will help students, but let them know your professor's name and the name of your school.

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Sunday, March 17, 2019

Modified Parenting Scale

The Modified Parenting Scale is a shortened version of the Parenting Scale developed by Arnold, O'Leary, Wolff, & Acker (1993).

The 2007 study by Prinzie, Onghena, and Hellinckx revealed two dimensions, which are overreactivity and laxness.

The reliability data were reported as acceptable to good in this sample of more than 1000 parents. There is some evidence of predictive validity. Inadequate parenting was positively related to problem behavior on the Child Behavior Checklist (Achenbach- See ASEBA for details) and stress as measured by the Parenting Stress Index (Dutch version; See Doll 1989 for a review).

The full version can be found on PsycTESTS. There are 20 items, which are rated on 7-point Likert scales.

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Item Examples

Laxness items

16 When my child does something I don’t like . . . I do something about it every time it happens – I
often let it go.

12 When I want my child to stop doing something . . . I firmly tell my child to stop – I coax or beg my child
to stop

Overreactivity items

3 When I’m upset or under stress . . . I am no more picky than usual – I am picky and on my
child’s back.

9 When my child misbehaves . . . I keep my talks short and to the point – I give my
child a long lecture.

Learn more about parenting in Discipline with Respect on AMAZON


Prinzie, P., Onghena, P., & Hellinckx, W. (2007). Reexamining the Parenting Scale: Reliability, factor structure, and concurrent validity of a scale for assessing the discipline practices of mothers and fathers of elementary-school-aged children. European Journal of Psychological Assessment, 23(1), 24-31. doi: 10.1027/1015-5759.23.1.24.


PsycTESTS is available in many library systems.

Thursday, January 10, 2019

Measuring Marital Satisfaction

The Kansas Marital Satisfaction Scale (KMSS) is a frequently used short measure of relationship quality. using just three items, the KMSS has yielded highly reliable and validity data.

Internal consistency (alpha) values were in the 90s range (see for example Schumm et al., 2008). Validity data were also adequate when the KMSS was compared with longer measures like the Dyadic Adjustment Scale (DAS; see for example Schumm et al., 1986).

The scale was developed by Walter R. Schumm of Kansas State University. See additional references below.

The scale may be used for educational and research purposes without permission.

Kansas Marital Satisfaction Scale (KMSS): 3-items
Items are rated on a 7-point scale ranging from 1 (extremely dissatisfied) to 7 (extremely satisfied).

1.      How satisfied are you with your marriage?

2.      How satisfied are you with your husband/wife as a spouse?

3.      How satisfied are you with your relationship with your husband/wife?

Books related to Surveys and for Counselors and Psychotherapists

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References to studies using the KMSS.

Bowman, A., & Sutton, G.W. (2004). Marital satisfaction and relational attachment in a sample of newly married couples. Psychological Reports, 95, 989-991.  Academia Link ResearchGate Link

McLeland, K. C., & Sutton, G. W. (2005) Military service, marital status, and men’s relationship satisfaction. Individual Differences Research, 3, 177-182.  Academia Link    ResearchGate Link

McLeland, K. C., Sutton, G. W., & Schumm, W. (2008). Marital Satisfaction before and after deployments associated with the global war on terror. Psychological Reports, 103, 836-844. Academia Link    Research Gate Link

Schumm, W. R., Crock, R. J., Likcani, A., Akagi, C. G., & Bosch, K. R. (2008). Reliability and Validity of The Kansas Marital Satisfaction Scale With Different Response Formats in a Recent Sample of U.S. Army Personnel. Individual Differences Research, 6(1), 26–37. Retrieved from


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Tuesday, October 9, 2018

Dark Triad Scale (Dirty Dozen)

The toxic triad is commonly known as the Dark Triad. The triad consists of three sets of personality traits representing features of Narcissistic, Psychopathic, and Machiavellian personality clusters.

The Dirty Dozen Scale

Psychological Scientists Peter Jonason and Gregory Webster developed a scale known as the Dirty Dozen (2010), which uses 12-items to identify key features of this “Dark” or Toxic Triad.

Here’s the 12 items

1.      I tend to manipulate others to get my way.
2.      I tend to lack remorse.
3.      I tend to want others to admire me.
4.      I tend to be unconcerned with the morality of my actions.
5.      I have used deceit or lied to get my way.
6.      I tend to be callous or insensitive.
7.      I have used flattery to get my way.
8.      I tend to seek prestige or status.
9.      I tend to be cynical.
10.  I tend to exploit others toward my own end.
11.  I tend to expect special favors from others.
12.  I want others to pay attention to me.

Each item is rated on a 7-point Likert-type scale based how much it applies to a person. Here’s the subscales:

Narcissism = 3, 8, 11, 12
Psychopathy = 2, 4, 6, 9
Machiavellianism = 1, 5, 7, 10

As you can see, scores could range from 12 to 84. Webster & Jonason (2013) examined the scale in samples totaling 1,014 college students. The second sample used the 7-point rating scale, which resulted in an overall item mean of 2.92 and SD of 1.07.

Overall alpha was .87. See Table 3 of their article for more details. Note that this is a general population college sample thus we would expect higher scores in clinical samples.

For a more recent meta-analytic review of various measures of the Dark Triad, see Muris et al., 2017 (reference below).

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Jonason, P. K., & Webster, G. D. (2010). The dirty dozen: A concise measure of the dark triad. Psychological Assessment, 22(2), 420-432. doi:10.1037/a0019265 [See Table 8 on page 429 for the list of the 12 items.]

Muris, P.,  Merckelback, H., Otgaar, H. & Meijer, E. (2017). The Malevolent Side of Human Nature: A Meta-Analysis and Critical Review of the Literature on the Dark Triad (Narcissism, Machiavellianism, and Psychopathy). Perspectives on Psychological Science, 12 (2), 183-204.

Webster, G. D., & Jonason, P. K. (2013). Putting the 'irt' in 'dirty': Item response theory analyses of the dark triad dirty dozen—an efficient measure of narcissism, psychopathy, and Machiavellianism. Personality and Individual Differences, 54(2), 302-306. doi:10.1016/j.paid.2012.08.027

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 Geoff W. Sutton

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Friday, September 28, 2018

The Moral Foundations Questionnaire (MFQ)

The Moral Foundations Questionnaire (MFQ) is available online and as a download. You can take the test online and get your scores. The MFQ is designed to measure the five core moral foundations derived from Moral Foundations Theory developed by Jonathan Haidt and his colleagues. (See references at the end of this post).

The MFQ evaluates moral foundations based on answers to questions. There are five moral foundations in the MFQ:

Equality-Fairness; aka fairness/cheating
Authority-Respect; aka Authority/subversion
Purity-Sanctity aka Sanctity/degradation

I added the aka because you will find somewhat different words in some articles.

See this page for a description of the five core foundations

Researchers can use the MFQ items to create their own surveys.

The current version (2018) is a 30-item version known as the MFQ30. There is also a shorter version known as the MFQ20, which has 20 items, 4-items for each of the 5 core moral foundations.

The MFQ is available in multiple languages.

Where to get the MFQ:

Haidt and his colleagues have added a sixth foundation to assess liberty. There are two subscales to this foundation.

Where to get the Liberty Scale Items: 

See the Appendix at the end of the Iyer et al., article on Plos


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Graham, J., & Haidt, J. (2010). Beyond beliefs: Religions bind individuals into moral communities. Personality and Social Psychology Review, 14, 140–150. doi: 10.1177/1088868309353415
Graham, J., Haidt, J., & Nosek, B. A. (2009).  Liberals and conservatives rely on different sets of moral foundations. Journal of Personality and Social Psychology, 96, 1029-1046. doi:10.1037/a0015141
Graham, J., Nosek, B. A., & Haidt, J. (2012). The moral stereotypes of liberals and conservatives: Exaggeration of differences across the political spectrum. PLoS ONE7(12), e50092.

Graham, J., Nosek, B. A., Haidt, J., Iyer, R., Koleva, S., & Ditto, P. H. (2011). Mapping the moral domain. Journal of Personality and Social Psychology, 101, 366-385. doi:10.1037/a0021847
Haidt, J. (2001). The emotional dog and its rational tail: A social intuitionist approach to moral judgment. Psychological Review, 108, 814–834. doi:10.1037//0033-295x.108.4.814
Haidt, J. (2012). The righteous mind: Why good people are divided by politics and religion. New York: Pantheon.
Haidt, J., & Graham, J. (2007).  When morality opposes justice: Conservatives have moral intuitions that liberals may not recognize. Social Justice Research, 20, 98-116. doi:10.1007/s11211-007-0034-z
Haidt, J., & Joseph, C. (2004). Intuitive ethics: How innately prepared intuitions generate culturally variable virtues. Daedalus: Special Issue on Human Nature133(4), 55–66. doi:10.1162/0011526042365555
Iyer, R., Koleva, S., Graham, J., Ditto, P., & Haidt, J. (2012). Understanding Libertarian morality: The psychological dispositions of self-identified Libertarians. Plos One, 7(8): e42366. doi: 10.1371/journal.pone.0042366
Johnson, K. A., Hook, J. N., Davis, D. E., Van Tongeren, D. R., Sandage, S. J., & Crabtree, S. A. (2016). Moral foundation priorities reflect U.S. Christians’ individual differences in religiosity. Personality and Individual Differences. doi: 10.1016/j.paid.2015.12.037.

Post-Traumatic Stress Disorder Checklist and DSM-5 (PCL-5)

The PCL-5 is a 20-item self-report checklist of symptoms that can help clinicians screen patients for PTSD (Post-Traumatic Stress Disorder)....