Table 2.
Final summary of the psychometric properties of the reviewed apathy scales.
| Reference (#) |
Name of Scale |
Number of items & Time frame |
Self or Rater Administered |
Time to complete |
Reliability | Psychometric Properties Validity |
|---|---|---|---|---|---|---|
| Apathy Evaluation Scale – Subject, Informant and Clinician Versions (AES-S/I/C) | ||||||
| 46 | Apathy Evaluation Scale - Self (AES-S); Informant (AES-I); & Clinician (AES-C) versions; Available in German Arabic Chinese Russian translations | 18-item scale capturing symptomatology over last 4 weeks | Same 18 core items. AES-S = self- report AES-I = informant-based AES-C = semi-structured clinician administered |
10–20 minutes for a trained interviewer |
Internal consistency: Cronbach’s α = 0.86 to 0.94 for the three versions of the AES. Test-retest reliability: 25.4 days apart: α = 0.76 to 0.94 Inter-rater reliability: High inter-rater reliability: ICC = 0.94 |
Convergent validity: Assessed by examining the correlation between the three versions of the AES (i.e., self, clinician, and informant): r = 0.43** to 0.72** Discriminant validity: Assessed by examining the correlation between apathy and depression (for self-rated (r = 0.43) and informant-rated (r=0.27**)) and anxiety (for the clinician (r = 0.35**) and self-ratings (r = 0.42)). |
| 49 | Apathy Evaluation Scale - Self (AES-S); Informant (AES-I); & Clinician (AES-C) versions | As indicated above | As indicated above | As indicated above |
Internal consistency: Cronbach’s α = 0.76 to 0.94 for the three versions of the AES. Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: Not assessed Discriminant validity: Not assessed |
| 54 | Apathy Evaluation Scale - Self (AES-S); Informant (AES-I); & Clinician (AES-C) versions | As indicated above | As indicated above | 10–20 minutes for greater than Bachelor-level trained interviewer but up to 30 minutes if only Bachelor-level trained. |
Internal consistency: Cronbach’s α = 0.86 to 0.94 for the three versions of the AES. Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: Assessed by examining the correlation between the three versions of the AES (i.e., self, clinician, and informant) and apathy as measured by the apathy subscale of the NPI: Self-rated: r = 0.22* Clinician-rated: r = 0.27** Informant-rated: r = 0.49** AES-C-apathy factor: r =0.27** AES-I-apathy factor : r = 0.48** Discriminant validity: Assessed by examining the correlation between apathy and depression (for self-rated (r = 0.23*) and informant-rated (r=0.20)) and anxiety (for the clinician (r = 0.12) and self-ratings (r = 0.12)). |
| 56 | Apathy Evaluation Scale (AES) and the Positive and Negative Syndrome Scale (PANSS) | As indicated above | As indicated above |
Internal consistency: Total score on the AES-C as well as the Apathy factor of the AES-C (i.e., 12 of the 18 items) found to have high Cronbach alphas (i.e., α = 0.87 and α = 0.90 respectively) Corrected mean item-total correlation = 0.49 for the AES-C total score and 0.62 for the total score on the Apathy Factor indicating that the apathy factor could be a stand alone scale. Test-retest reliability: Not assessed. Inter-rater reliability: AES-C: ICC = 0.98* |
Convergent validity: Statistically significant and moderate to strong correlations between the AES-C total score and with the PANSS negative factor → r = 0.59*** specifically: Emotional withdrawal: r=0.61*** Apathetic social withdrawal: r=0.54*** Lack of flow: r=0.45*** Similarly, statistically significant and moderate to strong correlations were found between the Apathy factor of the AES-C and the PANSS negative factor → r = 0.58*** specifically: Emotional withdrawal: r=0.62*** Apathetic social withdrawal: r=0.52*** Lack of flow: r=0.45*** Discriminant validity: The AES-C total score had a statistically significant but weak correlation with the PANSS positive factor → r = 0.28** and poorly with most of the items the make up the positive factor (i.e., r = −0.04 for excitement to r = 0.28** for hallucinations). Similar correlations were found between the AES-C Apathy factor and the PANSS positive factor (r = 0.21) and its respective items (r = −0.01 for grandiosity and r = 0.29** for hallucinations). |
|
| Variations of Marin’s Apathy Evaluation Scale | ||||||
| 51 | Apathy Scale (AS) | 14-items: 8 positively and 6 negatively worded items capturing symptomatology over past 4 weeks | Interviewer-administered | Not assessed |
Internal consistency: Cronbach’s α = 0.76 Test-retest reliability: Subset of 11 PD patients used to assess 1-week test-retest reliability: r = 0.81** Inter-rater reliability: A second subset of 11 PD patients used to assess inter-rater reliability (independent ratings on 2 different days): r = 0.90** |
Convergent validity: Not assessed. Criterion validity: Using an independent neurologists blind clinical assessment of apathy as the “gold” standard: sensitivity = 66% and specificity = 100% for a cut-point of 14 on the AS. Discriminant validity: Not assessed. |
| 59 | Abridged version of the AES 5 of the original items and 2 newly developed items plans/goals for the future | 7-item scale | Clinician administered to formal caregiver. Period prior to hospitalization | <20 minutes |
Internal consistency: á = 0.67 good for a measure with few items (Nunnally and Bernstein, 1994) Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: AES-18 and the 7-item AS highly correlated (r=0.87) AS-7 significant, but low, correlation with PI as assessed by nurse (r=0.36)*, physical therapist (r=0.39), and the occupational therapist (r=0.42)* and depression (r=0.45**) GDS. Predictive validity: AS-7 predictive of functional performance at discharge (lower scores = greater functional performance (â =−0.22**) Discriminant validity: Not assessed |
| The Apathy Inventory (AI) | ||||||
| 33 | Apathy Inventory (AI)-Caregiver and patient-based versions | 3-item scale (emotional blunting, lack of interest, & lack of initiative) Assess change in symptomatology since the onset of the illness but can also be used to assess changes in frequency and severity of symptoms over a specified time period | Caregiver/informan t-rated | Not assessed |
Internal consistency: Cronbach’s α= 0.84 Test-retest reliability: Test-retest reliability (kappa = 0.99, 0.97 and 0.99 for emotional blunting, lack of initiative and lack of interest respectively and 0.96 overall) Inter-rater reliability: Inter-rater reliability (kappa = 0.99) |
Construct validity: Correlation between the lack of initiative (r=0.23)** and lack of interest (r=0.63)*** items and the NPI apathy subscale score. Convergent validity: Not assessed Discriminant validity: AI caregiver distinguish AD patients and controls, with AD patients having significantly higher score on lack of initiative and global score than control |
| Dementia Apathy Interview and Rating (DAIR) | ||||||
| 61 | Dementia Apathy Interview and Rating (DAIR) | 16 items capturing symptomatology over past month Follow up question determines behavioral changes |
Clinician administered structured interview to caregivers. | Not assessed |
Internal consistency: Overall: α = 0.89 In-person: α = 0.91 Telephone: α = 0.94 Test-retest reliability: Assessed using 20 randomly selected caregivers with assessments on average 56 days apart: r = 0.85*** Inter-rater reliability: Inter-rater reliability determined by a second rater’s rating of 10 audio-taped interviews: r = 1.00** |
Convergent validity: Correlation between apathy score and an independent clinician’s blind assessment of apathy on a 10-point Likert-like scale: 0=very uncharacteristic to 10=very characteristic: r = 0.31* to 0.46** Criterion validity: Optimal cut-points and associated sensitivity and specificity not determined. Discriminant validity: Very poor correlation between apathy score and depression: r=0.08. |
| Lille Apathy Rating Scale (LARS) | ||||||
| 57 | Lille Apathy Rating Scale (LARS) & Apathy Evaluation Scale (AES) | 33 items representing 9 domains capturing symptomatology over past four weeks | A structured clinician-administered scale based on patient’s self-report. | Not assessed |
Internal consistency: Cronbach’s á = 0.80 (items) & á = 0.74 (subscales) Split half reliability: á = 0.73** & á = 0.84** (after Spearman Brown “Prophecy Formula”) Test-retest reliability: 4-month test-retest assessed using a subset of 35 patients: r = 0.95*** Inter-rater reliability: Inter-rater reliability between 2 clinicians assessed using a subset of 32 patient: intraclass correlation coefficient (ICC)= 0.98*** |
Convergent validity: Strong correlation between AES & LARS total scores (r = 0.87**); AES & LARS Intellectual Curiosity subscale (r = 0.84**); AES & LARS Action Initiation subscale (r = 0.65**). Criterion validity: Expert blind classification of patients as severely apathetic vs. non- or mildly-apathetic as the “gold standard” provided good sensitivities (0.87 to 0.94 using cut-off scores of −15 to −17) & specificities (0.87 to 0.93 using on cut-off scores of −17 to −15). Discriminant validity: No interaction between apathy (LARS) & depression (MDARS) indicated good Discriminant validity. |
| 58 | Lille Apathy Rating Scale (LARS-I and C) & Apathy Evaluation Scale (AES-I and C) | As indicated above | Informant-completed | Not assessed |
Internal consistency: Cronbach’s á = 0.88 (items) & á = 0.83 (subscales) Split half reliability: á = 0.90 & á = 0.79 (after Spearman Brown “Prophecy Formula”) Test-retest reliability: test-retest assessed a few days later using a subset of 29 patients: r = 0.96 Inter-rater reliability: Inter-rater reliability between 2 clinicians assessed using a subset of 34 patient: intraclass correlation coefficient = 0.99 |
Convergent validity: Strong correlation between the informant and clinician version of the LARS: r = 0.814*** Strong correlation between the informant versions of the LARS and the AES: r = 0.85*** Criterion validity: An independent experienced neurologist’s classification of patients as severely apathetic vs. non- or mildly-apathetic as the “gold standard” using 23 patients and ROC curve analysis showed area under the curve (AUC) for the LARS-C = 0.98***; for the LARS-I = 0.93*** AUC difference between the LARS-I and AES-I = 0.05; p>0.19. Discriminant validity: Significantly higher apathy score (LARS-I) in demented PD patients compared to non-demented PD patients |
| Brief Psychiatric Rating Scale (BPRS) | ||||||
| 65 | BPRS-negative symptom (NS) scale; Available in Czech Estonian Italian German Polish Hebrew, and Russian translations. | The items emotional withdrawal, depressive mood, motor retardation, and blunted affect loaded onto the same factor comprising the negative symptom subscale Captures symptomatology from previous 2–3 days |
Clinician-administered | Not assessed |
Internal consistency: BPRS-NS-subscale/factor found to have high internal consistency (α = 0.85). Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: Not assessed Discriminant validity: The BPRS-NS-subscale poorly correlated with: The agitation factor: r=0.13 Cognitive dysfunction factor: r=0.26 Hostile suspiciousness factor: r=0.16 Psychotic Distortion factor: r=−0.07 |
| 63 (Review) | BPRS-negative symptom scale | Negative symptoms subscale comprised of emotional withdrawal, motor retardation, and blunted affect items | Clinician-administered | Not assessed |
Internal consistency: Ranging from 0.73 to 0.86 for individual items of the BPRS-NS. Sum score: r=0.87 Test-retest reliability: Ranging from 0.80 to 0.87 for BPRS-NS items Inter-rater reliability: Not assessed |
Convergent validity: Not assessed Discriminant validity: Not assessed |
| 66 | BPRS-negative symptom (NS) subscale | Negative symptoms subscale comprised of emotional withdrawal, uncooperativeness, motor retardation, disorientation and blunted affect items | Clinician-administered | Not assessed |
Internal consistency: BPRS-NS-subscale: α = 0.68 Test-retest reliability: Not assessed Inter-rater reliability: ICC for the individual items of the BPRS-NS-subscale were r=0.71*** (blunted affect), r=0.52*** (emotional withdrawal), r=0.74*** (motor retardation), uncooperativeness (r=0.61**) and r=0.87*** (disorientation). For the overall BPRS-NS-subscale the ICC was very high (r=0.90***) |
Convergent Validity: BPRS-NS-subscale vs. the PANSS-NS-subscale: r=0.82*** Discriminant validity: Not assessed Predictive validity: BPRS-NS-subscale significantly but weakly correlated with work skills (r=0.27**), personal presentation (r=0.18**), work quality (r=0.21**) and social skills (r=0.39***). BPRS-NS-subscale was not statistically related work motivation and work conformance. |
| 64 | BPRS-negative symptom scale | Negative symptoms subscale comprised of emotional withdrawal, motor retardation, and blunted affect items | Clinician-administered | Not assessed |
Internal consistency: Not reported for each subscale Test-retest reliability: Not assessed Inter-rater reliability: ICC for the individual items of the BPRS-NS-subscale were r=0.36*** (blunted affect), r=0.55*** (emotional withdrawal), r=0.68*** (motor retardation) and r=0.74*** (depressive mood). |
Convergent validity: Not assessed Discriminant validity: Not assessed |
| 67 | BPRS-negative Symptom scale | Negative symptoms subscale comprised of emotional withdrawal, motor retardation, and blunted affect items | Clinician-administered | Not assessed |
Internal consistency: Not assessed Test retest reliability: Not assessed Inter-rater reliability: Inter-rater reliability for blunted affect (r=0.46) and motor retardation (r=0.44) indicate fair reliability. Inter-rater reliability was said to vary depending on the discipline of the raters (i.e. nurse/social worker versus physician/social worker pairs). Reliability coefficient for the other items that comprise the BPRS-NS-subscale not given but indicated to be higher than that given for blunted affect and motor retardation. Note, statistical significance of the correlation coefficients Not assessed. |
Convergent validity: Not assessed Discriminant validity: Not assessed |
| Scale for the Assessment of Negative Symptoms (SANS) | ||||||
| 68 | Scale for the Assessment of Negative Symptoms (SANS) | 30 negative symptoms representing 5 domains. 5 items for apathy over the past month. Captures symptomatology over past month. | Clinician-administered | Not assessed. |
Internal consistency: High internal consistency for the SANS-avolition/apathy subscale (α = 0.799). Test-retest reliability: Not assessed. Inter-rater reliability: High inter-rater reliability across items that comprised the SANS-apathy subscale (ICC = 0.701 – 0.918); global rating of apathy (ICC = 0.763) and the subscale score (ICC = 0.864). |
Convergent validity: Not assessed. Discriminant validity: Not assessed. |
| 69 | Scale for the Assessment of Negative Symptoms (SANS) | As indicated above | As indicated above | Not assessed |
Internal consistency: Not assessed Test-retest reliability: 6 months (0.44 to 0.59)*** Inter-rater reliability: Not assessed |
Convergent validity: Fair correlation with the PANSS-NS subscale (r=0.43**) Discriminant validity: Poorly correlated with the Positive symptom subscale of DPRS (r=0.16) but had fair and significant correlation with the Ham-D (r=0.50**), which is confounded by the lack of interest item in the Ham-D score. Weaker correlation with Depression, r=0.32** as measured by PANSS scale. |
| Positive and Negative Syndrome Scale (PANSS) | ||||||
| 66 | PANSS-negative syndrome scale; Available in Swedish and Spanish translations | 30-item scale 7 items comprise the negative symptom scale Captures symptoms over past week for acute, chronic, and long-term chronic phases of schizophrenia |
Clinician-administered | 30–50 minutes semi-structured interview |
Internal consistency: Good internal consistency for the PANSS-NS-subscale: α=0.69 Test-retest reliability: Not assessed Inter-rater reliability: Overall PANSS-NS-subscale score: r= 0.94*** ICC reliability coefficient for the individual items of the PANSS-NS-subscale ranged from 0.63–0.90. For example, 0.88 for Blunted affect 0.84 for Emotional Withdrawal 0.79 for Passive Withdrawal |
Convergent validity: Correlation between the PANSS-NS-subscale and the BPRS-NS-subscale items ranged from 0.11 to 0.74. PANSS-NS-subscale and BPRS-NS-subscales highly correlated: r=0.82** Discriminant validity Not assessed Predictive validity: PANSS-NS-subscale significantly but weakly correlated with work skills (r=0.35**), work conformance (r=0.15*), work motivation (r=0.24*) and personal presentation (r=0.23**). Stronger correlations observed between the PANSS-NS-subscale and social skills (r=0.54***) and work quality (r=0.55***). |
| 71 (Review) | PANSS-negative syndrome scale | As indicated above | Clinician-administered | 30–50 minutes semi-structured interview |
Internal consistency: Good internal consistency for the PANSS-NS-subscale: α =0.85 Test-retest reliability: Substantial test-retest reliability observed for the PANSS-NS-subscale: r=0.68** Inter-rater reliability: Good inter-rater reliability observed for the PANSS-NS-subscale: r=0.85** |
Convergent Validity: Good correlation between the PANSS-NS-subscale and SANS: r= 0.77*** Substantial correlation between the PANSS-NS-subscale and PANSS-General Psychopathology Subscale (GPS): r= 0.60*** Discriminant validity: Weak correlation between the PANSS-NS and the PANSS-PS-subscales: r=0.27**, which reduced to r=−0.23* when the GPS effects were partial out) |
| 70 | PANSS-negative syndrome scale | As indicated above | Clinician-administered | 30–50 minutes semi-structured interview |
Internal consistency: Not assessed. Test-retest reliability: Not assessed. Inter-rater reliability: Inter-rater reliability using sets of 3 assessors (comprised of 2 psychiatrist and 1 psychologist) for PANSS-NS-subscale (r=0.70 to 0.89***) with a mean value of r=0.78***. |
Convergent validity: Strong correlation between the PANSS-NS-subscale and the SANS (r=0.77***). Discriminant validity: Weak correlation between the PANSS-NS-subscale and Scale for the Assessment of Positive Symptoms (r=0.25**). |
| 75 | PANSS-negative syndrome scale | As indicated above | Clinician-administered | 30–50 minutes semi-structured interview |
Internal consistency: Alpha coefficient for the PANSS-NS-subscale (α=0.68) indicated acceptable internal reliability. Test-retest reliability: Good test-retest reliability observed for the PANSS-NS-subscale (r=0.92***). Inter-rater reliability: Not assessed |
Convergent validity: Weak but statistically significant correlation (r=0.29*) between the PANSS-NS-subscale and the negative speech/behavior subscale of the Psychiatric Assessment Schedule – Adults with Developmental Disability (PAS-ADD). Similar correlation was observed between the PANSS-NS-subscale and the informant rating of depression in the patients using the PAS-ADD (r=0.34**) Discriminant validity: Weak but statistically significant correlations between the PANSS-NS and PANSS-PS subscales (r=0.28*). Weak and non-statistically significant correlation between the PANSS-NS-subscale and the delusion (r=−0.11) and the auditory hallucination (r=−0.001) subscales of the Psychotic Symptom Rating Scale (PSYRATS). |
| 73 | PANSS-negative syndrome scale | As indicated above | Clinician-administered | 30–50 minutes semi-structured interview |
Internal consistency: Strong and statistically significant reliability coefficients for the PANSS-NS-subscale in acute (α=0.87), chronic (α=0.78), and long-term care (LTC: α=0.82) patients with schizophrenia. Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: In multiple regression analyses, a great amount of the variance in the prediction of PANSS-NS-subscale was explained by affective impairment as measured by the Manifest Affect Rating Scale in acute (r2=0.70), chronic (r2=0.55) and LTC (r2=0.55) patients with schizophrenia. Discriminant validity: Weak and non-statistically significant correlations between the PANSS-NS and PANSS-PS subscales in acute (r=0.07), chronic (r=0.27), and LTC (r=0.23) patients with schizophrenia. |
| 74 | PANSS-negative syndrome scale | As indicated above | Clinician-administered | 30–50 minutes semi-structured interview |
Internal consistency: Strong and statistically significant reliability coefficients for the PANSS-NS-subscale: (α=0.83). Test-retest reliability: 3–6 month test-retest reliability coefficient (r=0.68**) indicated substantial reliability. Inter-rater reliability: Not assessed |
Convergent validity: Statistically significant but weak correlation between then PANSS-NS-subscale and the motor retardation (r = 0.22*). The PANSS-NS-subscale accounted for chiefly by general affective impairment as measured by the Manifest Affect Rating Scale (MARS) including impoverished thought content (r=0.52**), lack of insight (r=0.50**) and active social withdrawal (r=0.32–0.64**). Discriminant validity: Weak but statistically significant correlations between the PANSS-NS and PANSS-PS subscales (r=0.27**), which decreased slightly once the shared variance from the general psychopathology subscale was removed (r=0.23*). Weak and non-significant correlation between the PANSS-NS subscale and unspecified psychosis (r=0.29) and major affective disorder (r=−0.21) |
| 76 | PANSS & PANSS-S (i.e., the Spanish version) | As indicated above | Clinician-administered | Not assessed |
Internal consistency: Not assessed Test-retest reliability: Not assessed Inter-rater reliability: PANSS-NS-subscale r= 0.84*** PANSS-S-NS-subscale r= 0.74*** |
Convergent validity High correlation between the PANSS-NS and the PANSS-S-NS subscales: r=0.83*** Substantial to high correlations between the individual items on the PANSS-NS and on PANSS-S-NS subscales: r= 0.64 to 0.90** Discriminant validity: Not assessed |
| Unified Parkinson’s Disease Rating Scale (UPDRS) | ||||||
| 78 | Unified Parkinson’s Disease Rating Scale; Available in Dutch French, and German translations | A single item meant to screen motivation and/ or initiative in elective (non-routine) or day-to-day (routine) activities Assess change in symptomatology since the onset of PD. | Clinician-administered | Not assessed. |
Internal consistency: Not assessed Test-retest reliability: Not assessed. Inter-rater reliability: Not assessed. |
Convergent validity: Correlation between: UPDRS apathy and apathy per diagnostic schema by independent clinician : r = 0.27* UPDRS apathy and MADRS loss of interest: r = 0.62*** Criterion validity: Using apathy per diagnostic schema by independent clinician: Score ≥1→ 80% sensitivity → 23% specificity Optimal cut-point Score ≥2 → 70% sensitivity → 75% specificity → AUC = 0.70* Discriminant validity: Correlation between: UPDRS apathy and UPDRS depression: r = 0.22 UPDRS apathy and MADRS depression: r = 0.07 |
| 77 | Unified Parkinson’s Disease Rating Scale | As indicated above | As indicated above | As indicated above |
Internal consistency: Not assessed Test-retest reliability: Not assessed. Inter-rater reliability: Not assessed. |
Concurrent validity: Highly correlated with the total score on the AS-14: r = 0.55*** Criterion validity: Using the diagnostic schema to ascertain apathy status (gold standard): Score ≥1→ 91% sensitivity → 46% specificity → AUC = 0.72*** Score ≥2→ 73% sensitivity (59–84) → 65% specificity (65–74) → AUC = 0.76*** Discriminant validity: Difference between AUC for UPDRS apathy and UPDRS depression = 0.10* indicate significant and higher accuracy of the UPDRS to detect clinical apathy. |
| Irritability-Apathy Scale (IAS) | ||||||
| 79 | Irritability-Apathy Scale (IAS) | 10 item scale, 5 items tap into apathy Items capture behavior changes since onset of illness |
Clinician-administered to a knowledgeable informant | Not assessed |
Internal consistency: IAS-apathy: α = 0.78 Test-retest reliability: IAS-apathy: r = 0.76 Inter-rater reliability: IAS-apathy: r = 0.85 |
Convergent validity: Not assessed Discriminant validity: No significant correlation between apathy and premorbid traits (i.e., being “good tempered,” “bad tempered,” “happy” or a “worrier.” Construct validity: IAS apathy subscale differentiated between controls and AD, and controls and HD.* |
| Frontal Lobe Personality Scale (FLOPS) now known as the Frontal Systems Behavior Scale (FrSBe) | ||||||
| 81 | FLOPS/FrSBe | 46 items with 3 subscales: Apathy, disinhibition, and executive function. Captures symptoms and behavioral changes pre- and post- lesion of the frontal lobe, as well as symptoms in past two weeks for healthy controls |
3 different modes of administration: patient, family and staff forms. | Not assessed |
Internal consistency: Item-total correlation for the apathy items (r=0.87) Test-Retest reliability: Not assessed Inter-rater reliability: Normative sample of family (r=0.78) and self |
Convergent validity: Not assessed Discriminant validity: Not assessed. |
| 85 | FLOPS/FrSBe | As indicated above | As indicated above | Not assessed |
Internal consistency: Not assessed Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: Only fair correlation between the FrSBe-Apathy and NPI-Apathy: (r=0.37*) Discriminant validity: Not assessed |
| 87 | FLOPS/FrSBe | As indicated above | As indicated above | Not assessed |
Internal consistency: Not assessed Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: Not assessed Discriminant validity: FrSBe – Apathy and Depression (GDS-short form) not significantly correlated. |
| 84 | FLOPS/FrSBe | As indicated above | As indicated above | <10 minutes |
Internal consistency: Cronbach’s α for the apathy subscale = 0.88 Test-retest reliability: Apathy subscale: r = 0.65*** 3 month Inter-rater reliability: Cronbach’s α ranged from 0.79 for to 0.92 |
Convergent validity: FrSBe-apathy highly correlated with emotional withdrawal (r = 0.51***), motor retardation (r = 0.47***), blunted affect (r = 0.55***), and retardation factor (r = 0.62***) from the BPRS. Criterion validity: Scores on the FrSBe apathy distinguish between controls (21.94 (6.16)) and patients with schizophrenia (39.26 (9.08))*** Discriminant validity: Very poor correlation between apathy score and depression: r=0.13 Weak correlation with disinhibition (r=0.30) Predictive validity: Apathy per FrSBe negatively correlated with functional performance (−0.59 to −0.47)*** |
| 86 | FLOPS/FrSBe | As indicated above | As indicated above | Not assessed |
Internal consistency: Not assessed Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: FrSBe Apathy and loss of interest/reactivity item (r=0.54**) Discriminant validity: FrSBe-Apathy vs. Cornell-Scale for depression (r=0.47*) FrSBe Apathy and negative mood (depression and anxiety) no significant correlation (r = −0.27) |
| Key Behavior Change Inventory (KBCI) | ||||||
| 88 | Key Behavior Change Inventory (KBCI) Apathy Subscale |
8 apathy items (4 positively and 4 negatively worded items) Items capture behavior change post-injury | Completed by an informant | Not assessed |
Internal consistency Internal consistency for KBCI ranged from 0.82 to 0.91 with an alpha coefficient of 0.89 for the apathy subscale. Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Construct validity: Construct validity was assessed using TBI and MS patients and neurologically intact controls The ratings for those with TBI and MS were significantly higher than controls on all the subscales of the KBCI*** Convergent validity: Not assessed Discriminant validity: Not assessed |
| 89 | Key Behavior Change Inventory (KBCI) Apathy Subscale |
As indicated above | As indicated above | Not assessed |
Internal consistency: Not assessed Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: Demonstrated by statistically significant correlation with measures of executive functioning (COWA: −0.24*; semantic fluency: −0.32*; D span back: −0.23*) Discriminant validity: Demonstrated by non-significant correlation with measures of language, visuospatial memory and global cognitive functioning. |
| Neuropsychiatric Inventory (NPI) | ||||||
| 90 | Neuropsychiatric Inventory (NPI); Available in Afrikaans Chinese Croatian Czech Danish Dutch Estonian Finnish French German Greek Hebrew Hungarian Italian Japanese Korean Norwegian Polish Portuguese Russian Slovak Spanish Swedish, and Thai | 12-subscales on commonly-observed behaviors in dementia. The NPI-apathy subscale consists of the screen question, which is rated on a NO vs. YES basis. If the screen question is answered YES then 7 sub-questions are administered followed by overall frequency and severity questions Items capture behavioural change during past month or since the last evaluation |
Administration: Clinician-administered to a knowledgeable informant using a structured interview | Not assessed |
Internal consistency: NPI-apathy: α = 0.87– 0.88 Test-retest reliability: NPI-apathy: 0.74*** for frequency and 0.68*** for severity Inter-rater reliability: NPI-apathy: 0.98 for frequency and 0.89 for severity |
Content validity: Panel of international experts used (Delphi Panel) to rate screening questions and subquestions; all question groups except “troublesome behavior” received a score of less than 2, indicating “high content validity”. “Troublesome behavior” was reformulated as “aberrant motor behavior” Convergent validity: Not assessed for the NPI-apathy subscale. Discriminant validity: Not assessed for the NPI-apathy subscale. |
| 92 | Korean version of Neuropsychia tric Inventory (K-NPI) | As indicated above, with Korean translation | As indicated above | Not assessed |
Internal consistency: Cronbach’s α = 0.85 for total score (0.81 for frequency, 0.82 for severity) Test-retest reliability: Test-retest was 0.76*** for frequency score and 0.75*** for severity score Inter-rater reliability: Not assessed |
Convergent validity: Not assessed Discriminant validity: Discriminate between mild and severe** and between moderate and severe* cognitively impaired groups |
| 95 | Brief version (NPI-Q) | 12 symptom domains derived from the NPI’s core symptom manifestations | Informants self-rate; asked to circle yes or no responses; rates symptom severity on a 1–3 scale; frequency not rated. Caregiver distress rated on a 0–5 scale identical to NPI. | Approximately 5 minutes |
Internal consistency: Interscale correlations for symptoms ratings (range 0.71–0.93)*** and caregiver distress ratings (range 0.71–0.97)*** were strongest for euphoria, disinhibition, and delusions, and weakest for agitation and depression Test-retest reliability: For severity and distress were 0.80*** and 0.94*** respectively NPI-total = Not assessed NPI-Apathy = Not assessed Inter-rater reliability: Not assessed |
Convergent validity: Interscale correlation with total score on NPI was 0.91*** Interscale correlation on distress was 0.92.*** Interscale item correlations for severity and either NPI Total or NPI severity were “virtually identical” NPI-Q vs. NPI = 0.84*** NPI-Q-Apathy vs NPI-Apathy = 0.86*** Discriminant validity: Not assessed |
| 98 | C-NPI (Chinese version of the NPI) | See Cummings et al., 1994 | See Cummings et al., 1994 | See Cummings et al., 1994 |
Internal consistency: C-NPI overall: α = 0.84 Frequency α = 0.86 Severity α = 0.79 Internal consistency not assessed for the C-NPI-Apathy and other subscales Test-retest reliability: Not assessed. Inter-rater reliability: C-NPI apathy: Frequency: r = 0.89 Severity: r = 1.00 |
Convergent validity: Not assessed for the C-NPI-apathy subscale. Discriminant validity: Not assessed for the C-NPI-apathy subscale. |
| 96 | Nursing home version (NPI-NH) | Same as NPI but with addition of degree of disruption (i.e. extra stress and workload) to the nursing staff caused by the presenting symptoms. | Completed by nursing home caregiver | Not assessed |
Internal consistency: Not assessed Test-retest reliability: Test-retest correlation for total score was 0.76; individual scales ranged from 0.55 to 0.88 NPI-Total = 0.76 NPI-Apathy = 0.71 Inter-rater reliability: Not assessed |
Convergent validity: Not assessed Discriminant validity: Not assessed |
| 93 | Hellenic version (H-NPI) | Not assessed | Not assessed | Not assessed |
Internal consistency: Cronbach’s for total H-NPI was 0.76 (from 0.69–0.76) NPI-Apathy = between 0.69–0.76 Test-retest reliability: Not assessed Inter-rater reliability: Not assessed |
Convergent validity: Compared scores to Brief Psychotic Rating Scale (BPRS) and Caregiver Emotional Distress Scale (EDS); H-NPI total score significantly correlated with EDS score (r= 0.42*). EDS total score and individual H-NPI scores were delusions (r = .55**), aggression (r=0.57**), apathy (r= −0.67***) and irritability (r=0.482**) H-NPI Apathy vs. BPRS – Withdrawn/Negative = 0.48*** Discriminant validity: Not assessed |
| 97 | P-NPI (Brazilian/Po Rtuguese version of the NPI) | Not assessed | Not assessed | Not assessed |
Internal consistency: NPI-Total = 0.70 NPI-Apathy = not assessed Inter-rater reliability: NPI-Total = 0.98*** ICC NPI-Apathy =0.67*** Test-retest reliability: NPI=.82** NPI-Apathy =.53** |
Convergent validity: Not assessed Discriminant validity: Not assessed |
*
p<0.05
**
p<0.01
***
p <0.001
AES, AS-7, AS-10, AS-14, AI, DAIR, IAS, NPI, SANS and KBCI : Items listed in the original article. Copy can be obtained from author or publisher.
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