Skip to main content
PMC home page
International Journal of Methods in Psychiatric Research logoLink to International Journal of Methods in Psychiatric Research
. 2007 May 14;16(2):97–110. doi: 10.1002/mpr.207

An appraisal of the psychometric properties of the Clinician version of the Apathy Evaluation Scale (AES‐C)

Diana E Clarke 1,✉, Robert Van Reekum 2, Jigisha Patel 3, Martine Simard 4, Everlyne Gomez 5, David L Streiner 5
PMCID: PMC6878351  PMID: 17623389

Abstract

This article examines the psychometric properties of the clinician version of the Apathy Evaluation Scale (AES‐C) to determine its ability to characterize, quantify and differentiate apathy. Critical appraisals of the item‐reduction processes, effectiveness of the administration, coding and scoring procedures, and the reliability and validity of the scale were carried out. For training, administration and rating of the AES‐C, clearer guidelines, including a more standardized list of verbal and non‐verbal apathetic cues, are needed. There is evidence of high internal consistency for the scale across studies. In addition, the original study reported good test‐retest and inter‐rater reliability coefficients. However, there is a lack of replication on these more stable and informative measures of reliability and as such they warrant further investigation. The research evidence confirms that the AES‐C shows good discriminant, convergent and criterion validity. However, evidence of its predictive validity is limited. As this aspect of validity refers to the scale's ability to predict future outcomes, which is important for treatment and rehabilitation planning, further assessment of the predictive validity of the AES‐C is needed. In conclusion, the AES‐C is a reliable and valid measure for the characterization and quantification of apathy. Copyright © 2007 John Wiley & Sons, Ltd.

Keywords: apathy, AES‐C, reliability, validity, psychometric properties

Full Text

The Full Text of this article is available as a PDF (223.8 KB).

REFERENCES

  1. Andersson S, Bergedalen AM. Cognitive correlates of apathy in traumatic brain injury. Neuropsychiatry Neuropsychol Behav Neurol 2002; 15: 184–91. [PubMed] [Google Scholar]
  2. Andersson S, Gundersen PM, Finset A. Emotional activation during therapeutic interaction in traumatic brain injury: effect of apathy, self‐awareness and implications of rehabilitation. Brain Inj 1999b; 13: 393–404. [DOI] [PubMed] [Google Scholar]
  3. Andersson S, Krogstad JM, Finset A. Apathy and depressed mood in acquired brain damage: relationship to lesion localization and psychophysiological reactivity. Psychol Med 1999a; 29: 447–56. [DOI] [PubMed] [Google Scholar]
  4. Andreasen NC. Schizophrenia: Positive and Negative Symptoms and Syndromes, Karger, Basel, 1990. [Google Scholar]
  5. Campbell DT, Fiske DW. Convergent and discriminant validation by multitrait‐multimethod Matrix. Psychol Bull 1959; 56: 81–105. [PubMed] [Google Scholar]
  6. Clarke DE, van Reekum R, Simard M, Streiner D, Conn D, Freedman M. Apathy in dementia: An examination of the psychometric properties of the Apathy Evaluation Scale. Journal of Neuropsychiatry and Clinical Neuroscience, 2007; 19: 57–64. [DOI] [PubMed] [Google Scholar]
  7. Cortina JM. What is coefficient alpha? An examination of theory and applications. J Appl Psychol 1993; 78: 98–104. [Google Scholar]
  8. Cummings JL, Mega M, Gray K, Rosenberg‐Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14. [DOI] [PubMed] [Google Scholar]
  9. Gorsuch RL. Factor Analysis. Hillsdale, NJ: Erlbaum, 1983. [Google Scholar]
  10. Guilford JP. Psychometric Methods. 2 edn. New York: McGraw‐Hill, 1954. [Google Scholar]
  11. Guilliksen H, Messick S. Psychological Scaling: Theory and Application, New York: John Wiley & Sons, 1960. [Google Scholar]
  12. Guyatt GH. Making sense of quality of life data. Med Care 2000; 38(supplement II): 175–9. [DOI] [PubMed] [Google Scholar]
  13. Kane RA, Kane RL. Assessing the Elderly: A Practical Guide to Measurement. Toronto: Lexington Books, 13–17, 1981. [Google Scholar]
  14. Kant R, Duffy PD, Pivovarnik A. Prevalence of apathy following head injury. Brain Inj 1998; 12: 87–92. [DOI] [PubMed] [Google Scholar]
  15. Kiang M, Christensen BK, Remington G, Kapur S. Apathy in schizophrenia: clinical correlates and association with functional outcome. Schizophrenia Res 2003; 63: 79–88. [DOI] [PubMed] [Google Scholar]
  16. Kim J, Mueller CW. Introduction to Factor Analysis: What It Is and How To Do It. Thousand Oaks, CA: Sage Publications, 1978(a). [Google Scholar]
  17. Kim J, Mueller CW. Factor Analysis: Statistical Methods and Practical Issues. Thousand Oaks, CA: Sage Publications, 1978(b). [Google Scholar]
  18. Kirshner B, Guyatt G. A methodological framework for assessing health indices. J Chronic Disease 1985; 38: 27–36. [DOI] [PubMed] [Google Scholar]
  19. Lampe IK, Heeren TJ. Is apathy in late‐life depressive illness related to age‐at‐onset, cognitive function or vascular risk? Int Psychogeriatr 2004; 16: 481–86. [DOI] [PubMed] [Google Scholar]
  20. Lampe IK, Kahn RS, Heeren TJ. Apathy, anhedonia, and psychomotor retardation in elderly psychiatric patients and healthy elderly individuals. J Geriatr Psychiatr Neurol 2001; 14: 11–6. [DOI] [PubMed] [Google Scholar]
  21. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–74. [PubMed] [Google Scholar]
  22. Marin RS. Differential diagnosis and classification of apathy. Am J Psychiatry 1990; 147: 22–30. [DOI] [PubMed] [Google Scholar]
  23. Marin RS. Apathy: A Neuropsychiatric syndrome. J Neuropsychiatr Clin Neurosci 1991; 3: 243–54. [DOI] [PubMed] [Google Scholar]
  24. Marin RS, Biedrzycki RC, Firingiogullari S. Reliability and validity of the Apathy Evaluation Scale. Psychiatr Res 1991; 38: 143–62. [DOI] [PubMed] [Google Scholar]
  25. Marin RS, Firinciogullari S, Biedrzycki RC. The sources of convergence between measures of apathy and depression. J Affect Disord 1993; 28: 117–24. [DOI] [PubMed] [Google Scholar]
  26. Marin RS, Firinciogullari S, Biedrzycki RC. Group differences in the relationship between apathy and depression. J Nerv Ment Dis 1994; 182: 235–9. [DOI] [PubMed] [Google Scholar]
  27. Marin RS. Guidelines for Apathy Evaluation Scale. Western Psychiatric Institute and Clinic, Dittsburgh, DA: 2002. [Google Scholar]
  28. Marx RG, Bombardier C, Hogg‐Johnson S, Wright JG. Clinimetric and psychometric strategies for the development of a health measurement scale. J Clin Epidemiol 1999; 52: 105–11. [DOI] [PubMed] [Google Scholar]
  29. Pluck GC, Brown RG. Apathy in Parkinson's disease. J Neurol Neurosurg Psychiatr 2002; 73: 636–42. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Portney LG, Watkins MP. Statistical measures of reliability In Portney LG, Watkins MP. (eds) Foundation of Clinical Research: Applications to Practice. 2 edn. Appleton & Lange, 2000. [Google Scholar]
  31. Rabkin JG, Ferrando SJ, Van Gorp W, Rieppi R, McElhiney M, Sewell M. Relationships among apathy, depression, and cognitive impairment in HIV/AIDS. J Neuropsychiatry Clin Neurosci 2000; 12: 451–57. [DOI] [PubMed] [Google Scholar]
  32. Resnick B, Zimmerman SI, Magaziner J, Adelman A. Use of the Apathy Evaluation Scale as a measure of motivation in elderly people. Rehabil Nurs 1998; 23: 141–47. [DOI] [PubMed] [Google Scholar]
  33. Sheatsley PB. Questionnaire construction and item writing In Rossi PH, Wright JD, Anderson AB. (eds). Handbook of Survey Research. New York: Academic Press, 1983. [Google Scholar]
  34. Starkstein SE, Mayberg HS, Preziosi TJ, Andrezejewski P, Leiguarda R, Robinson RG. Reliability, validity and clinical correlates of apathy in Parkinson's disease. J Neuropsychiatry Clin Neurosci 1992; 4: 134–39. [DOI] [PubMed] [Google Scholar]
  35. Streiner DL, Norman GR. Devising the items In Streiner DL, Norman GR. (eds) Health Measurement Scales: A Practical Guide to their Development and Use. 2 edn. New York: Oxford University Press, 1995(a). [Google Scholar]
  36. Streiner DL, Reliability Norman GR.. DL Streiner In, Norman GR (eds) Health Measurement Scales: A Practical Guide to their Development and Use. 3 edn. New York: Oxford University Press, 1995(b). [Google Scholar]
  37. Streiner DL, Norman GR. Selecting the items In Streiner DL, Norman GR. (eds. Health Measurement Scales: A Practical Guide to their Development and Use. 3 edn. New York: Oxford University Press, 2003. [Google Scholar]
  38. Streiner DL, Validity Norman GR.. DL Streiner In, Norman GR (eds) Health Measurement Scales: A Practical Guide to their Development and Use. 2 edn. New York: Oxford University Press, 1995(c). [Google Scholar]
  39. Stuss DT, Van Reekum R, Murphy KJ. Differentiation of states and causes of apathy In Stuss DT. (ed.) Neuropsychology of Emotion. New York: Oxford University Press, 2000. [Google Scholar]

Articles from International Journal of Methods in Psychiatric Research are provided here courtesy of Wiley

RESOURCES