Difficulties in screening for adjustment disorder, Part II: An attempt to develop a novel self-report screening instrument in cancer patients undergoing bone marrow transplantation.
OBJECTIVE
Screening for adjustment disorder (AD) in cancer patients presents a significant clinical challenge. As seen in Part I of this research, conventional, existing measures are rather poor at detecting this most common of psychiatric diagnoses. Bone marrow transplantation (BMT) has a high level of morbidity that can cause significant stress for patients faced with the procedure.


METHODS
A sample of 95 BMT patients completed a semistructured interview and a novel self-report instrument, the Coping Flexibility Scale for Cancer (C-Flex), to determine if it could identify patients with adjustment disorder in need of further assessment and intervention.


RESULTS
The screen yielded four factors but was not predictive of AD. However, the C-Flex was significantly related to the presence of any disorder (r = -0.44, p < 0.001) in this sample. In addition, Factor I of the screen was found to be correlated to the presence of any diagnosis (r = -0.44, p < 0.001) and to have adequate sensitivity (81.63%) and specificity (76.09%).


CONCLUSIONS
Either because of problems with the scale or the amorphous nature of the AD category, or both, rapid identification of patients with this common problem has proven to be elusive.
Kirsh
Kenneth L
KL
Symptom Management and Palliative Care Program, Markey Cancer Center, University of Kentucky, Lexington, Kentucky 40536-0093, USA. klkirsh@uky.edu
McGrew
John H
JH
Passik
Steven D
SD
D000275:Adjustment Disorders / Q000175:diagnosis*; D016026:Bone Marrow Transplantation / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010865:Pilot Projects; D011581:Psychological Tests; D011788:Quality of Life; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires