27
Hopkins 53 pron
checklist (H3eL)
THE HOPKINS SYMPTOM CHECKLIST (HSCL):
‘A SELF-REPORT SYMPTOM INVENTORY’
by Leonard R. Derogatis; Ronald S, Lipman? Karl Rickelss B. H. Cilenhuth,’ and Lino Covi®
‘This report describes the historical evolution, development, le and validation
of the Hopkins S Checklist (HSCL', "ue HSCL
Is comprised of hich are representative of the symptom ct ‘commen
observed amon! te Tels 5
‘been identified in repeated factor analsses, A series Of studies have established the f
torial sowariance of the primary symptom dimensions, and substantial evidence is given in
support of their constract validity. Normative data in terms of both discrete symptoms
SniPpcimary symptom dimensions are precented on 2.500 subjects—-1.800 psychiatric out~
putichts and 700 nornials, Indices of pathology reflect both intensity of distress and preva.
Fence of symptoms in the normative samples. Standard indices of scale reliability are
presented, and e broad range of criterion-related validity studies, in particular an im:
Portant series reflecting sensitivity to treatment with psychotherapeutic drugs. are re
Hlewed and discussed.
ne NEED to expedite the processing of person direetly experiencing the phenom.
large numbers of men for military serv- ena, ie, the patient himself. All other ob
during World War I led Robert Wood- servers ‘ure limited to reporting apparent
fh to develop a procedure whereby each versions of the patient’s experience, based
“This on his behavior and verbal response.
A second advantage of the self-report
iiiode involves economy of profestonsl tine
Administration, scoring, and initial us
sessment of the data often can be accom:
plished by paramedieal or psychometric
Ps technician with # minimum of specialized
‘The self-report mode of psychological training or clinical experience, The sel
measurement possesses several unique ehar- report inventory may’ be used as a sercening
acteristics to recommend it, ax well as 4 deviee to aid in determining those who re-
number of inherent limitations. In the area quire professional time, and may: be utilized
if psychopathology, the self-report mode can by the clinician as an additional source of in
provide exclusive information that is imply formation regarding the presenting status of
‘unavailable through the patient
els, Self-report se
uuvantage of reflecting information vis the
Inventories are also highly
‘Shapiro ofthe Paye-Whitney Cline for geaciously
matings HSC ‘available {rom their patient
sem
: Sehiol
Mental H versity
NIH a
Meal
quests for Tei
pkins Uni
oe sent to
fine Hopkins Cui. Leonard KR, Derogatis, Department of Psychiatry
fe dats reported in and Behavioral Seiences, Johns Hopkins Unive
jodi sity.Sehoul of Medicine, Baltimore, Msryfanl
sy Research Branch, Na
al eat.
“Medicine, University of Pennsyt
lear aphreenation vo Mle
Liter ‘Fisher, Mise
Bridget Witvehberger
provided ‘techiieal + Sebi
assistance ou the project. In particular, the au> yang.
thors ate grateful to Dr, Alberto DiMaeci School af Medieine, University of Chicago.
Boston Stete Hospital, Dr Gerald 1, Kleen of ¢Sehuod of Medieiue, Johns Hopkins Uni.
the Harvard Medical Schuol, and Dr, Arthur versity
12 Denogans, Linuas, Rickens, Cauesauni, axp Covt
amenable to actuarial methods ng Donald, 1965). Further, in those instan
(Mochi d& Dahlstrom, 1900), and data aris where specific attributes anv precisel
ing from such measitres may be easily in fined in a common manner for both pat
eurporated within elinical decision ¥ystems Dbsvrver alike, thee
Fowler, 1980; Glueck & Stroebe, 196). In of significant agreement bet
audition, symptom sf mesures ubserver and th f
havi: been shown to be highly seasitive Schwab, Bison, & m
wide-range of treatment modalities, Barlow, & Aw
Wilde (1972) has recently cautioned that
in adopting the self-report mode one tacitly
assumes the validity of the inventory prem:
ise: that is to say that the patient can and
| will aceurately deseribe his relevant symp:
toms and behaviors. A number of studies
have indicated that this may not always be
the ease, In particular, the question of re
sponse sets as a potentially distorting in:
Aluence in self-report has often been raised,
The most frequently mentioned bias in this
regard is that of social desirability. (Ed-
wards, 1957). A number of other specific re
2, acquiescence, have been
postulated as systematie sources of varia.
tion affecting the accuracy uf solf-assess
ments. It should be noted, however, that
with the exception of social desirability, a
number of ezitieal assessments (Rorer, 1963)
have failed to sustain the contention that
response sets play a salient role in clinically
sented self-report scales. Even social de-
sirability has been observed to function in
complex and selective manner (Norman,
having a stronger influence in the ages.
sponse sets, 6
fated with social traits,
once alte
Fisko, 1
enee (W
‘view social des
ment construct.
Beyond response sets, there are @ number
of other potential problems associsted with
self-report, One issue is the extent to wheh
characteristic defenses or personal inve
‘ment in treatment may funetion to dist
patients self-evaluutions, Another diffieulty
Involves the ae! {reports from acutely
disturbed patients. The desire to please the
doetor is
confounding. Ts
). There is also convineing evi
gins, 1964) that itis unrealistie to
ability as au
| another potential souree of
hould be realized, however,
hat alternatives to patient self-report, i.
elinieal are also pen te
serious bias (Cooper, Kendall, Gurland,
Sartoris, & Fark, 1960; Lehinan, Ban, &
While it is ob
ventory posses
also clear that it provid
ns that the sell-repart i
ss certain limitations, it is
uuniqu
tion to our understanding of psvehilo
disorders, It is the most frequently obsere
‘means of operationally defining normality ¥
abnormality found in the literature (Soot
168), and in addition,
validity of self-report is very high
150). Final Ublenhuth, Lipman.
Chassan, Hines, and MeNair (1970) have
taken care to illustrate, when int.
cused on the outpatient
tient’s opinion with all its. bia
most relevant for the initiation and main
tenance of treatment.
DEVELOPMENTAL HISTORY OF THE HSCL
The Hopkins Symptom Cheeklist (HSCL,
is a self-report symptom rating seale which
‘eral major Fe and
has undergone si
numerous minor alterations
taken from a seale
It was developed primarly
The HSCL was first utilized as
measure in psychotropic drug t1
man, Cole, Park and Riekels (1965;
Ublénhuth and his
and by
wintes (Uhlenhuth,
Rickels, Fisher, Park, Lipman, & Mock,
1966). These investigators employed a sub
antially revised and enlarged version of the
instrument, termed the