Is Longer Always Better? Clinical Validation of the Korean Altman Self-Rating Mania Scale With a Comparison of 5-Item Versus 11-Item Versions.

Abstract

Objective: The Altman Self-Rating Mania Scale (ASRM) has been recommended as a brief and psychometrically promising tool for the self-reporting of (hypo)manic symptoms. However, there is a shortage of validation in clinical samples, and none for the newly developed 11-item version. Thus, this study aimed to test the reliability and validity of the ASRM-11 in comparison with the ASRM-5.

Methods: Through a retrospective chart review, self-reported data on the Korean ASRM (K-ASRM) were collected from 122 patients diagnosed with either bipolar or depressive disorder via a (semi)structured diagnostic interview. They were interviewed individually using the Korean Young Mania Rating Scale (K-YMRS). The reliability, construct, convergent, and diagnostic validity were also examined.

Results: The reliability of both versions of the K-ASRM ranged from good to excellent. Factor analyses revealed a unifactorial solution for K-ASRM-5, while a dual-factor structure emerged for K-ASRM-11, corresponding to the bright and dark sides of (hypo)mania. Moreover, both versions demonstrated a significant positive correlation with the total K-YMRS score. In the receiver operating curve analysis, the discriminating ability of both versions was fair when distinguishing manic from non-manic patients.

Conclusion: Both the K-ASRM-5 and K-ASRM-11 demonstrated comparable levels of sound psychometric properties, which supports their continued usage in research and clinical practice. It is necessary to test potential utility of the K-ASRM-11 for symptom monitoring and treatment response because of its additional coverage of dark-side (hypo)manic symptoms, including irritability and impulsivity, which are considered important for the quality of life of patients with bipolar disorder.