Dwarka Pershad (Chandigarh) Consumable Booklet

S. K. Verma
(Chandigarh)
A. Malhotra (Chandigarh)
of
S. Malhotra (Chandigarh) AGAA DAQ
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SCORING TABLE
P F C
DAQ Sub-Scales

Scores

Estd. 1971
O: (0562) 2364926
NATIONAL PSYCHOLOGICAL CORPORATION
4/230, KACHERI GHAT, AGRA-282 004 (INDIA)
2 Consumable Booklet of D A Q

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4| Consumable Booklet of DAQ

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2005, 1985. All ight

reserved. Reproduclion in any torm is Violalion of Copyrigjht Act.
Consumable
Booklet of Dystunction Analysis uestionnaire (DA Q).
 3 36
MEASUREMEYT OF DYSFUNCTION
rated mildly, moderately or severely. 1ou are AND
to pul a ick mirk ( u tihe
l e column as
appro
applicable to you/your patient. n the exaiipl: i Jni leel that
of the with penpic has deteriorated
Dysfunction Analysis Questionnaire (DA0)
our hs present ievel functiconing in area
mildly than put a lick mark in tihe column mirked ""mildly
of ixing in the statem*nt No. 1."

You are requestet to ansvwer al tiie questions earelu:' t0 n a 5 s 10 have

complete understanding ot the iliness So that wc can provIde you wHh beitur heip and
guidance. Take care so that you do not miss out any item. Kindiy read all the

careluly tuck the appropriaie columis. Tiere is o time limit

qucstioas
but you are
and mark ii
requested to work as quickly as you can.

Scoring
There are live a r e a s in ie Dysfunetion Aalysis Questionaire (DAQ).
These are 'social", "vocational, 'per sonal, "family" and cogeitive' arcas. Each area
centains 0 itcms. c n teni nas nve alternate answes ani linese ate Sured frCn
to
by
n c So.t i:ndicaiEs teitr ti p:emorbid leval of truitclioni.
M. & S. P.
ricans jusi as prem:orb: level ot fuictiOn.ng. D r . Dwarka Pershad, Ph. D., D.
Asstt. Professor ot Cin:al r5yUnuiogy
GN Sgly ifutti eLitig#. Ph. D., D. P., D. M. & S. P.
odCiaic dysisi.ni, n , aii. D r . S. K. Verma, G.
AsStt. Professor of Clinical Psychology
Imeans narked deierioraton in lunctuoiDg.
to a it Was, D r . A. Malhotra Ph. D., D. M. & S. P.
Someime an iieni may not be applicable paici.
licretore, Asstt. Profcssor ot Psycihology.
decide that raw score on a subscale was to be convertes iaio percentage and the
Malbotra, M. D.
seore
may be arrived at, on the busis of the iiems ppiicadic to im. The
weightuu Dr.Asstt.S. Prolessor of Psychiatry.
forinuia used for such an attentuation was as jolOws
Departnient of Psychiatry,
TO0X 001alned raW SCOTC Institute of Medical Education and Rescarch,
Attentuated percentape of nems Postgraduate
co No. attemptedX
score that can be a ttaincd s 30, li a Chandigar
On cach subscale the maxIun raw,

score ol 20 and 2 tems were not Incn iis attentuated

attains a raw appi:GabIe,
Subject
percentage score when converted by the tormula would be 0 ,

1008 50%
Interpretation
score of ab cach scalc *"No
An attentuzteca Would inean
perceta ge ol
to a Telereuce point premorbid leve.
dysfunction compi red woud mean hetter unction
score lower than 49,
An atentuatee percentapc
ing than the premorbrd level.
itan tie scoIC greatet
Whereas more than 407, wOuid dysttiiction. Tghei
the dysfunction.
1985

NATIONAL PSYCHOLOGICAL CORPORATION

AGRA-282004 (U. P.) India
4/230 Kacherl Gihat,
 ACKNOWLEDCEMENT

All rights resenved inctuding translation. o part of this book/manual, recor

or
norms and cenng may reprduced in any torm ot printing detailed report of tbe
the
ding form, 'n writng irom the auther.
The authors have a great n submittng
pleasure
by any other mcans without prepermison o Anaiysis Questionnaire", which
work done on the Development ysiunction
Instfute of Medical Educa-
2 years from the Post graduate
carried a research grant for
work to
The was done the longtanding need
meet
tion and Research, Chandigarb. in the assessment and
behaviourists others engagcd
of the clhinicians, surgeons, and
of their clientele.
psycho-social functioning
monitoring of the without the active

The timely completion of work could not bave been possible

Ms. P'ooTam Groier and Ms Mala
ASSIStani),
A sSistance of Kaobi Das (Kescarch N. T. S. Pataia). Ms.
Ms. LLecturer, at
A. Ahan (neOw
students). Mr. H.
Seshadr1 P'h. D. Prosthetic Centre,
Col. Vohra (Nevadac Zirakpur),
Assistant),
Ritu Mehra (Rescarch fedical Colcge, Jaipui) and
at
1" orthopurdic n o n
Anand Arya (Lecturer Institute
now at All Tndia of
Dr. (Asstt. Prot. ct Psychiatry
Dr. S, K. Khandewal
Medral Scicnces. NEW Deihi).
retencd Irom the rordent
crifal suztestions
t c C CLIgCnicnt it 71t V.
and Trem Protessor K.
oi Psyeh atry.
of ie depIiment
ducte)Ts, uiny Fraiilhunr
nie mbeis Dr S. . tAsM. Pivis i ,
ei Tsychatry) ir
(ic.a, Leptutnicnt
Vafi
AUTHORS1984
Authors
Dated: 1-21985

ot the test and the manuai were made available irom

Funds tor ihe devcioprient
insttuie of iedical Education and
Lhe research grant of the Postgraduate
Research, Chandigarh-16001

Price Rs. 40/

 ONTENTS
Part I : Review and Development of the Scale

Jntroduction
Development of the questionnaire
Results ol the pilot try out

Part II : Standardization
Objectives
Material and Methods
Kesuits and DseuCm
Conclustsuns
25

Part IIT Bibliography and Appendices

Referenes
Abridged Manual

Part I
D e v e l o p m e n t of
the Scale
Review and
 3
REVIEW
Iatroduction

Over the past few decades there has been considerableinterest in assessin t e
individual's psychosocial adjustment to illnes. ncreasing emphasis has been given to
the importance of individual functioning within a social tramework. A number of
measures both self reports and interviews, have been published which assess functio
ing within various roles. These are mostly the measures ol adjustment and
and are not the precise measures of psychosocial functioning. disability
A review of the above scales shows that their limitations are far too
many, which
utweigh their fruitfulucss. In the first place, most of them are rather
rating scales which tend to be too
complcx
dilflicult for the illiterates and low educated
to
comprehend. Some of the scales are unstructured subjects
(Frank, 1958 ; Mandel, 1959)
which does not ensure high
objectivity and their reported inger-rater reliabilities are
o r . In some of the scales the time period, for which the
measured varies, making it diflicult to disgbility or adjustment is
1955: Mandel. 1959). They also
compare resu lts (Barrabee, Barrabee, Fine Singer,
do
tion. These scales give an indication of
not measure the experienced cognitive dysfunc
disahility alone without
in the
premorbid state of the subject. So t is just possible, (as in havingareferençe point
the caSe of the handi-
capped) that the person was always disabled. These
to construct a limitations.compelled the authors
questionnaire (a) which would measure dysfunction and not disability,
(6) which would include cognitive failure subscale
also, (c) wvould be in simple spoken
language, and (d) such that not only the patient, but anyone living ith the patient,
could also assess the day to day
functioning of the
subject and fill the questionnaire.
The rationale
adopted for thee construction of scale-was hat up
any disturbance will
generally cause lowering of psychosocial
iou of liese functlions in functioning resulting in clearcut diferentia-
variuus walks of life, as
stage. comparcd to the predisturbance
To measure deteriorationor cffect of
intervening variables, on the
many terms currently in use. Some of them arepertormance
of an individual, there are
used sometimes
interchangably, though they do difter in their inherent
Definitions
meanings.
) Adjustment-Adjustment is defined as. "an
organism and its surroundings in which there is static equilibrium between an
response, no nced is unsatisfied and all the continuative stimulus change evoking a
no

proceeding normally." (English & English, functions of the organism are

t "as a 1970).
condition of harmonious relation to the Further, the same authors elaborate
obtain satisfaction for most of environment wherein one
one's necds and to meet fairly well the
is able to
physical and social put upon one." Wolman (1973) defines it as demands -the
an "harmonious rela-
tionship with the environment involving the ability to
meet most of the demands both satisly most of one's needs and
definit ion of adjustment which is
physical and social that are putupon them." The
latest
widely used is by Reading (1977) who has defined it
operationally as "adjustment is (1) changing to fit established conditions
wilhin system in
response to other change within systems; (3) response
: (2) change
producing tensions release (4) fitting of individual
of
of individual to social environment: (5)
fitting
indjvidual
it to its
to norms, and
(6) process whereby individual or group deliberately its
eDvironment."
 4
Thesc defñinitions
as clearly indicate that it is
they are present at a an
abiiity to to the
deterioration has occuredparticular moment. Adjustment does adap1 situation 1l.
because not show how Current and Past
adapt and fit into the of adverse
life situations, much Psychopathoiog Scales (CAPPS)
ratber it is to an Fleiss; et. al (Spitzer, Endicolt
has lesa
changed conditions. Thus in ability 1970)
important rolc to play in
medical specialities,
ructured and Scaled Interview to Assess Maladjustment (5SIAM)
:
probably, because of this limitation, understanding the effect of adverse adjustment situations. (Gurland ; Yorkston Goldberg et. al. 1972).
d:sability, came into 13.
(B) usage. Social Adjustment
Disability-Disability has also been Scale (SAS) (Paykel: Welsmann; Prusoff ; ct. al,
(1970, deined it as-"an 14. Bell's i9i1
(B:l1.
variously defined. English &
a
impairment or defeet ol Adjustmeint inventory
of scnse 1939
organs and or bodily organ or member English D.
; and
organs ol execution such as (especially
or
Psychosocial A djustment to IlIness Scale (PAIS) (Morrow; Chiarello
l:ck one1n more or arms, legs
lunctions severe tongue etc.) or a loss Denogatis, 1978)
enough
a to be of
disabiy fecting Handicap is a 16. Assessnent Schedule t1ircn
normal growih and
substantial period, il not development and alsohandiCap. Socia BehavIOur (SBAS) (Platt; Weyman,
pTmanenily adjustment to life over a and Hewatt, !980,.
(1979) lhave revicwed a rum.ber of (Srinivasan 1981). Wig, Murthy and Pershad
delinitions and defined it (B) Disability Scales
inability to satisty onc's necds or perform one's roles operationally as "an
tions indicatc that These two defini- 1. Social
disability is nearer to the term satisfactorily. Disabiity Scale (Ruesch and Brodsky, 1968 Ruesch, et. al. 1972)
connotauOn and sccondiy, it is an handicap which has a 2. Disability Assessineat Schcdule (Wii0, I1978)
inabiity which might be experienced or real.physical
3. P'sychiatric Disabili ty Scale (Murti.y, Aruradha, and Pershad 1975)
(C) Dysuzction-A rcwer term which has
come into usage is
Dystuncton is a
psychosoCal coicept, which indicates the individual's *dysfunction (C) Dysfunetion Scales
malfunctoning.
latlure 1.
Wolma (1973) has preciscly deñired dysfunction as "a
an Social Dysfunction Rating Scale (SDRS) (i.mn : : et. al
proceis. organ or system tu work organismic Suhulthorpe): Evje
dictionary, dehncs it as "() those -
properly". Hugo (1977) in the soical sciences 1969)
conscquence which Jessen the adaptation of the 2. The Social Function ing Schedule (SFS) (Remington, and
system and (2) dSintegrative sociai Tyrer, 1979)
consequences of social or cultural 3. The Cognitive Faiure Scaie (Verma. 1982. Yrma, Dubey and
clearly indcates hat dystunction is conceroed with the item. This Khan,
of the individual ai the
functioning or malfunctioning 1982).
moment, in comparison to his
Tt is less
previous Junctioning, or potentiatity.
vague than other terms in use and easier to i review of literatu re in this ficld gives o n e a
handle, assess and compare. disappointing picture about the
available adjustment or di sabiliiy scales in this SSRS Survey of Research
Psychological Instrument country.
in Psychology (1972) reports tiat "most of the work done
in this area is of an
There have been
many piychological tests in the hterature to measure post clementary type. No centic or instlution has undertakEIl Sustaitned work 1n the
area
1llness eflccts ver a have been
on various areas of ife. Thesecan be divided into three period of timc. SCveral studies in the arca
arcas-adjusl- reported of school,
ment, disability and dysfunciion. Some of the well known scales are as follows home and personal adjustment or bigh
School and coliege of both sexes. students
Some studies try to
relate adjustment wth vanabies k e inteiligence, achievement,
(A) Adjustment Scales age, sex, socio-cconomiC status, needs, anxiety and insecurity.
.Normative Social Adjustment Scale (Barrabee, Barrabee, and Finesinger. This source book does not throw light on any study where some
work on
1955) in adjustment as eifected by illness or
betause ot
change
s carried out. The main
or
seems to be lack ot
treatment signihcant life events
Social Inefectiveness Scale (Frank, 1958) reason suitabie clinical tools to
measure
such changes. tne
Mandel's Social Adjustmeat Rating Scale (Mandel, 1959) he vArtous sources
retercnee txe Firsi Measurement Hand
Mteatal
book for India (L.ong and ot
4. Social Adjustment Inventory Method (Berger, Rice ; Sewall ; et. al. 1964) in India (Pareek, 1966). FHandbook ot
Menta,
1soo) Ihe Directory
BehaviouralScience Research
and Social
PsychoiogIcal
5. Personal Adjust1neat and Role Skills (PARS I1) Ellsworth and Clayton, and Rao, 1974) and the various issues ot Indian Instruments. (Pareck
any evidence of Psychologcal
Abstracts do not show
1959). construetion Or stanuaroAt o Any comprehensive test of
Scale ment which could be used wth genetal aduit adjust-
6. Katz Adjustment (KASR) (Katz, and L.yerly, 1963; Hogarty and cinc POpulation in
coulidenece India with
Kaiz 1971)
7. Personality and Social Net work Adjust rnent Scale (Clark, 1968) In the psychiatric set
up, some
ot the have evaluated
8. Community Adaptation Seledule (CAS) (kocn, and Burnes 1968) mentally ill subjects.
Dube
Epidemiolegkal studhes workes disability in
1974), Nandi et al (1975) have not ot (1970), Seihi et al (1967,
9. Psychiatric Status Schedule (PSS) (Spitzer; Endicolt, Fieis, et. al (1970)) the 1972,
ather studies like that of Thacore (9s) the o
measurec severity
disability-objedivcly, In
:0. Psychiatric Evalu:tier Ferm (PE) (ptuer, Edicolt, Ikias, c:. al. (1970) aisdenty has been
used as a
part of the
 6)
7
criteria 1or identifying a case (úmpaired ehciency lcading to, change of work or in
al
sentence prefixed to it. The deck of items so written-under diferent arcas of dysfonc
"). rated the severity of
interpersonalor
disturbance as mild, relationships
familymoderate and severc Verghese (1973)
on giobalet evaluation and found this to be tion were administered to 12 attendarnis ot 1he paients hintrospective report was
taken account with and the
useful. Ganguli (1968) bas reported that
psychiatrically ill textile workers had greater into. regard to ditfculty in understanding the items
for any new itcms or area that should be incuded. These ftems were then remodified
need
disability in job, interpersonal relationships and leisure activities. The only study
to have measured the disability in the light of introspective reports of the subject. "Thinking aloud" method was
S1
systematically, as "social function ing' is that of Kapur the
also used to modily items. al, uems were tound to besutablea5 also
tne cinicians
(1973) who found that symptom group had lower mean scores of social fuctioning.
to be informative by (psychologists, psycbiatrists
In the above 1 15 suiticient to out
adjudged concernca
context, p01nt. that the concern tor i belonged to nve areas oI functioning. These were
social and sociclogists)These te ms
functioning and disability of the psycharic patient is relatively new, even n cinical
ani Each area contained
*social. 'vocational, personal, "1amily 'cognitive" areas.
done to find out social, for had Tl items. A pilot tryout was carried
and therapeutic department, 10 items cxcept 'personalarca which
personal and occupational
settings. ndisa
ourbilitues caused some
by diterent
work waspsychiatric condi lions. It
anct their attendanis, to nnd our any Bross in he structure
out on S0 subjecis deCicncy
was found that those who inproved showed
dimunition in the disability and those and anguage of tlhe fest.
who did not improve continued to show the same anmount
of disability in these areas.
The ering procedure wias also devised Since cach tem had 5 alternate
Disability in these areas was also jound to be related with
severity of illness. (Murthy, answers 1hese were scuret r o i l to >. A score of one indicalCs hetter 1han premor
Anuradha, Persad and Wig. 1975 ; WIE. Murliiy, Peishad, 1979). Cognitive i'ailure
e as
A score o1 Two means avcrage Tuictioning (. just
bid level ol Tuncioning.
Scale (Verma, Dubey & Khan 1982) aso showed satisfactory results in terms of reli secore of
A scorc ot ihrcc means sightly impoverised tunctioning. A
ability and valtdity. Taking lead results a "Dysfunction Anal ysis
from these premorbid).
Questi0n our mcans medetle ant ire i s c ieans marked dcterioration in functioning
naire (DAQ) was constructcd with the tolld wing muin obJecuves:
to all of subjects, For lor
Sone tems were not ippliciibie tinitrnly types cxample,
() to devise a suitable instrumcit for adult neuropsychiatric patients, to assess z.Under
Sucu iis "
housewit, quesitons * 77 *U7, *1HEAT U,
their level of functioning. at any given point of time, objectively, and 1o
was to asccrtain the score on that
such circumstances t particular tem.
utogIcal o n a subscale be converted
infornation from the credit 1or such an i t e m n was deeldca that score could
) which would eliit equully rclinble and valid give
into percentage and the weighted score was calculated on the basis of the itcms appl
significant family members about the subject's dysfunction.
cable to a peison. The formula used for such an attenuation was as follnws. n cach
DEVELOPMENT OF THE QUESTiONNAIRE
seale the maximum raw score that can be obtained is 50 except in personal area wnere
were collected fron Ifa suhject has obtaincd a Score of 20 and two items werc
not applicablc,
Items for the Dysfuuction Analysis Questionnaire (DAQ) it is $5.
four dillerent sources. then hts 2ttenuatea percentage score when converted by the lormula, would be 0 %

1. Detailed interviews the of the 100xObtained Score

wlth
to understand the arcas of dysfunction and the
relativesways they
psychiatric patient focussing
have been reportung the Attenuated Percentage ScorcC
No. of items attempted x 5
patuent's dystunction.
2. The psychiatnsts working in the department of pshchiatry, P.G.I., Chandi- 100* 20-50
havt bern asking their clients for the X
garh, were
requestcd to give the questions, they
assess ment of dysfunction. an attenuated percentage scure of 40 in each
Here it 1s worth mentionmg that
3. The available tools of adjustment and disability were secreened to extract A Scorec
scule would, demonstrate no comparea to premoroia ievel.
dystunctio a
score lower
wbile than this
the items relevant for general adult population. tis would be ndicative of dystunction
higher thun
ievcl. hc poSSibic range of
4. Items for wolild mean better tunctioning than the premorbid
dysfunction in cogoitive area were taken from the Cognitive
et al (1982) and Cognitive Pailure Scale attenuatecd score thus would
be 20 to 100.
Failure (CF) by Broadbent percentage
Questionuaire
(CFS) in Hindi by Verma et al (1983)
Results of the pilot tryout
were which were reviewed by a team of researchers
a, tryout were
n 300 tems framed The objectives
(3 clinical psychologists, one psychiatrist and one research worker). These ilems were of the pilot
of the fhDd our the discriminating capacity of the items.
then lurther subjected to face validity by ten psychiatrist, and five psycho logists .T of the instrument, and.
2. To lind out the re
liability and validity
and two faculty members in the Depart
department of psychiatry, P.G.I., Chandigarh reliable and valid infor-
the aim to find out which 3. To see whether this instrument can elicit cqually
ment of Sociology, Punjab Uníversity, Chandigarh, ith s about the subject's dysfunction.
and can with mation trom the significant family member
one tc0s are more explicit measures o dysluncti0n be, useu our popu- from amongst the
lation. One bundred itemswere thus chosen andrewritten wherever required insimp Sample-For the above objectives the sample was selected
short septenges: A key sentengewas framed and cach item Mas read out with the key consultation in the department of psychiatry.
who came for
patienfs and their relatives
 TABLE T
tem Analysis : Mean Scores for each Item of the DAQ in the Upper and Lower 1/3rd of the Subjects
7
Items/Areas of
Dysfunctio
37 3 87 3 65 U6 370 3:69
SOCIAL 70 4'12 S 394
(20) 96) 06) (90) (2 (O8)
Upper 1/3 (N-17) (26) (0 99) (. 0) (
2 I94
Lower 3 (N=17
(0) (0) (0)
6 6 03
T 79* 607 6 D6 9+s° 719 6' 9
325 S 35
VOCATIONAL
(99) (12) (73) (132
Lower 1 3 N-17) 41 194 2 T'67 32
(SS) (24) (26) (S3) (24) (S) 73) 9)
S15** S99** 109 TS5 7 69 6 37 10 35**
405 39 40 94 27 3 23
-ay (114 ( 06) l 2) 10 94) (07)
(I26) ()
23 0% 218 2"06
63) (0)
79) (43)
7 1 0 04** 6 93** 425* 457** 21$*' 62** 3 677** | 7 44
FAMILY 7 29 67 3-70 343 9 61 278
Pper3(N=17) i s 10) (03) (22) (TOS) (09) (T) 9) 85)
Lower3(S=1) 94 94 20D T93
(0) 24) (24) (24) (0) (0) (-26) 0) (0)
6 3-72
6 $2 477.3$7 609
cOGNITIV'E 3:39 2-55 233 244 372 278 2:72
PpT 13 (N-17) (95) (T'04) (78) (59) 70) (07! (S1) (67)
LOwer ( N = 7 ) 6 205 205 2 210
5) (23) (0) (0) (0) (31i (0)
6'5*. 397 06 289 236 9. 2S4 9. 4
01
 10

TABLE 3
Relationship of Overall Clinical Rating with the
Subseales of DAQN 23
Subscales o Correlation
DAQ_ greemen
Social 65 46
59 29 n.5.
Vocational
Personal

Family 20
Cogpitive

Total
cut at median
N.B.: For finding out agreement, 2x2 1ables, taking of points
were prepared. Teura-chorc 'r was computed.

The scale also proved to be cificient to identify thedysfunetion of the patient

when was not This is substantijated by Table TV. The
even he physically present.
as obtained the themselves and when rated by attendants for
mean scores, by patients
for of the ive areas of
to be significantly diflerent any
were not tound
patients
dystuncti0n.
TABLE 4 Part II
and
between
Responses siven by F a t i e n t s
Comparison
their Attendants (Mean Scores)
Standardization
Sub Scales

DAQ Social Vocationa rersona Family

Family Cognitive
Scores
5966 58&-01 ST'03 4931
Patient's 56 06
(8-52) (1498) (1545) (968)
Score (16-62)
59-03 44 5209
Attendant's S8 000 62 90
(1692) (13-73) (1574 (1408)
Scorc (1883)
94 37 45 1'14
90
25
38 48 64
Based on responses given by paticnts and their attendants

** p01
cores was found to be signilicant for all
the two
The correlation between
The reason might be that personal things
areas except for cognitive dysfunction.
family t 1s or
of ns the attendant
remain personal irrespective explicit nature. functions whereas
members who suffera lot because o patients patchy cognitive are
dysfunction. Thus there greater chances
over or
underestimate this
patient might when raled by subjects himself cim-

of disagreement about the cognstive Junctioning

for the subjects.
atfen
to rating by dan ts
pared
 13)
The results of the pilot try out were encourugny to launch standardization
on a larger sample to establish reliabilit. validity and usabilit, of the D. A.Q.

Objectives of the Staadardization

1. To establish reliability of the seale.
variables on the scores
2. To fînd out the infuencc ol clinico-demographic
of D. A. Q.
when the test is taken by the
3. To find out the extent of closeness of rating
rclative for tlhe patient.
patient and when t s t is iiled up bi the close
. To cstablish validity against external criteria.
five scales of D.A.Q.
. To find out interdependence of each of the
to test the
Simultancously, Various specihe hypotheses were formulated
validity and usability of the test and were carried out either as a part of standardiza

or were entrusted to iher ongoing inira and interdeparimental

ion procedure,
iypotheses were:-
r escarches. These
with the restoration ot health.
.Dysfurciion would be neyatively associatcd
be associaied with the
Degree of resumplion of work wouli negatively
dyslurcijon score's on D.A..
Treatmeni would iniprove fenctio!ng and his would be refiected on the

D.A.Q. scorcs.
value.
4. Various scales ot D.A.Q. would have dillerential

Material and Methods

was drawn from amongst the patients and their relatives
Sample-The sample
consultation and treatment in the department of psychiatry, P.G.I.,
who came for
the psychiatrist and thosc with the
Chandigarh. The patients were cxa mined by
for the study. Paticnts with
following criteria w e r e acceptcd
a g e more than 16 ycars
illness of at least 3 months duration ;
2. with an

3. with a clearcut diagnos1Is psychotic o r oganic illness

ol neurotic,
4. cooperative, communicative and amenablc 1o psychological testing, and,
S. able to understand spoken Hindi.
The patient was referred by the clinician to the research worker if he fulflled
the above criteria. The D.A.Q. was usually individually ad ministercd to the patients.
But in some patients, who were educated and test sophisticated, it was self adminis-
tered too. The attendant of the patient interviewed was usully the parent, grand-
parent, spouse, sibling, uncle, aunt, cousin or friend, who was staying with the patient
for some period of time, so that he could give information about the social, personal
and family life of the patient. The D.A Q. was usually self administercd by the
attendant. The instructions were given by the examiner and the atendant filled up
the D A.Q. giving the current state of functioning of the patient as compared to his
premorbid state.

The data collection was startcd irom the 1st ot

December 82 and
completed
on the 30th of November "83. The scale was administercd during this period, on
a
total of 641 subjects including 221 rclatives or the palienis. In
addition, 50 patient
 F
TABLE 6
Diagnostic breakdowu of
psychiatrie patients included in the study
eurolies N-193 PS-ychotiCs
JCD Type o N-132 rganics N=90
No. Dype
PT. Yo. of CD Type f
Pis. % No.
300*0 Anxiety States 54°84 295 1 Hebephrenic
3001 Hysteria 290 0 Senile dementia
10 60 2952 Catatonic 12-22
3002 Phobic State 290 I Presenile dementia
2S5*3 Paranoid 666
3 2902 Senile dementia
depressed or 3 33
300 3 Obsessive compul- 404 paran
255*4 Acute schizepisode 7 57 290 4
SIVC disorder Arteriosclerotic dementia 444
300-4 Neurotic 38 38 295 5 Latent
3450
depression Epilepsy generailised Non conv.
3005 Neurásthenia 0 Schizopnteni 42 22
2956 Residual 2272
S00°7 4 54
sclhizoplhrenia 3451
Hypochondriasi5 295°7 Sclhizoaftective Generalised conv. epilepsy 6 66
300 8 Other rcurotiC 70 3453 Grand mal Status
2-02 2 22
3458 Others
disorder 3-33
3009 Neurosis NOs. 03 ' S 9 Schizophrenia NOs 303 2930 Acute
301-0 Brief depressive 50 2960 Manic depressive confusional state
5 30 291-0 Kcrsakov's psychosis
Teaction 2 22
psychosis Mana
301-2 Adjustm.ent reaction 30 296'1 MDP-depresscd
with p 33 33 29I
. Dementia in condition,
of other emot:ons ype elsewliere
classiied
296 2 MDP-circuiar 3 78 948 Other org. psychotic conditions 222
Currently manic
296'3 MDP-Cireular 2'27
29 Patiological drug intoxication
2964
Currentuy depresscd
Mixed
MDP-Ci:cular 70 295"1 Sub acute conlustonal State
296'5 MDP-Circular 7S7 29 8 Other organic psychotic conditions 3'33
2980 e 1-organic 70 310 8
Otlier specnc .22
nonpsycnoic did 222
 )
In the
(1962, occuptionalarea,
categorization of occupation was based on
17
1972), presuge catcgones and
the three D'Souza's
on this variable. The hrst two groups of subjects diflered
prestige signiicantly
sional occupation such as doctor, occupational categories which
included TABIE
neuroics (D4%) ard psychetics lawyer, business executives ete. were profes Split balf Reliability
(68TZ) but not by occupied by
organic patients. In the Areas Neurotics
4th prestige categories, which
mcuded-semi 3rd and PsychotICs Organics
type of occupations, the distribut.on in the professinnals, Clerical stall, Shopkceper Dysfunction
cial
three groups were
37. in neurolics, more or less the same 97
2" i psychotics ard . n
92
category. which nclude reired organics). n the Sth prestige Vocationa
Personal "96
persons. houewives and stuctents etic.
neurotics, SS oI the 96
psvchotics and 47.of the organics, were found to be48% of the Aly
There were signilicant engaged.
the three 7
duralion of illness. ditterences among groups of patients for the ogni*
All cetrelattois are ui
The marital status Was sghinCant beyOa ievc
similarly distributed for tle three were 2. corrciation
single and groups. 24-25% Clnico-demogrophier varinhre and D.A.0.-The betwec
72, were marTIed and to ot Tot
percent were widowcd or divorced variaDies arid the total seoes
of on cach the 5 subeale D.A.
froips. in all the pac
patcht Soups are given belo" in Tabie " .
The diaenostic break down ol the thrie groups ol
psychiatrc pálCnis are E 9
given in Table Correlation betweta c i i n i c o - i e a o g e a p a i c d a i a a r a i o a i
6.
Results and Discussion
p T:p ofPatiens
The resuiis of the study are discussed below.
Denographic Veurot Psyehotics rganCs
Reliability--To a
test the consistency of scores over period'oftime the Variables 98 N=I132
questionnaire was repeated on s0 Subjects alter gap 2 weCkS Trom the
a
o initia Age + Social
administration. The significance of difference in mean scores of two test sessions were
+Vocational -07 6
determined by using difference method. None of the
" values reached the accepted level +Personal -"16* 16
of significance i. ce. 01. The corrclations in scores obtaned berween the two test sessions
was highly significant. Results are shown in Table 7 +Family
+Cogntive

TABLE 7 EducauSoCal
a
of two
test over period
Repeat reliability -33**
weeks interva
VOcationa
Personal

Repeat 7esting Family -42 2/&*

Initial Testing - --- -

Areas Cognitive 05
Mean a Occupation +
Dys/uncion Mean Sd
92 90 Social
57 50 2061 07
604 1721 ocational 22
Social 60 38 1884 77 06
Vocational 6444 67 efsonal 6
60-92 1675 0'74 85**
6184 15:43 34
Personal 0 20 Family
57-70 1720 76 26
$73 6 1643
Family $794 1617 92 Cognitive 19. 16
59 32 1598 Duration of lllness +
Cognitive
** p O1 was
Social
split-hall relinbility Vocational 31a*
of the questionnaire, l o r the
consistency
To test the intemal e v e n tems, separalely S3*»
odd and ersonal 07
fest into two parts of
-spliting tbe Irom the S
dternined were taken from each group serially amily 56
corfecied Jor length-using8 25
of subjects. Fifty subjects halves were
b e t w e e n two ognitive
Three groups correlatjons (Tablc 17
The obtained from "X& to 97 8). 60*
Cona.. F o r m u l a and ranged
armon-Brown Prophecv P<U'OI
 9
18)
the patients and their attepo
Thet-test' was applicd to the mcans o
1o associated with scores. No results as given in Table 10 showed s for
was significantly be DAQ ey.he
Age not ound. or the
hrec g r o u p s . s c p r a ttne patient and
each their attendant in
hat th
ol cinico-demograpbic variables and much dillerence between neans o
- consistent patiern correlation betwcenother. was not
too in. the
scores observcd 1or cducation-dysfunction that
dysfunction was except groups.
the cducation lesser the dysfunction was
Hgher Signihcantly higher dysfunctic
neurotic and psychotic groups In the psychotie group, the atendantsratedThis
was to be related with areas
could be attributed to eith
oniy. Iounu Signilicantly
Duralion ol illness dystunction lor the
observed. in functional in the patients OL sociar and 1amiy. citber
cases. The correlations De however, indicate
on D.A.Q. only in organic negalive or over estimation. croser O CoTelanon values,
scores under 1 the
o mal-adjustment with passage time, but patient because the correlatio
indiate of be
psychosis group might adaplationt wortnwhiie conCIusion. that it might a systetuner esmaton by a
and wtn neurouC organic
ratherOW to araw any pracucally signcsnt coupataoc grou
values were were
the correlation scores indicated values consist entiy
nal vith dystunctron tha may This conjecture
correlaion occupatio pFestigc It is just possible that psychoCS not assess tneirieal aystunclion.
The o persons lound u
trom a vocation the psychiatrically l out of ihe Iact nignet dystunction in all the
were higher tiat attendants Talcu
wherever demands thus obtainecd was also borne
various fhelds and pauenis hemselves. Somewhat similar
Their obiigalions in than t h e selt rang o r
more dihcuty t o discharge five areas of D.A.Q.
of D.A.Q. obtained by hapur, ct. they uscd the modificd
scores on almost all thc s u b - s c a l e s l (78) where
proportionately higher results have also beea n
-One of the to casure Tunctioning. severe psychiatric
befveen nd veision of KASIE 2 inventory soc
Extent of eloSeness of raling patient attenedani tnat of n e s s a s judged by the relative
3. was tuat not paticnt iound severiy
of the construction ot the D.A.Q. only ihe but illness (namely psychosis) thcy
Tnus t could be concluded that the scale
main objectives also assess his witn soctl dystunction.
be lhe or triend, could correlatcd highly
who was living with the palient, relative ot
dysfunction cven wlen ratine is
anyone administered to 442 patients was capable cliciling Cxtcnt ol patient s
D.A.9. was thus 1.e, D.A.Q.
ot life. The Or niarure ol the
various walks or therc This speakS explCt tems constitu-
functioning in ther attendanis). these, were done by the close attendantS, a Iso
and 22i Out 48
attendanis (221 patients 90 and ting the scale.
and their and iheir allcndant), psychotics
neurotics (1.c. 83 pairs-palient TABLE l1
83
of s

organics.
patient
Significanceot ditterence o aystuncuon n the three groups
Neurotics (4) Organics ( ) Ivalues
ABLE Psychotics (B)
Attendants
Patients and = 83)
between 0)
Relationsbip of Rating
(N-84)SD AB AC BC
SD
M SD
Alendanis 19.86 5463 18-34 5683 2117 174 076 061
Palienis Social 5969
Sub Scales Vocational 59'18 18.26 5948 2 0 92 61 02 22*12 166 049 0'35
Meun SD's
Mean SD's Personal 60 93 1698 S690 17:43 S8 33 18'87 154 079 043
D.AQ. 53-07 >S89 1846 0 0 025 097
5341 1615 2-23 60 Family 6.39
59 69 19-86 78 15.81 5169 777 1901
Neurolic Social 49 CogDiuve o'04 191 194
Voca tional 59]8 8.
26
546
5>94 1722 59 The above table 11 shows that the measure of various dysfunction on D.A.Q.
(N=83) Personal 6093 1698 1'27 43
9 54
6 ' :59 5l*
have no differential value in psychiatric patients as none of the mean diierences were
Family 53-07 0'67
20 found to be signihcant. Therelore it can be surmised that the scale is cqually cffective
Cognituve s1°78 15%1
07 °300 "604 in all the categories of psychiatric patients.
J8-34 61'01
5463 270 12 TABLE
Social 25 63
92 T90 SS** Correlations of the subscales of DAQ with the
20
PsychoticVocational 59 * 17:48 2690* *55**
N=90) Personal S690
1743
18.
1991 subscales of Psychiatric Disability Scale_
sor70 58.37 T620 "50 DAQ Psychiatric Disability Scale (N-26)
Famy 40 - - -

Coppitive 51 69 1456
21 0'38 Personal Social Vocational
5517 S7 63
5683 -17 227 0°25 69 38 0
Social 62"19
Organic Vocational 6 l 0 2 0 25 an
(N48)
64 Pers a
Personal 3833 1887 2361 074 56 62a S0
1846 014 58* Family 48 3
19
61 S6a
CogDitive
Famuy 377 99 5839 Cognitive
p0l
p
 20)
4.
Valndty aguinst external criletia: To 21
critcria, the "psychiatric establish validity
disaDility scale Ful against externai
D. A:
test of inteligence (WAS-R) Health Questionnaire N-2" and a The subuales of
were administered
the verbal er subscales of D. A. Q.
correlafions of the
given in Tables 12 & 13. alongwith D.A.Q. The results are are corielaked with cach other in all the three groups. The results are

in
highly
Tables-14, 15 and 16.
B
TABLE 13 TABLE 14
nter Correlation Matrix of Neurotic Patients and their Atten0ant*
Correlations of tbe subseales of DAQ with
Health PGI
Questionnaire N-2 & Verbal PATIENTS
Seale of WAIS-R
Srenles -
D.A.Q. P'GT lcalth Social V'e Persoaai
Hindi WAIS-R
CNIOnnire (N 27) Social 70t $7
(N=28) Vocaliona
69-
Socal 49 Persconal 55 82**
9 8
Family 70 6/9*
Vocational 65 17
Personal 74-
-09
Famly **
ENDAN
p< 01
Cogvitive 22
TABI.E 5

p<0 p < 01 fater Corrclation Matriz of Psychotic Patients and their Attendas

PATIENTs
The Psyciinttic Disability Scale was psychiatric paticnts Stub Scales
socal and areas of Cogi1e
administered to 26 vocational Social Personal Family
alongwith the D.A.Q. t wa observed tinat personal,
areas of
Vocationa
coTeiated wcll with the similar D.A.Q. However,
psychiatric Disability Sezle Soel 67* 81 S
disability scale correleated moderate to high, with
the "Persona!' area of psychiairic
Siniilar cor relations 6i**
More or less
areas of D.A.Q. 73
vOcational, iamily and cognitive with rers **
vocational areas of Psychatic DisabilityScale
were notuced with social and tty
in all the areas of
is mostly perviasiIve Tb*
D.A.Q. In the psychiatric patients dystunction Cognilive 65* S0*

ife. administered on an independent ATTENDANTS

was
Health Questionnaric N - 2 two werc p01
The PGl between the
The correlation
ls alongwith the D.A.Q. with
Sample ol 27 patien jarlurc to cope
The ertciently TABLF 16
in cogpitive area (Table 13).
except lead to further i
Sgnincant functioning will deteriorationhad Inter Correlation Matrix of
low degree of on 3 0 suiects Organic Paticats anc their Attendants
circumstancçs, "Youth Adjusiment ADalyser
he (1965) using PATIENTS
TunctiobiDg. Bengalce to be highly correlated with it (r="86).
found n e u r o t i c i s m of
ub Seale
also is more or Joctal ocational Personal
which iess a part
intciligence Famil
the verbal Cogaitive
the D.A.Q. is valid, cognitve aysTunc S0s
was
correlate signihcantly with t and cven SoCa 71a
not Vocational 9 64
crystalised
should v e r b l test of i n l e l i g c n c e ( W A I S R
'g' . in
weil with Q. A Personal 76*
76
i o D should
not correlate this he resuns, ls gvventhe
2 part of
with
validatiOn.
D.A.9. 83*>
the D.A.Q as correlatjons
Thus, 78
alongwith be a amly 91
assumcd
oministered evealed low negativee not be to Cognitive 78+.
table 13, and should 73
Tne a b o v e not S7*
D.A.Q can tbe purposetonlyY
scale of neither t
dyslunclion function, r e s u l t s have
was ATTENDANTS
cODgilive cognitive The similar
measure ol dysfunction.
Substitute
lor a of Detwcen
coriciatuon cogll
n a t u r e of
the eAperience
n e personal found negligbic
who also
cccis Weeks (980)
observed by tests.
Deen
intcliyence
and different
tive faiure
 23

22
Other related studies
at
ranged from 5l 1o 91, all being signihcant n s
The varrous inter-correlations related but independent
one were aiso testcd independent studies as
If the subscales are so bighly correlated, with each othe, than may Additional bypothesesproccaure. Their results are as follows
01 level. standardization
five only one. The answer a part of the
well argue that instead of baviDg of neurólogy an
illness
subscales why not ofhave
nature is such that if there
A collaborative study between the departments
in psychiatric pauents the I. rehabilitationn psycho-
10 this that he
would be in 1or example in the socíal area
then it is reflected 10
1S high dyslunction one area logy was
carmed oUt to see Tne cCo psychosocial euro
was administered to 100 adult a
These results do not necesS & D.A.9. patients
and vocational life too. Persnad, 1o*).
other areas of personal, fanmily where the inpatients' (Prabhakar Score on
D.A.Q.
illnesses such as orthopacdic problems aTound nat tne related
other iypc of
who came for follow up o n c n
mprovement,
arily applY to a r c a . If all the hve subcales C.
be reliected manly 1n
the occupational
thne with the physical state O cpaent
dystunction may were Ound to have on c
as the present study, then those cascS improved clinical ne
lactor 1.e. in
dystunction showed that all
a Results
are measunng dommon n lairiy well, their mean scores raneet
T he reportcd indings cxaminalion were unctioning TFom
inter-correlations cannot be low. itcraure ais
various Charellow and logical as
irom "40 to *70 (Morow, partially improvcd or
nter cOiTelations vary to 4693 in the nve suo-scaies :w ere ratcd
indicale that such 1or 42:3 s clear trom table 18.
Anuradha, Pershad and Wig, 1975) scores On Tnis
1978; Bengalce, MuTthy, worsened, ad higher D.A.9
Derogatis, 1963; scales.
areas ol disability and lor the adjustment
vrious
carried out TABLE 18
in the 3 paluent groups was
factor the subscules
The analysis of in all s
iactor cinerged
resuits showed that
Singie the groups. n17. Mean D.A.2 Score of neurology patient on long follow-up
and the only one in Tablc
8. The results arc given
each area is above
on
factor oacings all the five subscales are measuring
ihe contention that
This bas further strergtbened
Improvea Partially Improved Worse
1actor in the psychiatnc patients.
common
ne

Social 46°93 70*56 75 33

TABLE 17
4) (&*7)
of the Sab-scales of DAQ
The Factor Analysis Vocational 4561 16 892

urtance (6'5) 8 4) (94)

Sub Scales Loading
TDpe o Personal 45 71 59 3 624
Patien ofDAC (68) (77)) (T9)
Social Family 442 58 3 60 66
Neurotic
Ocational (65) (76) (78)
95 76 80
Fersonal 42'3
Cognitive
Family (6-5) (73) (74)
Cogniluv
above results show that dysfunction would negatively be associated witn
Social The
restoration of healih.
PsychouC
Vocationa 92 71 33
Personal In an 1.C.M.R. funded
ment
2. retrospective study "the use of psycho
in brain dysfunction cases"
F'amily (by Pershad, Verma, Malhotra, and
Coynuve teats vho came for follow up were assessed on the D.A.Q. and were
AC toate their present orking efficiency as compared to prior
Saal queston askedto was--"What is your present working eficiency in term P
OIgan Vocalional 93
pare prior illness ?*" The hypothesis was that "the degree of resuu
Perwnal woTk WoUid negatively be associated with dysfunction scores on D.A.
Fanily
92
given below in Table 19 showed that there was high
02) Deganve
Coptve between the subscales of D.A.Q. and cfficieacy ot dvsfunction
casca. Tlhe consistently high correlation withworking
each of the five scale may ora te that
the of
resumption work/duty is an index of general rebabilitation.
 24
25

TABLE 19 4.A Study with the collaboration of

orthopaedics
conducte
and the Nevadac Prostlketic
the departments of
psycnia
naa
Correlation between the DAQ Scores and Centre, Zirakpur, was on patients who nav
as
Working eflicieney unilateral,
upper, or lower imb amputation and those who have been
reported by brain dysfunction patients (n=70) artincjal limbs al a
uSiDg
lor period of 6 months. The total number of
lcast
werc 43 Out ot these 18 were those subjecis stuaeu
A &woik Eficicney ( ¥ . )
males. using artibcial limbs. The mean dysiunction
OTes or Amputees Were nigner than those using arificia! limbs but the diercnce was
SIgnineant io the vOCalonall arca al»,c ds siiwl bcio in Table 2 .

SoCial& W.E.
4 TABLE 21
Vocational &WE. 3 Mean Dilference of patients with Amputations and the
Personal & W.E, patients who are using Artilicial limbs
Family &W.E. 62
dreas of Anpulces (W= S0)
Cognitive &WE. Aniputees Usng
Dysfuneion rtftcia LnnDS P
SD Mcan

3. h e D.A.Q. was used irn a departmental ongoing rescarch sudy (Arora, 0Ca 62'67 17-23 I'l6
vOcatioia 62-96
1983) "eicncy o ; h e yoga ireaiment 0n ieurotiIC patientS iN eroup o1 12 68 2-22* p<0s
Personai 1026 TI0 n.s.
26 auult psychialrie pattents was theDAQ betore they hid
administCTed
were again tested after months when ihey had coinpleled their
staried tie iiy 83 840 183 n.s.
ircatment and 428 22
reatnicht.. 1 he iesuits showed a distnet reduction in mcan Scofes ol post ireament CO 267 075 .s.

Irom pre-ireatment. This showed that the amputed patients usang artihcial limbs have
better voca
The difierence method was used for the evaluation of signilieance mean of tional functioning than ihe ampuled palicnts without arulical limbs. This c a n be
difference. The difference was significant in all areas except cognitive. Thus explained on the lnes that ihie less of a L.and or eg may make a person so handicap-
results suggest (1able 20) that the ircatment does bring the positve chunges n
the
the ped that it may mean the loss of a job. Whereas wilh the Supplement of an artificial
This furnher adds to the a iimb which of courSe
functioning of the individual. validity o the scalc as does not compensaie lor the loss of a limb, atleast
may help him
tool to evaluate the post treatment changes in psycho-socil functioning ol the in a
resuming job which in turn helps in esscnilg vocGational dyslunction and leadss
palieDts. 1o overall oetter unctioning.

TABLE 20 TABLE 22
Pre and Post treatment comparison of Neuro tic patients on
Significance of mean differences between the dysfunction
DAQ Scores (N=26)
areas in two and
groups (amputces aruhcial limbs)
Mean DAQ Patienis with
Pre-Ireaiment Post-1rcalmen Amputees using
Arcas Mean SD Mean SD Reductio Anpuiation artificial limbs
Score dreas of dysfunction - --

Social Vs Vocational 0'Os n.s.

0-96 n.s.
Social 5169 1521 42'8- 8 85 305 Personal 254* P 05
298*
I75 n.s.
Vocational 54 54. 1733 46 7. 740 781 Family 3-13. p< 01
Personal J-72 14 1204 28*.
55-46 4342 Cognitive 4 75 p<o
4238 1518 4 39 2:09 Vocational Vs Personal 364 P<Ot
Family 4077| 241 P<O 090 n.s.
l20 44°11 1433 358 S Family
Cognitive 0 2-37 P 05
Vs Cognitive 438 O 3-30 p<o
method was used for the cvaluation of signilhcance o Personal Vs. Family 00S
N.B. Dilference 62 n.s.
difference Vs. Cognitive
Family Vs. Cognitive 19P05 267 P<05
0°77 n.s.
*p<01 p<05
 27

This study a The scores on dystunction were 10und fo be poorly assoriat.

though conducted on small sample explains thee diferential value ated
of the D. A. Q.Patients with his ith
amputations nave dystunctuon in the social, vocational, soCiO-demographic CharactenstCs ODC estces. shows
in the 10e
Success of the
personal and family arcas but tDeir unctoniDg areas is not investigators in developing a to0 WIC can De used uniformly with hetetoe
mean
cognitive etfected at
all The table 22 furtber explains that the differeces between the various population. The neuroties, psychotics and organics showed dysfur heteurogebous
scales of DAQ are signihcant. This may indicate that the areas of DAQ are measuring on all the areas of dystunction measurea by this tool. One can
illnesses such gue t
case because of the was the slate of affairs then oniy one o tne arcus could be retained witho
different dysfunctions.Io psychiatric
nature of illness wberein dystunction in onc arca may ctect
is notthetheother arcas t0o. can
the sensitivity of the instrument. This line of thought be clarised if one lo
at the Table 2l and 22. Thesc tables provide the data 0ks
cONCIISTONS
T nC evidcnce iS also by
orthopacdicaly anmputatcd CASCs. supported
In order to fulnl the long sliaualiug uccd for a measure of dysfunction in the CAses On
soeres obtained by
elinic ncurological tOOW up ablc 18) where social, aDd
, and
vocational dyslunetion (Table 18) was greater than the dysfunction it
the treatment and rehubilitation
populaion that may also be used for evaluating Questionnuire' devised and was of the scale.
programmes, the present scale-Dyfunetion Analysis
standardized. The reed was felt because available scales were only the measurc of
Thus it can be concludcu t i t to be a
adjustment or disability; that too they were for the clinic onlas tne strunent ppears measure of
eant objective assessinent t dystneno, su0e
wnich were rural. uneducated in use ot tests. In a pccu oy heC patients at any
majonty or wncn we u , uncaucateu,
numper o n p aresonduce
And unsophislicatea
e
the
ucpartent or Psychiatry, P l ,
81vC Psnle s t i bednnistered on the paticnt as well as on the
by Wig and Smgh (19T0). Wig and Gupta (975). Wig (1975) there was a felt need to
signilicanl ieiative tor the palicne n nis aosence gvng reljable and valid results,.
measure post operanve functions, but wis discarded xcausc o lhe non-availability
7he cale is in imple spoken
langiage, CAsy to administer and score,
tive, reliable, valiu and iikely to prove useui
objec-
of a usable, Telable and valid nstrument sutable lor general adult population. Hence assessment of
the effort over the ast couple of years werc directed towards the development and tioning in diflerent type of patienis in Indla
any pre Or
functioning/dysfuzc-
ment
wnerever post illness/treat
comparison have to be made over a period of time.
standardization of a Dysfunction Analysis Questionnaire
The scale was
based on
the material in
the existing instruments of similar
nature and our experiences with the patient population. A variation in the methodo
to eet she reiemete h
provide a too which could e o0ceuvean p t n p t u e 50 a t even a 5Ignun=

cant rate tne

1amly member could
these ends, a
junetionng o une Suocetacuateiy achieve
simple key statement o the areas or aystunction.
These items were also written in simple spoken Hindi.
preceded the emsThe scale consisted of s areas
of daily life namely 'social', "vocational, 'personal', 'family and "cogortive, with 10
items in cach.

into this kind ere

found to be useful as
The effots put ol test construction
inital Sconng system developed
indicated by vanous
was quite objective and the
pre-standardization phases,
resultis showed consistent hndmgs Even when a significant

relative hled up the questionnaire for the patient (Table 10).

Standardiation daia a
revealed highly satisfactory tcst-relest and split-half
to the diagnostic
reliabilities which mnged from 77 to "97 in the subjects belonging
and (able 7 & 8). The absolute
groups of neuroses, psycboses organics
inienval of 2 wceks. The means the dysfunc
reability was also cbecked after an of
tion score did not difer significantly. The test alo sh0wed high validity-convergent
The test
and correlaled wilh disability and
divergent and construct validity. correlation with WAIS-R. The
neuroticism scales apd tbere was negligible, negative
found to be associated with improvement in the clinical
scores the 5
on scales were 1ound o
in neurologica, paychiatric and orthopaedically handicapped patiena. (Table
picture
18, 20, 21).