Twenty-Two Item Screening Score

Abstract

The Twenty-Two Item Screening Score (Langner, 1962) is a brief and efficient screener designed for the assessment of Psychiatric symptoms that indicate functional impairment. This tool was specifically developed for use in large-scale epidemiological studies and mass surveys to place individuals on a continuum of life functioning disruption due to common mental disorders. The instrument’s 22 items were derived primarily from established inventories, notably the MMPI (Minnesota Multiphasic Personality Inventory) and the Neuropsychiatric Screening Adjunct. These selected items possess significant discriminatory power, successfully distinguishing between clinically defined “known well” groups and “known ill” groups (psychiatric patients). The scale demonstrated strong relationships with external psychiatric impairment ratings, with correlations ranging from .41 to .79, highlighting its utility as a rapid identifier for potential candidates requiring further clinical examination.

Keywords

Psychiatric Impairment, Test Development, Twenty-Two Item Screening Score, Psychometric Properties, Psychiatric Symptoms, Psychopathology, Test Construction, Test Validity, Functional Impairment.

Authors

Langner, Thomas S.

Purpose

The fundamental purpose of the Twenty-Two Item Screening Score is to provide a quick and standardized method for screening populations for psychiatric symptoms that are associated with functional impairment. It is intended to function as an initial triage tool, particularly valuable in non-clinical settings or extensive research surveys, where identifying individuals at higher risk for common psychiatric disorders is necessary before allocating resources for in-depth diagnostic interviews.

The scale focuses specifically on symptoms that reflect a reduction in an individual’s ability to function effectively in daily life, thereby measuring the severity of impairment rather than providing a formal diagnosis.

Construct

The scale measures the psychological construct of Psychiatric Impairment. This construct is understood as the degree of functional disruption experienced by an individual due to the presence of common psychiatric symptoms. The items selected for the scale were chosen to reflect symptomatic expressions commonly recognized as indicators of distress or disorder, thus operationalizing impairment along a measurable continuum.

Validity

The validity evidence supporting the Twenty-Two Item Screening Score is primarily criterion-based and indicative of strong construct validity.

The 22 items demonstrated powerful discriminatory capability, effectively separating psychiatric patients (“known ill” group) from non-patients (“known well” group, confirmed by psychiatrist interview) at a high level of statistical significance (0.01 confidence level or better). Furthermore, the scale scores exhibited substantial positive correlations with independent impairment ratings provided by psychiatrists, with correlation coefficients ranging from .41 to .79. These robust correlations confirm that the score accurately reflects the level of impairment recognized by clinical professionals.

Reliability

Specific internal consistency measures (such as Cronbach’s alpha) or test-retest reliability coefficients were not explicitly indicated or detailed in the foundational documentation provided for the Twenty-Two Item Screening Score.

Factor Analysis

Information regarding formal factor analysis procedures used to explore the underlying dimensional structure of the Twenty-Two Item Screening Score was not indicated in the original source material.

Instrument

Test Type: Screener

Format: The instrument is composed of 22 items. The response options vary across items but generally include categorical choices such as Yes, No, Don’t Know, and No Answer. Some items offer scaled options, including ranges like High to Very Low, Often to Never, Poor to Too Good, and Never to More than a Few Times.

Language Available: English (Implied by the United States location of the primary sample and publication).

Population Group: Human; Outpatient

Age Group: Adulthood (18 years & older); Young Adulthood (18-29 years); Thirties (30-39 years); Middle Age (40-64 years)

Population Details: The scale was validated using sample groups including Psychiatric Outpatients, Psychiatric Ex-Patients, and Non-Patients. The development and initial validation efforts took place within the United States.

Test Methodology: The scale’s methodology focused on item derivation from existing, validated clinical instruments (MMPI, Neuropsychiatric Screening Adjunct) and validation through known-groups comparison. The primary psychometric focus was on the items’ ability to discriminate between clinically defined groups and their correlation with external clinical ratings of impairment.

Keywords

Mental Health Assessment, Screening Score, Langner Scale, Functional Impairment, Epidemiology, Psychiatric Symptoms, Diagnostic Tool, MMPI, Known-Groups Validation.

Authors

Author ORCID Identifier: N/A

Affiliation Email addresses: N/A

Correspondence Address: N/A

Permissions & Fee and Test Year

The Twenty-Two Item Screening Score was first published in 1962. Specific information regarding current permissions, usage fees, and licensing must be obtained directly from the original publisher or the journal in which the reference article appeared. The test items are not publicly available.

Reference’s

Langner, T. S. (1962). A twenty-two item screening score of psychiatric symptoms indicating impairment. Journal of Health & Human Behavior, 3(4), 269–276. The original article detailing the scale’s development and construct validity can be accessed via DOI: https://doi.org/10.2307/2948599

Items of the Twenty-Two Item Screening Score

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The test items for the Twenty-Two Item Screening Score are not publicly available. Please contact the publisher or copyright holder for information regarding access to the test items.