What can the CAT-MH® measure?
The modules below are available for immediate use in English, Spanish, and Chinese. Each have been validated and are available via our browser-based clinical portal or API integration. For additional information on the underlying science behind the modules, please read our academic press.
MAJOR DEPRESSIVE DISORDER (SCREENER)
The Major Depressive Disorder (CAD-MDD) module produces a screening diagnosis of MDD and a corresponding confidence level associated with that diagnosis. With an average of only 4 items, the CAD-MDD has a sensitivity (the probability that the screener will correctly detect true cases) of 0.95 and specificity (the probability that the screener will not falsely diagnose patients without the disease) of 0.87 for predicting the results of a SCID DSM-5 structured clinical interview for MDD. The validation study’s population included psychiatric outpatient subjects and non-psychiatric controls.
READ ARTICLEDEPRESSION
The Depression (CAT-DEP) module is a dimensional measure that produces continuous severity scores of depression based on symptomatology experienced. Using an average of 12 questions, the CAT-DEP maintains a correlation of close to r=0.95 with the entire bank of 389 depression items. This module takes an average of 66 seconds to complete. The HAM-D (r=0.79), PHQ-9 (r=0.90), and the CES-D (r=0.90) scales were used to study the convergent validity of this measure, and the SCID DSM-5 was used to obtain diagnostic classifications of minor and major depressive disorder. Using empirically derived thresholds based on a mixture of normal distributions, researchers found a sensitivity of 0.92 and a specificity of 0.88 for the classification of major depressive disorder in a sample consisting of depressed patients and healthy controls.
READ ARTICLEREAD ARTICLEANXIETY
The Anxiety (CAT-ANX) module is a dimensional measure that produces continuous severity scores of anxiety based on symptomatology experienced. Using an average of 12 questions, the CAT-ANX maintains a correlation of r=0.94 with the entire bank of 431 anxiety items. This module takes an average of 79 seconds to complete. In the validation study, The HAM-D (r=0.73), PHQ-9 (r=0.78), and the CES-D (r=0.81) scales were used to study the convergent validity of this measure. The SCID DSM-5 was used to obtain diagnostic classifications of generalized anxiety disorder and major depressive disorder. Individuals with and without generalized anxiety disorder from a psychiatric clinic and community mental health center were recruited. The CAT-ANX has a sensitivity of 0.65 and a specificity of 0.93. The lower sensitivity is a function of the DSM criterion for generalized anxiety disorder specifying that the symptoms had to have been present for at least 6 months. Patients with high levels of anxiety that have not yet lasted for 6 months would therefore not receive a generalized anxiety disorder diagnosis, yet would score high on the CAT-ANX.
READ ARTICLEREAD ARTICLEMANIA/HYPOMANIA
The Mania/Hypomania (CAT-MANIA) module is a dimensional measure that produces continuous severity scores of the mania/hypomania spectrum based on symptomatology experienced. Using an average of 12 questions the CAT-MANIA maintains a correlation of r=0.91 with the entire bank of 87 mania/hypomania items. In an independent validation study involving adults from a community outpatient clinic, we found a 12-fold increase in the probability of a current bipolar disorder across the range of the scale. Ratings were compared with SCID DSM-5, HAM-D, and CES-D. This module takes an average of 121 seconds to complete.
READ ARTICLESUBSTANCE USE DISORDER (SUD)
The CAT-SUD is the first adaptive substance use disorder measure. It provides a crosswalk between mental health symptoms (depression, anxiety, PTSD), social supports, risky behaviors, and self-reports of the abuse of substances (tobacco, alcohol, illegal drugs, opioids). It can detect substance use risk in people who have not yet started to abuse substances or refuse to admit that they are. The CAT-SUD provides a dimensional substance use disorder severity score as well as self-reports of the use/abuse of specific substances. The CAT-SUD has been validated against the CIDI structured clinical diagnostic interview. The AUC is 0.85, confirming the strong relationship between the CAT-SUD test score and the SUD diagnosis. This module takes an average of 144 seconds to complete.
READ ARTICLESUBSTANCE USE DISORDER-EXPANDED
The CAT-SUD-E extends the CAT-SUD by providing diagnoses of 8 different substance use disorders (SUDs) for adults and 10 different substance use disorders for adolescents: alcohol, marijuana, nicotine, opioids, cocaine, amphetamines, hallucinogens, inhalants (adolescents only), sedatives, and over the counter medications such as cough syrup or Imodium (adolescents only). The SUD diagnoses are both lifetime and current (past month). The adaptive SUD severity measure provides a crosswalk between substance use and mental health symptoms (depression, anxiety, PTSD), social supports and risky behaviors. It can detect SUD risk in people who have not yet started to abuse substances or refuse to admit that they are. The severity measure describes the impact of the specific SUD diagnoses, both current and lifetime, on the person’s current life. The CAT-SUD-E validation study involved a general population with a diverse set of substance use histories. Ratings were compared with SCID-based presence of any lifetime SUD, with an AUC=0.92 for current and AUC=0.94 for lifetime. For individual diagnoses, classification accuracy for current SUDs ranged from an AUC=0.76 for alcohol to AUC=0.96 for nicotine/tobacco. Classification accuracy for lifetime SUDs ranged from an AUC=0.81 for hallucinogens to AUC=0.96 for stimulants. Median completion time is under 4 minutes.
READ ARTICLESUICIDE
The Suicide (CAT-Suicide) module is the first adaptive suicide measurement scale. It draws items from depression, anxiety and suicidal ideation domains which define a single unified dimension. Using an average of 10 items, it maintains a correlation of 0.96 with the 111-item bank. This module has been validated against structured clinician interviews for current suicidal ideation or worse, with perfect sensitivity and specificity of 0.95. Two recent studies have shown that the CAT-Suicide accurately predicts future suicidal behavior within 6 months and one year. This module takes an average of 55 seconds to complete. The validation study involved adult treatment-seeking outpatients and resulted in cross-validated sensitivity of 0.81 and specificity of 0.90.
READ ARTICLEPTSD
The PTSD module is a dimensional measure of PTSD severity based on a modification of the 20 item PCL-5. The test can be adaptively administered using an average of 6 items and maintains a correlation of r=0.98 with the total 20 item test score. The measure is reported on a 100-point scale with 5 points of precision. The thresholds are below 55 for No Evidence of PTSD, 55-70 for Possible PTSD, and above 70 for PTSD Definite or Highly Likely. The original PCL-5 threshold of 33 is similar to the threshold for Possible PTSD. This module takes an average of 37 seconds to complete.
PTSD-DIAGNOSIS (SCREENER)
The PTSD-DX is used for diagnostic screening. It reproduces a CAPS-5 structured clinical interview administered by a trained clinician with high sensitivity and specificity as evidenced by the AUC=0.91 (outstanding range) using a maximum of 6 items in a median time of 35 seconds. The validation study involved US military veterans conducted at the Veterans Health Administration facility. The item bank was developed to apply to both military and civilian forms of PTSD.
READ ARTICLEPTSD-EXPANDED
The PTSD-E is a dimensional measure used for measurement-based care, treatment triage, and outcome assessment. It produces a continuous severity score on a scale of 0 to 100 with approximately 5 points of precision. Total administration time is an average of 94 seconds. The validation study involved US military veterans conducted at the Veterans Health Administration facility. The item bank was developed to apply to both military and civilian forms of PTSD. Convergent validity of the PTSD-E was demonstrated against the PCL-5 (r=0.88) and diagnostic validity against the CAPS-5 (AUC=0.85 – excellent range).
READ ARTICLEPSYCHOSIS
The Psychosis (CAT-Psychosis) module is a dimensional measure of the severity of psychosis. The questions are intended to be answered directly by the patient (self-report) or by a clinician. The test requires an average of 11 adaptively administered items and maintains a correlation of r=0.94 with the total 73 item test score. The measure is reported on a 100-point scale with 6 points of precision. These tests have been validated against the clinician rated BPRS and SCID in a sample of inpatient and outpatient psychiatric patients and healthy controls. This module takes an average of 73 seconds to complete. The CAT-Psychosis discriminates psychosis from healthy individuals (AUC=0.965 for clinician-report, and AUC=0.850 for self-report).
READ ARTICLE 1READ ARTICLE 2SOCIAL DETERMINANTS OF HEALTH
The SDoH module is an adaptive version of a life quality measure which was designed and validated for people with mental health disorders. The scale consists of seven subdomains (Family, Finance, Health, Leisure, Living, Safety, and Social), each with 4–6 items for a total of 35 items. Each item is rated on a 7-point scale ranging from 1 = terrible to 7 = delighted. The test requires an average of 11 adaptively administered questions yet maintains a correlation of r=0.96 with the 35 item total test score. It is reported on a 100 point scale with precision of 5 points. The CAT-SDoH should be interpreted as the person’s perspective on their own experience of aspects of their social and physical environment that can influence their health. High scores represent overall satisfaction and low scores represent overall dissatisfaction. These scores can be compared to or integrated with traditional SDoH measures to obtain a more complete picture of the person’s SDoH. In addition, the CAT-SDoH can be used as a general measure of life satisfaction, where changes in the score over time represent changes in life quality.
ADULT ADHD
The Adult ADHD module is a dimensional severity measure of attention-deficit/hyperactivity disorder symptomatology for adults 18 and over. It is based on the validated K-CAT® module with items rewritten to be appropriate for adults. This module takes an average of 109 seconds to complete.
In some cases, the average completion times stated above are faster than those stated in our academic press because of further optimization of the adaptive testing algorithms.
