HSS

The HSS is a computerized presentation of 12 standard psychological tests in similar, easy-to-use formats (depicted below) that fully replace oral explanations of how to perform the tests for most people. Instructions and tests are presented in written english and available in spoken english as a selectable on/off option at any time during the test, for most tests.The HSS is designed to be used in field research using Mac PowerBooks with a durable 9BUTTON (DataSled) response input device [pictured] placed over the keyboard, which reduces computer reluctance for the naive.

Collaborative relationships for academic purposes (eg, epidemiologic research) are sought; hardware and software available from us on an economical rental basis. It is NwETA’s intention to incorporate this questionnaire delivery capability in BARS.

Health Screening System (HSS) Tests

• Penn Inventory for PTSD (Penn)
• Mississippi PTSD Scale (MIssissippi)
• Posttraumatic Stress Disorder Checklist (PCL-C)
• Combat Exposure Scale-revised (CES-r)
• Life Experiences Scale (LES)
• Beck Depression Inventory (BDI) *
• Beck Anxiety Inventory (BAI) *
• Substance Abuse Subtle Screening Inv. (SASSI)
• Positive and Negative Affect Schedule (PANAS)
• Health Status Questionnaire (SF-36)

* Requires prior approval by copyright holder (Psychological Corporation) and per use fee. The SCL-90R and MMPI-2, previously included in the HSS,are no longer available in the HSS.

• All tests have the same instructions as the original; the LES has a sequenced presentation to avoid the confusion of the paper-and-pencil version.
• On-screen training teaches use of the 9-button DataSled response unit and options for spoken instructions, test items or responses.
• Output is in the form of published questionnaire scales.
• A logo, picture, or quicktime movie of the investigators can be inserted at the beginning of training.
• Test order and choice of tests are options.
• Up to 10 people can be tested simultaneously by a single Examiner.
• New tests can be readily added if they fit one of the current formats. The simplest format is shown in the image of a typical screen drawn from the HSS training on how to take the tests (see HSS Test Details to see examples of each test).
• The HSS is copyrighted by Oregon Health & Science University

Test Descriptions and References
PTSD SCALES

Penn Inventory for PTSD (Penn)
DESCRIPTION: The Penn is a 26-item scale tapping DSMIII-R symptoms of posttraumatic stress disorder (PTSD).
PENN REFERENCE: Hammarberg; Psychological Assessment; 1992, 41: 67-76.
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS test (1 week test/retest; n=30): 0.93 (Campbell et al., 1999)
PENN COPYRIGHT: None (Hammarberg, 1995).
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

Mississippi PTSD Scale
DESCRIPTION: The Mississippi is a 39-item scale reporting war-related military posttraumatic stress disorder (PTSD) symptoms.
MISSISSIPPI REFERENCE: Keane et al.; Journal of Consulting and Clinical Psychology; 1988, 56: 85-90.
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS test (1 week test/retest; n=30): 0.89 (Campbell et al., 1999)
MISSISSIPPI COPYRIGHT: Keane, Caddell, Taylor (1989).
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

Posttraumatic Stress Disorder Checklist (PCL-C)
DESCRIPTION: The PCL-C is a 17-item questionnaire that assesses frequency of complaints in relation to stressful experiences.
PCL-C REFERENCE: Weathers et al.; International Society for Traumatic Stress Studies (F.W. Weathers, National Center for PTSD, Boston Veterans Affairs Medical Center, Boston, MA 02130, October, 1993).
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS test (1 week test/retest; n=30): 0.88 (Campbell et al., 1999)
PCL-C COPYRIGHT: None (Weathers, Litz, Herman, Huska, Keane; 1995).
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

EXPERIENCE SCALES

Combat Exposure Scale-revised (CES-r)
DESCRIPTION: The CES-r is a 50-item questionnaire assessing war-zone exposure to violence, wounding, wounding/death of others, threat of severe injury/death, leadership failures, abusive violence, and POW captivity to which we have added a series of additional questions reflective of the types of events typifying the 1991 Persian Gulf War.
CES-r REFERENCES: Keane et al.; Psychological Assessment; 1989, 1: 53-55. -and- Wolfe et al.; Psychological Assessment; 1993, 5: 330-335.
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS test (1 week test/retest; n=30): 0.96 (Campbell et al., 1999)
CES-r COPYRIGHT: Kovera, Campbell, Anger (1995).
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

Life Experiences Scale (LES)
DESCRIPTION: The LES is a 57-item questionnaire that provides a measure of present-life stressors that may be coloring one’s presentation of symptoms. (Image from a question in which a “yes” response in part 1 sequentially triggers part 2 [impact] followed by part 3 [control}.)
LES REFERENCE: Sarason, Johnson, Siegel; Consulting and Clinical Psychology; 1978, 46: 932-946.
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS Test (1 week test/retest; n=30; Campbell et al., 1999):
Positive events = 0.78
Negative events = 0.89
Positive control = 0.59
Negative control = 0.88
Number of events = 0.92
LES COPYRIGHT: None (Sarason, Johnson, Siegel, 1995).
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

PSYCHOPATHOLOGY SCALES

Beck Depression Inventory (BDI)
DESCRIPTION: The BDI is a 21-item questionnaire that assesses the intensity of cognitive, affective, somatic, and performance-related symptoms with regard to depression. (Image censored to protect the copyright.)
BDI REFERENCE: Beck et al.; Cognitive Therapy of Depression (Guilford, New York, 1979).
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS Test (1 week test/retest; n=30): 0.92 (Campbell et al., 1999)
BDI COPYRIGHT: Aaron T. Beck (1978). Requires prior approval by Psychological Corporation (which we arrange) and per use fee.
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

Beck Anxiety Inventory (BAI)
DESCIPTION: The BAI is a 21-item questionnaire that assesses subjective, somatic, and panic-related symptoms of anxiety. (Image censored to protect the copyright.)
BAI REFERENCE: Ware, Sherbourne; Medical Care; 1992, 30: 473-483.
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS test (1 week test/retest; n=30): 0.89 (Campbell et al., 1999)
BAI COPYRIGHT: Aaron T. Beck (1987, 1990). Requires prior approval by Psychological Corporation (which we arrange) and per use fee.
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

Substance Abuse Subtle Screening Inventory-2 (SASSI)
DESCRIPTION: The SASSI-2 is an 88-item questionnaire that samples a broad range of alcohol and drug abuse patterns, including subtle attributes of abuse and denial. This version includes the RPS.
SASSI REFERENCE: Miller; Substance Abuse Subtle Screening Inventory Manual (Spencer, IN, 1988).
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS Test (1 week test/retest; n=30; Campbell et al., 1999):
COR = 0.92
SAM = 0.83
SASSI COPYRIGHT: Glenn Miller (1994) [+ RPS by State of Indiana Department of Mental Health, 1978].
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

PERSONALITY SCALES

Positive and Negative Affect Schedule (PANAS)
DESCRIPTION: The PANAS is a 20-item questionnaire that assesses the “emotional style” a person uses to cope with life/world events
PANAS REFERENCE: Watson, Clark, Tellegen; Journal of Personality and Social Psychology; 1988, 54: 1063-1070.
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY of HSS test (1 week test/retest; n=30; Campbell et al., 1999):
PA = 0.90
NA = 0.92
PANAS COPYRIGHT: American Psychological Association (Watson, Clark, Tellegen, 1995).
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

HEALTH STATUS QUESTIONNAIRE

Health Status Questionnaire (SF-36)
DESCRIPTION: The SF-36 is a 36-item questionnaire that assesses functional (somatic) impairment and symptoms due to medical health problems. (The screen from the early part of the SF-36 appears much like the following test; the image to the right is from the latter part of the SF-36 in which a series of related questions are posed on a single screen.)
SF-36 REFERENCE: Ware, Sherbourne; Medical Care; 1992, 30: 473-483.
HSS REFERENCE: Kovera et al.; Neurotoxicology and Teratology; 1996, 18: 511-518.
RELIABILITY (1 week test/retest; n=30) (Campbell et al., 1999):
Physical Functioning = 0.95
Social Functioning = 0.64
Role-Physical = 0.52
Role-Emotional = 0.57
Mental Health = 0.93
Vitality = 0.75
Bodily Pain = 0.80
General Health = 0.88
SF-36 COPYRIGHT: MOS Trus, Inc. (1992).
HSS COPYRIGHT: Oregon Health & Science University; Portland, OR USA (1996).

References (by developers)

• Ford JD, Campbell KA, Storzbach D, Binder LM, Anger WK, Rohlman DS. Postraumatic stress symptomatology is associated with unexplained illness attributed to Persian Gulf Military Service. Psychosomatic Medicine 2001, 63:842-849.
• Storzbach D, Rohlman DS, Anger WK, Binder LM, & Campbell K. Neurobehavioral Deficits in Persian Gulf Veterans: Additional Evidence from a Population-Based Study. Environmental Research, 2001, 85:1-13.
• Storzbach D, Campbell K, Anger WK, Binder, LM, Rohlman D, McCauley L and members of the Portland Environmental Hazards ResearchCenter. Psychological differences between veterans with and without Persian Gulf war unexplained symptoms. Psychosomatic Medicine, 2000, 62: 726-735.
• Binder LM, Storzbach D, Campbell KA, Rohlman DS, Anger WK, Salinski MO, Campbell BR, Mueller R and members of PEHRC. Comparison of MMPI-2 profiles of Gulf War veterans with epileptic and non-epileptic seizure patients. Assessment , 2000, 7:73-78.
• Anger WK, Rohlman DS, Storzbach D. Neurobehavioral Testing in Humans. Current Protocols in Toxicology (M Maines, L Costa, IG Sipes, S Sasse, DJ Reed, eds). John Wiley & Sons, New York, 1999. rapid response capability described
• Lowry LK, Rountree, PP, Levin JL, Collins S, Anger WK. The Texarkana mercury incident. Texas Medicine, 1999, 95: 65-70.
• Binder LM, Storzbach D, Anger WK, Campbell KA, Rohlman DS, & other members of the Portland Environmental Hazards Research Center. Subjective cognitive complaints, affective distress, and objective cognitive performance in Persian Gulf War veterans. Archives of Clinical Neuropsychology, 1999, 14: 531-536.
• Anger WK, Storzbach D, Binder LM, Campbell KA, Rohlman DS, McCauley L, Kovera CA, Davis KL. Neurobehavioral Deficits in Persian Gulf Veterans: Evidence from a Population-Based Study. Journal of the International Neuropsychology Society, 1999; 5:203-212.
• Campbell KA, Rohlman DS, Storzbach D, Binder LM, Anger WK, Kovera CA, Davis K, Grossmann S. Test-retest reliability of psychological and neurobehavioral tests self-administered by computer. Assessment, 1999; 6:21-32.
• Anger WK, Storzbach D, Amler RW, Sizemore OJ. Human behavioral neurotoxicology: Workplace and community assessments. In: Environmental and Occupational Medicine (third edition) (W Rom, Ed.) Little, Brown, and Co., 1998.
• Kovera CA, Anger WK, Campbell, KA, Binder LM, Storzbach D, Davis KL, Rohlman DS. Computer-Administration of Questionnaires: A Health Screening System (HSS) Developed for Veterans. Neurotoxicology and Teratology, 1996; 18: 511-518.