Altman Self-Rating Mania Scale

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Altman Self-Rating Mania Scale

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About Altman Self-Rating Mania Scale

Scale Name

Altman Self-Rating Mania Scale

Author Details

Edward Altman

Translation Availability

Not Sure

Background/Description

The Altman Self-Rating Mania Scale (ASRM), developed by Dr. Edward Altman in 1997, is a concise and effective tool for identifying and measuring the severity of manic or hypomanic symptoms. Primarily used in the context of bipolar disorder, the ASRM offers a way for individuals to self-report their experiences over the past week, providing valuable insights for both patients and clinicians.

The scale consists of just five key questions, each focusing on a core aspect of mania: mood, self-confidence, sleep disturbance, speech, and activity level. For each question, respondents choose from a range of options reflecting the frequency and intensity of their experience. Scores are then summed to provide a total that indicates the potential presence and severity of manic symptoms.

Beyond its brevity, a key strength of the ASRM lies in its demonstrated validity. Studies have shown strong correlations between ASRM scores and scores on clinician-administered mania rating scales, suggesting the tool effectively captures the essence of manic experiences. This allows clinicians to gain valuable patient perspectives alongside their own observations.

The ASRM offers several advantages in various settings. In inpatient settings, it can be used as a screening tool to quickly identify potential manic episodes. Outpatient settings benefit from its use as a psychoeducational tool. By completing the ASRM regularly, patients can become more attuned to their own symptoms, allowing for earlier recognition of potential mood swings. This empowers them to take action, such as contacting their healthcare provider, before symptoms escalate.

The ASRM can also be a valuable tool for treatment monitoring. By tracking scores over time, both patients and clinicians can assess the effectiveness of treatment plans. Decreasing scores may indicate a positive response to medication or therapy, while persistently high scores might necessitate adjustments.

It’s important to note that the ASRM, with its limited number of questions, doesn’t capture the full spectrum of manic symptoms. For a comprehensive diagnosis, a clinical evaluation remains essential. However, the ASRM serves as a valuable starting point for both self-assessment and clinician-patient discussions.

In conclusion, the Altman Self-Rating Mania Scale offers a simple yet powerful tool for assessing manic symptoms. Its brevity, validity, and versatility make it a valuable asset in various settings, empowering patients, informing clinicians, and ultimately aiding in the management of bipolar disorder.

Administration, Scoring and Interpretation

  • Ensure the individual has access to a copy of the ASRM. This can be a physical form or a digital version.
  • Provide clear instructions. Explain the purpose of the ASRM and how to complete it.
  • Emphasize honesty and accuracy. Encourage the individual to reflect on their experiences over the past week and choose the response that best reflects their reality.
  • Scoring: Each question offers a range of response options, typically from 0 (not at all) to 4 (all of the time). The individual assigns a score based on the frequency and intensity of their experience for each question.
  • Total Score Calculation: Once all questions are answered, add the individual scores from each question to obtain a total score.

Reliability and Validity

The Altman Self-Rating Mania Scale (ASRM) demonstrates good reliability and validity, making it a valuable tool for assessing manic symptoms in adults and adolescents with bipolar disorder. Here’s a closer look at these aspects:

Reliability:

Test-Retest Reliability: Studies have shown good test-retest reliability for the ASRM. This means that when individuals complete the scale twice within a short period (typically during a medication washout phase), their scores tend to be consistent. This indicates the ASRM produces stable results over time within similar mental states.

Validity:

  • Concurrent Validity: Research has established strong concurrent validity for the ASRM. This means scores on the ASRM correlate well with scores on clinician-administered mania rating scales, such as the Clinician-Administered Rating Scale for Mania (CARS-M) and the Mania Rating Scale (MRS). This suggests the ASRM captures similar information about manic symptoms as these established clinical tools.
  • Content Validity: The ASRM focuses on core symptoms of mania, such as mood changes, self-confidence, sleep disturbance, increased talkativeness, and activity level. This alignment with established criteria for mania strengthens the content validity of the scale.

Limitations:

Despite its strengths, the ASRM has limitations to consider:

  • Limited Scope: With only five questions, the ASRM doesn’t capture the full spectrum of manic symptoms. For a comprehensive assessment, a clinical evaluation remains crucial.
  • Self-Report Bias: Individuals completing the scale might unintentionally underreport or overreport symptoms due to social desirability or lack of awareness.
  • Specificity: High scores on the ASRM don’t necessarily guarantee a manic episode. Other conditions can cause similar symptoms. A qualified mental health professional should interpret scores within the context of the individual’s specific situation.

Available Versions

05-Items

Reference

Altman, E. G., Hedeker, D., Peterson, J. L., & Davis, J. M. (1997). The Altman Self-Rating Mania Scale. Biological psychiatry42(10), 948–955. https://doi.org/10.1016/S0006-3223(96)00548-3

Important Link

Scale File:

Frequently Asked Questions

What is the ASRM?
A short (5-question) self-assessment tool to screen for manic or hypomanic symptoms.

Who uses it?
Individuals with bipolar disorder and mental health professionals.

How is it administered?
Individuals complete the questionnaire on their own, reflecting on experiences from the past week.

What are the benefits?
Easy to use, helps with self-monitoring, informs clinicians, and tracks treatment effectiveness.

Is it reliable and valid?
Yes, it shows good test-retest reliability and correlates well with clinician-administered mania rating scales.

Are there limitations?
Limited scope (doesn’t capture all symptoms), susceptible to self-report bias, and high scores don’t guarantee a manic episode.

Is it a diagnostic tool?
No, high scores warrant further evaluation by a clinician.

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