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2.07 Human Research Protection Office Box 8089 (314)633-7400 Fax (314)367-3041 Standard Screening Instruments Not Requiring Submission with Research Protocols The following are well-known, approved measures and do not need to be included in submissions to the HRPO. We have marked the questionnaires, in bold, that may contain more sensitive questions. Depending on the nature of your study, whether the information is already know and in the medical record, the targeted populations, and the other protections in place in your study, you may wish to obtain a Certificate of Confidentiality. Those in italic red contain no sensitive questions. Psychiatric, Cognitive, and Behavioral Surveys AAMR Adaptive Behavior Scales Achenbach Child Behavior Checklist Beck Anxiety Inventory Beck Depression Inventory Behavioral Assessment of Pain – Medical Stability Quick Screen (BAP – MSQS) California Healthy Kids Survey CES-D Children’s (High School) Personality Questionnaire Children’s Depression Inventory Connors Rating Scales Diagnostic Interview Schedule (DIS) Diagnostic Interview Schedule for Children (DIS-C) Diagnostic Interview Schedule for DSM-IV Fear-Avoidance Beliefs Questionnaire Hamilton Rating Scales (Depression, Anxiety) Hendler Screening Test Kaufman Tests Millon (MCMI and variants) Mini Mental Status Examination Minnesota Multiphasic Personality Inventory (MMPI) and variants Modified Zung Depression Inventory Monitoring the Future National Household Survey on Drug Abuse (NHSDA) Pain Anxiety Symptoms Scale Personality Assessment Inventory (PAI) Personality Factor Profile of Mood Scales Reynold’s Adolescent Depression Scale Structured Clinical Interview for DSM-III –R (SCID-P) Schizophrenia and Affective Disorders Schedule (SADS) Screening Instrument for Targeting Educational Risk in Preschool Children (S.I.F.T.E.R.) Screening Instrument for Targeting Educational Risk (S.I.F.T.E.R.) Spielbarger Inventories (Anger/Anxiety) Stanford Binet Structured Psychiatric Interview for DSM-III (SCID and its variants) Structured Clinical Interview for DSM-III-R – Patient Version (SCID-P) Survey of Student Resources and Assets (Search Institute) Symptom Checklist 90 Wechsler Intelligence and Memory Scales Weschler Memory Scales Wide Range Achievement (WRAT) or Memory (WRAML) Scales Youth Risk Behavior Surveillance Survey (YRBSS) (CDC) Cognitive Factors and Coping Strategies Cognitive Errors Questionnaire Cognitive Evaluation Questionnaire Pain Locus of Control Questionnaire Pain and Impairment Relationship Scale (PAIRS) Cognitive Strategies Questionnaire (CSQ) Coping Strategy Questionnaire Pain Assessment Back Pain Classification Scale Behavioral Assessment of Pain - Medical Stability Quick Screen (BAP-MSQS) Behavioral Assessment of Pain Questionnaire Chronic Illness Problem Inventory Functional Rating Scale Hendler Screening Test Illness Behavior Questionnaire The Pain Behavior Scale Neck Pain Disability Index McGill-Melzack Pain Questionnaire McGill- Melzack Comprehensive Pain Questionnaire Vanderbilt Pain Management Inventory West Haven – Yale Multidimensional Pain Inventory (WHYMPI) Other Measures Assessment of Informed Consent – Evaluator Version (SD-18) – newly added DHEA Level of Expressed Needs Questionnaire Job Stress Survey Sickness Impact Profile SF-36 Vietnam Era Twin Study of Aging (VETSA) Vietnam Era Twin Study of Aging (VETSA) Medical -History Interview Vietnam Era Twin Study of Aging (VETSA) Medical Questionnaire References: HRPO Task Force composed of psychologists, psychiatrists, and social/behavioral scientists. Lewandowski, Michael J Ph.D. “Pain Assessment: Implications for Vocational Rehabilitation. Fall 2000. www.painassessmentresources.com/Files/ABVE%20presentation.pdf Pittsburg IRB. List of Standard Screening Instruments. WUMC Department of Psychiatry. Compilation of surveys commonly administered to school-age children. Dec 2001. ExemptScreening under HRPO Forms Committee.