Psychometric evaluation of the Forensic Inpatient Observation Scale (FIOS) in youngsters with a judicial measure

BACKGROUND In this article, the psychometric properties of the Forensic Inpatient Observation Scale (FIOS) were examined. This instrument was developed to observe behavioral functioning of forensic psychiatric patients. Up till now, it has only been used among adult forensic psychiatric patients and this is the first study in which the FIOS is used with youngsters. METHODS Data were gathered of 133 patients. The FIOS was routinely used to assess the psychiatric condition of youngsters at fixed intervals with a three-month time period between each measurement. Ward staff working in close contact with the patient conducted the assessments. Of these 133 patients, an YSR/ASR questionnaire was available for 96 of them and a TRF for 110 of the 133 patients. For the descriptive, reliability and validity analyses, SPSS version 16.0 was used. Factor analyses were performed by means of Mplus Version 5.2. RESULTS A series of confirmatory and exploratory factor analyses revealed a five-factor structure for the FIOS. The five-factor structure consisted of the following scales: self-care, social behavior, oppositional behavior, verbal skills and distress. The insight scale of the original factor structure could not be replicated in the youth sample. Cronbach's alpha's of the five scales ranged from .70 to .85. The self-care, verbal skills and oppositional behavior scales of the FIOS showed no relation with emotional and behavior problems reported by the patients themselves or their teachers. The distress scale of the FIOS did show a relation with the emotional problems reported by patients themselves and the social behavior scale with behavioral problems as reported by teachers. CONCLUSIONS The internal consistency of the FIOS was sufficient and the factor structure in the present sample of youngsters was in general comparable to the original factor structure in an adult sample. Its value lies in the focus on behavioral functioning of youngsters with judicial measures. What remains to be seen is whether this instrument is sensitive enough to register all aspects of behavioral changes, whether the interrater reliability is sufficient, and whether it has predictive validity to relapse and recidivism.