Cited by 430Psychometric Methodologies and TestingPsychological Testing and AssessmentAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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The Symptom Check-List-90-R (SCL-90-R): A German validation study

Schmitz, N., Hartkamp, N., Kiuse, J., Franke, G.H., Reister, G., Tress, W.·2000·Quality of Life Research

DOI 10.1023/a:1008931926181

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Abstract

The Symptom Check-List-90-R (SCL-90-R) is a widely used psychological status symptom inventory. The properties of the German SCL-90-R version were studied in two clinical samples: psychosomatic outpatients and primary care patients. The data were compared with a German community sample. The internal consistency, measured by Cronbach's alpha coefficients, was found to be high, for the global scale and all original subscales. Mokken scale analysis indicated hierarchical structure for most of the subscales. Concurrent validity, evaluated by studying the relationship between the SCL-90-R subscales and the Inventory of Interpersonal Problems (IIP-C) and the General Health Questionnaire (GHQ-12) was also high. On the basis of receiver operating characteristic (ROC) analyses, it was found that the SCL-90-R was able to differentiate between subjects known to have a given psychological disorder and those who do not. Results of exploratory and confirmatory factor analysis failed to support the original nine factor model and two subsequent factor models. The strong interdependence of the original subscales and the strong first unrotated factor of the exploratory factor analyses raised concern regarding the multi-dimensionality of the SCL-90-R subscales. We concluded that the SCL-90-R is a useful tool for measuring psychological status, measuring change in outcome studies, or screening for mental disorders.

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Method
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Method
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Background
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Method
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Wang, Z., Zhang, Z., & Wu, Y. (2024) · Journal of Health Population and Nutrition · doi:10.1186/s41043-024-00691-4 · Cited by 25
Inpatient or day clinic treatment? Results of a multi-site-study
Zeeck, A., von Wietersheim, J., Hartmann, A., Einsele, S., Weiß, H., Sammet, I., Gaus, E., Semm, E., Harms, D., Eisenberg, A., et al. (2009) · PubMed Central · doi:10.3205/psm000059 · Cited by 25
“The German version has been well validated on a large heterogeneous sample and has shown acceptable reliability as a general measure of distress [15], [16].”
Background
Disturbed cognitive functions after nasal provocation in patients with seasonal allergic rhinitis
Lutgens, I., Vermeeren, A., Vuurman, E. F. P. M., & Kremer, B. (2009) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2009.03200.x · Cited by 25
Deconstructing sub-clinical psychosis into latent-state and trait variables over a 30-year time span
Wulf Rössler, A., Hengartner, M. P., Ajdacic‐Gross, V., Haker, H., & Angst, J. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.07.042 · Cited by 25
“The SCL-90-R has historically shown good internal consistency and test–retest reliability (Schmitz et al., 2000).”
Gaze Synchrony between Mothers with Mood Disorders and Their Infants: Maternal Emotion Dysregulation Matters
Lotzin, A., Romer, G., Schiborr, J., Noga, B., Schulte‐Markwort, M., & Ramsauer, B. S. (2015) · PLoS ONE · doi:10.1371/journal.pone.0144417 · Cited by 24
Effect of Mild Thyrotoxicosis on Performance and Brain Activations in a Working Memory Task
Göbel, A., Heldmann, M., Göttlich, M., Dirk, A.-L., Brabant, G. E., & Münte, T. F. (2016) · PLoS ONE · doi:10.1371/journal.pone.0161552 · Cited by 25
“To assess effects on mood and psychological well-being, the Beck Depression Inventory II (German version [37,38]), the Symptom-Check-List SCL 90R [39] and the “Aktuelle Stimmungsskala” (ASTS [40], which is the German version of the “profile of mood state” scale (POMS), were administered.”
BackgroundMethod
Dyspareunia in the Context of Psychopathology, Personality Traits, and Coping Resources: Results From a Prospective Longitudinal Cohort Study From Age 30 to 50
Leeners, B., Hengartner, M. P., Ajdacic‐Gross, V., Wulf Rössler, A., & Angst, J. (2015) · Archives of Sexual Behavior · doi:10.1007/s10508-014-0395-y · Cited by 24
Posttraumatic Stress Disorder (PTSD) Patients Exhibit a Blunted Parasympathetic Response to an Emotional Stressor
Meyer, T., Albrecht, J., Bornschein, G., Sachsse, U., & Herrmann‐Lingen, C. (2016) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-016-9341-1 · Cited by 24
The prevalence of psychological distress in Parkinson's disease patients: The brief symptom inventory (BSI-18) versus the Hopkins symptom checklist (SCL-90-R)
Carrozzino, D., Siri, C., & Bech, P. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.07.012 · Cited by 24
Applicability of Family Therapy for Chinese Children and Adolescents Suffering from Anorexia Nervosa in a Chinese Context: A Preliminary Study
Joyce, L. C., & Lai, K. Y. C. (2009) · Social Work in Mental Health · doi:10.1080/15332980802237750 · Cited by 24
Role conflict and health behaviors: Moderating effects on psychological distress and somatic complaints
Pomaki, G., Supeli, A., & Verhoeven, C. (2007) · Psychology and Health · doi:10.1080/14768320600774561 · Cited by 25
“It has also been shown to have good psychometric properties (Derogatis & Cleary, 1977; Schmitz et al., 2000).”
Background
Increased Amygdala Activity Associated With Cognitive Reappraisal Strategy in Functional Neurologic Disorder
Hassa, T., Spiteri, S., Schmidt, R., Merkel, C., & Schoenfeld, M. A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.613156 · Cited by 23
Adult Psychiatric Outcomes of Very Low Birth Weight Survivors
Westrupp, E. M., NORTHAM, E. A., Doyle, L. W., Callanan, C., & Anderson, P. J. (2011) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048674.2011.620561 · Cited by 23
Análisis factorial confirmatorio del Cuestionario SA-45 en una muestra mexicana
Alvarado-Bravo, B. G. (2012) · Anales de Psicología · doi:10.6018/analesps.28.2.148851 · Cited by 22
“…globales de gravedad psicopatológica (Derogatis, 1994; Gempp y Avendaño, 2008; Hard, Gerbershagen y Franke, 2000; Jin et al., 2010; López, Fernández y Becoña, 2009; Strauman y Wetzler, 1992; Sandín, Chorot, Valiente, Lostao y Santed, 2002; Schmitz et al., 2000; Strauman y Wetzler, 1992).”
Background
ADHD as a Serious Risk Factor for Early Smoking and Nicotine Dependence in Adulthood
Matthies, S., Holzner, S., Feige, B., Scheel, C. N., Perlov, E., Ebert, D., van Elst, L. T., & Philipsen, A. (2013) · Journal of Attention Disorders · doi:10.1177/1087054711428739 · Cited by 25
“General level of psychopathology was measured with the Symptom Check List–90– Revised (SCL-90-R; Derogatis & Cleary, 1977), German version (Franke, 1995; Schmitz et al., 2000).”
Method
Level and Change in Alcohol Consumption, Depression and Dysfunctional Attitudes among Females Treated for Alcohol Addiction
Gjestad, R., Franck, J., Hagtvet, K. A., & Haver, B. (2011) · Alcohol and Alcoholism · doi:10.1093/alcalc/agr018 · Cited by 22
“Although the Depression scale of SCL-90 has been widely used, its validity has been questioned (Cyr et al., 1985; Schmitz et al., 2000; Zack et al., 1998).”
Method
Mental health differences between German gay and bisexual men and population-based controls
Sattler, F. A., Franke, G. H., & Christiansen, H. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1435-7 · Cited by 22
“These findings are in line with previous results on the SCL-90-R, indicating that the measure is best described as a unidimensional measure for psychological distress rather than as a multidimensional measure [26, 27].”
ResultSelf-citation
Oral health-related quality of life and somatization in the elderly
Hassel, A. J., Rolko, C., Leisen, J., Schmitter, M., Rexroth, W., & Leckel, M. (2006) · Quality of Life Research · doi:10.1007/s11136-006-9122-z · Cited by 22
“The German version has been validated [19] and population-based standards are available [20].”
Cortisol reactivity in social anxiety disorder: A highly standardized and controlled study
Petrowski, K., Schmalbach, I., Strunk, A., Hoyer, J., Kirschbaum, C., & Joraschky, P. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.104913 · Cited by 21
The relationship between sleep disturbance and self-harming behaviours in high-risk clinical adolescents
Nguyen, T. P., Lerch, S., Maggetti, A., Reichl, C., Tarokh, L., & Kaess, M. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.12.034 · Cited by 21
Does Psychological Profile Influence Third Molar Extraction and Postoperative Pain?
González-Martínez, R., Jovani‐Sancho, M., & Cortell‐Ballester, I. (2016) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.joms.2016.09.023 · Cited by 21
Path Analysis of the SCL-90-R
Grande, T. L., Newmeyer, M. D., Underwood, L. A., & Williams, C. (2014) · Measurement and Evaluation in Counseling and Development · doi:10.1177/0748175614538061 · Cited by 21
Maternal emotion dysregulation is related to heightened mother–infant synchrony of facial affect
Lotzin, A., Schiborr, J., Barkmann, C., Romer, G., & Ramsauer, B. S. (2015) · Development and Psychopathology · doi:10.1017/s0954579415000516 · Cited by 21
“Evidence for convergent, divergent, and criterion validity was also reported (Brophy, Norvell, & Kiluk, 1988; Franke, 2002; Peveler & Fairburn, 1990; Schmitz et al., 2000).”
Background
Imaging Genetics Towards a Refined Diagnosis of Schizophrenia
Jiang, W., King, T. Z., & Turner, J. A. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00494 · Cited by 22
Tinnitus-frequency specific activity and connectivity: A MEG study
Salvari, V., Korth, D., Paraskevopoulos, E., Wollbrink, A., Ivanšić, D., Guntinas‐Lichius, O., Klingner, C. M., Pantev, C., & Dobel, C. (2023) · NeuroImage Clinical · doi:10.1016/j.nicl.2023.103379 · Cited by 19
“…as well as tinnitus severity (THI, THQ, TQ) (Beck & Steer, 1984; Goebel & Hiller, 1994; Goebel and Wolfgang, 1998; Kemper et al., 2012; Kuk et al., 1990; Newman et al., 1996; Schmitz et al., 2000; Spielberger et al., 1971; Spitzer et al., 1999; Üstün et al., 2010; Spielberger et al., 1983;).”
Background
Effects of physical fitness on mental health of Chinese college students: across-sectional study
Ma, S., Yang, Y., Soh, K. G., & Tan, H. (2024) · BMC Public Health · doi:10.1186/s12889-024-18097-6 · Cited by 19
“The SCL-90 is a psychosomatic screening scale proposed by Derogatis that is widely used in China and elsewhere [10], and it can be used to distinguish patients with and without psychosomatic diseases and has good reliability and validity [11–13].”
Background
The validity of self-rated psychotic symptoms in depressed inpatients
Seemüller, F., Riedel, M. J., Obermeier, M., Schennach-Wolff, R., Spellmann, I., Meyer, S., Bauer, M., Adli, M., Kronmüller, K., Ising, M., et al. (2011) · European Psychiatry · doi:10.1016/j.eurpsy.2011.01.004 · Cited by 19
The role of self‐image as a predictor of psychotherapy outcome
Ryum, T., Vogel, P. A., Walderhaug, E. P., & Stiles, T. C. (2014) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12167 · Cited by 19
Psychopathology, Defence Mechanisms, and the Psychosocial Work Environment
Larsen, A., Bøggild, H., Mortensen, J. T., Foldager, L., Hansen, J. C., Christensen, A., Arendt, M. C. B. B., Rosenberg, N., & Munk‐Jørgensen, P. (2009) · International Journal of Social Psychiatry · doi:10.1177/0020764008099555 · Cited by 18
“The GSI cut-off was defined conservatively at 1.00 in accordance with the European validations of the instrument (Holi et al., 2003; Schmitz et al., 2000).”
MethodResultInfluential
Alterations of Regional Homogeneity in Crohn's Disease With Psychological Disorders: A Resting-State fMRI Study
Huang, M., Li, X., Fan, W., Li, J., Zhu, L., Lei, P., Wu, L., Sun, Q., Zou, Y., & Han, P. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.817556 · Cited by 18
SCL-90-R Symptom Profiles and Outcome of Short-Term Psychodynamic Group Therapy
Jensen, H. H., Mortensen, E. L., & Lötz, M. (2013) · ISRN Psychiatry · doi:10.1155/2013/540134 · Cited by 18
“Similarly, improvement in the Global Symptom Index (GSI) was classified according to Jacobson and Truax [14] and Danish norms [6].”
BackgroundMethod
Intervention of the Nuss Procedure on the Mental Health of Pectus Excavatum Patients
Luo, L., Xu, B., Wang, X., Tan, B., & Zhao, J. (2017) · Annals of Thoracic and Cardiovascular Surgery · doi:10.5761/atcs.oa.17-00014 · Cited by 18
Stabilizing mandibular complete dentures by a single midline implant—influence on quality of life: 2-year results from a randomized clinical trial comparing different loading protocols
Abou‐Ayash, S., von Maltzahn, N., Passia, N., Freitag‐Wolf, S., Reissmann, D. R., Luthardt, R. G., Mündt, T., Raedel, M., Rammelsberg, P., Wolfart, S., et al. (2019) · Clinical Oral Investigations · doi:10.1007/s00784-019-02969-y · Cited by 18
Impact of psychological problems in chemical warfare survivors with severe ophthalmologic complication, a cross sectional study
Ghaedi, G., Ghasemi, H., Mousavi, B., Soroush, M. R., Rahnama, P., Jafari, F., Afshin‐Majd, S., Naeeni, M. S., & Naghizadeh, M. M. (2012) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-10-36 · Cited by 18
“The severities of psychological discomfort were graded as normal, mild, moderate, severe, or very severe [23].”
Background
Structure of the University Personality Inventory for Chinese College Students
Zhang, J., Lanza, S. T., Zhang, M., & Su, B. (2015) · Psychological Reports · doi:10.2466/08.02.pr0.116k26w3 · Cited by 17
Longitudinal associations of temperament and character with paranoid ideation: A population-based study
Saarinen, A. I. L., Rosenström, T. H., Hintsanen, M., Hakulinen, C. A., Pulkki-Råbäck, L., Lehtimäki, T. J., Raitakari, O. T., Cloninger, C. R., & Keltikangas‐Järvinen, L. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.12.044 · Cited by 19
Investigating Psychometrics of Career Decision Ambiguity Tolerance Scale
Park, I., Hai, S., Lee, S., & Sohn, Y.-W. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02067 · Cited by 19
“The Mokken model assumes there is an underlying continuum applied to the scale’s items (Schmitz et al., 2000).”
Method
Emotional Reactivity and Family-Related Factors Associated With Self-Injurious Behavior in Adolescents Presenting to a Child and Adolescent Psychiatric Emergency Service
Kandsperger, S., Jarvers, I., Ecker, A., Schleicher, D., Madurkay, J., Otto, A., & Brunner, R. M. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.634346 · Cited by 17
“SCID, Structured Clinical Interview for DSM-IV; Axis II; SCL-90-R, Symptom Checklist-90 Revised; GSI, Global Severity Index; GAF, Global Assessment of Functioning Scale; CGI-S, Clinical Global Impressions Scale. group of patients and n = 2 patients qualified for a borderline personality disorder.”
Method
The Position of Anxiety Disorders in Structural Models of Mental Disorders
Wïttchen, H., Beesdo‐Baum, K., & Gloster, A. T. (2009) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2009.06.004 · Cited by 16
Evolución de la sintomatología psicopatológica de los drogodependientes a lo largo del tratamiento
Pérez, E. J. P., García, C. P., lópez, I. S., & del Río, S. M. O. (2004) · Trastornos Adictivos · doi:10.1016/s1575-0973(04)70161-0 · Cited by 17
Sex differences in sub-clinical psychosis—Results from a community study over 30years
Rössler, W., Hengartner, M. P., Ajdacic-Gross, V., Haker, H., & Angst, J. (2012) · Schizophrenia Research · doi:10.1016/j.schres.2012.04.017 · Cited by 16
“Commonly, fewer than nine factors are identified when this instrument is applied (Schmitz et al., 2000), and the “psychoticism” subscale yields the least consistent data (Olsen et al.”
Machine learning models for predicting the risk of depressive symptoms in Chinese college students
Yu, C., Kong, X., Yu, W., Ni, X., Chen, J., & Liao, X. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1648585 · Cited by 23
The dimensions of the Dutch SCL-90: more than one, but how many?
Hafkenscheid, A., Maassen, G. H., & Veeninga, A. T. (2007) · Netherlands journal of psychology · doi:10.1007/bf03061059 · Cited by 16
The Body Image Dissatisfaction and Psychological Symptoms among Invasive and Minimally Invasive Aesthetic Surgery Patients.
Yazdandoost, R. Y., Hayatbini, N., Farid, A. A. A., Gharaee, B., & Latifi, N. A. (2016) · PubMed Central · Cited by 16
My job, my child, my house: the predictive value of job- and housework-related factors on depressive symptoms during the postpartum period
Schaber, R., Karl, M., Kopp, M., Kress, V., Weidner, K., Martini, J., & Garthus‐Niegel, S. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.04.016 · Cited by 18
Self-Reported Psychotic Symptoms in the General Population: Correlates in an Iranian Urban Area
Sharifi‎, V., Bakhshaie, J., Hatmi, Z., Faghih-Nasiri, L., Sadeghianmehr, Z., Mirkia, S., Darbooy, S., Effatpanah, M., & Mirsharifa, S. M. (2012) · Psychopathology · doi:10.1159/000337749 · Cited by 16
The co-occurrence between depressive symptoms and paranoid ideation: A population-based longitudinal study.
Saarinen, A., Hintsanen, M., Hakulinen, C., Pulkki-Råback, L., Lehtimäki, T., Raitakari, O., & Keltikangas-Järvinen, L. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.12.045 · Cited by 15
“Earlier studies have found high reliability and predictive validity for the scale (e.g. Olsen et al., 2004; Schmitz et al., 2000).”
Background

Authors: Schmitz, N., Hartkamp, N., Kiuse, J., Franke, G. H., Reister, G., & Tress, W.
Affiliations: Heinrich Heine University Düsseldorf (DE)
ORCID: Schmitz, N.
Hartkamp, N.
Franke, G.H.
Venue: Quality of Life Research
Publisher: Springer Science and Business Media LLC
Published: 2000-03
Volume: 9
Issue: 2
Pages: 185-193
ISSN: 0962-9343 (ISSN-L)
1573-2649
DOI: 10.1023/a:1008931926181
OpenAlex: W2121333311
Cited by: 430
References: 32
Citations by year: 2026: 14 · 2025: 19 · 2024: 29 · 2023: 21 · 2022: 23 · 2021: 20 · 2020: 21 · 2019: 24 · 2018: 10 · 2017: 19 · 2016: 27 · 2015: 20 · 2014: 31 · 2013: 15 · 2012: 22
FWCI: 5.42
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Quality of Life Research (publishedVersion)
PubMed (publishedVersion)
Funders: Bundesministerium für Forschung und Technologie
Topics: Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: SCL-90-R, psychometric properties, internal consistency, Mokken scale analysis, concurrent validity, factor structure, mental disorder screening, psychosomatic outpatients, primary care patients, Inventory of Interpersonal Problems, General Health Questionnaire
MeSH terms: Adult, Mental Disorders, Factor Analysis, Statistical, Female, Germany, Humans, Male, Mass Screening, Predictive Value of Tests, Psychiatric Status Rating Scales, Psychometrics, Quality of Life, Self Disclosure, Sensitivity and Specificity, Reproducibility of Results, Area Under Curve

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The Symptom Check-List-90-R (SCL-90-R): A German validation study

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