Psychology Roots22-Item Screening Score of Psychiatric Symptoms
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About 22-Item Screening Score of Psychiatric Symptoms
Scale Name
22-Item Screening Score of Psychiatric Symptoms
Author Details
Thomas S. Langner
Translation Availability
English
Background/Description
The 22-Item Screening Score of Psychiatric Symptoms, developed by Thomas S. Langner in 1962, is a self-report or interviewer-administered questionnaire designed to screen for common psychiatric symptoms in community populations, particularly for the Midtown Manhattan Study. Published in Journal of Health and Human Behavior (1962), it identifies individuals along a continuum of impairment due to neurotic and psychosomatic symptoms (e.g., anxiety, depression, somatic complaints) without diagnosing specific disorders or detecting organic brain damage, mental retardation, or sociopathic traits. Derived from the U.S. Army’s Neuropsychiatric Screening Adjunct and the Minnesota Multiphasic Personality Inventory (MMPI), the 22 items were selected from 120 for their ability to discriminate between psychiatrically well individuals and psychiatric patients.
Items use closed-ended questions with 3-point response scales (e.g., 0 = “No,” 1 = “Sometimes,” 2 = “Often”). The total score sums “pathognomonic” (symptom-indicating) responses, ranging from 0–22, with a cutoff of ≥4 (or ≥7, ≥10 in some studies) suggesting impairment. A weighted scoring system was proposed but showed minimal improvement over simple summation. The scale was validated with 1,660–11,000 adults (mean age ≈ 20–65 years, mixed gender, U.S.-based), correlating with psychiatric ratings (r = 0.41–0.79) and other symptom scales (r = 0.65–0.77). It is used in public health, clinical psychology, and epidemiological research for mental health screening. Access requires permission from Journal of Health and Human Behavior.
Administration, Scoring and Interpretation
- Obtain the scale from Langner (1962) or Journal of Health and Human Behavior, ensuring ethical permissions.
- Explain to participants (adults 18+ in community settings) that the questionnaire screens for common emotional and physical symptoms, emphasizing confidentiality and voluntary participation.
- Administer the 22-item scale via self-report, interview, or telephone in survey or clinical settings, rating symptoms over recent weeks.
- Estimated completion time is ~5 minutes (self-report) or 10–15 minutes (interview).
- Ensure a private, supportive environment; provide mental health resources (e.g., crisis hotlines) and adapt for accessibility (e.g., large print, oral administration) if needed.
Reliability and Validity
The 22-Item Screening Score demonstrates acceptable psychometric properties (Langner, 1962; Johnson & Meile, 1981). Internal consistency is good (Cronbach’s alpha = 0.77–0.83, omega = 0.80, N = 11,000), with stable results across age, sex, and education. Item-total correlations range from 0.17–0.54. One-week test-retest reliability is strong (r = 0.88, N not specified). Four-year test-retest for a 10-item psychological subscale yields path coefficients of 0.68–0.81 (N = 613, 250).
Convergent validity is supported by correlations with psychiatric impairment ratings (r = 0.41–0.79, N = 1,660), Taylor’s Manifest Anxiety Scale (r = 0.77, N = 566), MMPI depression score (r = 0.72), Eysenck’s Neuroticism Scale (r = 0.72), and a 45-item behavioral symptom scale (r = 0.65). Factor analysis identifies three factors (physical, psychological, psychophysiological). Discriminant validity is shown by distinguishing psychiatric inpatients from community samples, though sensitivity (67%) and specificity (63%) at a cutoff of 4 are modest, improving to 20% and 96% at a cutoff of 10. Positive predictive value is low (13–21%). Pairing with the Beck Depression Inventory or General Health Questionnaire enhances comprehensive assessment.
Available Versions
22-Items
Reference
Langner, T. S. (1962). A twenty-two item screening score of psychiatric symptoms indicating impairment. Journal of Health and Human Behavior, 3(4), 269-276.
Important Link
Scale File:
Frequently Asked Questions
What does the 22-Item Screening Score measure?
It screens for neurotic and psychosomatic symptoms indicating psychiatric impairment.
Who is the target population?
Adults (18+) in community or clinical settings for epidemiological screening.
How long does it take to administer?
Approximately 5 minutes (self-report) or 10–15 minutes (interview).
Can it inform interventions?
Yes, it identifies at-risk individuals for mental health interventions.
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