METHODOLOGICAL CONSIDERATIONS IN THE REFINEMENT OF CLINICAL-ASSESSMENT INSTRUMENTS

Instrument refinement refers to any set of procedures designed to impr ove an instrument's representation of a construct. Though often neglec ted, it is essential to the development of reliable and valid measures . Five objectives of instrument refinement are proposed: identificatio n of measures' hierarchical or aggregational structure, establishment of internal consistency of undimensional facets of measures, determina tion of content homogeneity of undimensional facets, inclusion of item s that discriminate at the desired level of attribute intensity, and r eplication of instrument properties on an independent sample. The use of abbreviated scales is not recommended. The refinement of behavioral observation procedures is discussed, and the role of measure refineme nt in theory development is emphasized.