The emotional lability questionnaire: a new measure of emotional lability in amyotrophic lateral sclerosis

In an ALS Clinic, use of the Pathological Laughter and Crying Scale of Robi nson et al. [Robinson RG, Parikh RM, Lipsey JR, Starkstein SE, Price TR. Pa thological laughter and crying following stroke: validation of a measuremen t scale and double-blind-treatment study. American Journal of Psychiatry 19 93;150(2):286-243] revealed several problems: reliance on self-rating, insu fficient period of assessment, inadequate exploration of 'appropriateness o f emotion', lack of an item for abnormal smiling, amusement rather than hap piness being the cause of laughter in ALS, and a frequency-based rating sys tem. The necessary modifications produced a new Emotional Lability Question naire (ELQ) that was tested in 43 ALS patients and 43 healthy controls. The self-rated version of the ELQ was administered as a structured interview t o each participant, and the independent-relationship between subscales of t he ELQ for both versions, thus confirming its internal validity. Greater em otional lability appeared associated with pseudobulbar symptoms. The questi on why 14 patients rated themselves as severely labile in the crying domain alone and four in the laughter domain alone, required further study. (C) 1 999 Elsevier Science B.V. All rights reserved.