Web-based measure of life events using Computerized Life Events and Assessment Record (CLEAR): preliminary cross-sectional study of reliability, validity, and association with depression

Article

Bifulco, A., Spence, R., Nunn, S., Kagan, L., Bailey-Rodriguez, D., Hosang, G., Taylor, M. and Fisher, H. 2019. Web-based measure of life events using Computerized Life Events and Assessment Record (CLEAR): preliminary cross-sectional study of reliability, validity, and association with depression. JMIR Mental Health. 6 (1). https://doi.org/10.2196/10675
TypeArticle
TitleWeb-based measure of life events using Computerized Life Events and Assessment Record (CLEAR): preliminary cross-sectional study of reliability, validity, and association with depression
AuthorsBifulco, A., Spence, R., Nunn, S., Kagan, L., Bailey-Rodriguez, D., Hosang, G., Taylor, M. and Fisher, H.
Abstract

Background: Given the criticisms of life event checklists and the costs associated with interviews, life event research requires a sophisticated but easy-to-use measure for research and clinical practice. Therefore, the Computerised Life Events and Assessment Record (CLEAR), based on the Life Events and Difficulties Schedule (LEDS), was developed.
Objectives: To test CLEAR’s reliability, validity, and association with depression.
Methods: CLEAR, the General Health Questionnaire, and the List of Threatening Experiences Questionnaire (LTE-Q) were completed by 328 participants (126 students; 202 matched midlife sample: 127 unaffected controls, 75 recurrent depression cases). Test-retest reliability over 3-4 weeks was examined, and validity determined by comparing CLEAR with LEDS and LTE-Q. Both CLEAR and LTE-Q were examined in relation to depression.
Results: CLEAR demonstrated good test-retest reliability for overall number of life events (.89) and severe life events (.60). Long-term problems showed similar findings. In terms of validity, CLEAR severe life events had moderate sensitivity (59.1%) and specificity (65.4%) when compared to LEDS. CLEAR demonstrated moderate sensitivity (43.1%) and specificity (78.6%) when compared to LTE-Q. CLEAR severe life events and long term problems were significantly associated with depression (OR = 3.50, 95% CI: 2.10-5.85, P < .001; OR = 3.38, 95% CI: 2.02-5.67, P < .001, respectively) whereas LTE-Q events were not (OR=1.06, 95% CI: .43-2.60, P =.90).
Conclusions: CLEAR has acceptable reliability and validity and predicts depression. It therefore has great potential for effective use in research and clinical practice identifying stress-related factors for the onset and maintenance of depression and related disorders.

Keywordsdepression; life change events; life stress; health technology; internet; psychometrics; psychological tests
Research GroupCentre for Abuse and Trauma Studies (CATS)
PublisherJMIR Publications
JournalJMIR Mental Health
ISSN2368-7959
Electronic2368-7959
Publication dates
Online08 Jan 2019
PrintJan 2019
Publication process dates
Deposited05 Sep 2018
Accepted26 Jul 2018
Output statusPublished
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Copyright Statement

© Antonia Bifulco, Ruth Spence, Stephen Nunn, Lisa Kagan, Deborah Bailey-Rodriguez, Georgina M Hosang, Matthew Taylor, Helen L Fisher. Originally published in JMIR Mental Health (http://mental.jmir.org), 08.01.2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on http://mental.jmir.org/ , as
well as this copyright and license information must be included.

Digital Object Identifier (DOI)https://doi.org/10.2196/10675
Web of Science identifierWOS:000455251900001
LanguageEnglish
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Bifulco, A., Schimmenti, A., Jacobs, C., Bunn, A. and Rusu, A. 2014. Risk factors and psychological outcomes of bullying victimization: a community-based study. Child Indicators Research. https://doi.org/10.1007/s12187-014-9236-8
Adverse childhood experiences and their impact on frequency, severity, and the individual function of nonsuicidal self-injury in youth
Kaess, M., Parzer, P., Mattern, M., Plener, P., Bifulco, A., Resch, F. and Brunner, R. 2013. Adverse childhood experiences and their impact on frequency, severity, and the individual function of nonsuicidal self-injury in youth. Psychiatry Research. 206 (2-3), pp. 265-272. https://doi.org/10.1016/j.psychres.2012.10.012
Life events
Bifulco, A. 2013. Life events. in: Gabe, J. and Monaghan, L. (ed.) Key concepts in medical sociology London, UK SAGE Publications. pp. 45-50
Setting up a youth violence prevention project in a London hospital emergency department
Ilan-Clarke, Y., Bunn, A., DeMarco, J., Bifulco, A., Criddle, J. and Holdsworth, G. 2013. Setting up a youth violence prevention project in a London hospital emergency department. Journal of Public Mental Health. 12 (2), pp. 80-92. https://doi.org/10.1108/JPMH-09-2012-0005
Understanding alexithymia in female adolescents: the role of attachment style
Oskis, A., Clow, A., Hucklebridge, F., Bifulco, A., Jacobs, C. and Loveday, C. 2013. Understanding alexithymia in female adolescents: the role of attachment style. Personality and Individual Differences. 54 (1), pp. 97-102. https://doi.org/10.1016/j.paid.2012.08.023
Psychiatrie infantojuvénile en Europe: 68 Grande-Bretagne
Bifulco, A. and Thomas, G. 2012. Psychiatrie infantojuvénile en Europe: 68 Grande-Bretagne. in: Ferrari, P. and Bonnot, O. (ed.) Traité européen de psychiatrie et de psychopathologie de l'enfant et de l'adolescent Paris Lavoisier. pp. 691-697
Caring about attachment in young people in residential care: the use of the attachment style interview. Report of a voluntary sector and university partnership
Jacobs, C., Ilan-Clarke, Y. and Bifulco, A. 2012. Caring about attachment in young people in residential care: the use of the attachment style interview. Report of a voluntary sector and university partnership. Community Care Inform.
Vulnerability, life events and depression amongst Moslem Malaysian women: comparing those married and those divorced or separated
Abdul Kadir, N. and Bifulco, A. 2011. Vulnerability, life events and depression amongst Moslem Malaysian women: comparing those married and those divorced or separated. Social Psychiatry and Psychiatric Epidemiology. 46 (9), pp. 853-862. https://doi.org/10.1007/s00127-010-0249-4
Attachment style and psychological adjustment in couples
Conde, A., Figueirido, B. and Bifulco, A. 2011. Attachment style and psychological adjustment in couples. Attachment & Human Development. 13 (3), pp. 271-291. https://doi.org/10.1080/14616734.2011.562417
Condividere e condividere allo stesso modo.Il maltrattamento è un’esperienza condivisa dai fratelli? [= To share and share alike: is maltreatment an experience shared by siblings?]
Bifulco, A., Ilan-Clarke, Y., Hannan, L. and Schimmenti, A. 2008. Condividere e condividere allo stesso modo.Il maltrattamento è un’esperienza condivisa dai fratelli? [= To share and share alike: is maltreatment an experience shared by siblings?]. Noos – Aggiornamenti in Psichiatria. 3, pp. 253-274.
Quando i genitori maltrattano i figli. Le radici psicopatologiche dello sviluppo affettivo (When the parents maltreat their young: the developmental roots of psychopathology)
Schimmenti, A. and Bifulco, A. 2008. Quando i genitori maltrattano i figli. Le radici psicopatologiche dello sviluppo affettivo (When the parents maltreat their young: the developmental roots of psychopathology). in: Caretti, V. and Creparo, G. (ed.) Trauma e psicopatologia. Un approccio evolutivo-relazionale Rome Astrolabi. pp. 94-131
Le esperienze di maltrattamento vissute dai fratelli: tra ambiente condiviso e non condiviso
Schimmenti, A. and Bifulco, A. 2010. Le esperienze di maltrattamento vissute dai fratelli: tra ambiente condiviso e non condiviso. in: Schimmenti, V. (ed.) Oltre la madre: relazioni familiari e sviluppo psicologico Milan, Italy FrancoAngeli. pp. 114-129
Loss trauma
Bifulco, A. 2007. Loss trauma. in: Encyclopedia of Stress Academic Press. pp. 612-615
Il bambino maltrattato: le radici della depressione nel trauma e nell'abuso infantile
Bifulco, A. and Moran, P. 2007. Il bambino maltrattato: le radici della depressione nel trauma e nell'abuso infantile. Rome Astrolabio Ubaldini.
Familial patterns of stress
Bifulco, A. 2007. Familial patterns of stress. in: Fink, G. (ed.) Encyclopedia of Stress Academic Press. pp. 1-6
Wednesday's child: research into women's experience of neglect and abuse in childhood and adult depression
Bifulco, A. and Moran, P. 1998. Wednesday's child: research into women's experience of neglect and abuse in childhood and adult depression. London, U.K. Routledge.
Risk and resilience in young Londoners
Bifulco, A. 2009. Risk and resilience in young Londoners. in: Brom, D., Pat-Horenczyk, R. and Ford, J. (ed.) Treating traumatized children: risk, resilience and recovery Hove, U.K. Routledge. pp. 117-130
Depressed mothers and their children: attachment issues
Bifulco, A. 2010. Depressed mothers and their children: attachment issues. in: Kohen, D. (ed.) Oxford Textbook of Women and Mental Health Oxford, U.K. Oxford University Press (OUP). pp. 271-277
Predicting onset of depression: the vulnerability to depression questionnaire
Moran, P., Bifulco, A., Ball, C. and Campbell, C. 2001. Predicting onset of depression: the vulnerability to depression questionnaire. British Journal of Clinical Psychology. 40 (4), pp. 411-427. https://doi.org/10.1348/014466501163896
History of childhood abuse in Portuguese parents
Figuieredo, B., Bifulco, A., Paivia, C., Maia, A., Fernandes, E. and Matos, R. 2004. History of childhood abuse in Portuguese parents. Child Abuse and Neglect. 28 (6), pp. 669-682. https://doi.org/10.1016/j.chiabu.2003.11.021
Maternal attachment style and depression associated with childbirth ; preliminary results from a European and US cross-cultural study
Bifulco, A., Figueiredo, B., Guedeney, N., Gorman, L., Hayes, S., Muzik, M., Glatigny-Dallay, E., Valoriani, V., Kammerer, M. and Henshaw, C. 2004. Maternal attachment style and depression associated with childbirth ; preliminary results from a European and US cross-cultural study. The British Journal of Psychiatry. 184, pp. s31-s37.
Attachment style measurement: a clinical and epidemiological perspective
Bifulco, A. 2002. Attachment style measurement: a clinical and epidemiological perspective. Attachment & Human Development. 4 (2), pp. 180-188. https://doi.org/10.1080/14616730210157501
Lifetime stressors and recurrent depression: preliminary findings of the Adult Life Phase Interview (ALPHI)
Bifulco, A., Bernazzani, O., Moran, P. and Ball, C. 2000. Lifetime stressors and recurrent depression: preliminary findings of the Adult Life Phase Interview (ALPHI). Social Psychiatry and Psychiatric Epidemiology. 35 (6), pp. 264-275. https://doi.org/10.1007/s001270050238
Motherhood as a vulnerability factor in major depression: the role of negative pregnancy experiences
Bernazzani, O. and Bifulco, A. 2003. Motherhood as a vulnerability factor in major depression: the role of negative pregnancy experiences. Social Science & Medicine. 56 (6), pp. 1249-1260. https://doi.org/10.1016/S0277-9536(02)00123-5
Malaysian moslem mothers' experience of depression and service use
Abdul Kadir, N. and Bifulco, A. 2010. Malaysian moslem mothers' experience of depression and service use. Culture, Medicine, and Psychiatry. 34 (3), pp. 443-467. https://doi.org/10.1007/s11013-010-9183-x
Exploring psychological abuse in childhood. I: developing a new interview scale
Moran, P., Bifulco, A., Ball, C., Jacobs, C. and Benaim, K. 2002. Exploring psychological abuse in childhood. I: developing a new interview scale. Bulletin of the Menninger Clinic. 66 (Summer), pp. 213-240.
Childhood experiences of care and abuse (CECA): validierung der Deutschen version des fragebogenund korrespondierenden Interview sowie Ergebnisse einer Untersuchung von Zusammenhangen belastenader Kindheitserlebnisse mit suizdalen Verhaltensweisen
Kaess, M., Parzer, P., Mattern, M., Resch, F., Bifulco, A. and Brunner, R. 2011. Childhood experiences of care and abuse (CECA): validierung der Deutschen version des fragebogenund korrespondierenden Interview sowie Ergebnisse einer Untersuchung von Zusammenhangen belastenader Kindheitserlebnisse mit suizdalen Verhaltensweisen. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie. 39 (4), pp. 243-252. https://doi.org/10.1024/1422-4917/a000115
Investigating police practice in the UK: achieving best evidence in work with young victims of abuse
Davidson, J. and Bifulco, A. 2009. Investigating police practice in the UK: achieving best evidence in work with young victims of abuse. Pakistan Journal of Criminology. 1 (3), pp. 19-46.
Childhood experience and sexual offending: the use of the Childhood Experience of Care and Abuse (CECA) interview in forensic psychology research and practice
Bifulco, A. 2006. Childhood experience and sexual offending: the use of the Childhood Experience of Care and Abuse (CECA) interview in forensic psychology research and practice. in: Pham, T. (ed.) L'évaluation diagnostique des agresseurs sexuels Belgium Mardaga Pierre.
Early adversity and depression
Bifulco, A. 2009. Early adversity and depression. in: Ingram, R. (ed.) The International Encyclopedia of Depression New York Springer Publishing Company.
Multi-agency working: Implications for an early-intervention social work team
Moran, P., Jacobs, C., Bunn, A. and Bifulco, A. 2007. Multi-agency working: Implications for an early-intervention social work team. Child & Family Social Work. 12 (2), pp. 143-151. https://doi.org/10.1111/j.1365-2206.2006.00452.x
Teenage pregnancy, attachment style, and depression: a comparison of teenage and adult pregnant women in a Portuguese series
Figueiredo, B., Bifulco, A., Pacheco, A., Costa, R. and Magarinho, R. 2006. Teenage pregnancy, attachment style, and depression: a comparison of teenage and adult pregnant women in a Portuguese series. Attachment & Human Development. 8 (2), pp. 123-138. https://doi.org/10.1080/14616730600785686
Solutions on Stress (SOS): programmes, packages and products for helping teenagers
Bunn, A., Bifulco, A., Lorenc, A. and Robinson, N. 2007. Solutions on Stress (SOS): programmes, packages and products for helping teenagers. Young Consumers: Insight and Ideas for Responsible Marketers. 8 (1), pp. 29-35. https://doi.org/10.1108/17473610710733758
Exploring psychological abuse in childhood: II. Association with other abuse and adult clinical depression
Bifulco, A., Moran, P., Baines, R., Bunn, A. and Stanford, K. 2002. Exploring psychological abuse in childhood: II. Association with other abuse and adult clinical depression. Bulletin of the Menninger Clinic. 66 (3), pp. 241-258.
The childhood experience of care and abuse questionnaire (CECA.Q): validation in a community series
Bifulco, A., Bernazzani, O., Moran, P. and Jacobs, C. 2005. The childhood experience of care and abuse questionnaire (CECA.Q): validation in a community series. British Journal of Clinical Psychology. 44 (4), pp. 563-581.
The Vulnerable Attachment Style Questionnaire (VASQ): an interview-based measure of attachment styles that predict depressive disorder
Bifulco, A., Mahon, J., Kwon, J., Moran, P. and Jacobs, C. 2003. The Vulnerable Attachment Style Questionnaire (VASQ): an interview-based measure of attachment styles that predict depressive disorder. Psychological Medicine. 33 (6), pp. 1099-1110. https://doi.org/10.1017/S0033291703008237
Problem partners and parenting: exploring linkages with maternal insecure attachment style and adolescent offspring internalizing disorder
Bifulco, A., Moran, P., Jacobs, C. and Bunn, A. 2009. Problem partners and parenting: exploring linkages with maternal insecure attachment style and adolescent offspring internalizing disorder. Attachment & Human Development. 11 (1), pp. 69-85. https://doi.org/10.1080/14616730802500826
Child victims of sexual abuse: children's experience of the investigative process in the criminal justice system
Davidson, J., Bifulco, A., Thomas, G. and Ramsay, M. 2006. Child victims of sexual abuse: children's experience of the investigative process in the criminal justice system. Practice: Social Work in Action. 18 (4), pp. 247-263. https://doi.org/10.1080/09503150601025253
Adult attachment style as mediator between childhood neglect/abuse and adult depression and anxiety
Bifulco, A., Kwon, J., Jacobs, C., Moran, P., Bunn, A. and Beer, N. 2006. Adult attachment style as mediator between childhood neglect/abuse and adult depression and anxiety. Social Psychiatry and Psychiatric Epidemiology. 41 (10), pp. 796-805. https://doi.org/10.1007/s00127-006-0101-z
Childhood adversity, parental vulnerability and disorder: examining intergenerational transmission of risk
Bifulco, A., Moran, P., Ball, C., Jacobs, C., Baines, R., Bunn, A. and Cavagin, J. 2002. Childhood adversity, parental vulnerability and disorder: examining intergenerational transmission of risk. Journal of Child Psychology and Psychiatry. 43 (8), pp. 1075-1086. https://doi.org/10.1111/1469-7610.00234
The Attachment Style Interview (ASI): a support-based adult assessment tool for adoption and fostering practice
Bifulco, A., Jacobs, C., Bunn, A., Thomas, G. and Irving, K. 2008. The Attachment Style Interview (ASI): a support-based adult assessment tool for adoption and fostering practice. Adoption and Fostering. 32 (3), pp. 33-45. https://doi.org/10.1177/030857590803200306
Adult Attachment Style. II: Its relationship to psychosocial depressive-vulnerability
Bifulco, A., Moran, P., Ball, C. and Lillie, A. 2002. Adult Attachment Style. II: Its relationship to psychosocial depressive-vulnerability. Social Psychiatry and Psychiatric Epidemiology. 37 (2), pp. 60-67. https://doi.org/10.1007/s127-002-8216-x
Adult attachment style. I: Its relationship to clinical depression
Bifulco, A., Moran, P., Ball, C. and Bernazzani, O. 2002. Adult attachment style. I: Its relationship to clinical depression. Social Psychiatry and Psychiatric Epidemiology. 37 (2), pp. 50-59. https://doi.org/10.1007/s127-002-8215-0
Assessing psychosocial risk in pregnant/postpartum women using the Contextual Assessment of Maternity Experience (CAME)
Bernazzani, O., Marks, M., Bifulco, A., Siddle, K., Asten, P. and Conroy, S. 2005. Assessing psychosocial risk in pregnant/postpartum women using the Contextual Assessment of Maternity Experience (CAME). Social Psychiatry and Psychiatric Epidemiology. 40 (6), pp. 497-508. https://doi.org/10.1007/s00127-005-0917-y
Problem partners and parenting: exploring linkages with maternal insecure attachment style and adolescent offspring internalizing disorder
Bifulco, A., Moran, P., Jacobs, C. and Bunn, A. 2009. Problem partners and parenting: exploring linkages with maternal insecure attachment style and adolescent offspring internalizing disorder. Attachment & Human Development. 11 (1), pp. 69-85. https://doi.org/10.1080/14616730802500826
Concordance between mother and offspring retrospective reports of childhood adversity
Fisher, H., Bunn, A., Jacobs, C., Moran, P. and Bifulco, A. 2011. Concordance between mother and offspring retrospective reports of childhood adversity. Child Abuse and Neglect. 35 (2), pp. 117-122. https://doi.org/10.1016/j.chiabu.2010.10.003
The longitudinal psychometric properties of the EAS temperament survey in adolescence
Spence, R., Owens, M. and Goodyer, I. 2013. The longitudinal psychometric properties of the EAS temperament survey in adolescence. Journal of Personality Assessment. 95 (6), pp. 633-639. https://doi.org/10.1080/00223891.2013.819513
Item response theory and validity of the NEO-FFI in adolescents
Spence, R., Owens, M. and Goodyer, I. 2012. Item response theory and validity of the NEO-FFI in adolescents. Personality and Individual Differences. 53 (6), pp. 801-807. https://doi.org/10.1016/j.paid.2012.06.002
Understanding adult attachment in family relationships: assessment and intervention
Bifulco, A. and Thomas, G. 2012. Understanding adult attachment in family relationships: assessment and intervention. Routledge.
Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders
Fortune, Z., Barrett, B., Armstrong, D., Coid, J., Crawford, M., Mudd, D., Rose, D., Slade, M., Spence, R., Tyrer, P. and Moran, P. 2011. Clinical and economic outcomes from the UK pilot psychiatric services for personality-disordered offenders. International Review of Psychiatry. 23 (1), pp. 61-69. https://doi.org/10.3109/09540261.2010.545989
An evaluation of new services for personality-disordered offenders: staff and service user perspectives
Fortune, Z., Rose, D., Crawford, M., Slade, M., Spence, R., Mudd, D., Barrett, B., Coid, J., Tyrer, P. and Moran, P. 2010. An evaluation of new services for personality-disordered offenders: staff and service user perspectives. International Journal of Social Psychiatry. 56 (2), pp. 186-195. https://doi.org/10.1177/0020764009105281
Fostering reflective thinking with the Learning Achievement Self-Evaluation Record (LASER)
Coulson, M., Torrance, S. and Nunn, S. 2007. Fostering reflective thinking with the Learning Achievement Self-Evaluation Record (LASER). Psychology Learning and Teaching Journal. 6 (1), pp. 12-19. https://doi.org/10.2304/plat.2007.6.1.12