The Persian Altman Self-rating Mania Scale (ASRM): Psychometric Assessment in Bipolar Spectrum Disorder

Abstract

Background: The Altman Self-rating Mania Scale (ASRM) is a brief instrument used for screening, repeated symptom monitoring, and research purposes. Objectives: This study aimed to translate, adapt, and validate the Persian version of the ASRM to address the lack of self-assessment tools for mania in Iran. Methods: This cross-sectional study, conducted using a convenience sampling method, involved 200 participants who were selected to take part in the study. The ASRM underwent forward-backward translation by bilingual experts. Participants completed the ASRM, 32-item Hypomania Checklist (HCL-32), and Patient Mania Questionnaire-9 (PMQ-9) during a single session. Psychometric testing included assessments of reliability, validity, and factor structure. Results: The Persian ASRM demonstrated strong psychometric properties in our clinical sample (N = 200). The scale showed good internal consistency (Cronbach’s α = 0.74) and excellent test-retest reliability [intraclass correlation coefficient (ICC) = 0.82] over a one-week interval. Convergent validity was established through significant correlations with established measures: The PMQ-9 (R = 0.43, P < 0.001) and HCL-32 (R = 0.43, P < 0.001). Discriminant validity was confirmed by a non-significant correlation with the Spontaneous Use of Mental Imagery Scale (SUIS; R = 0.08, P = 0.61). Factor analysis revealed a unidimensional structure explaining 41.7% of the variance [Kaiser-Meyer-Olkin (KMO) = 0.72; Bartlett’s χ2 = 114.6, P < 0.001], consistent with the construct of the original scale. All items showed adequate item–total correlations (0.33 - 0.47) and contributed meaningfully to the total score. Conclusions: The ASRM serves as a reliable self-report tool, offering both validity and reliability in identifying and measuring the intensity of manic symptoms. The Altman Scale represents a validated self-assessment instrument with demonstrated reliability in screening for and measuring the severity of manic symptoms. It enables quick and straightforward evaluations of patients’ conditions and is suitable for research, clinical, and screening purposes. Its practical design supports brief yet effective assessments, allowing for versatile use in research settings, clinical evaluations, and screening programs.