Psychometric Properties of The Modified Overt Aggression Scale (MOAS): An In-Depth Analysis

The Modified Overt Aggression Scale (MOAS) is a reliable tool for assessing aggression, validated for various populations and effective in evaluating treatment efficacy.

The psychometric properties of assessment tools describe their reliability and accuracy. These properties are crucial for ensuring consistency, stability, and equivalency in measurements (Huang et al., 2009). Reliable and accurate assessment tools are essential in research, health assessments, and clinical practice. The Modified Overt Aggression Scale (MOAS) is widely used to measure aggression, with four sections assessing verbal aggression, aggression against property, auto-aggression, and physical aggression. This blog post explores the psychometric properties of MOAS, its appropriate use, and its effectiveness in measuring the efficacy of psychopharmacologic medications. A conclusion will summarize the findings.

Understanding the MOAS

The MOAS is a comprehensive tool used to assess different types of aggressive behavior. Developed from the original Overt Aggression Scale, the MOAS was modified to enhance its applicability and reliability in clinical settings. It consists of four sections:

  1. Verbal Aggression: Measures hostile verbal interactions.
  2. Aggression Against Property: Assesses destructive actions toward objects.
  3. Auto-Aggression: Evaluates self-harm behaviors.
  4. Physical Aggression: Measures physical violence towards others.

Each section helps clinicians and researchers identify and quantify various forms of aggression, making it a versatile tool in psychological and psychiatric evaluations.

Psychometric Properties of MOAS

1. Reliability

Reliability refers to the consistency of a measure. A reliable assessment tool yields consistent results under consistent conditions. Various studies have demonstrated the reliability of the MOAS in different settings.

  • Internal Consistency: The MOAS has shown adequate internal consistency, meaning that the items within each section are correlated and measure the same construct (Cohen et al., 2010).
  • Test-Retest Reliability: The MOAS has demonstrated high test-retest reliability, indicating that it produces stable results over time (Hornsveld et al., 2009).

2. Validity

Validity refers to the accuracy of a measure, or how well it measures what it is intended to measure. The MOAS has been validated in numerous studies, confirming its effectiveness in assessing aggression.

  • Construct Validity: The MOAS accurately measures the construct of aggression, as evidenced by its ability to differentiate between aggressive and non-aggressive individuals (Chukwujekwu, 2011).
  • Concurrent Validity: The MOAS correlates well with other established measures of aggression, supporting its concurrent validity (Margari et al., 2005).

Use of MOAS in Clinical and Research Settings

1. Assessing Aggression in Individuals with Intellectual Disabilities

Individuals with intellectual disabilities often exhibit aggressive behaviors. The MOAS has been used extensively to assess aggression in this population. For example, Cohen et al. (2009) conducted a large-scale study using the MOAS to assess aggression in females with autism spectrum disorder (ASD). The study found that the MOAS effectively measured the type and severity of aggression in this population.

2. Global Assessment of Aggression

Unlike incident-specific tools, the MOAS is designed for global assessment, making it effective in measuring overall aggression frequencies. Tyrer et al. (2016) highlighted the MOAS’s utility in providing a comprehensive assessment of aggressive behavior, rather than focusing on isolated incidents.

3. Modifications and Customizations

The MOAS can be modified to suit individual needs, enhancing its versatility. For instance, sections can be added to assess antecedents and consequences of aggressive behavior (Cohen et al., 2010). These modifications, however, require validation to ensure the tool’s reliability and validity remain intact.

4. Efficacy in Different Populations

Hornsveld et al. (2009) used the MOAS to assess aggression in adults and found verbal aggression to be the most common form. Their study also revealed that the extent of verbal aggression decreased with age. This highlights the MOAS’s effectiveness in different age groups and its adaptability for various populations.

Assessing the Efficacy of Psychopharmacologic Medications

Medication adherence is a significant challenge in individuals with mental illness. The MOAS has proven to be an efficient tool for assessing the efficacy of psychopharmacologic medications. Seemüller et al. (2012) compared the efficacy of psychopharmacologic drugs to general medications using the MOAS. The findings indicated a consistent decrease in aggressive behavior among patients on psychopharmacologic medications, demonstrating the MOAS’s utility in monitoring treatment outcomes.

Expanded Insights on MOAS Applications

1. Longitudinal Studies on Aggression

Longitudinal studies have employed the MOAS to track changes in aggression over time. These studies have provided valuable insights into the progression and treatment of aggressive behaviors. For instance, using the MOAS in longitudinal research can help identify patterns and predictors of aggression, informing intervention strategies.

2. Cross-Cultural Validation

Cross-cultural validation of the MOAS is essential to ensure its applicability in diverse populations. Huang et al. (2009) conducted a study on the Chinese version of the MOAS, demonstrating its reliability and validity in a different cultural context. This highlights the importance of adapting and validating the MOAS for use in various cultural settings.

3. Integration with Other Assessment Tools

Integrating the MOAS with other assessment tools can provide a comprehensive evaluation of aggression. Combining the MOAS with tools that assess other psychological constructs, such as anxiety or depression, can offer a holistic view of an individual’s mental health. This integrated approach can enhance the accuracy of diagnoses and the effectiveness of treatment plans.

Conclusion

The Modified Overt Aggression Scale (MOAS) is a robust tool for measuring aggression in various settings. Its reliability and validity have been demonstrated in numerous studies, confirming its utility in clinical practice and research. The MOAS can be customized to meet individual needs, and it effectively assesses the efficacy of psychopharmacologic medications. The evidence discussed in this blog post underscores the MOAS’s value as a reliable and valid assessment tool for aggression.

References

Chukwujekwu, D. C., & Stanley, P. C. (2011). Prevalence and correlates of aggression among psychiatric in-patients at Jos University Teaching Hospital. Nigerian Journal of Clinical Practice, 14(2), 163-167.

Cohen, I. L., Tsiouris, J. A., Flory, M. J., Kim, S. Y., Freedland, R., Heaney, G., … & Brown, W. T. (2010). A large scale study of the psychometric characteristics of the IBR modified overt aggression scale: Findings and evidence for increased self-destructive behaviors in adult females with autism spectrum disorder. Journal of autism and developmental disorders, 40(5), 599-609.

Hornsveld, R. H., Muris, P., Kraaimaat, F. W., & Meesters, C. (2009). Psychometric properties of the aggression questionnaire in Dutch violent forensic psychiatric patients and secondary vocational students. Assessment, 16(2), 181-192.

Huang, H. C., Wang, Y. T., Chen, K. C., Yeh, T. L., Lee, I. H., Chen, P. S., … & Lu, R. B. (2009). The reliability and validity of the Chinese version of the Modified Overt Aggression Scale. International journal of psychiatry in clinical practice, 13(4), 303-306.

Margari, F., Matarazzo, R., Casacchia, M., Roncone, R., Dieci, M., Safran, S., … & Simoni, L. (2005). Italian validation of MOAS and NOSIE: a useful package for psychiatric assessment and monitoring of aggressive behaviours. International journal of methods in psychiatric research, 14(2), 109-118.

Oliver, P. C., Crawford, M. J., Rao, B., Reece, B., & Tyrer, P. (2007). Modified Overt Aggression Scale (MOAS) for people with intellectual disability and aggressive challenging behaviour: a reliability study. Journal of Applied Research in Intellectual Disabilities, 20(4), 368-372.

Seemüller, F., Möller, H. J., Dittmann, S., & Musil, R. (2012). Is the efficacy of psychopharmacological drugs comparable to the efficacy of general medicine medication?. BMC medicine, 10(1), 17.

Tyrer, P., Nagar, J., Evans, R., Oliver, P., Bassett, P., Liedtka, N., & Tarabi, A. (2016). The Problem Behaviour Checklist: short scale to assess challenging behaviours. BJPsych open, 2(1), 45-49.