The Turkish version of the Modified Agitation Severity Scale: validity and reliability study

Abstract

Objective This study aimed to evaluate the validity and reliability of the Turkish version of the Modified Agitation Severity Scale (MASS) among patients diagnosed with schizophrenia and bipolar disorder. Methods The study was conducted in the acute male psychiatry unit of a regional mental health hospital in Istanbul, with 136 patients who met the inclusion criteria. The adaptation process involved translation, back‐translation, expert review, and pilot testing. Reliability analyses included the Kuder–Richardson Formula 20 (KR‐20) for dichotomous scoring and Cronbach's alpha for weighted scoring. Item–total correlations and “alpha if item deleted” values were examined. Construct validity was assessed through correlations with the Overt Aggression Scale (OAS). Criterion validity was evaluated by comparing MASS scores between patients who required clinical intervention and those who did not. Results The Turkish MASS demonstrated strong internal consistency (KR‐20 = 0.863; Cronbach's alpha = 0.828). Item–total correlations were within acceptable ranges. Significant positive correlations were observed between MASS total scores and OAS subscale scores ( r = 0.324–0.816), supporting construct validity. Patients who required intervention had significantly higher MASS scores than those who did not (17.57 ± 10.01 vs. 2.58 ± 2.55; p < 0.001), confirming criterion‐related validity. Conclusion The Turkish version of the MASS is a valid, reliable, and practical instrument for assessing agitation in psychiatric settings. It offers an objective and standardized method that supports timely detection, early intervention, and improved patient safety.