Key Takeaways
Extended Takeaways
- In this sample of 14 psychosis self-report instruments, every instruction and item section exceeded the recommended sixth-grade threshold, suggesting that even brief screening tools may impose a literacy burden at the point of care.
- The average reading demand was similar for instructions and items—9.08 (SD = 1.44, range, 7.13–10.70) versus 9.06 (SD = 1.98, range, 7.08–13.79)—so simplifying only the directions is unlikely to make these measures broadly accessible.
- A high school reading level or above was required in 8 of 14 measures (62%), which may be especially problematic in psychosis populations where cognitive and attentional impairments can further reduce questionnaire completion accuracy.
- Readability varied substantially across tools: the PQ-16 had the lowest scores (instructions averaging 7.13 and items averaging 7.77), while the PROD had the most complex items at 13.79, so measure selection may affect feasibility when literacy is a concern.
- Among the readability methods used, FORCAST produced the highest mean grade level at 10.50 compared with 7.70 for Gunning Fog, 8.50 for SMOG, and 8.42 for Flesch Reading Ease, indicating that perceived accessibility can differ depending on which index is used.
