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Abnormal Involuntary Movement Scale
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About Abnormal Involuntary Movement Scale
Scale Name
Abnormal Involuntary Movement Scale
Author Details
William Guy
Translation Availability
English
Background/Description
The Abnormal Involuntary Movement Scale (AIMS) is a standardized clinician-administered tool designed to assess the presence and severity of abnormal involuntary movements, particularly those associated with tardive dyskinesia (TD), a side effect of long-term antipsychotic medication use. Developed by William Guy in 1976 as part of the ECDEU Assessment Manual for Psychopharmacology, the AIMS was created to provide a systematic method for monitoring movement disorders in psychiatric patients, especially those treated with neuroleptics. Its introduction marked a critical advancement in psychopharmacology, enabling clinicians to detect and manage medication-related side effects with greater precision.
The AIMS consists of 12 items, with the first 10 focusing on specific body regions (e.g., face, lips, jaw, tongue, upper and lower extremities, trunk) and overall movement severity, scored on a 5-point scale (0 = “none” to 4 = “severe”). The final two items address global judgments about the patient’s condition, including incapacitation and awareness of movements. Total scores range from 0 to 40 for the primary items, with higher scores indicating more severe dyskinesia. The scale is typically administered through direct observation and brief patient interaction, often following standardized prompts to elicit movements. Its validation involved diverse clinical populations, ensuring its applicability in psychiatric settings.
For psychologists, psychiatrists, and neurologists, the AIMS is an indispensable tool for routine monitoring of patients on antipsychotics, aiding in early detection of TD and guiding decisions about medication adjustments or adjunctive treatments. Its structured format and focus on observable symptoms make it accessible to trained professionals, while its translations enhance its utility across global healthcare systems. By offering a clear framework to evaluate movement disorders, the AIMS supports patient safety and quality of care in psychopharmacological treatment.
Administration, Scoring and Interpretation
- Obtain a copy of the Abnormal Involuntary Movement Scale from a reputable source, such as government health publications or authorized medical resources, ensuring proper use permissions.
- Explain the purpose of the AIMS to the patient, clarifying that it assesses involuntary movements to monitor medication side effects and ensure their well-being.
- Provide instructions, guiding the clinician to observe the patient’s movements in specified body regions, using standardized prompts (e.g., asking the patient to walk or hold their hands outstretched) and rating each item.
- Approximate time for completion is about 5-10 minutes, depending on the clinician’s experience and the patient’s cooperation.
- Administer the scale in a well-lit, private setting, allowing clear observation of movements, with the patient seated and relaxed to minimize voluntary actions.
Reliability and Validity
The Abnormal Involuntary Movement Scale demonstrates solid psychometric properties, supporting its use in clinical monitoring. Inter-rater reliability is high, with intraclass correlation coefficients ranging from 0.85 to 0.92 among trained clinicians, reflecting consistent scoring across observers. Test-retest reliability is moderate to strong, with correlations of 0.70-0.82 over short intervals in stable patients, indicating dependable measurement of involuntary movements.
Validity evidence is robust. Concurrent validity is shown through strong correlations with other dyskinesia measures, such as the Simpson-Angus Scale for extrapyramidal symptoms (r = 0.60-0.75). Discriminant validity is supported by its ability to differentiate tardive dyskinesia from other movement disorders, like parkinsonism, with lower correlations to unrelated scales (r < 0.40). Criterion validity is evidenced by its sensitivity to changes in TD severity, such as worsening with prolonged antipsychotic use or improvement with dose reduction. These properties confirm the AIMS as a reliable and valid tool for assessing medication-induced movement disorders.
Available Versions
12-Items
Reference
Guy, W. (1976). ECDEU assessment manual for psychopharmacology. US Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, Psychopharmacology Research Branch, Division of Extramural Research Programs.
Important Link
Scale File:
Frequently Asked Questions
What does the AIMS measure?
It assesses involuntary movements, especially tardive dyskinesia, from antipsychotics.
Who administers the AIMS?
Trained clinicians, like psychiatrists or neurologists, use it.
How long does the AIMS take to complete?
It takes about 5-10 minutes.
Is the AIMS used only for tardive dyskinesia?
It’s primarily for TD but can detect other involuntary movements.
Can the AIMS guide treatment decisions?
Yes, it helps monitor side effects and adjust medications.
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