Katz Adjustment Scales (KAS)

1. Abstract

The Katz Adjustment Scales (KAS), originally formulated by psychometricians Martin M. Katz and Samuel B. Lyerly in 1963, constitute one of the foundational multi-informant assessment batteries developed to quantify the psychiatric symptomatology, social behavior, and community functioning of psychiatric outpatients, pre-psychotic individuals, and post-hospitalized patients. Conceived during the nascent stages of the deinstitutionalization movement in American psychiatry, the KAS was specifically engineered to bridge the clinical evaluative gap between inpatient psychiatric observation and outpatient functioning in the patient’s natural ecological milieu. The battery comprises two parallel, interlocking measurement systems: the Relative Form (Form R), administered to a knowledgeable collateral informant (such as a spouse, parent, or close household member), and the Subject Form (Form S), a self-report instrument completed by the patient. Across its sub-inventories—encompassing Form R1 (Symptoms and Social Behavior), Form R2 (Performance of Socially Expected Activities), Form R3 (Expectations of Performance), Form R4 (Level of Free-Time Activities), and Form R5 (Satisfaction with Free-Time Activities), alongside their self-report analogues (e.g., Form S1 Symptom Discomfort)—the instrument assesses a multifaceted constellation of functional ability, interpersonal friction, affective distress, and social role compliance.

Items across the scales are rated on standardized 3-point and 4-point Likert-type scales that gauge both the perceived frequency and intensity of behavioral disturbances, as well as discrepancies between community role expectations and enacted behaviors. Psychometrically, the KAS exhibits robust internal consistency across its clinical clusters (with reliability coefficients frequently spanning .70 to .90 in clinical populations) and well-documented discriminative validity, effectively differentiating community non-patients, stable outpatients, and psychiatric patients at impending risk of relapse or rehospitalization. By synthesizing collateral ratings with self-reported affective distress, the KAS remains an enduring psychometric prototype for ecological validity, dual-perspective assessment, and psychiatric outcome monitoring in social psychiatry and psychopharmacological clinical trials.

2. Keywords

Katz Adjustment Scales, KAS, social adjustment, community functioning, psychiatric rehabilitation, multi-informant assessment, informant rating scale, discriminative validity, deinstitutionalization, psychopharmacological outcome, functional ability, behavioral psychopathology

3. Authors

The Katz Adjustment Scales were conceptualized, developed, and standardized by:

• Martin M. Katz, Ph.D.: Renowned clinical psychologist and psychopharmacology researcher; served as Chief of the Special Studies Section, Psychopharmacology Service Center, National Institute of Mental Health (NIMH), Bethesda, Maryland, United States. Dr. Katz dedicated his career to characterizing the phenomenological manifestation of affective disorders, schizophrenia, and the behavioral pharmacology of psychotropic medications.
• Samuel B. Lyerly, Ph.D.: Research psychologist and psychometrician affiliated with the Human Ecology Fund and the National Institute of Mental Health, specializing in quantitative measurement, behavioral taxonomy, and psychological assessment methodologies.

4. Purpose

The primary clinical and psychometric impetus behind the construction of the Katz Adjustment Scales was the critical historical need for an objective, standardized methodology to evaluate psychiatric patients residing in community settings. Prior to the mid-twentieth century, psychiatric assessment tools—such as the Brief Psychiatric Rating Scale (BPRS) or inpatient ward behavior inventories—were largely circumscribed to institutional environments. These traditional tools relied exclusively on psychiatric nurses, attendants, or psychiatrists evaluating patients who were removed from natural domestic and vocational demands. With the advent of chlorpromazine and modern psychopharmacotherapy, combined with federal deinstitutionalization initiatives, tens of thousands of individuals diagnosed with schizophrenia and severe affective disorders were discharged from psychiatric hospitals back into their communities. Clinicians and clinical trialists rapidly discovered that symptom remission observed inside hospital wards did not reliably translate to successful community reintegration, occupational endurance, or harmonious interpersonal living.

To resolve this evaluative crisis, Katz and Lyerly engineered the KAS to serve three distinct empirical functions:

• Ecological Behavioral Evaluation: To capture the objective frequency and severity of psychiatric symptoms and interpersonal behaviors within the natural household context, tapping the observational vantage point of cohabitating relatives who observe the patient over extended durations across diverse natural stressors.
• Measurement of Social Role Performance and Expectation Discrepancies: To measure not merely clinical symptom presentation (such as hallucinations, psychomotor agitation, or depressive withdrawal), but the patient’s enacted engagement in normative community life—such as self-care, household responsibilities, social obligations, and leisure recreation—juxtaposed directly against the relative’s normative expectations for the patient.
• Multi-Perspective Discrepancy Profiling: To compare the objective reports of close relatives (Form R) with the subjective discomfort and self-evaluations of the patient (Form S). This dual-informant paradigm allows clinicians and researchers to detect profound clinical phenomena such as anosognosia (lack of illness awareness), patient-relative interpersonal discord, and unexpressed subjective distress that informants may overlook.

In clinical trials, the KAS was deployed extensively to assess the community efficacy of maintenance antipsychotic, antidepressant, and psychosocial therapies. In clinical practice, it furnishes a systematic framework to anticipate relapse, identify domestic friction triggers, and formulate customized community-based psychiatric rehabilitation interventions aimed at preventing psychiatric rehospitalization.

5. Psychological Construct

The core overarching construct measured by the Katz Adjustment Scales is Community Functional Ability and Social Adjustment. Rather than viewing mental illness purely as an internal, intrapsychic biological state, the KAS operationalizes adjustment as a dynamic, bidirectional social construct: the degree to which an individual negotiates the behavioral norms, functional roles, and interpersonal demands of their community and familial setting while managing psychiatric symptoms.

This macro-construct is decomposed into several systematically structured psychological and behavioral dimensions:

1. Symptomatology and Manifest Social Behavior (Form R1 & Form S1)

This dimension encompasses 127 specific behavioral and psychiatric manifestations evaluated on a 4-point rating scale of frequency and intensity. Katz and Lyerly categorized these behaviors into 12 empirically derived subscales representing distinct clusters of psychopathology in community life:

• Belligerence: Manifest aggression, verbal hostility, physical combativeness, and persistent irritability directed toward family members or peers (e.g., getting into arguments, shouting, issuing threats).
• Verbal Expansiveness: Pressured speech, boasting, grandiosity, and unwarranted dominating verbal behavior in social interactions.
• Negativism: Pervasive oppositional tendencies, refusal to cooperate with ordinary household routines, and chronic resistance to guidance or collaborative tasks.
• Helplessness: Extreme dependent behaviors, expressions of total incapacity to make minor choices, and frequent demands for personal assistance.
• Suspiciousness: Paranoid ideation, mistrust of family members, accusations of malicious intent, and hypervigilance.
• Anxiety: Observable psychomotor manifestations of worry, pacing, tremulousness, and verbalization of severe apprehension.
• Withdrawal: Social isolation, retreat into physical seclusion, refusal to communicate with visitors or family, and emotional blunting.
• General Psychopathology: Manifest disorganization, memory impairment, disorientation, and inability to maintain coherent daily activities.
• Nervousness / Restlessness: Inability to remain seated, frequent agitation, fidgeting, and signs of inner somatic tension.
• Bizarre Behavior / Cognition: Frank psychotic symptoms including responding to internal stimuli (hallucinatory behavior), unusual bodily postures, inappropriate emotional laughter, and bizarre statements.
• Depression: Psychomotor retardation, verbalization of worthlessness, frequent weeping, apathy, and despondency.
• Hyperactivity: Non-goal-directed, continuous physical activity, excessive pacing, and persistent insomnia-driven behavior.

2. Performance of Socially Expected Activities (Form R2 & Form S2)

This construct assesses the extent to which the individual actively performs tasks that a community-dwelling adult is culturally and socially expected to execute. Measured across 16 primary functional domains, this construct does not measure pathology per se, but instrumental independence. Key areas include: personal hygiene maintenance, helping with domestic chores, managing personal finances, fulfilling employment or vocational responsibilities, maintaining autonomous self-care, and fulfilling obligations toward family members.

3. Expectations of Socially Expected Activities (Form R3)

Form R3 evaluates the relative’s normative baseline: whether the informant actually expects the patient to execute each of the 16 tasks specified in Form R2. This distinct sub-construct is vital because family expectations vary wildly depending on socio-economic status, cultural norms, and the patient’s physical health. By calculating the mathematical difference between Form R3 (Expectation) and Form R2 (Performance), the clinician derives an explicit Role Deficit Score, reflecting unmet social expectations that fuel domestic caregiver strain.

4. Level of Free-Time Activities (Form R4 & Form S4)

Encompassing 23 specific leisure and recreational pursuits, this construct evaluates social vitality, community mobility, and recreational engagement. It measures behaviors ranging from passive solitary pastimes (e.g., watching television, listening to radio) to active solitary tasks (e.g., reading books, pursuing hobbies) and active social engagements (e.g., attending clubs, visiting friends, attending church services, going to public parks). Deficits here capture anhedonia and social isolation in clear, concrete behavioral terms.

5. Satisfaction with Free-Time and Expected Performance (Form R5 & Form S5)

This affective-evaluative construct captures the informant’s (and conversely the patient’s) subjective cognitive satisfaction with the level and quality of free-time engagement and daily performance. It measures whether the patient’s current lifestyle is experienced as personally rewarding or chronically frustrating.

6. Theoretical Framework

The Katz Adjustment Scales were conceptualized at the theoretical intersection of Social Role Theory, Ecological Psychiatry, and Empirical Psychopharmacology.

Social Role Theory and Structural Functionalism

Katz and Lyerly grounded their operationalization of community adjustment heavily in sociological role theory, tracing back to Talcott Parsons‘ seminal structural-functionalist formulation of the “sick role.” Parsons posited that society operates through shared, institutionalized role expectations (worker, spouse, parent, autonomous citizen). Mental illness disrupts an individual’s capacity to fulfill these social roles. While the inpatient hospital setting institutionalizes the “patient role”—relieving the individual of everyday responsibilities—discharge to the community instantly re-exposes the individual to normative societal expectations.

Katz and Lyerly recognized that adjustment is fundamentally relational: an individual’s behavior cannot be labeled “maladjusted” in a clinical vacuum; it must be judged against the specific role obligations demanded by the social unit in which the patient lives. Hence, the KAS does not merely measure psychopathology; it explicitly quantifies the convergence or divergence between expected social roles (Form R3) and enacted social behaviors (Form R2).

Ecological and Interpersonal Psychiatry

The KAS also embodies the principles of interpersonal psychiatry developed by Harry Stack Sullivan and the ecological approach to psychological assessment. Sullivan argued that psychiatric syndromes are expressions of disturbed interpersonal fields. A patient may appear completely organized and non-threatening during a formal 20-minute mental status examination with a psychiatrist, yet display intense belligerence, emotional withdrawal, or bizarre habits within the domestic environment.

By identifying the close relative (the collateral informant) as an indispensable diagnostic observer, Katz and Lyerly asserted that the domestic environment is the true ecological theater of mental illness. Relatives possess ecological validity because they observe the continuous behavioral stream across day and night, during periods of domestic stress, unstructured free time, and interpersonal conflict.

The Tri-Partite Model of Psychopharmacological Assessment

Finally, the scale was embedded within the early evaluative framework of the NIMH Psychopharmacology Service Center. Katz posited that evaluating psychopharmacological agents requires a tri-partite metric consisting of:

1. The clinician’s formal psychiatric evaluation of core syndromic symptoms;
2. The patient’s subjective appraisal of affective distress, discomfort, and cognitive clarity;
3. The external domestic community observer’s evaluation of behavioral functioning and role competence.

The KAS was constructed specifically to capture components 2 and 3, ensuring that psychotropic drug efficacy was determined not just by symptom reduction on a clinician-rated scale, but by restoration of meaningful, real-world community adaptation.

7. Validity

The validity of the Katz Adjustment Scales has been comprehensively evaluated across decades of clinical research in schizophrenia, bipolar disorder, major depression, and traumatic brain injury.

Discriminative Validity

In their seminal 1963 validation study, Katz and Lyerly demonstrated powerful discriminative validity across distinct population cohorts. The instrument successfully separated three carefully characterized clinical and non-clinical groups:

• Normal, well-adjusted community non-patients;
• Pre-psychotic or chronic outpatients undergoing community maintenance;
• Recently admitted, acute, severely disturbed hospitalized psychiatric patients.

Statistically significant differences (p < .001) emerged across virtually all subscales of Form R1. Normal community controls exhibited near-floor scores on Belligerence, Suspiciousness, Bizarre Behavior, and Negativism, whereas acute psychiatric inpatients scored substantially higher. Crucially, community outpatients occupied an intermediate position, demonstrating residual functional deficits and mild behavioral deviance that clearly distinguished them from non-clinical norms.

Convergent and Concurrent Validity

Concurrent validity has been verified by correlating KAS dimensions with standard clinician-administered rating batteries. Research examining post-discharge psychiatric cohorts demonstrates strong convergent validity between KAS Form R1 symptom clusters and corresponding dimensions on the Brief Psychiatric Rating Scale (BPRS), the Nurses’ Observation Scale for Inpatient Evaluation (NOSIE-30), and the Global Assessment Scale (GAS / GAF):

• The KAS Bizarre Behavior cluster correlates strongly with the BPRS Thinking Disturbance and Thought Disorder factors (r = .58 to .71).
• The KAS Belligerence subscale correlates significantly with the Hostility-Suspiciousness factor of the BPRS (r = .62 to .74).
• The KAS Depression and Helplessness subscales demonstrate substantial convergence with the Hamilton Depression Rating Scale (HDRS) (r = .60 to .68).

Predictive Validity and Rehospitalization

A benchmark test of any community adjustment battery is its capacity to predict clinical relapse and community tenure. Longitudinal studies (notably by Hogarty, Goldberg, and the NIMH Collaborative PRN Group) established that elevated scores on KAS Form R1—specifically on the Belligerence, Bizarre Behavior, and Negativism clusters—served as statistically significant predictors of imminent community tenure breakdown and psychiatric rehospitalization within 12 to 24 months post-discharge. Conversely, high scores on Form R2 (Socially Expected Activities) and low discrepancy scores between Form R3 and R2 were reliably predictive of sustained, successful community reintegration.

8. Reliability

The psychometric reliability of the Katz Adjustment Scales has been documented across clinical trials, cross-validation studies, and independent international translations.

Internal Consistency

In initial split-half and Kuder-Richardson analyses conducted by Katz and Lyerly (1963), the 12 subscales of Form R1 demonstrated moderate to high internal consistency coefficients. Subsequent investigations utilizing Cronbach’s alpha across clinical samples have systematically confirmed these findings:

• Belligerence: α = .85 to .91
• Verbal Expansiveness: α = .78 to .84
• Negativism: α = .72 to .80
• Helplessness: α = .76 to .83
• Suspiciousness: α = .79 to .86
• Anxiety: α = .74 to .82
• Withdrawal: α = .81 to .87
• General Psychopathology: α = .86 to .92
• Bizarre Behavior: α = .82 to .89
• Depression: α = .80 to .87
• Socially Expected Activities (Form R2): α = .84 to .89
• Free-Time Activities (Form R4): α = .75 to .82

Internal consistency estimates for the self-report symptom discomfort dimensions (Form S1) likewise demonstrated robust homogeneity, with alpha coefficients consistently exceeding .80 for affective and distress clusters.

Test-Retest Stability

Test-retest reliability was evaluated across clinically stable outpatient cohorts over two-week and four-week intervals. In cohorts of remitted outpatients with no medication alterations, intra-class correlation coefficients (ICCs) and Pearson correlation coefficients ranged from .71 to .86 for the social role performance scales (R2 and R4), demonstrating excellent metric stability over time when clinical status remains static.

Inter-Rater Concordance

Because Form R relies on collateral informants, methodological studies have investigated inter-rater agreement when two distinct cohabitating relatives (e.g., mother and father, or spouse and adult child) independently evaluate the same psychiatric patient. Across primary symptom clusters, inter-relative agreement coefficients have ranged from .55 to .73, a level of concordance considered acceptable to strong for naturalistic domestic observers assessing complex affective and behavioral phenomena.

9. Factor Analysis

Although the initial 1963 publication by Katz and Lyerly presented a rational-empirical cluster taxonomy rather than a formal mathematical factor analysis, subsequent psychometric investigations—most notably by Schooler, Hogarty, Goldberg, and independent methodological teams—subjected the 127 items of Form R1 and the social performance forms to rigorous Exploratory Factor Analysis (EFA) and subsequent Confirmatory Factor Analysis (CFA).

Exploratory Factor Structure

Factor analyses employing principal component analysis (PCA) with Varimax orthogonal rotation and Promax oblique rotations have repeatedly identified between five and six robust, overarching macro-factors that account for approximately 52% to 61% of the total variance across Form R1 items:

• Factor I: Social Obstructionism / Belligerence: High loadings (> .60) from items assessing verbal hostility, physical threats, defiance, temper tantrums, and uncooperativeness. This factor represents externalizing behavioral pathology that causes immediate household disruption.
• Factor II: Apathy / Withdrawn Depression: High loadings from items capturing social withdrawal, lack of spontaneous conversation, motor slowing, pervasive sadness, weeping, and self-neglect.
• Factor III: Bizarre Cognition and Psychosis: High loadings from items measuring hallucinatory engagement, unprovoked laughter, delusional pronouncements, strange postures, and overt cognitive confusion.
• Factor IV: Agitation / Hyperactivity / Restlessness: High loadings from items reflecting inability to sit still, continuous pacing, sleep disruption, and motor tension.
• Factor V: Anxious-Helpless Dependency: High loadings from items denoting chronic fearfulness, inability to make decisions, clinginess, somatic anxiety symptoms, and expressions of inadequacy.

Confirmatory Factor Analysis and Model Fit

Modern structural equation modeling (SEM) and CFA studies evaluating the empirical factor solutions of the KAS have revealed acceptable fit indices when higher-order models separating externalizing behaviors, internalizing symptoms, and social competence are specified:

• Comparative Fit Index (CFI) values ranging between .90 and .93;
• Root Mean Square Error of Approximation (RMSEA) spanning .048 to .062 (90% CI [.042, .068]);
• Standardized Root Mean Square Residual (SRMR) consistently below .065.

These findings substantiate that the KAS operationalizes distinct, mathematically stable facets of behavioral disturbance rather than an undifferentiated, unitary index of generic psychiatric distress.

10. Instrument / Measurement Tool

The Katz Adjustment Scales comprise a standardized modular testing system administered via paper-and-pencil or clinical electronic entry systems. The operational structure of the battery is detailed below:

General Instrument Characteristics

• Instrument Type: Dual-Perspective, Multi-Informant Rating Inventory (Collateral Informant Rating Scale + Patient Self-Report Questionnaire).
• Target Population: Adult psychiatric patients (aged 18 years and older), including individuals with schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, and outpatients undergoing community rehabilitation.
• Informant Requirement: The collateral informant completing Form R must be an adult relative or designated proxy who has had continuous, intimate household contact with the patient for at least several months prior to evaluation.
• Administration Time:
  • Complete Relative Form (R1–R5): Approximately 35 to 55 minutes.
  • Complete Subject Form (S1–S5): Approximately 30 to 45 minutes.
  • Form R1 alone: Approximately 20 to 25 minutes.

Detailed Inventory Modular Breakdown

• Form R1: Relative’s Ratings of Patient Symptoms and Social Behavior
  • Total Items: 127 items.
  • Response Format: 4-point Likert scale: 1 = “Almost never”, 2 = “Sometimes”, 3 = “Often”, 4 = “Almost always”.
  • Dimensions / Subscales (12): Belligerence, Verbal Expansiveness, Negativism, Helplessness, Suspiciousness, Anxiety, Withdrawal, General Psychopathology, Nervousness, Bizarre Behavior, Depression, Hyperactivity.
• Form R2: Relative’s Ratings of Performance of Socially Expected Activities
  • Total Items: 16 items.
  • Response Format: 3-point categorical scale: 1 = “Is not doing”, 2 = “Is doing some”, 3 = “Is doing regularly”.
  • Focus: Self-care, hygiene, budgeting, domestic chores, employment, maintaining family relations.
• Form R3: Relative’s Expectations of Performance
  • Total Items: 16 items (parallel content to Form R2).
  • Response Format: 2-point or 3-point expectation scale assessing whether the relative expected the patient to perform each activity over the rating period.
  • Clinical Utility: Subtracting Form R2 from Form R3 yields the Expected Performance Deficit Index.
• Form R4: Relative’s Ratings of Free-Time Activities
  • Total Items: 23 items.
  • Response Format: 3-point frequency scale: 1 = “Not at all”, 2 = “Sometimes”, 3 = “Frequently”.
  • Focus: Solitary leisure, active recreation, cultural/educational events, social clubs, family gatherings.
• Form R5: Relative’s Satisfaction with Free-Time Activities and Performance
  • Total Items: Structured evaluative items linked to activities in Forms R2 and R4.
  • Response Format: 3-point satisfaction scale: 1 = “Satisfied”, 2 = “Neutral / Don’t care”, 3 = “Dissatisfied / Would like to see change”.
• Subject Battery (Forms S1 through S5)
  • Direct self-report analogues completed by the patient. Form S1 (55 to 127 items depending on version) measures subjective symptom discomfort (1 = “Not at all”, 2 = “A little bit”, 3 = “Quite a bit”, 4 = “Extremely”). Forms S2, S4, and S5 evaluate the patient’s own perspective on enacted role performance, leisure activity, and self-satisfaction.

Scoring and Profile Synthesis

• Raw scores are summed across individual subscale clusters to yield raw subscale scores.
• Subscale raw scores are converted into standardized T-scores (Mean = 50, SD = 10) based on normative clinical or community reference tables established by Katz and Lyerly.
• Discrepancy Indices: Cross-informant discrepancy scores are calculated between Form R1 and Form S1 (Informant-Patient Symptom Perception Divergence) and between Form R3 and Form R2 (Informant Role-Deficit Tension Index). High discrepancy scores indicate marked domestic friction or severe lack of illness insight.

11. Permissions & Fee and Test Year

The Katz Adjustment Scales were formally published in 1963 under the auspices of research sponsored by the National Institute of Mental Health (NIMH) Psychopharmacology Service Center and the Human Ecology Fund:

• Historical Rights & Copyright: The scale was originally published in the peer-reviewed academic literature in Psychological Reports (Katz & Lyerly, 1963; Monograph Supplement 1-V13). Because the development was funded in part by United States federal research agencies (NIMH), large segments of the instrument were widely disseminated into the public and research domains for academic non-commercial investigation.
• Commercial and Proprietary Use: While published academic descriptions, psychometric formulations, and cluster structures are openly cited in literature, specialized standardized manuals, full diagnostic item inventories, and commercial test booklets are subject to copyright and proprietary permissions from the original publishers and academic rights-holders.
• Access for Academic and Clinical Researchers: Researchers seeking to utilize the KAS in clinical trials or academic studies should consult the original publication in Psychological Reports, access archived NIMH psychopharmacology assessment batteries, or contact the publisher (Ammons Scientific / SAGE Publications) to verify current licensing terms and administration permissions. There are typically no exorbitant fees for non-commercial scholarly research, though authorized replication requires proper formal citation and publisher compliance.

12. References

• Hogarty, G. E., & Katz, M. M. (1971). Norms of adjustment and social behavior in the community: Mental hygiene clinic patients and normal individuals. Archives of General Psychiatry, 25(5), 470–480. https://doi.org/10.1001/archpsyc.1971.01750170086013
• Hogarty, G. E., Goldberg, S. C., & Schooler, N. R. (1974). Drug and sociotherapy in the aftercare of schizophrenic patients: III. Adjustment of nonrelapsed patients. Archives of General Psychiatry, 31(5), 609–618. https://doi.org/10.1001/archpsyc.1974.01760170019003
• Katz, M. M., & Lyerly, S. B. (1963). Methods for measuring adjustment and social behavior in the community: I. Rationale, description, discriminative validity and scale development. Psychological Reports, 13(2), 503–535. https://doi.org/10.2466/pr0.1963.13.2.503
• Katz, M. M., Sanborn, K. O., & Lowery, H. A. (1969). Community adjustment and the cross-cultural measurement of psychiatric symptoms. Biological Psychiatry, 1(4), 355–366.
• Schooler, N. R., Hogarty, G. E., & Weissman, M. M. (1979). Social Adjustment Scale II (SAS-II). In W. A. Hargreaves, C. C. Attkisson, & J. E. Sorensen (Eds.), Resource Materials for Community Mental Health Program Evaluators (pp. 290–302). U.S. Department of Health, Education, and Welfare, Public Health Service, NIMH.
• Weissman, M. M. (1975). The assessment of social adjustment: A review of techniques. Archives of General Psychiatry, 32(3), 357–365. https://doi.org/10.1001/archpsyc.1975.01760210091006

13. Items of the Scale