Item response modeling of DSM-IV mania symptoms in two representative US epidemiological samples.
Item response modeling of DSM-IV mania symptoms in two representative US epidemiological samples.
复制标题
在两个具有代表性的美国流行病学样本中对 DSM-IV 躁狂症症状进行项目反应建模。
DOI：
10.1017/s0033291709992005
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发表时间：
2010
影响因子：
6.9
通讯作者：
Lynskey,MT
中科院分区：
文献类型：
--
作者：
Agrawal,A;NurnbergerJr,JI;Lynskey,MT
背景围绕用于评估流行病学样本中躁狂症的DSM-IV症状的有效测量存在相当大的争论。方法使用两个具有全国代表性的数据集，即全国酒精和相关疾病流行病学调查（NESARC，第1波时n=43 093，3年随访时n=34 653）和科摩罗全国调查-重复（NCS-R，n=9282），我们检查了用于评估DSM-IV躁狂症状的心理测量学特性。躁狂因子评分的预测效用进行了测试，使用3年的后续数据在NESARC.ResultsCriterion B症状是一维的（单因素）在两个样本。评估思想飞行、注意力分散和目标导向活动增加的症状具有高因子负荷（0.70-0.93）和中等赞同率，从而提供了良好的躁狂症患者和非躁狂症患者之间的区分。在两个样本中，症状评估夸大表现不佳。定量躁狂因子评分是一个很好的预测更严重的疾病在3年的后续NESARC样本，即使在控制过去的历史DSM-IV诊断躁狂disorder.ConclusionsThese分析表明，问题的基础上，一些DSM症状有效区分个人在高和低的躁狂症的易感性，但其他人没有。定量躁狂因子评分可能有助于预测有躁狂病史患者的复发。在缺乏临床评估的情况下，使用结构化访谈评估躁狂症的方法需要进一步改进。
BackgroundThere is considerable debate surrounding the effective measurement of DSM-IV symptoms used to assess manic disorders in epidemiological samples.MethodUsing two nationally representative datasets, the National Epidemiological Survey of Alcohol and Related Conditions (NESARC, n=43 093 at wave 1, n=34 653 at 3-year follow-up) and the National Comorbidity Survey – Replication (NCS-R, n=9282), we examined the psychometric properties of symptoms used to assess DSM-IV mania. The predictive utility of the mania factor score was tested using the 3-year follow-up data in NESARC.ResultsCriterion B symptoms were unidimensional (single factor) in both samples. The symptoms assessing flight of ideas, distractibility and increased goal-directed activities had high factor loadings (0.70–0.93) with moderate rates of endorsement, thus providing good discrimination between individuals with and without mania. The symptom assessing grandiosity performed less well in both samples. The quantitative mania factor score was a good predictor of more severe disorders at the 3-year follow-up in the NESARC sample, even after controlling for a past history of DSM-IV diagnosis of manic disorder.ConclusionsThese analyses suggest that questions based on some DSM symptoms effectively discriminate between individuals at high and low liability to mania, but others do not. A quantitative mania factor score may aid in predicting recurrence for patients with a history of mania. Methods for assessing mania using structured interviews in the absence of clinical assessment require further refinement.