Informant Discrepancies in Adult Social Anxiety Disorder Assessments: Links With Contextual Variations in Observed Behavior
Informant Discrepancies in Adult Social Anxiety Disorder Assessments: Links With Contextual Variations in Observed Behavior
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DOI：
10.1037/a0031150
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发表时间：
2013-05-01
影响因子：
4.6
通讯作者：
Beidel, Deborah C.
中科院分区：
文献类型：
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作者：
De Los Reyes, Andres;Bunnell, Brian E.;Beidel, Deborah C.
对成人精神病理学的多个线人评估往往会导致线人报告之间的差异。在符合广泛型(106例)和非广泛型(51例)社交焦虑症(SAD)亚型标准的157名成年人中，我们检查了患者和临床医生报告的患者症状之间的差异是否与SAD亚型和社交技能缺陷的表达在多个社交任务中的差异有关。潜在阶层分析揭示了两种行为模式：(A)特定于背景的社交技能缺陷和(B)跨背景社交技能缺陷。同样，患者的症状报告可能与临床医生的报告一致或不一致。患者临床医生一致认为，患者的症状水平相对较高，与患者满足泛化相对非泛化亚型标准的可能性增加有关。此外，患者临床医生对患者症状水平相对较高的看法是一致的，这与在社交任务中持续表现出社交技能缺陷的可能性增加有关(相对于特定背景的社交技能缺陷)。这些关系在考虑患者年龄、临床严重程度以及Axis I和II共病方面是强有力的。此外，临床严重性不能完全解释患者在实验室任务中的行为差异或患者与临床医生报告之间的差异。研究结果首次以实验室为基础，支持了在成人临床评估中，信息者的差异能够表明跨背景的可变性，并且在任何发展阶段中，第一次为SAD评估指出了这一点。这些发现对临床评估和发展精神病理学研究具有重要意义。
Multi-informant assessments of adult psychopathology often result in discrepancies among informants' reports. Among 157 adults meeting criteria for either the generalized (n = 106) or nongeneralized (n = 51) social anxiety disorder (SAD) subtype, we examined whether discrepancies between patients' and clinicians' reports of patients' symptoms related to variations in both SAD subtype and expressions of social skills deficits across multiple social interaction tasks. Latent class analyses revealed two behavioral patterns: (a) context-specific social skills deficits and (b) cross-context social skills deficits. Similarly, patients' symptom reports could be characterized by concordance or discordance with clinicians' reports. Patient clinician concordance on relatively high levels of patients' symptoms related to an increased likelihood of the patient meeting criteria for the generalized relative to nongeneralized subtype. Further, patient clinician concordance on relatively high levels of patients' symptoms related to an increased likelihood of consistently exhibiting social skills deficits across social interaction tasks (relative to context-specific social skills deficits). These relations were robust in accounting for patient age, clinical severity, and Axis I and II comorbidity. Further, clinical severity did not completely explain variability in patients' behavior on laboratory tasks or discrepancies between patient and clinician reports. Findings provide the first laboratory-based support for the ability of informant discrepancies to indicate cross-contextual variability in clinical adult assessments, and the first of any developmental period to indicate this for SAD assessments. These findings have important implications for clinical assessment and developmental psychopathology research.