REFINING ADOLESCENT DEPRESSION MEASUREMENT

描述（由申请人提供）：鉴于受单相抑郁症影响的青少年的比例，准确的评估是必要的，以确定那些可能需要照顾。虽然有理由相信抑郁症在整个发展过程中表现得不同，但我们不知道有专门针对青少年的工具。某些抑郁症状可能在不同年龄段的青少年中更为明显或突出，或在基于性别，物质使用和身体健康的各种亚组中更为明显或突出。项目反应理论为开发对这些影响敏感的灵活测量系统提供了一个有用的框架。利用现有的数据，从3个大的全国代表性的青少年样本，拟议的发展研究将采用项目反应理论的方法，青少年测量的发展和完善。项目目标是：1.为每个量表建立重叠的、特定年龄的项目集（使用IRT分析），其中包含有关抑郁症潜在脆弱性的信息（即，性别、身体健康和药物使用状况），方法是：a）确定可被视为跨年龄组共有的量表项目和应针对年龄的量表项目;以及B）确定应针对这些弱势群体中的一个或多个群体的人区别对待的量表项目;以及2.链接数据集并比较项目，以开发一套年龄特异性评估的原型：a）比较每个量表中抑郁项目在开发重叠年龄特异性评估中的潜在效用（使用IRT分析）通过连接数据集并同时生成所有项目的项目特征;和B）利用这些信息开发一套适合于抑郁症的植物人、认知和情感方面的年龄特异性评估原型;对与性别、身体健康和物质使用状况相关的可能脆弱性敏感;并通过共同项目联系起来，以便可以在评估中比较分数。成功完成这些目标将产生一套针对青少年的特定年龄评估原型，该原型独特地结合了现有研究中最敏感和最相关的项目。随后，这套工具（拟作为R 01的后续工具）的投入使用将有助于对原型项目进行评价和改进，建立诊断标准，并开发便携式评分系统。

DESCRIPTION (provided by applicant): Given the proportion of adolescents affected by unipolar depression, accurate assessments are necessary to identify those likely to be in need of care. While there is reason to believe that depression manifests itself differently throughout development, we know of no instruments that are tailored expressly to adolescents. Certain depressive symptoms may be more apparent or salient for adolescents of different ages, or in various subgroups based on gender, substance use and physical health. Item response theory provides a useful framework for the development of a flexible measurement system that is sensitive to these influences. Using existing data from 3 large nationally representative adolescent samples, the proposed developmental study will adopt an item response theory approach to adolescent measurement development and refinement. Project aims are to: 1. Establish overlapping, age-specific item sets for each scale (using IRT analyses) that incorporate information about potential vulnerabilities to depression (i.e., gender, physical health and substance use status) by: a) identifying scale items that can be considered common across age groups and scale items that should be age-specific; and b) identifying scale items that should be treated differently for people in one or more of these vulnerable groups; and 2. Link data sets and compare items in order to develop a prototype set of age-specific assessments: a) compare the potential utility of depression items from each of the scales in the development of overlapping age-specific assessments (using IRT analyses) by linking the data sets and generating item characteristics for all items simultaneously; and b) use this information to develop a prototype set of age-specific assessments that appropriately cover the vegetative, cognitive, and affective aspects of depression; are sensitive to possible vulnerabilities associated with gender, physical health, and substance use status; and are linked through common items so that scores can be compared across assessments. Successful completion of these aims will result in a prototype set of age-specific assessments for adolescents that uniquely combines the most sensitive and relevant items from the existing studies. Subsequent fielding of this instrument set (to be proposed as a follow-on R01) will allow for evaluation and refinement of the prototype items, establishment of diagnostic norms, and development of a portable scoring system.