Psychiatric Symptoms and Social Functioning: IRT and DIF

描述（由申请人提供）：精神疾病是残疾的主要来源。此外，精神疾病往往是慢性的，对其他慢性疾病有深远的影响。由于精神疾病和医学疾病是如此紧密地联系在一起，因此开发一种方法来解释精神和身体健康对慢性病患者报告的结果的影响是至关重要的。我们的独立研究项目的总体目标，精神症状和社会功能：IRT和DIP，是建立更精确的精神症状（抑郁，焦虑，愤怒/敌意，酒精和药物滥用）和社会功能之间的关系的大小。该项目将采用大量不同的精神病患者和社区居民样本，这些患者和社区居民表现出广泛的精神病症状，医疗状况和社会功能水平。我们的计划是开发全面的项目库，挖掘相关结构的所有严重程度，并在个人电脑上管理它们。数据分析将依赖于项目反应理论（IRT）模型的心理测量优势。我们将应用这些模型的精神症状和社会功能的项目，首先，校准他们在分级IRT的方式，第二，调查项目之间的差异功能（DIP）的社会功能视症状状态。分析DIP与精神症状类型和严重程度的变化相关，将使我们能够创建与症状混淆较少的功能措施，甚至比目前可用的功能措施更强大。在三个横截面样本（阶段I-III，总N = 2，400）中迭代开发和改进措施后，我们将在依赖于纵向计算机自适应测试（CAT）的前瞻性研究（阶段IV，N = 500）中使用它们。我们还提出了两个项目的病人报告的结果测量信息系统（PROMIS）研究网络的重点是：1）评估的负面影响（抑郁，焦虑和愤怒）和疼痛以及这些结构与PROMIS可能感兴趣的其他核心领域之间的关系，包括身体，社会和职业功能;（2）睡眠-觉醒功能核心成套测验的开发和测试，以及睡眠-觉醒功能与PROMIS相关的其他核心领域之间的关系的调查。

DESCRIPTION (provided by applicant): Psychiatric disorders are a major source of disability. In addition, psychiatric disorders are often chronic and have a profound impact on other chronic medical illnesses. Because psychiatric and medical disorders are so intimately entwined, it is critical to develop methods that account for the influence of both mental and physical health on patient-reported outcomes in chronic disease. The general goal for our independent research project, Psychiatric Symptoms and Social Functioning: IRT and DIP, is to establish with greater precision the magnitude of relationships between psychiatric symptoms (depression, anxiety, anger/hostility, and alcohol and substance abuse) and social functioning. The project will be done with large and diverse samples of psychiatric patients and community residents that display a broad range of psychiatric symptoms, medical conditions, and levels of social functioning. Our plan is to develop comprehensive item banks tapping all levels of severity of the relevant constructs and to administer them on personal computers. Data analysis will rely on the psychometric advantages of item response theory (IRT) models. We will apply such models to the items for psychiatric symptoms and social functioning, first, to calibrate them in graded IRT fashion and, second, to investigate differential item functioning (DIP) among items for social functioning contingent on symptomatic status. Analyses of DIP related to variations in the type and severity of psychiatric symptoms will allow us to create measures of functioning that are less confounded with symptoms and even, more robust than those currently available. After the measures are developed and refined iteratively in three cross-sectional samples (Phases I-III, total N = 2,400), we will use them in a prospective study (Phase IV, N = 500) that relies on longitudinal computerized adaptive testing (CAT). We also propose two projects for the Patient-Reported Outcomes Measurement Information System (PROMIS) research network focused on: 1) assessment of negative affects (depression, anxiety, and anger) and pain and the relationships between these constructs and other core domains likely to be of interest to PROMIS, including physical, social, and occupational functioning; and 2) development and testing of a core battery for sleep-wake function (SWF) and investigation of the relationship between SWF and other core domains relevant to PROMIS.