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，对其他慢性医学疾病有深远的影响。由于精神疾病和医学疾病是如此紧密地交织在一起，因此开发能够解释精神和身体健康对慢性疾病患者报告的结果的影响的方法至关重要。我们的独立研究项目“精神症状和社会功能：IRT和DIP”的总体目标是更精确地确定精神症状（抑郁、焦虑、愤怒/敌意、酒精和药物滥用）与社会功能之间的关系程度。该项目将以大量不同的精神病患者和社区居民为样本进行，这些患者和社区居民表现出广泛的精神症状、医疗状况和社会功能水平。我们的计划是开发综合题库，利用相关结构的所有严重程度，并在个人计算机上管理它们。数据分析将依赖于项目反应理论（IRT）模型的心理测量优势。我们将这些模型应用于精神症状和社会功能的项目，首先，以分级IRT的方式校准它们，其次，调查不同症状状态下社会功能项目之间的差异项目功能（DIP）。对DIP与精神症状类型和严重程度变化相关的分析，将使我们能够创建与症状混淆更少的功能测量，甚至比目前可用的功能测量更可靠。在三个横截面样本（第I-III阶段，总N = 2,400）中开发和改进测量方法后，我们将在依赖于纵向计算机化自适应测试（CAT）的前瞻性研究（第IV阶段，N = 500）中使用它们。我们还为患者报告结果测量信息系统（PROMIS）研究网络提出了两个项目，重点是：1)评估负面影响（抑郁、焦虑和愤怒）和疼痛，以及这些构式与PROMIS可能感兴趣的其他核心领域（包括身体、社会和职业功能）之间的关系；2)睡眠-觉醒功能（SWF）核心电池的开发和测试，以及SWF与其他与PROMIS相关的核心域的关系研究。

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.