Psychiatric Symptoms and Social Functioning: IRT and DIF

描述(申请人提供)：精神障碍是残疾的主要来源。此外，精神障碍往往是慢性的，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交织在一起，因此开发一种方法来说明心理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。我们独立研究项目的总体目标是：精神症状和社会功能：IRT和DIP，旨在更准确地确定精神症状(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。该项目将以大量和多样化的精神病人和社区居民样本进行，这些样本显示了广泛的精神症状、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)模型的心理测量学优势。我们将这些模型应用于精神症状和社会功能项目，首先，以分级IRT的方式对其进行校准，其次，根据症状状态来调查社会功能项目之间的差异项目功能(DIP)。对与精神症状类型和严重程度变化相关的DIP进行分析，将使我们能够创建与症状混淆较少的功能测量方法，甚至比现有的方法更可靠。在三个横断面样本(阶段I-III，总N=2,400)中迭代地开发和改进测量之后，我们将在依赖纵向计算机化自适应测试(CAT)的前瞻性研究(阶段IV，N=500)中使用它们。我们还为患者报告的结果测量信息系统(PROIS)研究网络提出了两个项目，重点放在：1)评估负面情绪(抑郁、焦虑和愤怒)和疼痛，以及这些结构与其他可能对PROIS感兴趣的核心域之间的关系，包括身体、社会和职业功能；2)开发和测试睡眠-觉醒功能(SWF)核心电池，并调查SWF与其他与PROIS相关的核心域之间的关系。

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.