Development of a Computerized Adaptive Test of Personality Disorder (CAT-PD)

描述（由申请人提供）：人格障碍在普通人群中很常见，在精神病患者中尤为普遍。值得关注的是，人格障碍与许多不良后果有关，包括自杀、治疗反应减弱、卫生保健服务利用率增加和严重的功能损害。因此，临床医生和研究人员拥有有效评估心理功能这一关键方面的工具是至关重要的。不幸的是，许多常见的人格病理学测量相当长，效率低下，并且/或者必须由专业人员进行管理和评分。此外，已经提出了一些人格病理学的分类和维度模型，但这些模型之间缺乏整合和全面性，导致了卫生保健和研究环境的混乱，并导致人格病理学评估的减少。因此，在拟议的研究中，我们的总体目标是(a)确定与人格病理学相关的全面和综合的一套维度，以及(b)开发一种有效的计算机化自适应方法CAT-PD来测量这些维度。计算机化自适应测试（CATs）植根于现代心理测量方法，旨在为每位患者量身定制的项目选择管理，这通常会显著提高测量效率，而测试的信度或效度几乎没有成本。为了实现我们的总体目标，我们计划了一个五阶段的项目，其中我们（第一阶段）确定要评估的内容领域，并根据公共领域的国际人格项目库（IPIP）开发初始项目库，（第二阶段）从两个样本中收集自我报告项目的回答，每个样本分别是精神病患者（总N = 500）和社区居民成年人（总N = 500），并对这些回答进行分析，以开发和交叉验证CAT-PD量表。（第三阶段）利用项目反应理论（IRT）校准CAT- pd项目并进行CAT模拟以指导现场CAT- pd软件的构建；（第四阶段）基于前几阶段的结果开发CAT- pd软件；（第五阶段）在新的精神病患者样本（N = 300）中进行CAT-PD的实时测试研究，以研究其效率和构建有效性，并建立cut point和评分规则，旨在提高该工具在各种应用和研究环境中的实际效用。我们希望本研究有助于整合人格病理学的众多维度模型，产生一套全面有效的人格障碍维度测量方法，并为人格障碍理论、研究、诊断和干预的进步做出贡献。公共卫生相关性：由于人格障碍在一般人群中很常见，并与许多不良后果相关，包括自杀、治疗反应减弱、卫生保健服务利用率增加和严重的功能损害，因此拟议的项目与公共卫生相关。至关重要的是，临床医生和研究人员拥有有效评估心理功能这一关键方面的工具。本研究将有助于整合人格病理学的众多模型，产生一套全面有效的人格障碍维度测量方法，并有助于人格障碍理论、研究、诊断和干预的进步。

DESCRIPTION (provided by applicant): Personality disorders are common in the general population and are particularly prevalent among psychiatric patients. Of concern, personality disorders are associated with a number of adverse outcomes, including suicidality, attenuated treatment response, increased utilization of health care services, and significant functional impairment. It is therefore crucial that clinicians and researchers have tools available to efficiently assess this key aspect of psychological functioning. Unfortunately, many common measures of personality pathology are quite long and inefficient and/or must be administered and scored by professional staff. Moreover, a number of categorical and dimensional models of personality pathology have been proposed, but the lack of integration and comprehensiveness among these models has led to confusion in health care and research settings and has resulted in a decrease in assessment of personality pathology. Thus, in the proposed research, our general aims are to (a) identify a comprehensive and integrative set of dimensions relevant to personality pathology, and (b) develop an efficient computerized adaptive method the CAT-PD to measure these dimensions. Computerized adaptive tests (CATs) are rooted in modern psychometric methods and are designed to select items for administration that are tailored individually to each patient, which typically leads to significant gains in measurement efficiency with little or no cost to test reliability or validity. To accomplish our general goals, we plan a five-phase project in which we (Phase 1) identify the content domains to be assessed and develop the initial item pool based on the public domain International Personality Item Pool (IPIP), (Phase 2) collect self-report item responses from two samples each of psychiatric patients (total N = 500) and community-dwelling adults (total N = 500) and conduct analyses of those responses to develop and cross-validate the CAT-PD scales, (Phase 3) calibrate the CAT-PD items using item response theory (IRT) and conduct CAT simulations to guide construction of the live CAT-PD software, (Phase 4) develop CAT-PD software based on the results of all previous phases, and (Phase 5) conduct a live-testing study of the CAT-PD in a new sample of psychiatric patients (N = 300) to study its efficiency and construct validity and establish cut points and scoring rules designed to increase the tool's practical utility across a wide variety of applied and research settings. It is our hope that the proposed research will help to integrate the numerous dimensional models of personality pathology, yield a comprehensive set and efficient measure of personality disorder dimensions, and contribute to advancements in personality disorder theory, research, diagnosis, and intervention. PUBLIC HEALTH RELEVANCE: Because personality disorders are common in the general population and are associated with a number of adverse outcomes, including suicidality, attenuated treatment response, increased utilization of health care services, and significant functional impairment, the proposed project is relevant to public health. It is crucial that clinicians and researchers have tools available to efficiently assess this key aspect of psychological functioning. The proposed research will help to integrate the numerous models of personality pathology, yield a comprehensive set and efficient measure of personality disorder dimensions, and contribute to advancements in personality disorder theory, research, diagnosis, and intervention.