Computerized adaptive self-report diagnostic assessment for mental health: the SC

描述（由申请人提供）：为了提高我们对精神疾病的理解和治疗，这是国家精神卫生研究所（NIMH）的主要任务，必须首先准确地诊断研究参与者和接受常规临床护理的患者。通过这种方式，可以在特定疾病、生物标记物和治疗效果之间建立适当的联系。诊断精神健康障碍的黄金标准是标准化的临床医生管理的访谈。然而，由于时间、专业知识和资金要求，这种诊断性访谈在研究和临床实践中并不总是实用的。目前只有一种有效的自我报告诊断评估存在，即精神病学诊断筛选问卷（PDSQ）。然而，这个工具不是为社区精神卫生人群开发的，也没有在社区精神卫生人群中得到验证。PDSQ也缺乏许多重要的特征，减轻应答者和工作人员的负担，增加研究和临床实践的有用性。鉴于对有效的、成本效益高的诊断评估的巨大需求，我们建议开发SCID-SR，这是一种计算机化的、自适应的自我报告诊断评估，具有自我评分、即时叙述性报告生成和可搜索的响应数据库。SCID-SR将包含15个诊断类别，并将以scid - 1为基础。scid - 1是临床医生对I轴疾病进行诊断评估的黄金标准，它使用《精神疾病诊断与统计手册》第四版文本修订（DSM-IV-TR）的标准。SCID-SR将适用于成人社区精神健康人群，包括SPMI个体。它将使用严格的项目创作方法来开发，这些方法已在以前的SBIR项目中成功使用，并产生易于阅读和理解的项目，具有广泛的文化相关性，并且可以直接翻译成其他语言。在开发过程中，专家小组将对SCID-SR项目进行审查和评分，随后对来自美国最大的私人非营利精神卫生组织之一的60名成人社区精神卫生门诊患者进行三轮反复的认知访谈测试。认知访谈将包括参与者在回答SCID-SR自我报告项目时的思考，与词汇、时间框架和回答选择有关的后续访谈问题。以及一组经过修改的SCID-I问题，以便由训练有素的采访者在SCID-SR回答和SCID-I评级之间建立对应关系。认知访谈的结果将为专家小组选择最终的SCID-SR项目提供信息。最后一套SCID-SR项目将在第二阶段对大量不同样本的社区精神卫生门诊患者进行充分的定量验证。为与计划于2013年发布的DSM-V保持一致，对SCID-SR的必要修订也将在第二阶段完成。

DESCRIPTION (provided by applicant): In order to improve our understanding and treatment of mental illnesses, the primary mission of the National Institutes of Mental Health (NIMH), one must first accurately diagnose research participants and patients receiving routine clinical care. In this way, the appropriate links may be drawn between specific disorders, biological markers, and the effectiveness of treatments. The gold-standard for diagnosing mental health disorders is a standardized clinician-administered interview. However, such diagnostic interviews are not always practical in research and clinical practice due to time, expertise, and monetary requirements. Currently only one validated self-report diagnostic assessment exists, namely the Psychiatric Diagnostic Screening Questionnaire (PDSQ). However, this instrument was not developed for and has not been validated with a community mental health population. The PDSQ also lacks many important features that ease respondent and staff burden and increase usefulness in research and clinical practice. Given the tremendous need for valid cost-effective diagnostic assessments, we propose to develop the SCID-SR, a computerized, adaptive self-report diagnostic assessment with self-scoring, instantaneous narrative report generation, and a searchable response database. The SCID-SR will contain 15 diagnostic categories and will be based on the SCID-I, a gold-standard clinician administered diagnostic assessment for Axis I disorders, which uses criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). The SCID-SR will be appropriate for use with an adult community mental health population, including SPMI individuals. It will be developed using rigorous item authoring methods that have been used successfully in previous SBIR projects and produce items that are easy to read and understand, hold widespread cultural relevance, and are amenable to direct translation to other languages. SCID-SR items will be reviewed and rated by an Expert Panel during development and subsequently tested with three iterative rounds of cognitive interviewing with 60 adult community mental health outpatients from one of the largest private non-profit mental health organizations in the U.S. Cognitive interviews will include thinkalouds by participants while responding to the SCID-SR self-report items, follow-up interview questions pertaining to vocabulary, timeframe and selection of responses, as well as a modified set of SCID-I questions in order to establish correspondence between SCID-SR responses and SCID-I ratings by a trained interviewer. Results of cognitive interviews will inform the selection of the final set of SCID-SR items by the Expert Panel. The final set of SCID-SR items will undergo full quantitative validation with a large, diverse sample of community mental health outpatients in Phase II. Necessary revisions of the SCID-SR to conform with DSM-V, scheduled for release in 2013, will also be completed in Phase II. PUBLIC HEALTH RELEVANCE: Accurate diagnoses are the necessary first step to improving our understanding and treatment of mental illnesses, the primary mission of the National Institutes of Mental Health (NIMH). Availability of the SCID-SR, a computerized, adaptive self-report diagnostic assessment of Axis I mental health disorders, will provide researchers and clinicians with a rigorous, cost-effective alternative to clinician-administered diagnostic assessments. The SCID-SR will include Likert response sets, concise, easy to read and understand questions, automated scoring, instantaneous generation of comprehensive narrative reports, and a searchable response database, which will ease staff and respondent burden and increase usefulness in research and clinical practice.