A New Statistical Paradigm for Measuring Psychopathology Dimensions in Youth

描述（由申请人提供）：我们建议开发、测试和应用一种新的计算机自适应测试方法来测量儿童和青少年（9-17 岁）抑郁、焦虑、躁狂、破坏性行为和注意力缺陷/多动障碍的严重程度。该提案在方法论和科学上对儿科精神病理学评估的研究做出了贡献。拟议的工作将推进心理健康研究并改善初级保健中的精神病学筛查和监测。 本申请中提出的方法学工作是由一项基本的科学挑战推动的，该挑战限制了测量儿科人群精神病理学的进展。我们需要了解青少年精神病理学的测量从童年到青春期是如何变化的。我们提出的工作包括基于多维项目反应理论（IRT）的计算机自适应测试（CAT）的新统计方法，该方法使我们能够根据每个孩子的发展水平（垂直缩放）定制测量过程。该应用程序的总体目标是为儿童和青少年开发一个 CAT，以实现以下目标： 目标 1：提供抑郁、躁狂、焦虑、破坏性行为障碍 (DBD) 和注意力缺陷/多动障碍 (ADHD) 的维度严重程度评分。目标 2：确定患有与功能障碍相关的症状严重程度的儿童和青少年，他们可能会受益于更广泛的诊断评估，以评估治疗的需要。目标 3：使用差异项目功能来识别一组项目，这些项目可以最佳地区分严重程度的高低水平或每个精神病理学维度，对于该维度的父母和儿童评级。目标 4：准确预测 DSM 对重度抑郁症 (MDD)、ADHD、对立违抗性障碍 (ODD)、行为障碍 (CD)、焦虑症 (AD；广泛性焦虑症、分离焦虑症、社交恐惧症、特定恐惧症) 和双相情感障碍 (BD) 的分类诊断。探索性目标：使用同样强大的心理测量策略，我们将采取几个重要步骤来开发和测试研究领域标准 (RDoC) 中确定的两个核心生物心理过程的并行 CAT 测量。为了实现这些目标，我们将开发一个包含大约 1000 个项目的库，针对不同发育水平的抑郁症（包括自杀的子领域）、躁狂、焦虑、DBD 和 ADHD 以及正价和负价 RDoC 领域的症状。然后，我们将使用双因素 IRT 模型校准项目库，然后开发、测试和验证基于 CAT 的管理。

DESCRIPTION (provided by applicant): We propose to develop, test, and apply a new computerized adaptive testing approach to measuring severity of depression, anxiety, mania, disruptive behavior, and attention-deficit/hyperactivity disorders in children and adolescents (9-17 years). This proposal contributes both methodologically and scientifically to research on the assessment of pediatric psychopathology. The proposed work will advance mental health research and improve psychiatric screening and monitoring in primary care. The methodological work proposed in this application is driven by a fundamental scientific challenge that has limited progress in measuring psychopathology in pediatric populations. We need to understand how the measurement of psychopathology in youth changes from childhood through adolescence. Our proposed work includes new statistical methodology for a Computerized Adaptive Test (CAT) based on multidimensional Item Response Theory (IRT) that allows us to tailor the measurement process to each child's developmental level (vertical scaling). The overarching aim of this application is to develop a CAT for children and adolescents that achieves the following goals: Aim 1: Provides dimensional severity scores for depression, mania, anxiety, disruptive behavioral disorders (DBDs), and attention-deficit/hyperactivity disorder (ADHD). Aim 2: Identifies children and adolescents who have symptom severity associated with functional impairment who would potentially benefit from a more extensive diagnostic assessment to evaluate the need for treatment. Aim 3: Uses differential item functioning to identify a set of items that optimally discriminate high and low levels of severity or each of psychopathology dimension equally well for parent and child ratings of that dimension. Aim 4:Accurately predicts DSM categorical diagnoses of major depressive disorder (MDD), ADHD, oppositional defiant disorder (ODD), conduct disorder (CD), anxiety disorders (AD; generalized anxiety disorder, separation anxiety disorder, social phobia, specific phobia), and bipolar disorder (BD). Exploratory Aim: Using the same powerful psychometric strategies, we will take several important steps toward developing and testing of a parallel CAT measure of two of the core biopsychological processes identified in the Research Domain Criteria (RDoC). To achieve these aims, we will develop a bank of approximately 1000 items addressing at different developmental levels symptoms of depression (including a subdomain of suicidality), mania, anxiety, DBDs and ADHD, as well as positive and negative valence RDoC domains. We will then calibrate the item bank using a bifactor IRT model and then develop, test and validate CAT-based administration.