REFINING ADOLESCENT DEPRESSION MEASUREMENT

描述(由申请人提供)：考虑到受单相抑郁影响的青少年比例，有必要进行准确的评估，以确定那些可能需要护理的人。虽然有理由相信抑郁症在整个发育过程中表现得不同，但我们还不知道有什么工具是专门为青少年量身定做的。某些抑郁症状可能在不同年龄段的青少年中更加明显或突出，或者在基于性别、药物使用和身体健康的不同亚组中。项目反应理论为开发对这些影响敏感的灵活测量系统提供了一个有用的框架。利用3个具有全国代表性的大型青少年样本的现有数据，拟议的发展研究将采用项目反应理论的方法来测量青少年的发展和完善。项目的目标是：1.为每个量表(使用IRT分析)建立重叠的、特定于年龄的项目集，其中包括有关抑郁症潜在易感性的信息(即，性别、身体健康和药物使用状况)，方法是：a)确定可被认为是跨年龄组通用的量表项目，以及应针对特定年龄群体的量表项目；以及b)确定应针对这些弱势群体中的一个或多个群体的人区别对待的量表项目；2.链接数据集和比较条目，以便开发年龄特定评估的原型集：a)通过链接数据集并同时生成所有条目的条目特征，比较来自每个量表的抑郁症条目在制定重叠的年龄特定评估(使用IRT分析)方面的潜在效用；以及b)使用这些信息来开发适当涵盖抑郁症的植物人、认知和情感方面的年龄特定评估的原型集；对与性别、身体健康和物质使用状况相关的可能的脆弱性敏感；并且通过公共条目链接，以便可以在不同评估之间比较分数。成功完成这些目标将产生一套针对青少年的具体年龄评估的原型，它独特地结合了现有研究中最敏感和最相关的项目。随后部署这套仪器(拟作为R01的后续版本)将允许对原型项目进行评估和改进，建立诊断规范，并开发便携式评分系统。

DESCRIPTION (provided by applicant): Given the proportion of adolescents affected by unipolar depression, accurate assessments are necessary to identify those likely to be in need of care. While there is reason to believe that depression manifests itself differently throughout development, we know of no instruments that are tailored expressly to adolescents. Certain depressive symptoms may be more apparent or salient for adolescents of different ages, or in various subgroups based on gender, substance use and physical health. Item response theory provides a useful framework for the development of a flexible measurement system that is sensitive to these influences. Using existing data from 3 large nationally representative adolescent samples, the proposed developmental study will adopt an item response theory approach to adolescent measurement development and refinement. Project aims are to: 1. Establish overlapping, age-specific item sets for each scale (using IRT analyses) that incorporate information about potential vulnerabilities to depression (i.e., gender, physical health and substance use status) by: a) identifying scale items that can be considered common across age groups and scale items that should be age-specific; and b) identifying scale items that should be treated differently for people in one or more of these vulnerable groups; and 2. Link data sets and compare items in order to develop a prototype set of age-specific assessments: a) compare the potential utility of depression items from each of the scales in the development of overlapping age-specific assessments (using IRT analyses) by linking the data sets and generating item characteristics for all items simultaneously; and b) use this information to develop a prototype set of age-specific assessments that appropriately cover the vegetative, cognitive, and affective aspects of depression; are sensitive to possible vulnerabilities associated with gender, physical health, and substance use status; and are linked through common items so that scores can be compared across assessments. Successful completion of these aims will result in a prototype set of age-specific assessments for adolescents that uniquely combines the most sensitive and relevant items from the existing studies. Subsequent fielding of this instrument set (to be proposed as a follow-on R01) will allow for evaluation and refinement of the prototype items, establishment of diagnostic norms, and development of a portable scoring system.