San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, USA.
Int J Geriatr Psychiatry. 2010 Jun;25(6):578-87. doi: 10.1002/gps.2377.
Homebound older adults are at high risk for depression and anxiety. Systematic screening may increase identification of these difficulties and facilitate service usage. The purpose of this study was to investigate the factor structure, internal consistency, and concurrent validity of the Brief Symptom Inventory-18 (BSI-18) for use as a screening instrument for depression and anxiety with homebound older adults and to examine if the BSI-18 could be shortened further and exhibit comparable psychometric properties.
A sample of 142 older adults receiving in-home aging services completed interviews that included the BSI-18 and the depression and anxiety modules of the structured clinical interview for DSM-IV.
Confirmatory factor analysis showed that the theorized three-factor, second-order model of the BSI-18 fit the data well (S-B X(2) = 136.17; p = 0.36). The depression and anxiety subscales exhibited high internal consistency (alpha > 0.81), whereas the somatic subscale exhibited lower internal consistency (alpha = 0.69). Receiver operator curve (ROC) analyses suggest that the BSI-18 depression and anxiety subscales were able to predict those with DSM-IV diagnoses (Depression AUC = 0.89 p < 0.001; Anxiety AUC = 0.80, p < 0.001). The ROC results suggested adapting a cut score of T = 50 to achieve optimal sensitivity and specificity. The short three-item depression scale exhibited comparable psychometric properties to the full scale, while the three-item somatic and anxiety scales exhibited lower internal consistency and sensitivity.
These findings provide initial evidence that the BSI-18 is valid for use with homebound older adults.
居家老年人有较高的抑郁和焦虑风险。系统筛查可能会增加对这些困难的识别，并促进服务的使用。本研究旨在调查 Brief Symptom Inventory-18（BSI-18）作为居家老年人抑郁和焦虑筛查工具的结构、内部一致性和同时效度，并检验BSI-18 是否可以进一步缩短，并具有相当的心理测量特性。
一个由 142 名接受家庭养老服务的老年人组成的样本完成了访谈，包括 BSI-18 和 DSM-IV 结构化临床访谈的抑郁和焦虑模块。
验证性因素分析表明，BSI-18 的理论三因素、二阶模型很好地拟合了数据（S-B X(2) = 136.17；p = 0.36）。抑郁和焦虑分量表表现出较高的内部一致性（alpha > 0.81），而躯体分量表表现出较低的内部一致性（alpha = 0.69）。接收器操作曲线（ROC）分析表明，BSI-18 的抑郁和焦虑分量表能够预测那些具有 DSM-IV 诊断的人（抑郁 AUC = 0.89，p < 0.001；焦虑 AUC = 0.80，p < 0.001）。ROC 结果表明，采用 T = 50 的切点可以达到最佳的敏感性和特异性。简短的三项目抑郁量表与完整量表具有相当的心理测量特性，而三项目躯体和焦虑量表则表现出较低的内部一致性和敏感性。
这些发现为 BSI-18 用于居家老年人提供了初步的有效性证据。
