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《诊断婴幼儿评估量表(Diagnostic Infant and Preschool Assessment)的信度和效标效度:一种用于幼儿的新型诊断工具》

The reliability and criterion validity of the Diagnostic Infant and Preschool Assessment: a new diagnostic instrument for young children.

机构信息

Department of Psychiatry & Behavioral Sciences, Institute of Infant and Early Childhood Mental Health, Tulane University Health Sciences Center, 1440 Canal St., New Orleans, LA 70112, USA.

出版信息

Child Psychiatry Hum Dev. 2010 Jun;41(3):299-312. doi: 10.1007/s10578-009-0169-2.

Abstract

The need to assess Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) disorders in children younger than 7 years of age has intensified as clinical efforts to diagnose and treat this population have increased, and clinical research on psychopathology has advanced. A new diagnostic instrument for young children was created, the Diagnostic Infant Preschool Assessment (DIPA), and was tested for test-retest reliability and concurrent criterion validity. The caregivers of 50 outpatients aged 1-6 years were interviewed twice by trained interviewers, once by a clinician and once by a research assistant, about eight disorders. The median test-retest intraclass correlation was 0.69, mean 0.61, and values ranged from 0.24 to 0.87. The median test-retest kappa was 0.53, mean 0.52, and values ranged from 0.38 to 0.66. There were no differences by duration between interviews. Concurrent criterion validity show good agreement between the instrument and DSM-based Child Behavior Checklist scales when the DSM-based scales were matched well to the disorder (attention-deficit/hyperactivity inattentive and hyperactive and oppositional disorders). Preliminary data support the DIPA as a reliable and valid measure of symptoms in research and clinical work with very young children. This measure adds a tool that is flexible in covering both DSM-IV syndromes and empirically-validated developmental modifications that can help increase confidence in assessing young children, ensuring coverage of symptoms, and improve access to care.

摘要

随着临床诊断和治疗该人群的努力增加,以及儿童精神病理学临床研究的进展,评估《精神障碍诊断与统计手册》第四版(DSM-IV)在 7 岁以下儿童中的疾病的需求也日益增加。为年幼的儿童创建了一种新的诊断工具,即诊断婴儿学前评估(DIPA),并对其进行了重测信度和同时效标准效度测试。对 50 名 1-6 岁的门诊患者的照顾者进行了两次访谈,由受过培训的访谈者进行,一次由临床医生进行,一次由研究助理进行,涉及八个障碍。中位数重测信度的组内相关系数为 0.69,平均为 0.61,范围从 0.24 到 0.87。中位数重测信度 kappa 为 0.53,平均为 0.52,范围从 0.38 到 0.66。两次访谈之间没有时间间隔的差异。当基于 DSM 的儿童行为检查表量表与障碍匹配良好时,该工具与基于 DSM 的量表之间的同时效标准效度显示出良好的一致性(注意力缺陷/多动障碍的注意力不集中和多动障碍以及对立违抗性障碍)。初步数据支持 DIPA 作为研究和临床工作中非常年幼的儿童症状的可靠和有效测量工具。该测量方法增加了一种灵活的工具,可以涵盖 DSM-IV 综合征和经验验证的发展变化,这有助于增加对评估幼儿的信心,确保症状的涵盖,并改善获得护理的机会。

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