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一种可在现实环境中为青少年提供心理社会治疗的便携评估方案:通过自我报告量表减轻评估负担。

A transportable assessment protocol for prescribing youth psychosocial treatments in real-world settings: reducing assessment burden via self-report scales.

机构信息

Department of Psychology, University of California at Los Angeles, 90095-1563, USA.

出版信息

Psychol Assess. 2012 Mar;24(1):141-55. doi: 10.1037/a0025176. Epub 2011 Aug 22.

DOI:10.1037/a0025176
PMID:21859220
Abstract

Current evidence-based assessment methods, such as structured interviews and lengthy assessment batteries, often require hours to administer, score, and interpret and thus are infrequently used in real-world practice. As evidence-based assessment tools are developed for implementation in real-world youth mental health settings, the transportability properties of assessment procedures (including administration and interpretation burden) need to be considered and improved. In the present study, we thus conducted an initial feasibility study using a clinical sample of community-based youths (N = 306) to develop an assessment protocol based on 2 child and 2 parent self-report questionnaires (thus low on administration burden). Using decision-tree analysis, we identified a series of cutoff scores across these scales that may be used to inform treatment need related to anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), and disruptive behavior problems. This algorithm-based approach to interpreting assessment information provided clear and simple guidelines (thus low on interpretation burden) that matched the best estimate treatment determinations derived by trained assessors, supervisors, and expert consultants who integrated information provided by child and parent structured interviews and self-report scales. The present study demonstrated the feasibility of developing an assessment protocol to inform various treatment allocation decisions in a way that imposes little assessment administration and interpretation burden yet maintains adequate classification accuracy. These characteristics make the proposed protocol promising with regard to its transportability and suitability for adoption and implementation in real-world mental health settings.

摘要

目前的循证评估方法,如结构化访谈和冗长的评估工具包,通常需要数小时的时间来进行管理、评分和解释,因此在实际实践中很少使用。随着基于证据的评估工具在现实世界中的青年心理健康环境中得到开发和实施,评估程序的可转移性(包括管理和解释负担)需要得到考虑和改进。在本研究中,我们因此使用基于社区的青年临床样本(N=306)进行了一项初步可行性研究,开发了一种基于 2 个儿童和 2 个父母自我报告问卷的评估方案(因此管理负担较低)。使用决策树分析,我们确定了这些量表上的一系列截断分数,这些分数可用于告知与焦虑、抑郁、注意缺陷/多动障碍(ADHD)和破坏性行为问题相关的治疗需求。这种基于算法的解释评估信息的方法提供了清晰和简单的指导(因此解释负担较低),与受过训练的评估员、主管和专家顾问根据儿童和父母结构化访谈和自我报告量表提供的信息得出的最佳估计治疗决策相匹配。本研究表明,开发一种评估方案来告知各种治疗分配决策是可行的,这种方案对评估管理和解释负担很小,但保持了足够的分类准确性。这些特征使得所提出的方案具有可转移性和在现实心理健康环境中采用和实施的适用性。

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