De Los Reyes Andres, Augenstein Tara M, Wang Mo, Thomas Sarah A, Drabick Deborah A G, Burgers Darcy E, Rabinowitz Jill
Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland.
Department of Management, University of Florida.
Psychol Bull. 2015 Jul;141(4):858-900. doi: 10.1037/a0038498. Epub 2015 Apr 27.
Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for "best practices" in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. (PsycINFO Database Record
儿童和青少年患者可能在某些情境下而非其他情境下表现出心理健康问题(例如,在家中与在学校)。因此,了解患者表现出问题的具体情境可能有助于心理健康专业人员根据患者需求调整治疗方案。因此,临床评估通常包括来自多个信息提供者的报告,这些信息提供者观察患者行为的情境各不相同(例如,患者、父母、教师)。以往的元分析表明,信息提供者的报告之间的相关性处于低到中等程度。然而,将报告之间的低一致性解释为患者在某些情境下表现出问题而在其他情境下没有,这种解释是否有效呢?我们对1989年至2014年间发表的341项报告了跨信息提供者一致性估计的研究进行了元分析,观察到低到中等程度的一致性(内化问题平均相关系数:r = 0.25;外化问题平均相关系数:r = 0.30;总体平均相关系数:r = 0.28)。信息提供者配对、心理健康领域和测量方法调节了一致性的程度。这些有力的研究结果为解释多信息提供者评估的概念发展提供了依据,使研究人员能够对这些评估的增量效度和结构效度做出具体预测。反过来,我们对临床儿童和青少年评估中多信息提供者方法的增量效度和结构效度的研究进行了批判性评估。在此过程中,我们确定了未来研究中关键的知识空白,并为在临床工作和研究中使用和解释多信息提供者评估提供了“最佳实践”建议。本文对于开发个性化的临床评估方法具有重要意义,目的是为根据患者表现出问题的具体情境调整治疗的技术提供信息。(PsycINFO数据库记录)