Martel Michelle M, Markon Kristian, Smith Gregory T
Department of Psychology, University of Kentucky, Lexington, KY, USA.
Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA.
J Child Psychol Psychiatry. 2017 Feb;58(2):116-128. doi: 10.1111/jcpp.12611. Epub 2016 Aug 5.
An empirically based, clinically usable approach to cross-informant integration in clinical assessment is needed. Although the importance of this ongoing issue is becoming increasingly recognized, little in the way of solid recommendations is currently provided to researchers and clinicians seeking to incorporate multiple informant reports in diagnosis of child psychopathology. The issue is timely because recent developments have created new opportunities for improved handling of this problem. For example, advanced theories of psychopathology and normal and abnormal child development provide theoretical guidance for how integration of multiple informants should be handled for specific disorders and at particular ages. In addition, more sophisticated data analytic approaches are now available, including advanced latent variable models, which allow for complex measurement approaches with consideration of measurement invariance.
The increasing availability and mobility of computing devices suggests that it will be increasingly feasible for clinicians to implement more advanced methods rather than being confined to the easily memorized algorithms of the DSM system.
Development of models of cross-informant integration for individual disorders based on theory and tests of the incremental validity of more sophisticated cross-informant integration approaches in comparison to external validation criteria (e.g. longitudinal trajectories and outcomes, treatment response, and behavior genetic etiology) should be a focus of future work.
临床评估中基于经验且具有临床实用性的跨信息提供者整合方法是必要的。尽管这个持续存在的问题的重要性日益得到认可,但目前几乎没有为寻求在儿童精神病理学诊断中纳入多信息提供者报告的研究人员和临床医生提供可靠的建议。这个问题很及时,因为最近的进展为更好地处理这个问题创造了新机会。例如,精神病理学以及正常和异常儿童发展的先进理论为针对特定障碍和特定年龄段应如何处理多信息提供者的整合提供了理论指导。此外,现在有了更复杂的数据分析方法,包括先进的潜在变量模型,其允许在考虑测量不变性的情况下采用复杂的测量方法。
计算设备可用性和移动性的不断提高表明,临床医生越来越有可能实施更先进的方法,而不是局限于DSM系统中易于记忆的算法。
基于理论开发针对个体障碍的跨信息提供者整合模型,并测试与外部验证标准(如纵向轨迹和结果以及治疗反应和行为遗传病因)相比更复杂的跨信息提供者整合方法的增量效度,应成为未来工作的重点。