Colins Olivier F
Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Endegeesterstraatweg 27, Leiden AK 2342, The Netherlands.
Int J Environ Res Public Health. 2016 Sep 21;13(9):932. doi: 10.3390/ijerph13090932.
It is unknown if the DSM-oriented (DSM) scales of the Youth Self-Report (YSR) are useful to determine what kind of narrowly-focused psychiatric assessment is needed, and how well these scales serve as a triage tool in real-world forensic settings. To address this knowledge gap, the YSR and diagnostic interviews were administered to 405 detained boys as part of a clinical protocol. Continuous DSM scale scores (e.g., Conduct Problems) were moderately to highly accurate in predicting their corresponding disorder (e.g., conduct disorder), whereas dichotomized DSM scale scores were not. To test the DSM scales' usefulness for triage purposes, the sensitivity and specificity of being in the borderline range of one or more DSM scales were calculated. Almost all boys who did not have a disorder were in the normal range of at least one DSM scale (high specificity). However, many boys with a disorder would have been missed if such a decision rule was used for triage purposes (low sensitivity). In conclusion, their relations with the corresponding disorders support the construct validity of the DSM scales in an applied forensic setting. Nevertheless, the findings also warrant against the use of these scales for planning further narrowly-focused assessment or for triage purposes.
尚不清楚《青少年自我报告》（YSR）中以《精神疾病诊断与统计手册》（DSM）为导向的量表是否有助于确定需要何种针对性较强的精神病学评估，以及这些量表在现实世界的法医环境中作为分诊工具的效果如何。为填补这一知识空白，作为临床方案的一部分，对405名被拘留男孩进行了YSR和诊断访谈。连续的DSM量表分数（如品行问题）在预测其相应疾病（如品行障碍）方面具有中等至高度的准确性，而二分法的DSM量表分数则不然。为测试DSM量表用于分诊目的的有效性，计算了处于一个或多个DSM量表临界范围内的敏感性和特异性。几乎所有没有疾病的男孩至少在一个DSM量表的正常范围内（高特异性）。然而，如果将这样的决策规则用于分诊目的，许多患有疾病的男孩将会被漏诊（低敏感性）。总之，它们与相应疾病的关系支持了DSM量表在应用法医环境中的结构效度。尽管如此，研究结果也表明不适合使用这些量表来规划进一步针对性较强的评估或用于分诊目的。
