a Research Institute of Child Development and Education , University of Amsterdam , Amsterdam , the Netherlands.
b Institute of Psychology, Leiden University , Leiden , the Netherlands.
Multivariate Behav Res. 2019 Jul-Aug;54(4):593-611. doi: 10.1080/00273171.2018.1563520. Epub 2019 Apr 19.
Careless responding by mental health patients on self-report assessments is rarely investigated in routine care despite the potential for serious consequences such as faulty clinical decisions. We investigated validity indices most appropriate for detecting careless responding in routine outcome monitoring (ROM) in mental health-care. First, we reviewed indices proposed in previous research for their suitability in ROM. Next, we evaluated six selected indices using data of the Brief Symptom Inventory and the Mood and Anxiety Symptom Questionnaire from 3,483 outpatients. Simulations showed that for typical ROM scales the index, Mahalanobis distance, and inter-item standard deviation may be too strongly confounded with the latent trait value to compare careless responding across patients with different symptom severity. Application of two different classification methods to the validity indices did not converge in similar prevalence estimates of careless responding. Finally, results suggest that careless responding does not have a substantial biasing effect on scale-score statistics. We recommend the person-fit index to screen for random careless responding in large ROM data sets. However, additional research should further investigate methods for detecting repetitive responding in typical ROM data and assess whether there are specific circumstances in which simpler validity statistics or direct screening methods perform similarly as the index.
尽管可能会导致严重后果，如临床决策错误，但精神卫生患者在自我报告评估中粗心作答的情况在常规护理中很少被调查。我们研究了在精神卫生保健常规结果监测（ROM）中最适合检测粗心作答的有效性指标。首先，我们回顾了之前研究中提出的指标，评估它们在 ROM 中的适用性。接下来，我们使用来自 3483 名门诊患者的简明症状量表和情绪与焦虑症状问卷的数据评估了六个选定的指标。模拟结果表明，对于典型的 ROM 量表，指标、马氏距离和条目间标准差可能与潜在特质值高度混淆，以至于无法比较不同症状严重程度的患者中的粗心作答情况。两种不同分类方法对有效性指标的应用在类似的粗心作答患病率估计中没有收敛。最后，结果表明粗心作答对量表分数统计数据没有实质性的偏差影响。我们建议使用个体拟合指数筛选大型 ROM 数据集的随机粗心作答。然而，还需要进一步研究用于检测典型 ROM 数据中重复作答的方法，并评估在何种特定情况下，更简单的有效性统计数据或直接筛选方法与 指标表现相同。
