Vaughn-Coaxum Rachel A, Mair Patrick, Weisz John R
Department of Psychology, Harvard University, Cambridge, MA.
Clin Psychol Sci. 2016 Mar;4(2):239-253. doi: 10.1177/2167702615591768. Epub 2015 Aug 13.
Accurate assessment of dysfunction is central to clinical psychological science, essential for valid conclusions about prevalence, risk, and appropriate intervention. Measures applied without adjustment across diverse racial/ethnic groups may risk errors if measurement equivalence has not been established. We tested this possibility in the domain of youth depression, applying item response theory (IRT) and differential item functioning (DIF) analyses to reports by White, Black, Latino, and Asian youths (N = 2,335) on the most widely-used measure of symptoms, the Children's Depression Inventory (CDI). Analyses revealed that 77% of CDI items were non-equivalent indicators of symptom severity across groups. CDI sum scores exhibited marked over-estimations of group differences and inappropriate classification as "clinically-elevated" for 29% of Latino, 23% of Black, and 10% of Asian youths. Applying DIF adjustment corrected these errors. The study demonstrates a useful strategy for ethnically sensitive assessment, applicable to other symptom domains and ethnic groups.
功能障碍的准确评估是临床心理科学的核心,对于得出关于患病率、风险和适当干预的有效结论至关重要。如果尚未确立测量等效性,那么在不同种族/族裔群体中未经调整就应用的测量方法可能会有出错的风险。我们在青少年抑郁症领域测试了这种可能性,对白人、黑人、拉丁裔和亚裔青少年(N = 2335)就最广泛使用的症状测量工具——儿童抑郁量表(CDI)所做的报告应用了项目反应理论(IRT)和项目功能差异(DIF)分析。分析表明,77%的CDI项目在不同群体中并非症状严重程度的等效指标。CDI总分对群体差异存在明显高估,并且将29%的拉丁裔、23%的黑人以及10%的亚裔青少年不恰当地归类为“临床症状加重”。应用DIF调整纠正了这些错误。该研究展示了一种对种族敏感的评估有用策略,适用于其他症状领域和种族群体。