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20 个社会中老年人自评(OASR)精神病理学综合征的可推广性。

The generalizability of Older Adult Self-Report (OASR) syndromes of psychopathology across 20 societies.

机构信息

Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington, VT, USA.

Department of Psychology, Bryn Mawr College, Philadelphia, PA, USA.

出版信息

Int J Geriatr Psychiatry. 2020 May;35(5):525-536. doi: 10.1002/gps.5268. Epub 2020 Feb 18.

Abstract

OBJECTIVES

As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co-occurring problems derived from self-ratings of psychopathology by US elders would fit self-ratings by elders in 19 other societies.

METHODS/DESIGN: The Older Adult Self-Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven-syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes.

RESULTS

In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies.

CONCLUSIONS

The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.

摘要

目的

随着世界人口老龄化,精神科医生将越来越需要能够将精神病理学结构推广到不同老年人的测量工具。本研究检验了源自美国老年人自我报告精神病理学的共病问题综合征是否适用于来自其他 19 个社会的老年人的自我评定。

方法/设计:来自北美洲、南美洲、亚洲以及东欧、北欧、南欧和西欧的 19 个社会的 12826 名 60 至 102 岁的成年人完成了《老年自评量表》(OASR)。个体和多群组验证性因素分析(CFA)检验了由焦虑/抑郁、担忧、躯体抱怨、功能障碍、记忆/认知问题、思维问题和易怒/抑制障碍综合征组成的七综合征 OASR 模型的拟合度。

结果

在个体 CFA 中,主要模型拟合指数显示所有社会的拟合度良好,而次要模型拟合指数显示可接受至良好的拟合度。这些项目强烈地加载在各自的因子上,在 20 个社会中,中位数项目加载值为.63,98.7%的加载值具有统计学意义。在多群组 CFA 中,98%的项目表现出近似或完全的度量不变性。15%的项目表现出近似或完全的标度不变性,另外 59%的项目在超过一半的社会中表现出标度不变性。

结论

这些发现支持 OASR 综合征在不同社会中的可推广性。这七个综合征提供了基于经验的临床结构,与不同背景的老年人相关。它们可用于评估不同的老年人,并作为一个分类框架,促进老年精神病学的沟通、服务、研究和培训。

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