Haroz Emily E, Kane Jeremy C, Nguyen Amanda J, Bass Judith K, Murray Laura K, Bolton Paul
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.
Glob Ment Health (Camb). 2020 Jan 9;7:e3. doi: 10.1017/gmh.2019.30. eCollection 2020.
There is a need for accurate and efficient assessment tools that cover a range of mental health and psychosocial problems. Existing, lengthy self-report assessments may reduce accuracy due to respondent fatigue. Using data from a sample of adults enrolled in a psychotherapy randomized trial in Thailand and a cross-sectional sample of adolescents in Zambia, we leveraged Item Response Theory (IRT) methods to create brief, psychometrically sound, mental health measures.
We used graded-response models to refine scales by identifying and removing poor performing items that were not well correlated with the underlying trait, and by identifying well-performing items at varying levels of a latent trait to assist in screening or monitoring purposes.
In Thailand, the original 17-item depression scale was shortened to seven items and the 30-item Posttraumatic Stress Scale (PTS) was shortened to 10. In Zambia, the Child Posttraumatic Stress Scale (CPSS) was shortened from 17 items to six. Shortened scales in both settings retained the strength of their psychometric properties. When examining longitudinal intervention effects in Thailand, effect sizes were comparable in magnitude for the shortened and standard versions.
Using Item Response Theory (IRT) we created shortened valid measures that can be used to help guide clinical decisions and function as longitudinal research tools. The results of this analysis demonstrate the reliability and validity of shortened scales in each of the two settings and an approach that can be generalized more broadly to help improve screening, monitoring, and evaluation of mental health and psychosocial programs globally.
需要准确且高效的评估工具来涵盖一系列心理健康和心理社会问题。现有的冗长自我报告评估可能会因受访者疲劳而降低准确性。利用来自泰国一项心理治疗随机试验中成年样本以及赞比亚青少年横断面样本的数据，我们运用项目反应理论（IRT）方法创建了简短且心理测量学上合理的心理健康测量工具。
我们使用等级反应模型来优化量表，通过识别和去除与潜在特质相关性不佳的表现较差的项目，以及通过识别潜在特质不同水平上表现良好的项目来辅助筛查或监测目的。
在泰国，最初的17项抑郁量表缩短至7项，30项创伤后应激量表（PTS）缩短至10项。在赞比亚，儿童创伤后应激量表（CPSS）从17项缩短至6项。两种情况下缩短后的量表都保留了其心理测量特性的优势。在泰国考察纵向干预效果时，缩短版和标准版的效应大小在量级上相当。
运用项目反应理论（IRT），我们创建了可用于帮助指导临床决策并作为纵向研究工具的缩短后的有效测量工具。该分析结果证明了缩短后的量表在两种情况下各自的可靠性和有效性，以及一种可更广泛推广以帮助改善全球心理健康和心理社会项目的筛查、监测及评估的方法。
