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荷兰样本中诊断婴幼儿评估(DIPA)的准确性。

Accuracy of the Diagnostic Infant and Preschool Assessment (DIPA) in a Dutch sample.

机构信息

Amsterdam UMC, University of Amsterdam, Department of Child and Adolescent Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; De Bascule, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands.

Amsterdam UMC, University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence based practice in Health Care, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.

出版信息

Compr Psychiatry. 2020 Jul;100:152177. doi: 10.1016/j.comppsych.2020.152177. Epub 2020 Apr 23.

Abstract

BACKGROUND

To prevent negative effects of early-onset psychiatric disorders on children's development, structured diagnostics are needed. However, validated diagnostic instruments (based on DSM-5) for children aged 7 years and younger are scarce. The Diagnostic Infant and Preschool Assessment (DIPA) is a diagnostic interview developed in the USA for measuring 16 psychiatric disorders in young children. The psychometric properties of the American version of the DIPA have been validated. Here we determined the accuracy of the psychometric properties of the Dutch DSM-5 based version of the DIPA for the corresponding population.

MATERIAL AND METHODS

Psychometric properties of the DSM-5 based version of the DIPA were determined based on a sample of 136 biological, foster, therapeutic foster and adoptive parents of clinically referred children and children involved in a serious accident (aged 1-7 years). In line with the American validation study, we included the following seven DIPA modules: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), separation anxiety disorder (SAD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). We administered the DIPA, Trauma Symptom Checklist for Young Children (TSCYC) and Child Behavior Checklist (CBCL). Analyses were conducted with continuous outcomes (number of symptoms) and categorical outcomes (diagnoses).

RESULTS

The Dutch DSM-5 based version of the DIPA showed good internal consistency and interrater reliability with both continuous and categorical variables. The concurrent validity was good; we found a good concordance between the DIPA and corresponding questionnaires on both the symptom and diagnoses level. In addition, the divergence on symptom level between the DIPA and non-corresponding questionnaires was adequate, which indicated adequate divergent validity. Due to a limited number of positive cases, we could not draw conclusions regarding its psychometric properties in the GAD and OCD modules.

CONCLUSIONS

Our study shows promising initial results regarding the reliability and validity of the Dutch version of the DIPA, that is based on the DSM-5. Therefore, we recommend the use of the DIPA in research and clinical practice.

摘要

背景

为了防止早期精神病对儿童发展的负面影响,需要进行结构化诊断。然而,针对 7 岁及以下儿童的经过验证的诊断工具(基于 DSM-5)却很少。Diagnostic Infant and Preschool Assessment(DIPA)是一种在美国开发的诊断性访谈工具,用于测量幼儿的 16 种精神障碍。美国版 DIPA 的心理测量学特性已经过验证。在这里,我们确定了基于 DSM-5 的荷兰版 DIPA 的心理测量学特性在相应人群中的准确性。

材料和方法

根据 136 名接受过临床转诊的儿童和严重事故中涉及的儿童(1-7 岁)的亲生父母、寄养父母、治疗性寄养父母和养父母的样本,确定了基于 DSM-5 的 DIPA 版本的心理测量学特性。与美国验证研究一致,我们包括以下七个 DIPA 模块:创伤后应激障碍(PTSD)、重度抑郁障碍(MDD)、注意缺陷多动障碍(ADHD)、对立违抗性障碍(ODD)、分离焦虑障碍(SAD)、广泛性焦虑障碍(GAD)和强迫症(OCD)。我们使用 DIPA、儿童创伤症状清单(TSCYC)和儿童行为清单(CBCL)进行评估。分析采用连续结果(症状数量)和分类结果(诊断)进行。

结果

荷兰基于 DSM-5 的 DIPA 版本在连续和分类变量上均表现出良好的内部一致性和评分者间可靠性。同时,它具有良好的效标关联效度;我们发现 DIPA 与相应问卷在症状和诊断水平上具有良好的一致性。此外,DIPA 与非对应问卷在症状水平上的差异也足够大,表明其具有足够的区分效度。由于阳性病例数量有限,我们无法得出关于其在 GAD 和 OCD 模块中的心理测量学特性的结论。

结论

我们的研究结果表明,基于 DSM-5 的荷兰版 DIPA 的可靠性和有效性具有初步的前景。因此,我们建议在研究和临床实践中使用 DIPA。

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