Thöne Ann-Kathrin, Görtz-Dorten Anja, Altenberger Paula, Dose Christina, Geldermann Nina, Hautmann Christopher, Jendreizik Lea Teresa, Treier Anne-Katrin, von Wirth Elena, Banaschewski Tobias, Brandeis Daniel, Millenet Sabina, Hohmann Sarah, Becker Katja, Ketter Johanna, Hebebrand Johannes, Wenning Jasmin, Holtmann Martin, Legenbauer Tanja, Huss Michael, Romanos Marcel, Jans Thomas, Geissler Julia, Poustka Luise, Uebel-von Sandersleben Henrik, Renner Tobias, Dürrwächter Ute, Döpfner Manfred
School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Front Psychol. 2020 Jul 24;11:1840. doi: 10.3389/fpsyg.2020.01840. eCollection 2020.
This study assesses the reliability and validity of the DSM-5-based, semi-structured (ILF-EXTERNAL).
Participant data were drawn from the ongoing ESCAschool intervention study. The ILF-EXTERNAL was evaluated in a clinical sample of 474 children and adolescents (aged 6-12 years, 92 females) with symptoms of attention-deficit/hyperactivity disorder (ADHD). To obtain interrater reliability, the one-way random-effects, absolute agreement models of the intraclass correlation (ICC) for single ICC(1,1) and average measurements ICC(1,3) were computed between the interviewers and two independent raters for 45 randomly selected interviews involving ten interviewers. Overall agreement on DSM-5 diagnoses was assessed using Fleiss' kappa. Further analyses evaluated internal consistencies, item-total correlations as well as correlations between symptom severity and the degree of functional impairment. Additionally, parents completed the German version of the (CBCL) and two DSM-5-based parent questionnaires for the assessment of ADHD symptoms and symptoms of disruptive behavior disorders (FBB-ADHS; FBB-SSV), which were used to evaluate convergent and divergent validity.
ICC coefficients demonstrated very good to excellent interrater reliability on the item and scale level of the ILF-EXTERNAL [scale level: ICC(1,1) = 0.83-0.95; ICC(1,3) = 0.94-0.98]. Overall kappa agreement on DSM-5 diagnoses was substantial to almost perfect for most disorders (0.38 ≤ κ ≤ 0.94). With some exceptions, internal consistencies (0.60 ≤ α ≤ 0.86) and item-total correlations (0.21 ≤ ≤ 0.71) were generally satisfactory to good. Furthermore, higher symptom severity was associated with a higher degree of functional impairment. The evaluation of convergent validity revealed positive results regarding clinical judgment and parent ratings (FBB-ADHS; FBB-SSV). Correlations between the ILF-EXTERNAL scales and the CBCL were moderate to high. Finally, the ILF-EXTERNAL scales were significantly more strongly associated with the CBCL than with the , indicating divergent validity.
In clinically referred, school-age children, the ILF-EXTERNAL demonstrates sound psychometric properties. The ILF-EXTERNAL is a promising clinical interview and contributes to high-quality diagnostics of externalizing disorders in children and adolescents.
本研究评估基于《精神疾病诊断与统计手册》第五版（DSM - 5）的半结构化访谈（ILF - EXTERNAL）的信度和效度。
参与者数据来自正在进行的ESCA学校干预研究。在474名有注意力缺陷多动障碍（ADHD）症状的儿童和青少年（6至12岁，92名女性）的临床样本中对ILF - EXTERNAL进行评估。为获得评分者间信度，计算了45次随机抽取访谈（涉及10名访谈者）的单一评分者内相关系数（ICC）的单向随机效应、绝对一致性模型（用于单一ICC(1,1)和平均测量值ICC(1,3)），访谈者与两名独立评分者之间进行了比较。使用Fleiss' kappa评估关于DSM - 5诊断的总体一致性。进一步分析评估了内部一致性、项目与总分的相关性以及症状严重程度与功能损害程度之间的相关性。此外，家长完成了德国版的儿童行为量表（CBCL）以及两份基于DSM - 5的家长问卷，用于评估ADHD症状和破坏性行为障碍症状（FBB - ADHS；FBB - SSV），这些问卷用于评估聚合效度和区分效度。
ICC系数在ILF - EXTERNAL的项目和量表水平上显示出非常好到极好的评分者间信度[量表水平：ICC(1,1)=0.83 - 0.95；ICC(1,3)=0.94 - 0.98]。对于大多数障碍，关于DSM - 5诊断的总体kappa一致性为中等至几乎完美（0.38≤κ≤0.94）。除了一些例外情况，内部一致性（0.60≤α≤0.86）和项目与总分的相关性（0.21≤ ≤0.71）总体上令人满意至良好。此外，症状严重程度越高，功能损害程度越高。聚合效度评估显示临床判断和家长评分（FBB - ADHS；FBB - SSV）方面有积极结果。ILF - EXTERNAL量表与CBCL之间的相关性为中等至高。最后，ILF - EXTERNAL量表与CBCL的相关性显著强于与 的相关性，表明具有区分效度。
在临床转诊的学龄儿童中，ILF - EXTERNAL表现出良好的心理测量特性。ILF - EXTERNAL是一种很有前景的临床访谈工具，有助于对儿童和青少年的外化障碍进行高质量诊断。
