Vitos Hospital for Psychiatry and Psychotherapy, Weilstrasse 10, 35789, Weilmuenster, Germany.
Department of Psychology, University of Berlin, Berlin, Germany.
Ther Innov Regul Sci. 2020 May;54(3):534-543. doi: 10.1007/s43441-019-00085-3. Epub 2020 Jan 6.
Self-management can be considered a way of dealing with oneself and relates to actions undertaken to create order, discipline, and control. The concept is closely linked to concepts of self-efficacy and self-regulation but can be distinguished from these. The Self-Management Self-Test (SMST) is a 5-item assessment scale designed to measure self-management competence in individuals with or without a psychiatric disorder (as screened using PHQ). The aim of this study was to validate the SMST in terms of convergent validity, the ability to differentiate, criterion validity, internal consistency, and test-retest reliability.
Eighty-seven adults hospitalized for treatment of major depression (clinical sample) and 595 individuals from the general population (population sample) filled out the SMST and 5 other stress-related psychometric instruments measuring similar constructs. All instruments were repeated 4 to 6 weeks later. Convergent validity, internal consistency, and test-retest reliability were tested based on data from the population sample. Convergent validity was determined by correlations with other stress-related psychometric instruments. Correlations in the range of r = -0.4 to -0.6 were expected. To test for criterion validity, the clinical sample was matched with a subsample from the population sample, consisting only of individuals without a psychiatric disorder as screened using PHQ (nonclinical subsample, n = 87). The ability to differentiate was based on receiver operating characteristic (ROC) curve analysis.
Correlations between the SMST and the other stress-related tests were significant and in the expected direction and predominantly within the expected range (Pearson r = - 0.40 to -0.64). The correlation with the Multidimensional Fatigue Inventory-20, measuring fatigue, and with the dimensional scale for depression in the PHQ was higher than expected and referred to very similar items. Thus, convergent validity mainly lay within the expected range. Internal consistency was high (Cronbach α = 0.80), and test-retest reliability was fairly low (r = 0.71). The SMST showed a significant difference, t(157) = 7.97, P < .001, between the clinical sample (M = 9.36, SD = 3.39) and the nonclinical subsample (M = 12.94, SD = 2.47) with a large effect size (d = 1.3). The area under the ROC curve (AUC) was excellent (AUC = 0.81, SE = 0.034, P < .001), suggesting that the SMST can distinguish between the clinical and nonclinical samples.
The SMST can be considered an effective self-rating test to assess self-management competence in individuals from the general population as well as in people with major depression. It may also be useful to detect treatment outcomes in people with major depression. The high internal consistency indicates that all 5 items are important for the test as a whole. The low test-retest reliability suggests sensitivity to change. The SMST is likely to differentiate particularly well at low levels of self-management competence, suggesting it may be a useful tool in studies investigating people with depression or other psychiatric disorders such as post-traumatic stress disorder. Furthermore, the SMST could be useful in assessing the effect of treatment interventions over time and evaluating patient-reported outcomes.
自我管理可以被视为一种自我应对的方式，涉及到为创造秩序、纪律和控制而采取的行动。这个概念与自我效能感和自我调节密切相关，但可以与之区分开来。自我管理自我测试（SMST）是一个由 5 个项目组成的评估量表，旨在衡量有或没有精神障碍（通过 PHQ 筛查）的个体的自我管理能力。本研究的目的是验证 SMST 在收敛效度、区分能力、效标效度、内部一致性和重测信度方面的有效性。
87 名因重度抑郁症住院治疗的成年人（临床样本）和 595 名来自普通人群的个体（人群样本）填写了 SMST 和其他 5 种测量相似结构的与压力相关的心理计量学工具。所有工具均在 4 至 6 周后重复测量。基于人群样本的数据测试了收敛效度、内部一致性和重测信度。收敛效度通过与其他与压力相关的心理计量学工具的相关性来确定。预计相关性在 r = -0.4 到 -0.6 之间。为了测试效标效度，将临床样本与人群样本中的一个亚组进行匹配，该亚组仅由使用 PHQ 筛查无精神障碍的个体组成（非临床亚组，n = 87）。区分能力基于接收者操作特征（ROC）曲线分析。
SMST 与其他与压力相关的测试之间的相关性显著，且与预期方向一致，且主要在预期范围内（Pearson r = -0.40 至 -0.64）。与多维疲劳量表-20（测量疲劳）和 PHQ 中的抑郁维度量表的相关性高于预期，并且涉及非常相似的项目。因此，收敛效度主要在预期范围内。内部一致性很高（Cronbach α = 0.80），重测信度相当低（r = 0.71）。SMST 在临床样本（M = 9.36，SD = 3.39）和非临床亚组（M = 12.94，SD = 2.47）之间表现出显著差异，t（157）= 7.97，P <.001，具有较大的效应量（d = 1.3）。ROC 曲线下面积（AUC）非常好（AUC = 0.81，SE = 0.034，P <.001），表明 SMST 可以区分临床和非临床样本。
SMST 可被视为一种有效的自评测试，可用于评估普通人群以及重度抑郁症患者的自我管理能力。它也可能有助于检测重度抑郁症患者的治疗效果。高内部一致性表明所有 5 个项目对整个测试都很重要。重测信度低表明对变化敏感。SMST 可能在自我管理能力较低的情况下区分效果特别好，这表明它可能是研究抑郁症或其他精神障碍（如创伤后应激障碍）患者的有用工具。此外，SMST 可用于随时间评估治疗干预措施的效果，并评估患者报告的结果。
