Kim Soo Youn, Lecavalier Luc
Department of Psychology, The Ohio State University, Columbus, OH, USA.
Nisonger Center, The Ohio State University, Columbus, OH, USA.
J Autism Dev Disord. 2024 Jul 13. doi: 10.1007/s10803-024-06456-6.
The aim of this study was to assess test-retest reliability and diagnostic validity of self-report instruments of depression and anxiety in autistic youth. Participants were 55 autistic youth aged 8-17 years presenting with depressive or anxiety symptoms. They were interviewed with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL) and completed the Children's Depression Inventory, Second Edition - Self Report Short (CDI 2:SR[S]) and the Revised Child Anxiety and Depression Scale (RCADS) twice, separated by a two-week interval. Test-retest reliability was measured with intraclass correlation coefficients (ICCs), and diagnostic validity was assessed using receiver operating characteristic (ROC) curves with the summary ratings on the K-SADS-PL as the criterion. The effect of participant characteristics was analyzed through a moderation analysis. Generalized anxiety (GAD) and social anxiety disorder (SOC) were the two most prevalent disorders in the sample. Test-retest reliability for most of the subscales was good (ICC = 0.74 - 0.87), with the exception of the RCADS obsessive-compulsive disorder (OCD) and GAD. The Adaptive Behavior conceptual score was a significant moderator of the reliability of the CDI 2:SR[S]. The ROC analysis suggested the RCADS SOC and the CDI 2:SR[S] to be good screening tools with inadequate specificity when appropriately sensitive cutoff scores are used. Optimal cutoff scores in this sample were lower than originally published. The findings suggest that autistic youth can provide stable reports of anxiety and depressive symptoms over time. Diagnostic validity varied according to the construct and instrument.
本研究的目的是评估自闭症青少年抑郁和焦虑自我报告工具的重测信度和诊断效度。研究参与者为55名年龄在8至17岁之间、有抑郁或焦虑症状的自闭症青少年。他们接受了《学龄儿童情感障碍和精神分裂症量表》（K-SADS-PL）的访谈，并两次完成了《儿童抑郁量表第二版 - 自我报告简表》（CDI 2:SR[S]）和《修订版儿童焦虑与抑郁量表》（RCADS），两次测试间隔两周。重测信度用组内相关系数（ICC）衡量，诊断效度以K-SADS-PL的总结评分作为标准，通过绘制受试者工作特征（ROC）曲线进行评估。通过调节分析来分析参与者特征的影响。广泛性焦虑症（GAD）和社交焦虑症（SOC）是样本中最常见的两种疾病。除了RCADS中的强迫症（OCD）和GAD分量表外，大多数分量表的重测信度良好（ICC = 0.74 - 0.87）。适应性行为概念得分是CDI 2:SR[S]信度的一个显著调节因素。ROC分析表明，当使用适当敏感的临界分数时，RCADS的SOC分量表和CDI 2:SR[S]是良好的筛查工具，但特异性不足。本样本中的最佳临界分数低于最初公布的分数。研究结果表明，随着时间推移，自闭症青少年能够提供稳定的焦虑和抑郁症状报告。诊断效度因结构和工具而异。
