Developing and Validating a Computerized Adaptive Test to Measure Broad and Specific Factors of Internalizing in a Community Sample

Abstract

Highly efficient assessments that better account for comorbidity between mood and anxiety disorders (internalizing) are required to identify individuals who are most at risk of psychopathology in the community. The current study examined the efficiency and validity associated with a multidimensional computerized adaptive test (CAT) to measure broad and specific levels of internalizing psychopathology. The sample comprised 3,175 respondents to an online survey. Items from five banks (generalized anxiety, depression, obsessive-compulsive disorder, panic disorder, social anxiety disorder) were jointly calibrated using a bifactor item response theory model. Simulations indicated that an adaptive algorithm could accurately ( rs ≥ 0.90) estimate general internalizing and specific disorder scores using on average 44 items in comparison with the full 133-item bank (67% reduction in items). Scores on the CAT demonstrate convergent and divergent validity with previously validated short severity scales and could significantly differentiate cases of DSM-5 disorder. As such, the CAT validly measures both broad and specific constructs of internalizing disorders in a manner similar to the full item bank and a static brief form but with greater gains in efficiency and, therefore, a reduced degree of respondent burden.

Comparing Scores From Full Length, Short Form, and Adaptive Tests of the Social Interaction Anxiety and Social Phobia Scales

“…The results of the current study suggest that the static short forms and the computerized adaptive versions generate scores with similar overall accuracy and precision levels, relative to the full scales. These findings are consistent with studies that have compared static short forms and computerized adaptive versions of similar constructs and have demonstrated similar psychometric properties (Choi et al, 2010; Sunderland, Batterham, Calear, et al, 2017; Sunderland, Batterham, Carragher, et al, 2017). These results beg the question: Is the additional complexity of adaptive testing warranted over and above a well-designed short form, which can easily be completed and automatically scored using online or pen-and-paper versions (in conjunction with raw score to IRT score crosswalk tables)?…”

“…The feasibility of CAT to efficiently estimate scores for mental health has been demonstrated in previous simulation studies across a range of disorders, including depression and anxiety and more recently for panic disorder, obsessive compulsive disorder, and SAD, along with broad assessment of internalizing disorders (Fliege et al, 2005; Gibbons et al, 2012, Gibbons et al, 2014; Sunderland, Batterham, Calear, & Carragher, 2017; Sunderland, Batterham, Carragher, Calear, & Slade, 2017; Walter et al, 2007). These studies demonstrate that a substantial reduction in items administered is achievable (50% to 75% reduction in the mean number of items administered), while maintaining high correlations to full scores and high overall precision.…”

Self-Reported Sleep Quality Modulates Amygdala Resting-State Functional Connectivity in Anxiety and Depression

“…Problematic sleep indicative of insomnia is marked by hyper-arousal [e.g., elevated autonomic and physiological activity; ( 7 – 9 )] and poor sleep is a risk factor in the development and maintenance of mood disorders ( 10 – 12 ). Moreover, common internalizing psychopathologies (IPs) such as major depression, generalized anxiety disorder, social anxiety disorder, and panic disorder ( 13 , 14 ) are highly comorbid with problematic sleep. For these anxiety disorders, 60–90% report sleep disturbances and for major depression, estimates are 50–83% ( 15 – 19 ).…”

Development of the RMT20, a composite screener to identify common mental disorders

“…symptoms of mood or anxiety disorders) at a transdiagnostic level. 10,11 Psychological distress measures, such as the Distress Questionnaire-5 (DQ5 12 ) and Kessler-6/Kessler-10 (K6/K10 13 ) are accurate for identifying a range of mental disorders. However, this approach to screening does not provide direction as to which disorder is most likely to be present, may miss specific manifestations of distress, and may not cover symptoms of disorders other than major depressive disorder (MDD) or generalised anxiety disorder (GAD).…”