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Psychiatry Res ; 335: 115862, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38554493


Large-scale studies and burdened clinical settings require precise, efficient measures that assess multiple domains of psychopathology. Computerized adaptive tests (CATs) can reduce administration time without compromising data quality. We examined feasibility and validity of an adaptive psychopathology measure, GOASSESS, in a clinical community-based sample (N = 315; ages 18-35) comprising three groups: healthy controls, psychosis, mood/anxiety disorders. Assessment duration was compared between the Full and CAT GOASSESS. External validity was tested by comparing how the CAT and Full versions related to demographic variables, study group, and socioeconomic status. The relationships between scale scores and criteria were statistically compared within a mixed-model framework to account for dependency between relationships. Convergent validity was assessed by comparing scores of the CAT and the Full GOASSESS using Pearson correlations. The CAT GOASSESS reduced interview duration by more than 90 % across study groups and preserved relationships to external criteria and demographic variables as the Full GOASSESS. All CAT GOASSESS scales could replace those of the Full instrument. Overall, the CAT GOASSESS showed acceptable psychometric properties and demonstrated feasibility by markedly reducing assessment time compared to the Full GOASSESS. The adaptive version could be used in large-scale studies or clinical settings for intake screening.

Transtornos de Ansiedade , Transtornos Psicóticos , Humanos , Transtornos de Ansiedade/psicologia , Psicopatologia , Transtornos do Humor/diagnóstico , Ansiedade , Psicometria , Reprodutibilidade dos Testes
J Neurosci Methods ; 386: 109795, 2023 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-36657647


BACKGROUND: Traditional paper-and-pencil neurocognitive evaluations and semi-structured mental health interviews can take hours to administer and score. Computerized assessment has decreased that burden substantially, and contemporary psychometric tools such as item response theory and computerized adaptive testing (CAT) allow even further abbreviation. NEW METHOD: The goal of this paper was to describe the application of CAT and related methods to the Penn Computerized Neurocognitive Battery (CNB) and a well-validated clinical assessment in order to increase efficiency in assessment and relevant domain coverage. To calibrate item banks for CAT, N = 5053 participants (63% female; mean age 45 years, range 18-80) were collected from across the United States via crowdsourcing, providing item parameters that were then linked to larger item banks and used in individual test construction. Tests not amenable to CAT were abbreviated using complementary short-form methods. RESULTS: The final "CAT-CCNB" battery comprised 21 cognitive tests (compared to 14 in the original) and five adaptive clinical scales (compared to 16 in the original). COMPARISON WITH EXISTING METHODS: This new battery, derived with contemporary psychometric approaches, provides further improvements over existing assessments that use collections of fixed-length tests developed for stand-alone administration. The CAT-CCNB provides an improved version of the CNB that shows promise as a maximally efficient tool for neuropsychiatric assessment. CONCLUSIONS: We anticipate CAT-CCNB will help satisfy the clear need for broad yet efficient measurement of cognitive and clinical domains, facilitating implementation of large-scale, "big science" approaches to data collection, and potential widespread clinical implementation.

Transtornos Mentais , Feminino , Masculino , Humanos , Psicometria , Testes Neuropsicológicos , Reprodutibilidade dos Testes
JAMA Psychiatry ; 76(9): 966-975, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31141099


Importance: Low socioeconomic status (L-SES) and the experience of traumatic stressful events (TSEs) are environmental factors implicated in behavioral deficits, abnormalities in brain development, and accelerated maturation. However, the relative contribution of these environmental factors is understudied. Objective: To compare the association of L-SES and TSEs with psychopathology, puberty, neurocognition, and multimodal neuroimaging parameters in brain maturation. Design, Setting, and Participants: The Philadelphia Neurodevelopmental Cohort is a community-based study examining psychopathology, neurocognition, and neuroimaging among participants recruited through the Children's Hospital of Philadelphia pediatric network. Participants are youths aged 8 to 21 years at enrollment with stable health and fluency in English. The sample of 9498 participants was racially (5298 European ancestry [55.8%], 3124 African ancestry [32.9%], and 1076 other [11.4%]) and economically diverse. A randomly selected subsample (n = 1601) underwent multimodal neuroimaging. Data were collected from November 5, 2009, through December 30, 2011, and analyzed from February 1 through November 7, 2018. Main Outcomes and Measures: The following domains were examined: (1) clinical, including psychopathology, assessed with a structured interview based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, and puberty, assessed with the Tanner scale; (2) neurocognition, assessed by the Penn Computerized Neurocognitive Battery; and (3) multimodal magnetic resonance imaging parameters of brain structure and function. Results: A total of 9498 participants were included in the analysis (4906 [51.7%] female; mean [SD] age, 14.2 [3.7] years). Clinically, L-SES and TSEs were associated with greater severity of psychiatric symptoms across the psychopathology domains of anxiety/depression, fear, externalizing behavior, and the psychosis spectrum. Low SES showed small effect sizes (highest for externalizing behavior, 0.306 SD; 95% CI, 0.269 to 0.342), whereas TSEs had large effect sizes, with the highest in females for anxiety/depression (1.228 SD; 95% CI, 1.156 to 1.300) and in males for the psychosis spectrum (1.099 SD; 95% CI, 1.032 to 1.166). Both were associated with early puberty. Cognitively, L-SES had moderate effect sizes on poorer performance, the greatest being on complex cognition (-0.500 SD 95% CI, -0.536 to -0.464), whereas TSEs were associated with slightly better memory (0.129 SD; 95% CI, 0.084 to 0.174) and poorer complex reasoning (-0.109 SD; 95% CI, -0.154 to -0.064). Environmental factors had common and distinct associations with brain structure and function. Structurally, both were associated with lower volume, but L-SES had correspondingly lower gray matter density, whereas TSEs were associated with higher gray matter density. Functionally, both were associated with lower regional cerebral blood flow and coherence and with accelerated brain maturation. Conclusions and Relevance: Low SES and TSEs are associated with common and unique differences in symptoms, neurocognition, and structural and functional brain parameters. Both environmental factors are associated with earlier completion of puberty by physical features and brain parameters. These findings appear to underscore the need for identifying and preventing adverse environmental conditions associated with neurodevelopment.

Desenvolvimento do Adolescente , Experiências Adversas da Infância , Sintomas Comportamentais , Circulação Cerebrovascular , Disfunção Cognitiva , Substância Cinzenta/diagnóstico por imagem , Transtornos Mentais , Trauma Psicológico , Puberdade , Classe Social , Estresse Psicológico , Adolescente , Desenvolvimento do Adolescente/fisiologia , Adulto , Experiências Adversas da Infância/estatística & dados numéricos , Sintomas Comportamentais/diagnóstico por imagem , Sintomas Comportamentais/epidemiologia , Sintomas Comportamentais/fisiopatologia , Circulação Cerebrovascular/fisiologia , Criança , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtornos Mentais/diagnóstico por imagem , Transtornos Mentais/epidemiologia , Transtornos Mentais/fisiopatologia , Philadelphia/epidemiologia , Trauma Psicológico/diagnóstico por imagem , Trauma Psicológico/epidemiologia , Trauma Psicológico/fisiopatologia , Puberdade/fisiologia , Estresse Psicológico/diagnóstico por imagem , Estresse Psicológico/epidemiologia , Estresse Psicológico/fisiopatologia , Adulto Jovem