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An item response theory analysis of the Prodromal Questionnaire-Brief Child Version: Developing a screening form that informs understanding of self-reported psychotic-like experiences in childhood.

ABSTRACT: The Prodromal Questionnaire-Brief Child Version (PQ-BC) has been developed as a tool for identifying psychotic-like experiences (PLEs) in school-age children. The current study examined the psychometric properties of the PQ-BC, examined how well the PQ-BC estimates the latent construct of PLEs (θ̂), and began the process of developing a screening form informed by item response theory (IRT). Utilizing the baseline (N = 11,129) sample from the Adolescent Brain Cognitive Development study, we examined which PQ-BC items provide the most information and best discriminate individuals experiencing PLEs. Using hierarchical linear models (HLMs), we found that θ̂ scores were significantly associated with several previously identified predictors of psychosis spectrum symptoms (i.e., history of psychosis, internalizing symptoms, cognitive impairments, developmental milestone delays, and resting-state functional connectivity impairments) at baseline and Year 1 (n = 5,532). Using item-level information and discrimination parameters of the PQ-BC from the baseline sample, we created a 7-item screening form. HLMs generally found significant associations between screening form scores for both baseline and Year 1 with the aforementioned predictors. The analyses provide evidence for the validity of a screening form derived from the PQ-BC using IRT-derived parameters. This screening form could prove useful when the full measure is not feasible. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

SUBMITTER: Karcher NR

PROVIDER: S-EPMC7102926 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceChildhood psychoticlike experiences (PLEs) are associated with greater odds of a diagnosis of a psychotic disorder during adulthood. However, no known, well-validated self-report tools have been designed to measure childhood PLEs.ObjectiveTo examine the construct validity and psychometric properties of a measure of PLEs, the Prodromal Questionnaire-Brief Child Version (PQ-BC).Design, setting, and participantsThis validation study used data from the first wave of the Adolescent Brain and Cognitive Development (ABCD) Study, a prospective longitudinal study aimed at assessing risk factors associated with adverse physical and mental health outcomes from ages 9 to 10 years into late adolescence and early adulthood. The population-based sample of 3984 children within the ABCD data set was recruited from 20 research sites across the United States. Data for this study were collected from June 1, 2016, through August 31, 2017.Main outcomes and measuresThe PQ-BC Total and Distress scores were analyzed for measurement invariance across race/ethnicity and sex, their associations with measures of PLEs, and their associations with known correlates of PLEs, including internalizing and externalizing symptoms, neuropsychological test performance, and developmental milestones.ResultsThe study analyses included 3984 participants (1885 girls [47.3%] and 2099 boys [52.7%]; mean [SE] age, 10.0 [0.01] years). The results demonstrated measurement invariance across race/ethnicity and sex. A family history of psychotic disorder was associated with higher mean (SE) PQ-BC Total (3.883 [0.352]; β = 0.061; 95% CI, 0.027-0.094) and Distress (10.210 [1.043]; β = 0.051; 95% CI, 0.018-0.084) scores, whereas a family history of depression or mania was not. Higher PQ-BC scores were associated with higher rates of child-rated internalizing symptoms (Total score: β range, 0.218 [95% CI, 0.189-0.246] to 0.273 [95% CI, 0.245-0.301]; Distress score: β range, 0.248 [95% CI, 0.220-0.277] to 0.310 [95% CI, 0.281-0.338]), neuropsychological test performance deficits such as working memory (Total score: β = -0.042 [95% CI, -0.077 to -0.008]; Distress score: β = -0.051 [95% CI, -0.086 to -0.017]), and motor and speech developmental milestone delays (Total score: β = 0.057 [95% CI, 0.026-0.086] for motor; β = 0.042 [95% CI, 0.010-0.073] for speech; Distress score: β = 0.048 [95% CI, 0.017-0.079] for motor; β = 0.049 [95% CI, 0.018-0.081] for speech).Conclusions and relevanceThese results provide support for the construct validity and demonstrate adequate psychometric properties of a self-report instrument designed to measure childhood PLEs, providing evidence that the PQ-BC may be a useful measure of early risk for psychotic disorders. Furthermore, these data suggest that PLEs at school age are associated with many of the same familial, cognitive, and emotional factors associated with psychotic symptoms in older populations, consistent with the dimensionality of psychosis across the lifespan.

Project description:Prodromal Questionnaire (PQ) and Structured Interview for Prodromal Syndromes (SIPS) have been used as a two-stage process for identifying subjects at clinical high risk (CHR) of psychosis. The Prodromal Questionnaire-Brief version (PQ-B) contains 21 items derived from the PQ. The present study aimed to examine the psychometric properties of PQ-B in a Chinese help-seeking outpatient sample and to explore which items can better predict CHR diagnosis by SIPS and future transition to psychosis. In our preliminary epidemiological study, 1461 patients from a pool of 2101 individuals (15-45 years of age) completed the two-stage process. In the present study, 239 (20%) people were randomly selected among the sample who met the initial PQ-B screening criteria but had no positive diagnosis on SIPS, as well as 72 individuals with negative results on both PQ-B and SIPS, 89 prodromal and 105 psychotic subjects, yielding a total of 505 participants. The internal consistency coefficient for the PQ-B was good, with a Cronbach's alpha of 0.897. The concordant validity of PQ-B with SIPS dichotomized diagnosis of prodrome/psychosis versus no psychosis was 0.54. To ensure 80% or a higher sensitivity and a certain specificity, 7 and 24 were respectively set as the cutoff points for the PQ-B total score and distress score for Chinese help-seeking outpatients. A logistic regression model based on six PQ-B items could allow predicting the psychotic diagnosis on SIPS, with an accuracy of 65.8%. Prodromal individuals who scored higher on the 12th item of PQ-B (Do you worry at times that something may be wrong with your mind?) were less likely to convert to psychosis. PQ-B is a useful instrument for screening CHR subjects, but the cutoff score may be higher than that recommended by the author scores for help-seeking individuals in outpatient clinics. Some specific PQ-B items may have significant predictive power on dichotomized SIPS diagnoses and deserve special attention from researchers in future studies.

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An item response theory analysis of the Prodromal Questionnaire-Brief Child Version: Developing a screening form that informs understanding of self-reported psychotic-like experiences in childhood.

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