Screening for Adolescents' Internalizing Symptoms in Primary Care: Item Response Theory Analysis of the Behavior Health Screen Depression, Anxiety, and Suicidal Risk Scales

TitleScreening for Adolescents' Internalizing Symptoms in Primary Care: Item Response Theory Analysis of the Behavior Health Screen Depression, Anxiety, and Suicidal Risk Scales
Publication TypeJournal Article
Year of Publication2012
AuthorsBevans KB, Diamond G, Levy S
JournalJournal of Developmental and Behavioral Pediatrics
Volume33
Issue4
Pagination283-90
Date Published05/2012
ISSN1536-7312
KeywordsAdolescent, Adult, Anxiety Disorders, Child, Depressive Disorder, Female, Humans, Male, Mass Screening, Mental Health, Primary Health Care, Psychiatric Status Rating Scales, Psychometrics, Risk, Sex Factors, Suicide, Young Adult
Abstract

OBJECTIVE: To apply a modern psychometric approach to validate the Behavioral Health Screen (BHS) Depression, Anxiety, and Suicidal Risk Scales among adolescents in primary care.

METHODS: Psychometric analyses were conducted using data collected from 426 adolescents aged 12 to 21 years (mean = 15.8, SD = 2.2). Rasch-Masters partial credit models were fit to the data to determine whether items supported the comprehensive measurement of internalizing symptoms with minimal gaps and redundancies.

RESULTS: Scales were reduced to ensure that they measured singular dimensions of generalized anxiety, depressed affect, and suicidal risk both comprehensively and efficiently. Although gender bias was observed for some depression and anxiety items, differential item functioning did not impact overall subscale scores. Future revisions to the BHS should include additional items that assess low-level internalizing symptoms.

CONCLUSIONS: The BHS is an accurate and efficient tool for identifying adolescents with internalizing symptoms in primary care settings. Access to psychometrically sound and cost-effective behavioral health screening tools is essential for meeting the increasing demands for adolescent behavioral health screening in primary/ambulatory care.

URLhttp://www.ncbi.nlm.nih.gov/pubmed/22395125
DOI10.1097/DBP.0b013e31824eaa9a
Alternate JournalJ Dev Behav Pediatr
PubMed ID22395125
Grant ListR49 CE000428-03 / CE / NCIPC CDC HHS / United States
U49CE001093-01 / CE / NCIPC CDC HHS / United States