Improving the Measurement of Functional Somatic Symptoms With Item Response Theory

More than 40 questionnaires have been developed to assess functional somatic symptoms (FSS), but there are several methodological issues regarding the measurement of FSS. We aimed to identify which items of the somatization subscale of the Symptom Checklist–90 (SCL-90) are more informative and discriminative between persons at different levels of severity of FSS. To this end, item response theory was applied to the somatization scale of the SCL-90, collected from a sample of 82,740 adult participants without somatic conditions in the Lifelines Cohort Study. Sensitivity analyses were performed with all the participants who completed the somatization scale. Both analyses showed that Items 11 “feeling weak physically” and 12 “heavy feelings in arms or legs” were the most discriminative and informative to measure severity levels of FSS, regardless of somatic conditions. Clinicians and researchers may pay extra attention to these symptoms to augment the assessment of FSS.

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Preliminary Validation of an Abbreviated Acute Concussion Symptom Checklist Using Item Response Theory

The American Journal of Sports Medicine ◽

10.1177/0363546520953440 ◽

2020 ◽

Vol 48 (12) ◽

pp. 3087-3093

Author(s):

Kristin Wilmoth ◽

Brooke E. Magnus ◽

Michael A. McCrea ◽

Lindsay D. Nelson

Keyword(s):

Item Response Theory ◽

Item Response ◽

Internal Consistency ◽

Symptom Severity ◽

False Positive ◽

Symptom Assessment ◽

Brief Symptom Inventory ◽

Symptom Checklist ◽

Response Theory ◽

Short Forms

Background: Symptom assessment is a critical component of concussion diagnosis and management, with item selection primarily driven by clinical judgment or expert consensus. We recently demonstrated that concussion symptoms assessed by the Sport Concussion Assessment Tool (SCAT) are essentially unidimensional, implying that overall symptom severity may be accurately estimated with relatively few questions. Briefer, evidence-based forms for symptom assessment would provide clinicians flexibility. Purpose: To develop and validate an abbreviated assessment of general concussion symptom severity using item response theory analyses. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Broad clinical assessments (SCAT3, Immediate Post-concussion and Cognitive Testing, Balance Error Scoring System, and Brief Symptom Inventory–18 Global Severity Index) were completed by 265 injured athletes and 235 matched teammate controls at 24 to 48 hours and 8, 15, and 45 days after concussion. Symptom checklist short forms (3-14 items from the original 22) were selected using item response theory item information curves. Internal consistency reliability (Cronbach alpha), correlation with criterion measures assessed concurrently (ie, acute neurocognitive performance, balance, and emotional symptoms), predictive validity (correlations with symptom duration), and differences between concussed and control groups (Cohen d) were examined across forms. Sensitivity and false-positive rates of the forms were estimated and compared using reliable change indices derived from controls. Results: Across the 3- to 22-item forms, internal consistency was excellent (Cronbach alphas, 0.90-0.94). Clinical correlations were significant ( P≤ .017) and to similar degrees for all short forms. Group difference confidence intervals overlapped across forms at 24- to 48-hour (Cohen d, 1.27-1.51) and 8-day follow-up (Cohen d, 0.31-0.44). Sensitivity remained similar across short forms, with a low false-positive rate in controls. Conclusion: Our findings suggest that even an ultrashort (3-item) inventory provides sufficiently reliable and valid estimates of overall concussion symptom severity 24 to 48 hours after injury. Future revisions of the SCAT could eliminate inefficient items, although replication in larger samples and extension to other postinjury time points are warranted.

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Application of Item Response Theory to the Assessment of Coping in an Environmental Risk Situation: Perspectives and Limits

Psychological Reports ◽

10.1177/0033294119884011 ◽

2019 ◽

Vol 123 (5) ◽

pp. 1966-1985

Author(s):

Colin Lemée

Keyword(s):

Item Response Theory ◽

Item Response ◽

Classical Test Theory ◽

Cultural Influences ◽

Test Theory ◽

Response Theory ◽

Data Set ◽

Passive Coping ◽

Irt Model ◽

Adult Participants

Classical test theory does not have a clear superiority over the item response theory (IRT) framework, as these approaches are meant to address different kinds of objectives. However, the use of the IRT framework makes it possible to take into account two different parameters in the assessment of coping willingness: the extent to which individuals declare that they use the different strategies and the level of difficulty of these strategies. Also, the IRT framework is strong enough to cope with inconsistent behaviors or missing data and can take into account the social, legal, and cultural influences on the ability to cope of respondents. The data set used in this study was obtained from different areas at risk from coastal flooding located in France. The sample was composed of 315 adult participants (mean age = 47; standard deviation = 15). In the present case, it appeared that just 10 items from an initial pool of 23 were sufficient to assess active and passive coping willingness because these had a good discriminatory power. Also, it appeared that the estimation of participants’ level of coping willingness was linked to their risk perception and anxiety toward the risk. This result has several implications. Firstly, if the IRT calibration is well performed, IRT can be used to compare scores across assessments with different properties and difficulties/locations. Also, the maximum likelihood estimate of participants’ level of active and passive coping willingness using an IRT model makes it possible to study the links between coping willingness and other factors of interest.

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Use of item response theory to understand differential functioning of DSM-IV major depression symptoms by race, ethnicity and gender

Psychological Medicine ◽

10.1017/s0033291708003875 ◽

2008 ◽

Vol 39 (4) ◽

pp. 591-601 ◽

Cited By ~ 56

Author(s):

L. A. Uebelacker ◽

D. Strong ◽

L. M. Weinstock ◽

I. W. Miller

Keyword(s):

Item Response Theory ◽

Major Depression ◽

Item Response ◽

American Indians ◽

Somatic Symptoms ◽

Depression Symptoms ◽

Depression Symptom ◽

Response Theory ◽

English Speaking ◽

Dsm Iv

BackgroundPsychological literature and clinical lore suggest that there may be systematic differences in how various demographic groups experience depressive symptoms, particularly somatic symptoms. The aim of the current study was to use methods based on item response theory (IRT) to examine whether, when equating for levels of depression symptom severity, there are demographic differences in the likelihood of reporting DSM-IV depression symptoms.MethodWe conducted a secondary analysis of a subset (n=13 753) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) dataset, which includes a large epidemiological sample of English-speaking Americans. We compared data from women and men, Hispanics and non-Hispanic Whites, African Americans and Whites, Asian Americans and Whites, and American Indians and Whites.ResultsThere were few differences overall, although the differences that we did find were primarily limited to somatic symptoms, and particularly appetite and weight disturbance.ConclusionsFor the most part, individuals responded similarly to the criteria used to diagnose major depression across gender and across English-speaking racial and ethnic groups in the USA.

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Using item response theory to disentangle constructs at different levels of generality.

Measuring psychological constructs: Advances in model-based approaches. ◽

10.1037/12074-006 ◽

2010 ◽

pp. 123-144 ◽

Cited By ~ 8

Author(s):

David Thissen ◽

Lynne Steinberg

Keyword(s):

Item Response Theory ◽

Item Response ◽

Response Theory ◽

Different Levels

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Improving the Measurement of Functional Somatic Symptoms with Item Response Theory

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2020.110009 ◽

2020 ◽

Vol 133 ◽

pp. 110009

Author(s):

A. Acevedo-Mesa ◽

J. Tendeiro ◽

A. Roest ◽

J. Rosmalen ◽

R. Monden

Keyword(s):

Item Response Theory ◽

Item Response ◽

Somatic Symptoms ◽

Response Theory

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Methodological issues regarding power of classical test theory (CTT) and item response theory (IRT)-based approaches for the comparison of patient-reported outcomes in two groups of patients - a simulation study

BMC Medical Research Methodology ◽

10.1186/1471-2288-10-24 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 24

Author(s):

Véronique Sébille ◽

Jean-Benoit Hardouin ◽

Tanguy Le Néel ◽

Gildas Kubis ◽

François Boyer ◽

...

Keyword(s):

Item Response Theory ◽

Item Response ◽

Simulation Study ◽

Patient Reported Outcomes ◽

Classical Test Theory ◽

Test Theory ◽

Methodological Issues ◽

Response Theory ◽

Classical Test ◽

Patient Reported

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Item Response Theory Modeling and Categorical Regression Analyses of the Five-Factor Model Rating Form: A Study on Italian Community-Dwelling Adolescent Participants and Adult Participants

Assessment ◽

10.1177/1073191115621789 ◽

2015 ◽

Vol 24 (4) ◽

pp. 467-483 ◽

Cited By ~ 3

Author(s):

Andrea Fossati ◽

Thomas A. Widiger ◽

Serena Borroni ◽

Cesare Maffei ◽

Antonella Somma

Keyword(s):

Item Response Theory ◽

Item Response ◽

Factor Model ◽

Five Factor Model ◽

Community Dwelling ◽

Regression Analyses ◽

Response Theory ◽

Italian Translation ◽

Adult Participants ◽

Rating Form

To extend the evidence on the reliability and construct validity of the Five-Factor Model Rating Form (FFMRF) in its self-report version, two independent samples of Italian participants, which were composed of 510 adolescent high school students and 457 community-dwelling adults, respectively, were administered the FFMRF in its Italian translation. Adolescent participants were also administered the Italian translation of the Borderline Personality Features Scale for Children–11 (BPFSC-11), whereas adult participants were administered the Italian translation of the Triarchic Psychopathy Measure (TriPM). Cronbach α values were consistent with previous findings; in both samples, average interitem r values indicated acceptable internal consistency for all FFMRF scales. A multidimensional graded item response theory model indicated that the majority of FFMRF items had adequate discrimination parameters; information indices supported the reliability of the FFMRF scales. Both categorical (i.e., item-level) and scale-level regression analyses suggested that the FFMRF scores may predict a nonnegligible amount of variance in the BPFSC-11 total score in adolescent participants, and in the TriPM scale scores in adult participants.

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