Resumen de Assessment of depression in the adult general population using self-reported measures. Psychometric approaches for screening and severity appraisal
This thesis provides evidence on the validity and diagnostic accuracy of generic and specific self-reported measures, developed from different psychometric approaches, to assess depression in the general population.
First, we compare the reliability and diagnostic accuracy of the 12-item Short Form Health Survey (SF-12) traditional scoring with Multidimensional Item Response Theory (MIRT) scoring in an adult general population sample from 6 European Countries (n=21,425). Secondly, we conduct systematic literature review and meta-analysis of the diagnostic accuracy of the Center for Epidemiologic Studies Depression (CES-D) as a screener for major depression. Finally, we assess the psychometric properties of IRT-based Patient Reported Outcomes Measurement Information System (PROMIS) Depression measures in general population (n=1,503) and clinical (n=218) samples.
Our results indicate that: a) the MIRT SF-12 model is more reliable and has comparable diagnostic accuracy than other scoring methods; b) general and specific measures herein included yield good diagnostic accuracy (area under the curve values over 0.85) as depression screeners, with sensitivities and specificities generally over 80% at the selected cut-off points; c) PROMIS Depression meets IRT assumptions, its measures are highly reliable and show good construct validity and responsiveness to change; d) one PROMIS item showed signs of differential item functioning according to country (Spain and US), but had negligible effects at test level, supporting measurement invariance.
We conclude that self-reported measures are adequate for assessingdepression in the general population, and provide additional information beyond detection of pathological individuals. The IRT psychometric approach provide higher flexibility and precision in administering and scoring questionnaires in survey studies, also allowing direct comparisons between populations.
