个人化设计在临床研究中的应用——从个体角度研究个体差异

本文从有关研究证据的基础上,介绍了个人化设计的理论基础和实验设计,并在此基础上讨论了个人化设计在临床研究领域中的应用价值,总结出一种适合临床病人使用的研究程序。个人化设计允许对个体的个人价值进行分析,并能同时研究不同刺激信息的作用,在个体水平上分析个体差异。通过简化了的实验程序,个人化设计为解决临床研究中的问题提供了一种新的思维方式。文中还对相关研究法的局限进行了讨论。     

Children's social behavior: Reliability and concurrent validity of two self-report measures

In this study the psychometric qualities of Deluty's Children's Action Tendency Scale (CATS) and Michelson and Wood's Children's Assertive Behavior Scale (CABS) were assessed with 157 Dutch children. Both instruments are designed to assess children's self-reported responses to interpersonal situations, whereby aggressive, assertive, and submissive scores are obtained. In general acceptable psychometric properties were obtained for both the CATS and the CABS, except for the assertive scale of the CATS. Furthermore, it was found that the ability of both the CATS and the CABS to discriminate between submissiveness and assertiveness was low. Important gender differences that were found regarding the relations with measures of perceived competence and social desirability are offered as a possible explanation for the relative failure of the CABS and the CATS to unbind submissive from assertive behavior. The parent version of the CABS is offered as a possible alternative or additional source of information for the assessment of children's submissiveness. Recommendations for future applications and research are presented.This research was supported by Grant 2843 from the NFGV to the second author.     

Latent trait models and dichotomization of graded responses

This paper discusses thecompatibility of the polychotomous Rasch model with dichotomization of the response continuum. It is argued that in the case of graded responses, the response categories presented to the subject are essentially an arbitrary polychotomization of the response continuum, ranging for example from total rejection or disagreement to total acceptance or agreement of an item or statement. Because of this arbitrariness, the measurement outcome should be independent of the specific polychotomization applied, for example, presenting a specific multicategory response format should not affect the measurement outcome. When such is the case, the original polychotomous model is called compatible with dichotomization.A distinction is made between polychotomization or dichotomization before the fact, that is, in constructing the response format, and polycho- or dichotomization after the fact, for example in dichotomizing existing graded response data.It is shown that, at least in case of dichotomization after-the-fact, the polychotomous Rasch model is not compatible with dichotomization, unless a rather special condition of the model parameters is met. Insofar as it may be argued that dichotomization before the fact is not essentially different from dichotomization after the fact, the value of the unidimensional polychotomous Rasch model is consequently questionable. The impact of our conclusion on related models is also discussed.     

Linear Analogue Self-Assessment and Procrustean Measurement: A Critical Review of Visual Analogue Scaling in Pain Assessment

Visual analogue scales (VASs) are one of the most widely used self-report measures of clinical pain. This article reviews the empirical literature on linear analogue self-assessment (LASA) and critically examines the features that appear to have made it such an attractive measurement option in pain assessment. It is concluded that analogue scaling does not withstand critical scrutiny as a primary measure of either pain intensity or pain affect and that, in most circumstances, the overall clinical utility of VASs is inferior to that of more structured pain indices.     

The Development of the Toddler Behavior Screening Inventory

The purpose of the present study was to develop the Toddler Behavior Screening Inventory (TBSI) for rapidly assessing maternal reports of toddler behavior problems. The TBSI is a 40-item measure intended for use by pediatricians, psychologists, and other child-care professionals. A group of mothers (n = 312) rated the initial 93-item TBSI in terms of behavior frequency and parental perception of the behavior as problematic. Following item elimination, 40 items were retained due to being both frequent and problematic at all toddler age levels. Data were obtained with a new sample of mothers (n = 581) and showed the TBSI to possess good reliability and validity.     

Human d-amphetamine drug discrimination: methamphetamine and hydromorphone.

Standard measures of subjective and discriminative effects of drugs were compared in 5 human volunteers. Subjects responded on a second-order color-tracking procedure, where 30 mg of d-amphetamine served as a discriminative stimulus for one response and its absence as the discriminative stimulus for another response. Self-reported subjective effects were assessed concurrently using the single-dose questionnaire, subscales of the Addiction Research Center Inventory, and several analogue rating scales. On different days following discrimination acquisition, varying doses of d-amphetamine, methamphetamine, and hydromorphone were administered. In these test sessions, either response was reinforced. Methamphetamine and d-amphetamine occasioned dose-related increases in d-amphetamine appropriate responding; hydromorphone did not. Methamphetamine and d-amphetamine occasioned dose-related increases in reports of the drug received being most like "speed"; hydromorphone occasioned dose-related increases in reports of the drug received being most like "dope." All three drugs occasioned dose-related increases in reports of drug liking, and increases in the morphine-benzedrine group, amphetamine, and benzedrine group scales of the Addiction Research Center Inventory. This experiment demonstrated that although explicit discriminative control of behavior by a drug may covary with drug identification, it does not necessarily covary with other self-reported subjective effects. Thus, the complementary nature of the data provided by drug discrimination and standard subjective-effects measures provides quantitative and qualitative data useful in studying both relatively novel compounds and the behavioral biology of psychoactive drugs in general.     

The Revised Conners' Parent Rating Scale (CPRS-R): Factor Structure, Reliability, and Criterion Validity

The Conners' Parent Rating Scale (CPRS) is a popular research and clinical tool for obtaining parental reports of childhood behavior problems. The present study introduces a revised CPRS (CPRS-R) which has norms derived from a large, representative sample of North American children, uses confirmatory factor analysis to develop a definitive factor structure, and has an updated item content to reflect recent knowledge and developments concerning childhood behavior problems. Exploratory and confirmatory factor-analytic results revealed a seven-factor model including the following factors: Cognitive Problems, Oppositional, Hyperactivity-Impulsivity, Anxious-Shy, Perfectionism, Social Problems, and Psychosomatic. The psychometric properties of the revised scale appear adequate as demonstrated by good internal reliability coefficients, high test-retest reliability, and effective discriminatory power. Advantages of the CPRS-R include a corresponding factor structure with the Conners' Teacher Rating Scale—Revised and comprehensive symptom coverage for attention deficit hyperactivity disorder (ADHD) and related disorders. Factor congruence with the original CPRS as well as similarities with other parent rating scales are discussed.     

Effects of diagnostic classification systems on clinical hypothesis-generation

In this study it was determined whether (a) classification as opposed to absence of classification has an effect on the quality of clinical hypotheses (b) the DSM-III-R and the CBCL have a different effect on the quality of clinical hypotheses, and (c) the potential difference between the DSM-III-R and the CBCL is moderated by the different number of syndromes identified by these systems. To investigate these questions, an experiment was conducted in which 86 clinicians generated hypotheses for six cases. The clinicians were divided into a DSM-III-R, a CBCL, and a control group. Of the six cases, two were classified by both classification systems as one syndrome, two were classified as one syndrome by the DSM-III-R but as two syndromes by the CBCL, and two were classified as two syndromes by the DSM-III-R but as one syndrome by the CBCL. The quality of the hypotheses was determined by means of four dependent variables selected from an overview of qualitative criteria: explanatory value, redundancy, possibility of operationalization, and specificity. No differences between the CBCL and the control groups were found. The DSM group performed better than the control group regarding explanatory value and redundancy. The DSM-III-R group also scored better than the CBCL group regarding explanatory value, particularly when the number of identified syndromes was two for the CBCL and one for the DSM-III-R.     

Validation of the Children's Assertive Behavior Scale

Relationships between sociometric indices and scores of 160 elementary-school children on the Children's Assertive Behavior Scale (CABS) were examined to determine whether this instrument differentiates children of varying levels of social competence. Children who obtained either high or low scores on peer nominations of friendship and admiration were identified and compared on CABS passive, aggressive, and assertive scores. Children who scored high on positive peer nominations responded in a significantly less aggressive manner than children who received low scores on such nominations. These effects were observed for the CABS format that consisted of stimulus situations involving adults but not for the form involving peers. With regard to responses toward peers, a significant interaction between sex and sociometric status emerged. These findings suggest the importance of incorporating subject variables such as race and sex as well as assessments of behavior toward both adults and children in isolating and training components of social skill.The authors wish to express their appreciation to Jean Birbilis, Gail Hammersly, Marieta Knopf, and Donna Wadley for their assistance in data collection and analysis.