Skip to main content Accessibility help
×
Home

Psychometric evaluation of the DSM-IV criterion B mania symptoms in an Australian national sample

  • N. Carragher (a1), L. M. Weinstock (a2) and D. Strong (a3)

Abstract

Background

Although numerous studies have examined the latent structure of major depression, less attention has focused on mania. This paper presents the first investigation outside the USA to evaluate the psychometric properties of the DSM-IV criterion B mania symptoms using item response theory (IRT).

Method

Data were drawn from the Australian 2007 National Survey of Mental Health and Well-Being (NSMHWB, n = 8841). The psychometric performance of the mania symptoms was evaluated using a two-parameter logistic model. Because substance use disorders (SUDs) frequently co-occur with mania and can influence manic symptom expression, differential item functioning (DIF) between mania respondents with/without a SUD diagnosis was also assessed.

Results

Factor analysis supported a unidimensional trait underlying mania. The grandiosity symptom displayed the highest discrimination whereas discrimination was lowest for decreased need for sleep. Relatively speaking, grandiosity tapped the severe end and increased goal-oriented activities tapped the mild end of the mania severity continuum. The symptoms generally performed equivalently between those with/without a SUD diagnosis, with one exception; the activities with painful consequences symptom was endorsed at lower levels of severity, and hence more frequently, by those with a SUD diagnosis versus those without a SUD diagnosis.

Conclusions

Accurate conceptualization of latent structure has crucial theoretical, statistical and clinical implications. The symptoms generally performed well in distinguishing between respondents with differing levels of liability, but others did not, suggesting modification is warranted to ensure optimal use in epidemiological samples. Given the dearth of psychometric evaluation studies of mania, further research replicating these results is necessary.

Copyright

Corresponding author

*Address for correspondence: Dr N. Carragher, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2031, Australia. (Email: n.carragher@unsw.edu.au)

References

Hide All
Aggen, SH, Neale, MC, Kendler, KS (2005). DSM criteria for major depression: evaluating symptom patterns using latent trait item response models. Psychological Medicine 35, 475487.
Agrawal, A, Nurnberger, JI, Lynskey, MT (2010). Item response modeling of DSM-IV mania symptoms in two representative US epidemiological samples. Psychological Medicine 40, 15491558.
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.
Baillie, AJ, Teesson, M (2010). Continuous, categorical and mixture models of DSM-IV alcohol and cannabis use disorders in the Australian community. Addiction 105, 12461253.
Balsis, S, Cully, JA (2008). Comparing depression diagnostic symptoms across younger and older adults. Aging and Mental Health 12, 800806.
Benjamini, Y, Hochberg, Y (1995). Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society, Series B 57, 289300.
Bentler, PM (1990). Comparative fit indexes in structural models. Psychological Bulletin 107, 238246.
Birnbaum, A (1968). Some latent trait models and their use in inferring an examinee's ability. In Statistical Theories of Mental Test Scores (ed. Lord, F. M. and Novick, M. R.), pp. 397472. Addison-Wesley: Reading, MA.
Brown, TA (2006). Confirmatory Factor Analysis for Applied Research. Guilford Press: New York.
Brown, TA, Barlow, DH (2005). Dimensional versus categorical classification of mental disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and beyond: comment on the Special Section. Journal of Abnormal Psychology 114, 551556.
Browne, MW, Cudeck, R (1992). Alternative ways of assessing model fit. Sociological Methods and Research 21, 230258.
Carragher, N, Mewton, L, Slade, T, Teesson, M (2011). An item response analysis of the DSM-IV criteria for major depression: findings from the Australian National Survey of Mental Health and Wellbeing. Journal of Affective Disorders 130, 9298.
Carragher, N, Mills, K, Slade, T, Teesson, M, Silove, D (2010). Factor structure of posttraumatic stress disorder symptoms in the Australian general population. Journal of Anxiety Disorders 24, 520527.
Cassano, GB, Mula, M, Rucci, P, Miniati, M, Frank, E, Kupfer, DJ, Oppo, A, Calugi, S, Maggi, L, Gibbons, R, Fagiolini, A (2009). The structure of lifetime manic-hypomanic spectrum. Journal of Affective Disorders 112, 5970.
Cassidy, F, Forest, K, Murry, E, Carroll, BJ (1998). A factor analysis of the signs and symptoms of mania. Archives of General Psychiatry 55, 2732.
Diler, RS, Uguz, S, Seydaoglu, G, Avci, A (2008). Mania profile in a community sample of prepubertal children in Turkey. Bipolar Disorders 10, 546553.
Edelen, MO, Reeve, BB (2007). Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement. Quality of Life Research 16, 518.
Edelen, MO, Thissen, D, Teresi, JA, Kleinman, M, Ocepek-Welikson, K (2006). Identification of differential item functioning using item response theory and the likelihood-based model comparison approach. Application to the Mini-Mental State Examination. Medical Care 44, S134S142.
Flora, D, Thissen, D (2002). IRTScore: Item Response Theory Score Approximation Software. Thurstone Psychometric Laboratory: Chapel Hill, NC.
Freeman, AJ, Youngstrom, EA, Freeman, MJ, Youngstrom, JK, Findling, RL (2011). Is caregiver-adolescent disagreement due to differences in thresholds for reporting manic symptoms? Journal of Child and Adolescent Ppsychopharmacology 21, 425432.
Gelhorn, H, Hartman, C, Sakai, J, Mikulich-Gilbertson, S, Stallings, M, Young, S, Rhee, S, Corley, R, Hewitt, J, Hopfer, C, Crowley, T (2009). An item response theory analysis of DSM-IV conduct disorder. Journal of the American Academy of Child and Adolescent Psychiatry 48, 4250.
Ghaemi, SN, Boiman, EE, Goodwin, FK (2000). Diagnosing bipolar disorder and the effect of antidepressants: a naturalistic study. Journal of Clinical Psychiatry 61, 804808.
Grant, BF, Dawson, DA, Stinson, FS, Chou, PS, Kay, W, Pickering, R (2003).## The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug and Alcohol Dependence 71, 716.
Grant, BF, Stinson, FS, Dawson, DA, Chou, SP, Dufour, MC, Compton, W, Pickering, RP, Kaplan, K (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61, 807816.
Gupta, SC, Sinha, VK, Praharaj, SK, Gandotra, S (2009). Factor structure of manic symptoms. Australian and New Zealand Journal of Psychiatry 43, 11411146.
Henry, DB, Pavuluri, MN, Youngstrom, E, Birmaher, B (2008). Accuracy of brief and full forms of the Child Mania Rating Scale. Journal of Clinical Psychology 64, 368381.
Hirschfeld, RM, Lewis, L, Vornik, LA (2003). Perceptions and impact of bipolar disorder: how far have we really come? Results of the National Depressive and Manic-Depressive Association 2000 Survey of Individuals with Bipolar Disorder. Journal of Clinical Psychiatry 64, 161174.
Hu, L, Bentler, PM (1998). Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychological Methods 3, 424453.
Judd, LL, Akiskal, HS, Schettler, PJ, Endicott, J, Maser, JD, Solomon, DA, Leon, AC, Rice, JA, Keller, MB (2002). The long-term natural history of the weekly symptomatic status of bipolar-I disorder. Archives of General Psychiatry 59, 530537.
Kendler, KS, Eaves, LJ, Walters, EE, Neale, MC, Heath, AC, Kessler, RC (1996). The identification and validation of distinct depressive syndromes in a population-based sample of female twins. Archives of General Psychiatry 53, 391399.
Kessler, RC, Chiu, WT, Demler, O, Merikangas, KR, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617627.
Kessler, RC, Rubinow, DR, Holmes, C, Abelson, JM, Zhao, S (1997). The epidemiology of DSM-III-R bipolar I disorder in a general population survey. Psychological Medicine 27, 10791089.
Kessler, RC, Üstün, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93121.
Krueger, FR, Finger, MS (2001). Using item response theory to understand comorbidity among anxiety and unipolar mood disorders. Psychological Assessment 13, 140151.
Kupfer, DJ, Angst, J, Berk, M, Dickerson, F, Frangou, S, Frank, E, Goldstein, BI, Harvey, A, Laghrissi-Thode, F, Leboyer, M, Ostacher, MJ, Sibille, E, Strakowski, SM, Suppes, T, Tohen, M, Yolken, RH, Young, LT, Zarate, CA (2011). Advances in bipolar disorder: selected sessions from the 2011 International Conference on Bipolar Disorder. Annals of the New York Academy of Sciences 1242, 125.
Lord, FM (1980). Applications of Item Response Theory to Practical Testing Problems. Erlbaum: Hillsdale, NJ.
Murray, CJ, Lopez, AD (1996). The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Harvard University Press: Cambridge, MA.
Muthén, BO, Grant, B, Hasin, D (1993). The dimensionality of alcohol abuse and dependence: factor analysis of DSM-III-R and proposed DSM-IV criteria in the 1988 National Health Interview Survey. Addiction 88, 10791090.
Muthén, LK, Muthén, BO (1998–2011). Mplus User's Guide Version 6. Muthén & Muthén: Los Angeles.
Orlando, M, Sherbourne, CD, Thissen, D (2000). Summed-score linking using item response theory: application to depression measurement. Psychological Assessment 12, 354359.
Picardi, A, Battisti, F, de Girolamo, G, Morosini, P, Norcio, B, Bracco, R, Biondi, M (2008). Symptom structure of acute mania: a factor study of the 24-item Brief Psychiatric Rating Scale in a national sample of patients hospitalized for a manic episode. Journal of Affective Disorders 108, 183189.
Plante, DT, Winkelman, JW (2008). Sleep disturbance in bipolar disorder: therapeutic implications. American Journal of Psychiatry 165, 830843.
Prisciandaro, JJ, Roberts, JE (2011). Evidence for the continuous latent structure of mania in the epidemiologic catchment area from multiple latent structure and construct validation methodologies. Psychological Medicine 41, 575588.
Proudfoot, H, Baillie, AJ, Teesson, M (2006). The structure of alcohol dependence in the community. Drug and Alcohol Dependence 81, 2126.
Robins, LN (2004). Using survey results to improve the validity of the standard psychiatric nomenclature. Archives of General Psychiatry 61, 11881194.
Sato, T, Bottlender, R, Kleindienst, N, Möller, HJ (2002). Syndromes and phenomenological subtypes underlying acute mania: a factor analytic study of 576 manic patients. American Journal of Psychiatry 159, 968974.
Simon, GE, Von Korff, M (2006). Medical comorbidity and validity of DSM-IV depression criteria. Psychological Medicine 36, 2736.
Slade, T, Johnston, A, Oakley Browne, MA, Andrews, G, Whiteford, H (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Australian and New Zealand Journal of Psychiatry 43, 594605.
Stapleton, LM (2008). Variance estimation using replication methods in structural equation modeling with complex sample data. Structural Equation Modeling 15, 183210.
Stark, S (2001). MODFIT: A Computer Program for Model-Data Fit. University of Illinois: Urbana-Champaign.
Steiger, JH (1990). Structural model evaluation and modification: an internal estimation approach. Multivariate Behavioral Research 25, 173180.
Sunderland, M, Mewton, L, Slade, T, Baillie, AJ (2010). Investigating differential symptom profiles in major depressive episode with and without generalized anxiety disorder: true co-morbidity or symptom similarity? Psychological Medicine 40, 11131123.
Thissen, D (2001). IRTLRDIF v.2.0b. Software for the Computation of the Statistics Involved in Item Response Theory Likelihood-Ratio Tests for Differential Item Functioning. Thurstone Psychometric Laboratory, University of North Carolina at Chapel Hill: Chapel Hill, NC.
Thissen, D (2003). Multilog User's Guide: Multiple Categorical Item Analysis and Test Scoring using Item Response Theory. Scientific Software: Chicago, IL.
Thissen, D, Steinberg, L, Kuang, D (2002). Quick and easy implementation of the Benjamini–Hochberg procedure for controlling the false positive rate in multiple comparisons. Journal of Educational and Behavioral Statistics 27, 7783.
Tohen, M, Greenfield, SF, Weiss, RD, Zarate, CA, Vagge, LM (1998). The effect of comorbid substance use disorders on the course of bipolar disorder: a review. Harvard Review of Psychiatry 6, 133141.
Tondo, L, Isacsson, G, Baldessarini, R (2003). Suicidal behaviour in bipolar disorder: risk and prevention. CNS Drugs 17, 491511.
Tucker, LR, Lewis, C (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika 38, 110.
Uebelacker, LA, Strong, D, Weinstock, LM, Miller, IW (2009). Use of item response theory to understand differential functioning of DSM-IV major depression symptoms by race, ethnicity and gender. Psychological Medicine 39, 591601.
Vandenberg, RJ, Lance, CE (2000). A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research. Organizational Research Methods 3, 470.
Weinstock, LM, Strong, D, Uebelacker, LA, Miller, IW (2009). Differential item functioning of DSM-IV depressive symptoms in individuals with a history of mania versus those without: an item response theory analysis. Bipolar Disorders 11, 289297.
Weinstock, LM, Strong, D, Uebelacker, LA, Miller, IW (2010). Use of item response theory methodology to evaluate differences between bipolar and unipolar depression. US Psychiatry 3, 1520.
Wolf, EJ, Millier, MW, Brown, TA (2011). The structure of personality disorders in individuals with posttraumatic stress disorder. Personality Disorders: Theory, Research, and Treatment 2, 261278.
Woods, CM (2008 a). Likelihood-ratio DIF testing: effects of nonnormality. Applied Psychological Measurement 32, 511526.
Woods, CM (2008 b). IRT-LR-DIF with estimation of the focal-group density as an empirical histogram. Educational and Psychological Measurement 88, 571586.
Woods, CM (2009). Empirical selection of anchors for tests of differential item functioning. Applied Psychological Measurement 33, 4257.

Keywords

Psychometric evaluation of the DSM-IV criterion B mania symptoms in an Australian national sample

  • N. Carragher (a1), L. M. Weinstock (a2) and D. Strong (a3)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed