ASAP-YS: Adaptive Screening and Assessment of Psychopathology. Project Summary: This Small Business Technology Transfer (STTR) Phase I proposal will develop and test a new computerized adaptive self-assessment measure: the Adaptive Screening and Assessment of Psychopathology-Youth Self-informant (ASAP-YS). This is a computer-assisted self-interview (A-CASI) for adolescents that presents the text of each question on screen as well as playing a high-quality audio recording of a human voice reading the question (in either English or Spanish). The ASAP-YS is innovative because it: 1. Combines Item Response Theory (IRT) based adaptive and rule-based algorithms to control the content and flow of an assessment that can efficiently screen for, and assess, a broad range of psychiatric disorders in adolescents. 2. Yields screening estimates, clinical risk profiles, and DSM-IV diagnoses, as well as continuous severity scores of psychopathology and functional impairment while using substantially fewer questions than comparable diagnostic interviews and with greater accuracy than brief screening questionnaires. Evaluation of the Phase I prototype will be carried out in four low-income, rural, and ethnically diverse sites in New Mexico. The screening module of the ASAP-YS will be given to 80 adolescents attending school based health clinics in these areas. Students will complete the ASAP-YS, a second non-adaptive screening instrument (in counterbalanced order) and then later receive a full psychiatric diagnostic interview. Administration time, number of questions asked, subject acceptability and diagnostic screening accuracy of the ASAP-YS will be calculated. If the ASAP-YS proves effective and acceptable in this sample, then the product will likely be appropriate for many under-served populations within the United States. While the shortage of mental health care for young people is not limited to rural areas, the lack of trained providers in these areas exacerbates the problem of screening, assessment and triage and makes the development of cost-effective, efficient and customizable automated assessment tools particularly attractive. Project Narrative: Adolescents are a particularly under-served population whose mental health needs are not frequently identified or treated. The shortage of trained mental health providers in many areas of the United States is compounded by a shortage of cost-effective, efficient and accurate standardized self-assessment measures. Developing a computerized adaptive test such as the ASAP-YS, that utilizes Item Response Theory (IRT) to carry out screening, diagnostic assessment and triage in a very time-efficient manner without sacrificing safety or accuracy, is a major advance. ? ? ?
