Background: Precise assessment tools for psychotic experiences in young people may help identify symptoms early and facilitate advances in treatment. In this study we provide an exemplar -with a paranoia scale for youth -for improving measurement precision for psychotic experiences using item response theory (IRT). We evaluate the psychometric properties of the new measure, test for measurement invariance, and assess its potential for computerised adaptive testing (CAT).
Method:The 18-item Bird Checklist of Adolescent Paranoia (B-CAP) was completed by 1102 adolescents including 301 patients with mental health problems and 801 from the general population. After excluding outliers (n=10), IRT was used to examine item properties, test reliability, and measurement invariance. The properties of an adaptive B-CAP were assessed using a simulation of 10,000 responses.Results: All B-CAP items were highly discriminative (a=1.15-2.76), whereby small shifts in paranoia led to a higher probability of item endorsement. Test reliability was high (a>0.90) across a wide range of paranoia severity (θ= -0.46-3.36), with the greatest precision at elevated levels. All items were invariant for gender, age, and population groups. The simulated adaptive B-CAP performed with high accuracy and required only 5-6 items at higher levels of paranoia severity.
Conclusions:The B-CAP is a reliable assessment tool with excellent psychometric properties to assess both non-clinical and clinical levels of paranoia in young people, with potential as an efficient adaptive test. In future, these approaches could be used to develop a multidimensional CAT to assess the full range of psychotic experiences in youth.
Objectives
Transgender and gender non-conforming people may face elevated rates of shame and self-criticism in light of minority stress. Compassion-focused therapy has a growing evidence base in addressing trans-diagnostic processes in mental health difficulties, including shame and self-criticism. The objective of the present study was to explore the experience of an initial pilot compassion-focused therapy group delivered online in a Gender Service during the COVID-19 pandemic.
Methods
Six transgender people completed a semi-structured interview after attending an 8-week compassion-focused therapy group in a national Gender Service. Inductive thematic analysis was used to identify themes in the data.
Results
Four themes were identified from the data: Transition Needs Compassion; Acceptability of the Compassion-Focused Approach; Being in a group with other transgender people; and Online delivery works despite its challenges. Participants reported that the compassion-focused framework was an appropriate and helpful way of understanding their experiences of stigma and that both the content and process of the group had benefitted them. Being with other transgender people raised some anxieties, such as comparisons or fear of offending, but also enabled seeing the self in more positive and accepting ways. While online delivery had some challenges, participants largely felt it was an effective mode of delivery, aided by the experiential nature of the group.
Conclusions
Compassion-focused therapy seems to be a feasible and acceptable approach for transgender and gender non-conforming people. Group processes may be helpful in increasing self-acceptance. Further quantitative exploration of therapy process and outcomes is warranted.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.