Advances in psychometrics: from Classical Test Theory to Item Response Theory

In the 20th century, development and evaluation of psychometric properties of tests was mainly based on the Classical Test Theory (CTT). Many tests are long and redundant, with measures influenced by the characteristics of the sample of the individuals being evaluated. Some of the limitations are a consequence of the use of the CTT. The Item Response Theory (IRT) has been proposed as a solution to some limitations of the CTT, improving the quality of assessment of the tests structure. In this paper we critically compare the characteristics of CTT and IRT methods in determining the psychometric properties of tests. We discuss the advantages and limitations of each method.No século XX, o desenvolvimento e avaliação das propriedades psicométricas dos testes se embasou principalmente na Teoria Clássica dos Testes (TCT). Muitos testes são longos e redundantes, com medidas influenciáveis pelas características da amostra dos indivíduos avaliados durante seu desenvolvimento, sendo algumas destas limitações consequências do uso da TCT. A Teoria de Resposta ao Item (TRI) surgiu como uma possível solução para algumas limitações da TCT, melhorando a qualidade da avaliação da estrutura dos testes. Neste texto comparamos criticamente as características da TCT e da TRI como métodos para avaliação das propriedades psicométricas dos testes. São discutidas as vantagens e limitações de cada método.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

KNOWLEDGE AND ATTITUDES OF NURSES TOWARDS ALCOHOL AND RELATED PROBLEMS: THE IMPACT OF AN EDUCATIONAL INTERVENTION

An exploratory study of quasi-experimental approach that aimed to verify the impact of an educational intervention on attitudes and knowledge of nurses towards alcohol use and associated problems. The sample included 185 nurses, divided into two groups: 84 submitted to a training course and formed the experimental group. Data were collected through a knowledge survey and an attitude scale. The attitudes of the participants of both groups were positive. There were no significant differences between groups in relation to knowledge. The strongest predictors of positive attitudes were possessed preparation to act with chemical dependents (OR = 2.18), "have received increased workload during graduation on the theme, 'alcohol and other drugs'" (OR = 1.70), and "completed graduate school" (OR = 2.59). The educational intervention had a positive impact on the attitudes of nurses towards alcoholics, work and interpersonal relationships with such clientele.Estudio exploratorio cuasi-experimental que tuvo como objetivo verificar el impacto de una intervención educativa sobre los conocimientos y las actitudes de las enfermeras frente al consumo de alcohol y problemas asociados. La muestra incluyó a 185 enfermeras, divididas en dos grupos. De los cuales, 84 se sometieron a un curso de capacitación y formaron el grupo experimental. Los datos fueron recolectados a través de un cuestionario de conocimientos y una escala de actitudes. Las actitudes de los participantes de ambos grupos fueron positivas. En lo que respecta al conocimiento, no hubo diferencias significativas entre los dos grupos. Los principales predictores de las actitudes positivas fueron estar preparados para actuar con dependientes químicos (OR = 2,18), "haber recibido mayor carga horaria en el pregrado sobre la temática de alcohol y otras drogas'" (OR = 1,70) y "haber realizado post-grado" (OR = 2,59). Se concluyó que la intervención educativa ejerció impacto positivo en las actitudes de las enfermeras frente a los alcohólicos, al trabajo y a las relaciones interpersonales con dicha clientela.Estudo exploratório de abordagem quase experimental que objetivou verificar o impacto de uma intervenção educativa em atitudes e conhecimentos de enfermeiros frente ao uso de álcool e problemas associados. A amostra incluiu 185 enfermeiros, divididos em dois grupos: 84 foram submetidos a um curso de capacitação e constituíram o grupo experimental. Os dados foram coletados por meio de um questionário de conhecimentos e uma escala de atitudes. As atitudes dos participantes de ambos os grupos foram positivas. Com relação aos conhecimentos, não se observaram diferenças significativas entre os grupos. Os maiores preditores de atitudes positivas foram possuir preparo para atuar com dependentes químicos (OR=2,18), "ter recebido maior carga horária durante a graduação sobre a temática 'álcool e outras drogas'" (OR=1,70) e "ter realizado pós-graduação" (OR=2,59). Concluiu-se que a intervenção educativa exerceu impacto positivo nas atitudes dos enfermeiros frente ao alcoolista, ao trabalho e às relações interpessoais com tal clientela

Atitudes e conhecimentos de enfermeiros frente ao álcool e problemas associados: impacto de uma intervenção educativa

An exploratory study of quasi-experimental approach that aimed to verify the impact of an educational intervention on attitudes and knowledge of nurses towards alcohol use and associated problems. the sample included 185 nurses, divided into two groups: 84 submitted to a training course and formed the experimental group. Data were collected through a knowledge survey and an attitude scale. the attitudes of the participants of both groups were positive. There were no significant differences between groups in relation to knowledge. the strongest predictors of positive attitudes were possessed preparation to act with chemical dependents (OR = 2.18), have received increased workload during graduation on the theme, alcohol and other drugs (OR = 1.70), and completed graduate school (OR = 2.59). the educational intervention had a positive impact on the attitudes of nurses towards alcoholics, work and interpersonal relationships with such clientele.Univ São Paulo, Sch Nursing, Grad Program Nursing, São Paulo, BrazilUniv São Paulo, Sch Nursing, Dept Maternal Child Nursing & Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilSUPERA Course, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilWeb of Scienc

Expression of behavioral sensitization to ethanol is increased by energy drink administration

Alcohol abuse and dependence are important medical, social and economical problems, affecting millions of people. A relatively recent habit among young people is mixing alcohol with energy drinks (ED), in spite of the risks involved may be higher than those associated with alcohol consumption alone. the mixture of alcohol and energy drinks, both with stimulant properties, may alter the perception of intoxication and could lead individuals to believe they are less drunk and can drink more or for longer periods of time. in animals, the repeated administration of ethanol can lead to a progressive increase of the locomotor stimulant effect, known as behavioral sensitization, a drug-dependent behavioral plasticity associated with vulnerability to addiction. As well as for addiction, there are clear individual differences in the level of sensitization to ethanol among species and even among individuals from the same strain. the present study assessed how ED affects the expression of ethanol sensitization. Female mice chronically treated with ethanol (2.4 g/kg) were classified as low-sensitized or high-sensitized. Two days later, different groups of mice were submitted to saline + water, ethanol + water or ethanol + ED systemic challenges. As expected, only the high-sensitized group expressed clear sensitization after ethanol administration. However, the administration of ethanol + ED triggered the sensitization expression in the low-sensitized group. These data indicate that the combined use of ED and ethanol can potentiate the stimulant and, consequently, the reward effects of ethanol in previously treated mice. If a similar process occurs in human beings, the use of ED can increase the risk of developing alcohol abuse or dependence. (C) 2013 Elsevier Inc. All rights reserved.Associacao Fundo de Incentivo a Pesquisa (AFIP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo UNIFESP, Dept Ps Biol, Esco Paulista Med, BR-04023062 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Ps Biol, Esco Paulista Med, BR-04023062 São Paulo, BrazilFAPESP: FAPESP 02/04191-0Web of Scienc

Distinct behavioral phenotypes in ethanol-induced place preference are associated with different extinction and reinstatement but not behavioral sensitization responses

Conditioned place preference (CPP) is a model to study the role of drug conditioning properties. in outbred strains, individual variability may affect some behavioral measures. However, there are few studies focusing on understanding how different phenotypes of ethanol conditioned behavior may influence its extinction, reinstatement, and behavioral adaptation measures. We used male Swiss Webster mice to study different phenotypes related to ethanol conditioning strength, reinstatement and behavioral sensitization. Mice went through a CPP procedure with ethanol (2.2 g/kg, i.p.). After that, one group of mice was submitted to repeated extinction sessions, while another group remained in their home cages without any drug treatment. Mice went through environmental and ethanol priming (1.0 g/kg, i.p.) reinstatement tests. Ethanol priming test reinstated the conditioned behavior only in the animals kept in the home-cage during the abstinence period. Besides, the ethanol conditioned behavior strength was positively correlated with the time required to be extinguished. in the second set of experiments, some mice went through a CPP protocol followed by behavioral sensitization (five i.p. administrations of ethanol 2.2 g/kg or saline per week, for 3 weeks) and another group of mice went through sensitization followed by CPR No positive correlation was observed between ethanol CPP strength and the intensity of behavioral sensitization. Considering that different phenotypes observed in CPP strength predicted the variability in other CPP measures, we developed a statistics-based method to classify mice according to CPP strength to be used in the evaluation of ethanol conditioning properties.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)AFIPFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Dept Psicobiol, Unidade Dependencia Drogas, São Paulo, BrazilNIAAA, Lab Integrat Neurosci, NIH, Rockville, MD 20852 USAUniversidade Federal de São Paulo, Dept Psicobiol, Unidade Dependencia Drogas, São Paulo, BrazilFAPESP: 2011/15258-8Web of Scienc

Hazardous alcohol use: screening and brief intervention as routine practice in primary care

The variety of problems related to the so-called hazardous patterns of alcohol use make the latter a prominent public health concern. Screening instruments associated with brief interventions in primary care provide one of the frequently recommended secondary prevention strategies. The objective of this study was to assess the implementation of this strategy as a routine practice in primary health care services in the city of Juiz de Fora, Minas Gerais State, Brazil. A qualitative design was employed, including the application of semi-structured interviews for managers and health care professionals in the city's public health system, in addition to content analysis and participant observation. Results point to difficulties in the effective implementation of such routines both by managers and health care professionals. Health care professionals limit the approach to alcohol-dependent patients and demonstrate lack of motivation for preventive work. Health services managers experience difficulties in the organization and administration of such instruments, despite affirming their interest in the project.Tendo em vista os diversos problemas associados ao assim chamado uso de risco de álcool, ele é considerado uma relevante questão de saúde pública. Uma das estratégias de prevenção secundária recomendadas é a utilização de instrumentos de rastreamento associados a intervenções breves em serviços de atenção primária à saúde. O objetivo deste estudo foi avaliar o processo de implantação desta estratégia na rotina de atenção primária à saúde da cidade de Juiz de Fora, Minas Gerais, Brasil. Foi utilizada uma abordagem qualitativa, incluindo a aplicação de entrevistas semi-estruturadas a gestores e/ou profissionais da assistência do Sistema Municipal de Saúde, associadas à análise de conteúdo e observação participante. Os resultados indicam que há dificuldades para a implantação efetiva destas rotinas, tanto em relação aos gestores quanto aos profissionais envolvidos diretamente na sua execução. Quanto aos profissionais destacam-se a restrição da abordagem a dependentes de álcool e a falta de motivação dos profissionais para trabalhos preventivos. Quanto aos gestores, foram detectadas dificuldades práticas no processo de organização e gerenciamento, a despeito de um afirmado interesse no projeto.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de Juiz de Fora Instituto de Ciências Humanas e de LetrasUniversidade Federal de Juiz de Fora Faculdade de MedicinaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PsicobiologiaUNIFESP, EPM, Depto. de PsicobiologiaSciEL

A baixa percepção de suporte familiar pode ser um marcador social da dependência de substâncias?

OBJECTIVE: Simultaneously assess the relationship between the family support perception and the intensity of hopelessness, depression, and anxiety symptoms in alcohol or drug dependent (AOD) patients and in non-AOD dependent control group (CON). METHOD: 60 patients who met the DSM-IV criteria for AOD dependence and 65 individuals with similar profile, but not dependent on AOD completed the Family Support Perception Inventory (FSPI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Beck Hopelessness Scale (BHS). RESULTS: Logistic regression analysis indicated that high scores in family autonomy (OR = 0.08), and low scores in hopelessness (OR = 0.64) were negatively correlated with AOD dependence. Individuals with high scores in BAI had higher probability (OR = 1.22) of belonging to the AOD group, as well as those who reported previous psychiatric treatment (OR = 68.91). Only in the AOD group the total FSPI scores presented significant correlation with depression, anxiety, and hopelessness. CONCLUSIONS: Individuals with AOD dependence and low scores of family support perception also presented high scores of depression, anxiety, and hopelessness, suggesting that FSPI scores could be a useful 'social marker' of AOD dependence with psychiatric comorbidities. These data also reinforce the relevance of evaluating family support in AOD treatment planning.OBJETIVO: Estudar as relações entre a percepção do suporte familiar e sintomas de desesperança, depressão e ansiedade em pacientes dependentes de álcool ou drogas (AOD) e um grupo-controle (CON). MÉTODO: Sessenta pacientes que preencheram critérios do DSM-IV para dependência de AOD e um grupo-controle com 65 indivíduos com perfil similar, mas não dependentes de AOD preencheram o inventário de Percepção de Suporte Familiar (IPSF), o Inventário de Depressão de Beck (BDI), o Inventário de Ansiedade de Beck (BAI) e a Escala de Desesperança de Beck (BHS). RESULTADOS: Segundo a análise de regressão logística, altos escores de autonomia familiar (OR = 0,08) e baixos escores de desesperança (OR = 0,64) correlacionaram-se negativamente com ser dependente de AOD. Pessoas com altos escores no BAI apresentaram maior chance (OR = 1,22) de pertencer ao grupo AOD, assim como as que relataram já terem sido submetidas a tratamento psiquiátrico (OR = 68,91). Somente no grupo AOD os escores totais no IPSF se correlacionaram significativamente com sintomas de depressão, ansiedade e desesperança. CONCLUSÕES: Dependentes de AOD com baixa percepção de suporte familiar apresentaram também altos escores de depressão, ansiedade e desesperança, sugerindo que o IPSF poderia ser um útil marcador social da dependência de AOD associada a comorbidades psiquiátricas. Os dados reforçam a relevância de avaliar o suporte familiar no planejamento de tratamento para dependência de AOD.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo (UNIFESP) Departamento de PsicobiologiaCentro de Estudos em Psicobiologia e ExercícioUniversidade Federal de São Paulo (UNIFESP) Departamento de BiociênciasUniversidade São Francisco Psychology Post-Graduation ProgramUNIFESP, Depto. de PsicobiologiaUNIFESP, Depto. de BiociênciasSciEL

Mediational Analyses of the Effects of Social Behaviour and Network Therapy on Alcohol Use

INTRODUCTION: Social behaviour and network therapy involves an active participation of the practitioner in recruiting a supportive network to change the client's alcohol use. Despite achieving beneficial effects on alcohol consumption, its possible mechanisms of change are a relatively under-studied topic compared to those of other alcohol treatment interventions. This study aimed to explore therapist skills through which social behaviour and network therapy may achieve effects on alcohol consumption in comparison with motivational enhancement therapy. METHODS: This study was secondary analysis of data from the UK Alcohol Treatment Trial, a multicentre, pragmatic, randomized controlled trial. The sample comprised 376 participants randomized to motivational enhancement therapy or social behaviour and network therapy. We used the UK Alcohol Treatment Trial Process Rating Scale to assess therapist skills. Outcomes drinks per drinking day and percentage of days abstinent were assessed 12 months after treatment initiation. Analyses were conducted in a simple mediation framework. RESULTS: Therapist skills score (combining frequency and quality) for involving others in behaviour change mediated social behaviour and network therapy effects on percentage of days abstinent (b = 0.06, 95% CI: 0.02; 0.10, p = 0.01). The frequency with which therapists acted as an active agent for change also mediated the effects of social behaviour and network therapy on percentage of days abstinent (b = 0.03, 95% CI: 0.003; 0.05, p = 0.03). The frequency with which the therapist stressed social support as a key factor in achieving change unexpectedly mediated an increase in drinks per drinking day (b = 0.10, 95% CI: 0.01; 0.18, p = 0.02). The two latter mediation effects were not sustained when quality was considered. All other indirect effects tested were non-significant. DISCUSSION/CONCLUSIONS: How social behaviour and network therapy exerts effects on alcohol outcomes is not yet well understood and in this study was not attributable to observed ratings of therapist treatment-specific skills. Therapist skill in planning the involvement of others during treatment, however, warrants further study. We suggest that the present findings should be regarded as hypothesis generating as it identifies specific targets for further investigation in alcohol treatment process studies

Crack-cocaine users have less family cohesion than alcohol users

Objective: Many studies correlate characteristics of family functioning and the development of drug addiction. This study sought to evaluate and compare the family environment styles of two groups of psychoactive substance users: 1) alcohol-only users and 2) crack-cocaine users. Methods: Three hundred and sixty-four users of alcohol, crack-cocaine, and other drugs, recruited from research centers in four Brazilian capitals participated in this study. Subjects were evaluated through the Family Environment Scale and the Addiction Severity Index, 6th version (ASI-6). ASI-6 t-scores were compared by analysis of variance (ANOVA) and post-hoc tests. A final model was obtained using a logistic regression analysis. All analyses were adjusted for partner, age, and psychiatric t-score. Results: We found a significant difference between groups in the cohesion subscale (p = 0.044). The post-hoc test revealed a difference of 1.06 points (95%CI 0.11-2.01) between groups 1 (6.4560.28) and 2 (5.3860.20). No significant between-group differences were observed in the other subscales. However, categorical analyses of variables regarding family dynamic showed that crack users more often reported that sometimes people in their family hit each other (30.4% vs. 13.2%, p = 0.007) and that people in their family frequently compared each other regarding work and/or school achievement (57.2% vs. 42.6%, p = 0.041). Conclusion: These results suggest that families of crack-cocaine users are less cohesive than families of alcohol users. This type of family environment may affect treatment outcome, and should thus be adequately approached