Measurement-Based Care Benchmarks and Bipolar Classification in ABCD Youth

To test whether two brief mania measures, the Parent General Behavior Inventory-10 Mania form (PGBI-10M) and 7-Up, retain useful psychometric properties in a large population cohort, and to evaluate whether the PGBI-10M can identify Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS)-defined bipolar spectrum disorders in that setting.

Analyses used 11,000+ youths across late childhood and early adolescence from the Adolescent Brain Cognitive Development (ABCD) Study. For both PGBI-10M and 7-Up, we estimated descriptive statistics, internal consistency, confirmatory factor models, graded response models, and measurement-based care benchmarks (minimally important difference, reliable change, and clinical cutpoints). For the PGBI-10M, receiver operating characteristic (ROC) analyses estimated concurrent classification accuracy for bipolar diagnoses at baseline and 2-year follow-up and compared area under the curve (AUC) values with prior outpatient and community mental health samples.

Scores were lower than in clinical samples, but both measures remained psychometrically sound. The PGBI-10M showed alpha=.87-.88 and omega=.88; the 7-Up showed alpha=.78 and omega=.79. Longitudinal analyses indicated threshold differences across waves, likely reflecting caregiver recalibration and developmental changes, with modest impact on estimates. ABCD-based benchmarks supported meaningful and reliable change. The PGBI-10M discriminated bipolar cases (AUC=0.68 baseline; 0.77 follow-up), though performance was lower than in clinical samples. Positive predictive values were low in this population.

The PGBI-10M and 7-Up support monitoring of manic and mixed symptoms, but the PGBI-10M alone is insufficient for universal bipolar screening. Brief mania scales are best used for targeted assessment and longitudinal monitoring within multi-informant workflows.