Measurement-Based Care Benchmarks and Bipolar Classification in ABCD Youth

Area of Science:

• Psychiatry
• Developmental Psychology
• Psychometrics

Background:

• Accurate assessment of manic and bipolar symptoms in youth is crucial for timely intervention.
• Brief screening tools are needed to evaluate mania symptoms in large pediatric populations.
• The Parent General Behavior Inventory-10 Mania form (PGBI-10M) and 7-Up are brief measures of mania symptoms.

Purpose of the Study:

• To evaluate the psychometric properties of the PGBI-10M and 7-Up in a large adolescent cohort.
• To determine if the PGBI-10M can identify Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS)-defined bipolar spectrum disorders.
• To establish measurement-based care benchmarks for these brief mania measures.

Main Methods:

• Analysis of over 11,000 youths from the Adolescent Brain Cognitive Development (ABCD) Study.
• Estimation of internal consistency, factor models, and measurement-based care benchmarks for PGBI-10M and 7-Up.
• Receiver operating characteristic (ROC) analyses to assess the PGBI-10M's classification accuracy for bipolar diagnoses.

Main Results:

• Both PGBI-10M (alpha=.87-.88) and 7-Up (alpha=.78) demonstrated sound psychometric properties in the ABCD cohort.
• The PGBI-10M showed moderate accuracy in discriminating bipolar cases (AUC=0.68 baseline; 0.77 follow-up), but with low positive predictive values.
• Longitudinal analyses revealed minor threshold differences, likely due to caregiver recalibration and developmental changes.

Conclusions:

• The PGBI-10M and 7-Up are suitable for monitoring manic and mixed symptoms in youth.
• The PGBI-10M alone is not sufficient for universal bipolar disorder screening in this population.
• Brief mania scales are most effective for targeted assessment and longitudinal monitoring within comprehensive evaluations.