Developing an African youth psychosocial assessment: an application of item response theory

Abstract

This study aimed to refine a dimensional scale for measuring psychosocial adjustment in African youth using item response theory (IRT). A 60-item scale derived from qualitative data was administered to 667 war-affected adolescents (55% female). Exploratory factor analysis (EFA) determined the dimensionality of items based on goodness-of-fit indices. Items with loadings less than 0.4 were dropped. Confirmatory factor analysis (CFA) was used to confirm the scale's dimensionality found under the EFA. Item discrimination and difficulty were estimated using a graded response model for each subscale using weighted least squares means and variances. Predictive validity was examined through correlations between IRT scores (θ) for each subscale and ratings of functional impairment. All models were assessed using goodness-of-fit and comparative fit indices. Fisher's Information curves examined item precision at different underlying ranges of each trait. Original scale items were optimized and reconfigured into an empirically-robust 41-item scale, the African Youth Psychosocial Assessment (AYPA). Refined subscales assess internalizing and externalizing problems, prosocial attitudes/behaviors and somatic complaints without medical cause. The AYPA is a refined dimensional assessment of emotional and behavioral problems in African youth with good psychometric properties. Validation studies in other cultures are recommended.

Keywords: Africa; Uganda; children and adolescents; item response theory (IRT); mental health assessment; psychometric measurement.

Figure 1

General workflow of the IRT analysis to produce the reduced AYPA measure.

Figure 2

Information curves for the AYPA subscales.

Figure 3

Item characteristic curves for the AYPA subscales: (a) internalizing subscale; (b) externalizing subscale; (c) prosocial subscale; (d) somatic subscale.