title: ASSERT--the Autism Symptom SElf-ReporT for adolescents and adults: bifactor analysis and validation in a large adolescent population.
abstract: With a view to developing a brief screening instrument for autism symptoms in a general population of adolescents, seven items from the Asperger syndrome (and high-functioning autism) diagnostic interview were adapted for use as self-report in an online questionnaire for youths aged 16-19 years (N=10,220). The selected items target lack of social understanding (4 items) and rigid and repetitive behavior and interests (RRBI; 3 items). Factor analyses were performed, and the seven items were also validated against self-reported ASD diagnosis. Best statistical model fit was found for a bifactor model with one general factor and two domain specific factors tied to social difficulties and RRBI. Both the general and the domain specific factors were associated with self-reported ASD diagnoses. The scale (referred to as the Autism Symptom SElf-ReporT for Adolescents and Adults--ASSERT) had good screening properties with a receiver operating curve-area under the curve (ROC-AUC) of 0.87 and a diagnostic odds ratio (DOR) of 15.8. Applying a modified scoring of the scale further improved the screening properties leading to a ROC-AUC of 0.89 and a DOR of 24.9. The ASSERT holds promise as a brief self-report screen for autism symptoms in adolescents, and further studies should explore its usefulness for adults.
authors.affiliation: Department of Child and Adolescent Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research, P.O. Box 7800, 5020 Bergen, Norway; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, P.O. Box 7800, Bergen, Norway. Electronic address: maj-britt.posserud@uni.no.
authors.forename: Maj-Britt
authors.initials: MB
authors.lastname: Posserud
authors.forename: Kyrre
authors.initials: K
authors.lastname: Breivik
authors.forename: Christopher
authors.initials: C
authors.lastname: Gillberg
authors.forename: Astri J
authors.initials: AJ
authors.lastname: Lundervold
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D020817:Asperger Syndrome / Q000175:diagnosis / Q000523:psychology; D001321:Autistic Disorder / Q000175:diagnosis / Q000523:psychology; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation; D011594:Psychometrics / Q000295:instrumentation; D012372:ROC Curve; D015203:Reproducibility of Results; D057566:Self Report; D012919:Social Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: ASD; ASSERT; Adolescents; Adults; Autism; Autism symptoms; Factor analysis; Screen; Self-report