- MacKenzie, 2024 | Developing a Measure of Key Adult Outcomes in Adults with Developmental Disabilities: Conceptual Model and Item Generation of the REALS (Relationships, Employment, Autonomy, and Life Satisfaction)
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Kristen T. MacKenzie, Kelly B. Beck, Shaun M. Eack, Katharine N. Zeglen, Caitlin M. Conner & Carla A. Mazefsky
Journal of Autism and Developmental Disorders 2024
- Day, 2023 | The Emotion Dysregulation Inventory-Young Child: Psychometric Properties and Item Response Theory Calibration in 2- to 5-Year-Olds
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Taylor N. Day, Carla A. Mazefsky, Lan Yu, Katharine N. Zeglen, Cameron L. Neece & Paul A. Pilkonis
Journal of the American Academy of Child and Adolescent Psychiatry 2023
ABSTRACT
Objective
The Emotion Dysregulation Inventory (EDI) was designed and validated to quantify emotion dysregulation (ED) in ages 6+. The purpose of this study was to adapt the EDI for use in young children (EDI-YC).
Method
Caregivers of 2139 young children (ages 2-5) completed 48 candidate EDI-YC items. Factor and item response theory (IRT) analyses were conducted separately for clinical (neurodevelopmental disabilities; N = 1369) and general population (N = 768) samples. The best performing items across both samples were selected. Computerized adaptive testing simulations were utilized to develop a short-form version. Concurrent calibrations and convergent/criterion validity analyses were performed.
Results
The final calibrated item banks included 22 items – 15 items for Reactivity, characterized by rapidly escalating, intense, and labile negative affect, and difficulty down-regulating that affect, and 7 items for Dysphoria, characterized primarily by poor up regulation of positive emotion, as well an item each on sadness and unease. The final items did not show differential item functioning based on age, sex, developmental status, or clinical status. IRT co-calibration of the EDI-YC Reactivity with psychometrically robust measures of anger/irritability and self-regulation demonstrated its superiority in assessing emotion dysregulation in as few as seven items. EDI-YC validity was supported by expert review and its association with related constructs (e.g., anxiety, depression, aggression, temper loss).
Conclusion
The EDI-YC captures a broad range of emotion dysregulation severity with a high degree of precision in early childhood. It is suitable for use in all children ages 2-5, regardless of developmental concerns, and would be an ideal broadband screener for emotional/behavioral problems during well-child checks and to support early childhood irritability and emotion regulation research.
- Mazefsky, 2022 | Editorial: The Boundaries of Irritability and Implications for Measurement
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Carla A. Mazefsky, PhD
Journal of the American Academy of Child and Adolescent Psychiatry 2022
- Day, 2022 | A PROMIS®ing New Measure for Quantifying Emotion Dysregulation in Toddlers and Preschoolers: Development of the Emotion Dysregulation Inventory-Young Child
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Taylor N. Day, Jessie B. Northrup & Carla A. Mazefsky
Journal of Autism and Developmental Disorders 2022
Abstract
The Emotion Dysregulation Inventory (EDI) was designed and validated to quantify emotion dysregulation (ED) in school-age children, with a particular emphasis on capturing ED in youth with ASD. We saw a need to adapt the EDI for use in young children (ages 2–5) given early childhood is a formative time for emotion regulation development. The present study discusses the adaptation process for the EDI-Young Child (EDI-YC), including item refinement/generation and cognitive interviews (N = 10 with ASD), consistent with the Patient-Reported Outcomes Measurement Information System (PROMIS®) methodology. The item bank was piloted in a sample of 2-year-olds with and without ASD (N = 31), which provided initial support for the EDI-YC as a valid and reliable measure.
- Mazefsky, 2021 | Evidence Base Update for Questionnaires of Emotion Regulation and Reactivity for Children and Adolescents
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Carla A. Mazefsky, Caitlin M. Conner, Kaitlyn Breitenfeldt, Nina Leezenbaum, Qi Chen, Lauren M. Bylsma & Paul Pilkonis
Journal of Clinical Child & Adolescent Psychology 2022
Abstract
Objective: Emotion regulation (ER) is a multi-faceted and dynamic process relevant to both normative emotional development and transdiagnostic emotional dysfunction for a range of psychological disorders. There has been tremendous growth in ER research over the past decade, including the development of numerous new measures to assess ER. This Evidence Base Update included a systematic review to identify self- and informant-report questionnaire measures of ER for children and adolescents, including measures of ER strategies and effectiveness (or emotion dysregulation).
Methods: PubMed, PsycInfo, and Health and Psychosocial Instruments databases were searched using the terms emotion OR affect AND regulation OR control OR reactivity OR response, as well as terms related to questionnaires and psychometrics, restricted to articles on youth (< 18 years old). Each measure’s psychometrics was evaluated based on modified criteria by De Los Reyes and Langer (2018).
Results: Nine-hundred ninety-seven papers were identified yielding 87 measures that met inclusion for review. Although the majority (60%) of identified ER measures could not be recommended based on these criteria, 8% were Excellent, 14% were Good, and 17% were Adequate. The recommended measures included: 11 general ER measures (5 focused on strategies, 5 focused on dysregulation/ effectiveness), 13 measures of ER as it relates to specific emotions or contexts such as irritability or peer stress (4 focused on strategies, 9 focused on dysregulation/effectiveness), and 11 measures of other constructs that include an ER subscale (all focused on dysregulation).
Conclusions: The characteristics, strengths, and weaknesses of the recommended ER measures are described in order to guide measure selection for clinical or research uses. A synthesis of themes identified during this review includes commonly observed areas of weakness and gaps in the literature to provide a foundation for future research and measure development.
- Mazefsky 2020 | Psychometric Properties of the Emotion Dysregulation Inventory in a Nationally Representative Sample
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Carla A. Mazefsky, Lan Yu, and Paul A. Pilkonis
Journal of Clinical Child & Adolescent Psychology 2020
Abstract
Objective: The Emotion Dysregulation Inventory (EDI) is an informant questionnaire developed based on the Patient-Reported Outcomes Measurement Information System (PROMIS®) Scientific Standards and refined through factor analyses and item response theory (IRT) analyses. Although it was developed to improve measurement of emotion dysregulation in youth with autism spectrum disorder, emotion dysregulation has transdiagnostic significance. Therefore, the aim of this study was to evaluate the EDI’s psychometric properties and to establish IRT-based scores for a general population of youth.
Methods: Data were collected from a sample of 1000 caregivers of 6- to 17-year-old youth matched to the US census on age, gender, race/ethnicity, years of education, and region. Confirmatory factor analyses and IRT analyses using the two-parameter graded response model were performed to evaluate the EDI’s structure and psychometric properties.
Results: Analyses supported the original two-factor structure of the EDI, reflecting factors for Reactivity and Dysphoria. Simulations of computerized adaptive testing supported use of the same items for a Reactivity short form as those that emerged as most informative in the original autism psychometric analyses. IRT co-calibration with commonly used measures of emotion regulation and irritability in child clinical or community samples indicated the EDI scales provide more information across a wider range of emotion dysregulation. Validity was supported by moderate correlations with measures of related constructs and expected known-group differences.
Conclusions: The EDI is an efficient and precise measure of emotion dysregulation for use in general community and clinical samples as well as samples of youth with ASD.
- Mazefsky, 2018 | Development of the Emotion Dysregulation Inventory: A PROMIS®ing Method for Creating Sensitive and Unbiased Questionnaires for Autism Spectrum Disorder
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Carla A. Mazefsky, Taylor N. Day, Matthew Siegel, Susan W. White, Lan Yu, Paul A. Pilkonis, and Autism and Developmental Disabilities Inpatient Research Collaborative (ADDIRC)
Journal of Autism and Developmental Disorders 2018
Abstract
The lack of sensitive measures suitable for use across the range of functioning in autism spectrum disorder (ASD) is a barrier to treatment development and monitoring. The Emotion Dysregulation Inventory (EDI) is a caregiver-report questionnaire designed to capture emotional distress and problems with emotion regulation without requiring verbal information. The first two phases of the EDI's development are described, including: 1) utilizing methods from the Patient-Reported Outcomes Measurement Information System (PROMIS®) project to develop the item pool and response options; and 2) assessment of the EDI in a sample of psychiatric inpatients with ASD. The results suggest that the EDI captures a wide range of emotion dysregulation, is sensitive to change, and is not biased by verbal or intellectual ability.
- Mazefsky, 2018 | The Emotion Dysregulation Inventory: Psychometric Properties and Item Response Theory Calibration in an Autism Spectrum Disorder Sample
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Carla A. Mazefsky, Lan Yu, Susan W. White, Matthew Siegel, and Paul A. Pilkonis
Autism Research 2018
Abstract
Individuals with autism spectrum disorder (ASD) often present with prominent emotion dysregulation that requires treatment but can be difficult to measure. The Emotion Dysregulation Inventory (EDI) was created using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS®) to capture observable indicators of poor emotion regulation. Caregivers of 1,755 youth with ASD completed 66 candidate EDI items, and the final 30 items were selected based on classical test theory and item response theory (IRT) analyses. The analyses identified two factors: 1) Reactivity, characterized by intense, rapidly escalating, sustained, and poorly regulated negative emotional reactions, and 2) Dysphoria, characterized by anhedonia, sadness, and nervousness. The final items did not show differential item functioning (DIF) based on gender, age, intellectual ability, or verbal ability. Because the final items were calibrated using IRT, even a small number of items offers high precision, minimizing respondent burden. IRT co-calibration of the EDI with related measures demonstrated its superiority in assessing the severity of emotion dysregulation with as few as seven items. Validity of the EDI was supported by expert review, its association with related constructs (e.g., anxiety and depression symptoms, aggression), higher scores in psychiatric inpatients with ASD compared to a community ASD sample, and demonstration of test-retest stability and sensitivity to change. In sum, the EDI provides an efficient and sensitive method to measure emotion dysregulation for clinical assessment, monitoring, and research in youth with ASD of any level of cognitive or verbal ability.