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Sophie Hsin-Yi Liang,1 Jen-Yu Chou,2 Yu-Yu Wu,3 Chin-Pang Lee,4 Brent Allan Kelsen,5 Yi-Chen Lee6 1Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University College of Medicine, Taoyuan, Taiwan; 2Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan; 3Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taiwan, YuNing Psychiatric Clinic, Taipei, Taiwan; 4Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan; 5Language Center, National Taipei University, New Taipei City, Taiwan, Department of Psychology, Auckland University of Technology, Auckland, New Zealand; 6Department of Psychiatry, Chang-Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Chiayi, TaiwanCorrespondence: Yi-Chen LeeSchool of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, TaiwanEmail peggylee599@gmail.comBackground: The Devereux Early Childhood Assessment for Toddlers (DECA-T), which is one of the few standardized, norm-referenced behavioral rating scales related to young children’s mental health, resilience, and social-emotional development, was developed for toddlers aged between 18 and 36 months.Objective: The aim of this study was to test the clinimetric properties of the Chinese (Traditional) version of the DECA-T (C-DECA-T) using a classical test theory analysis and an item response theory analysis.Methods: Seventy-five community-based toddlers aged from 18 to 36 months and 50 clinic-based participants recruited in hospitals in northern Taiwan participated in this study. Social-emotional competence was assessed by the C-DECA-T and children’s behavior problems were rated via the Child Behavior Checklist 1.5 to 5 (CBCL/1.5–5). Homogeneity of the C-DECA-T was assessed by Mokken analysis; sensitivity and specificity were assessed via receiver operating characteristic curve.Results: The results showed the C-DECA-T demonstrated good test–retest reliability (r=0.8) and high internal consistency (Cronbach’s alpha = 0.94). Inter-rater reliability between father and mother was fair (ICC = 0.46). Convergent validity of the CBCL/1.5–5 total behavior problems (r=−0.26) demonstrated acceptable psychometric performance. The overall measure of the sampling adequacy of the C-DECA-T assessed by principal component analysis was 0.93. Mokken scale analysis showed the 36-items of the C- DECA-T formed a weak unidimensional scale (Hs=0.35), supporting its construct validity. The area under curve of the C-DECA-T in prediction of social-emotional disturbance was 0.70. The optimal cutoff of the Total Protective Factor score of the C-DECA-T was a T score of 40.1 (T40.1), with a sensitivity of 95% and a specificity of 68%. Item 2 (“show affection for a familiar adult”) and item 33 (“calm herself/himself”) provide a good amount of information for the assessment of social-emotional strength and needs of a toddler in clinical practice.Conclusion: The C-DECA-T showed good psychometric properties. Our findings of high internal consistency of the three subscales and total score of the C-DECA-T suggest symptom manifestation of social-emotional competence and needs in Taiwanese toddlers is not culturally different from American toddlers. The clinimetric properties of the C-DECA-T examined by a classical test theory analysis approach and an item response theory analysis approach suggest that the C-DECA-T is a reliable and valid instrument for measuring social-emotional strength and needs in the population in Taiwan.Keywords: Devereux Early Childhood Assessment for Toddlers, DECA-T, social-emotional competence, item response theory, Mokken scale analysis, principal component analysis

Ya-Hsin Chou,1 Chin-Pang Lee,1,2 Chia-Yih Liu,1,2 Ching-I Hung1,2 1Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou, 2School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan Objective: Previous studies of the Depression and Somatic Symptoms Scale (DSSS), a free scale, have been based on the classical test theory, and the construct validity and dimensionality of the DSSS are as yet uncertain. The aim of this study was to use Mokken scale analysis (MSA) to assess the dimensionality of the DSSS.Methods: A sample of 214 psychiatric outpatients with mood and anxiety disorders were enrolled at a medical center in Taiwan (age: mean [SD] =38.3 [10.5] years; 63.1% female) and asked to complete the DSSS. MSA was used to assess the dimensionality of the DSSS.Results: All 22 items of the DSSS formed a moderate unidimensional scale (Hs=0.403), supporting its construct validity. The DSSS was divided into 4 subscales (Hs ranged from 0.35 to 0.67), including a general somatic scale (GSS), melancholic scale (MS), muscular pain scale (MPS), and chest symptom scale (CSS). The GSS is a weak reliable Mokken scale; the other 3 scales are strong reliable Mokken scales.Conclusion: The DSSS is a psychometrically sound measure of depression and somatic symptoms in adult psychiatric outpatients with depression or anxiety. The summed score of the DSSS and its 4 subscales are valid statistics. Further research is required for replication of the 4 subscales of the DSSS. Keywords: depression, somatization, Mokken scale analysis, item response theory, construct validity