妄想特质评定量表中文版评估精神分裂症妄想的效度和信度

发布时间：2018-07-10 01:26

本文选题：妄想 + 效度　；参考：《浙江大学》2014年硕士论文

【摘要】：研究目的：引进妄想特质评定量表(CDRS),并分析其评估妄想症状的效度和信度。运用CDRS评估精神分裂症患者治疗后妄想症状的变化情况,以进一步考察CDRS在临床测评妄想症状的有效性。研究方法：经原作者授权,将英文版CDRS经过翻译和回译后确定中文版(C-CDRS)。选取符合国际疾病分类手册第10版(ICD-10)精神分裂症诊断标准,存在妄想症状的患者137例,完成C-CDRS评定,对数据进行探索性因素分析和内部一致性检验；同时评定阳性与阴性症状量表(PANSS),检验效标效度。73例患者间隔1周后重复评定C-CDRS,检验量表的重测信度。40例患者在治疗4周后复评C-CDRS和PANSS,检测C-CDRS测评妄想症状的有效性。研究结果：C-CDRS共有11个条目,探索性因素分析提取到认知,情感和怪异性3个公因子。认知因子包括确信程度、关注程度、干扰程度、解体程度、向他人求证的程度和干扰程度；情感因子包括抵抗程度、导致担忧的程度、导致不愉快的程度；怪异性因子包括荒谬程度、不言而喻的程度。3个公因子对方差的累计贡献率为76.45%；C-CDRS总分及3个因子均与PANSS妄想条目分呈正相关(r=0.84、0.88、0.69、0.66,均P0.01);与PANSS阳性症状分正相关(r=0.67、0.70、0.57、0.63,均P0.01);C-CDRS总分与PANSS总分正相关(r=0.58,P0.01)。C-CDRS总分的Cronbach a系数为0.83,3个公因子的Cronbach a系数分别为0.84、0.77、0.78；73例患者在1周后再次测评C-CDRS,检验C-CDRS的重测信度。本研究中C-CDRS总量表的重测相关系数为0.85,3个公因子的重测相关系数分别为0.86、0.82、0.83,11个条目的重测相关系数在0.76-0.92之间(均P0.01)。40例患者在综合治疗4周后再次评定C-CDRS和PANSS, C-CDRS总分值由(76.32±7.79)降到(41.28±3.82),PANSS总分值由(84.35±9.13)降到(42.67±5.74),C-CDRS减分值与PANSS减分值呈显著性正相关,其Pearson相关系数为0.82(P0.01)。研究结论：妄想特质评定量表中文版的效信度符合心理测量学要求,可以用于研究工作中精神分裂症患者妄想障碍的评估。能够有效评估妄想症状在治疗前后的差异。
[Abstract]:Objective: to investigate the validity and reliability of the delusional trait rating scale (CDRS). To evaluate the efficacy of CDRS in clinical evaluation of delusional symptoms in patients with schizophrenia, the changes of delusion symptoms after treatment were evaluated by CDRS. Methods: the Chinese version (C-CDRS) of the English version was confirmed by the authorisation of the original author. 137 patients with delusional symptoms in accordance with the 10th edition of International Classification of Diseases Manual (ICD-10) were selected to complete the C-CDRS evaluation. The data were analyzed by exploratory factor analysis and internal consistency test. The positive and negative symptom scale (PANSS) was evaluated simultaneously, the validity of the test was measured in 73 patients, and the C-CDRSs were repeatedly evaluated after 1 week interval. The test-retest reliability of the scale was measured in 40 patients after 4 weeks of treatment, and the validity of C-CDRS and PANSSS were tested. The results showed that there were 11 items in C-CDRS. Exploratory factor analysis extracted 3 common factors: cognition, emotion and weirdness. Cognitive factors include degree of assurance, degree of concern, degree of interference, degree of disintegration, degree of seeking proof from others and degree of interference; emotional factors include degree of resistance, degree of worry, degree of unhappiness; Weird factors include absurd degree, self-evident degree. The cumulative contribution rate of the difference of three common factors is 76.45; The total score and three factors of C-CDRS were positively correlated with PANSS delusion item score (r ~ 0.84 ~ 0.8880.69 ~ 0.66, P ~ (0.01), and with PANSS positive symptom score (r ~ (0.670) 0.70 ~ 0.570 ~ 0.63, all P ~ (0.01). The Cronbach _ a coefficient of three common factors were 0.843 ~ 0.777 ~ 0.78, respectively (r _ 0. 58 / P _ (0.01) and the Cronbach _ a coefficient of three common factors were 0.843 ~ 0.77 ~ (0.78), respectively (r ~ (0.58) P _ (0.01) and the Cronbach _ a coefficient of three common factors were 0.843 ~ 0.77 ~ (0.78) ~ 0.78 (r ~ (0.58) P _ (0.01), respectively. After 1 week, 73 patients were tested again for the retest reliability of C-CDRS. In this study, the retest correlation coefficient of C-CDRS table was 0.85, the retest correlation coefficient of 3 common factors was 0.86 / 0.82 / 0.83 respectively, and the retest correlation coefficient of 11 items was 0.76-0.92 (all P0.01) .40 patients were re-evaluated with C-CDRS and PANSS after 4 weeks of comprehensive treatment, and the total score of C-CDRS was estimated again. The total score of PANSS decreased from (76.32 卤7.79) to (41.28 卤3.82) from (84.35 卤9.13) to (42.67 卤5.74). The Pearson correlation coefficient was 0.82 (P0.01). Conclusion: the validity and reliability of the Chinese version of the delusional trait rating scale meet the requirements of psychometrics and can be used in the evaluation of delusion disorder in schizophrenic patients. It can effectively evaluate the difference of delusional symptoms before and after treatment.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.3

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