CAJ | 학술논문

目的编制《精神障碍病史可信度评定量表》,并进行信效度检验,作为适用于各种医疗活动、司法鉴定的病史可信度评定工具.方法 (1)根据甄别病史可信度的经验,并参考有关研究及文献,编制适用于各种病史提供者的精神障碍病史可信度评定量表及各条目评分细则；(2)将该量表应用于随机抽取的600例精神障碍患者或司法鉴定案例；(3)同时由患者(或被鉴定人)及其病史提供者分别完成简易精神症状自陈量表(伪装精神症状评定工具).结果 (1)全量表的Cronbach'sα系数为0.901；Guttmann分半信度(间隔顺序分半)为0.924,Guttmann分半信度(前后顺序分半)为0.803,重测和评分者间各条目及总分相关在在0.588以上(P＜0.01).(2)量表的三级划界分为:总得分≤11分为不太可信；12～22分为部分可信；≥23分为基本可信.(3)与专家诊断比较,量表评定为不太可信、部分可信和基本可信的准确率分别为86.1％、95.2％和98.9％,总准确率94.8％.(4)全量表总分、第二部分总分和第三部分总分与病史提供者完成的简易精神症状自陈量表总分Pearson相关系数分别为为-0.776、-0.699和-0.816(均P＜0.01).结论编制的精神障碍病史可信度评定量表信效度参数指标符合心理测量学的基本要求,能够做为精神科临床中病史是否可靠,提供客观量化的评定工具.
목적 편제《정신장애병사가신도평정량표》,병진행신효도검험,작위괄용우각충의료활동、사법감정적병사가신도평정공구.방법 (1)근거견별병사가신도적경험,병삼고유관연구급문헌,편제괄용우각충병사제공자적정신장애병사가신도평정량표급각조목평분세칙；(2)장해량표응용우수궤추취적600례정신장애환자혹사법감정안례；(3)동시유환자(혹피감정인)급기병사제공자분별완성간역정신증상자진량표(위장정신증상평정공구).결과 (1)전량표적Cronbach'sα계수위0.901；Guttmann분반신도(간격순서분반)위0.924,Guttmann분반신도(전후순서분반)위0.803,중측화평분자간각조목급총분상관재재0.588이상(P＜0.01).(2)량표적삼급화계분위:총득분≤11분위불태가신；12～22분위부분가신；≥23분위기본가신.(3)여전가진단비교,량표평정위불태가신、부분가신화기본가신적준학솔분별위86.1％、95.2％화98.9％,총준학솔94.8％.(4)전량표총분、제이부분총분화제삼부분총분여병사제공자완성적간역정신증상자진량표총분Pearson상관계수분별위위-0.776、-0.699화-0.816(균P＜0.01).결론 편제적정신장애병사가신도평정량표신효도삼수지표부합심리측량학적기본요구,능구주위정신과림상중병사시부가고,제공객관양화적평정공구.
Objective To examine the reliability and validity of the Rating Scale of the Reliability in Mental Disorder Medical History (RSRMDMH) in order to develop a reliable measure to determine the reliability in mental disorder medical history.Methods RSRMDMH was conducted by concept,clinical feature in mental disorder medical history and assessment scales for malingering and compensationneurosis.Final 14 items was decided after initial usage and modification.It was administered to 600 subjects including the cases involved forensic problems,patients in general psychiatric clinic.Results ①The Cronbach' s α coefficients of RSRMDMH was 0.901.The split-half reliability was 0.803-0.924.The test-retest reliability and scorer reliability were more than 0.588 (P＜0.01).②The cut score of assessing different degree of the reliability in mental disorder medical history separately was ≤ 11,12-22,≥23.③Based on the experts diagnosis,the accuracy rate of RSRMDMH for evaluating different degree of the reliability in mental disorder medical history were more than 86.1％,and total accuracy rate was 94.8％.④Correlation analysis showed significantly correlation between RSRMDMH and assessment scales for malingering(self-report scale of brief psychopathological symptoms,SBPS).Conclusion The RSRMDMH has acceptable psychometrics properties on reliability and validity.It is a clinically reliable measure to determine the reliability in mental disorder medical history.