中华精神科杂志
中華精神科雜誌
중화정신과잡지
CHINESE JOURNA OF PSYCHIATRY
2015年
2期
104-108
,共5页
问卷调查%学生%自杀%哥伦比亚自杀筛选问卷%信度%效度
問捲調查%學生%自殺%哥倫比亞自殺篩選問捲%信度%效度
문권조사%학생%자살%가륜비아자살사선문권%신도%효도
Questionnaires%Students%Suicide%Columbia Suicide Screen%Reliability%Validity
目的 分析哥伦比亚自杀筛选问卷(Columbia Suicide Screen,CSS)对高中生自杀风险评估的信度和效度.方法 采用CSS和Beck抑郁量表(Beck Depression Inventory,BDI)对1 218名高一至高三年级学生进行测试,计算CSS的Cronbach α内在一致性系数及2周后重测信度,采用专家法和敏感性分析评估内容效度,计算CSS与BDI的平行效度,以MINI为金标准判定效标效度.结果 CSS筛选出有自杀问题(近1年自杀意念或既往自杀未遂)、抑郁情绪及物质使用的学生分别为225例(18％,225/1 218)、571例(47％,571/1 218)及243例(20％,243/1 218).CSS的Cronbach α系数为0.83;自杀意念筛选、物质使用筛选、自杀问题筛选及自杀问题合并抑郁情绪筛选的重测信度组内相关系数分别为0.90、1.00、0.88及0.78;敏感性分析,Cronbachα系数为0.82 ～0.83;CSS抑郁情绪筛选、CSS自杀意念筛选与BDI有一定相关性,Kappa值为0.43、0.70;CSS自杀问题合并抑郁情绪、CSS自杀问题合并BDI≥5分两种筛选的敏感度和特异度相对较平衡,分别为72％和62％、85％和60％.结论 CSS具有较好的内部一致性信度和内容效度,但其敏感度、特异度不高,需要合并抑郁筛选或诊断问卷来提高其对自杀风险的筛选能力.
目的 分析哥倫比亞自殺篩選問捲(Columbia Suicide Screen,CSS)對高中生自殺風險評估的信度和效度.方法 採用CSS和Beck抑鬱量錶(Beck Depression Inventory,BDI)對1 218名高一至高三年級學生進行測試,計算CSS的Cronbach α內在一緻性繫數及2週後重測信度,採用專傢法和敏感性分析評估內容效度,計算CSS與BDI的平行效度,以MINI為金標準判定效標效度.結果 CSS篩選齣有自殺問題(近1年自殺意唸或既往自殺未遂)、抑鬱情緒及物質使用的學生分彆為225例(18％,225/1 218)、571例(47％,571/1 218)及243例(20％,243/1 218).CSS的Cronbach α繫數為0.83;自殺意唸篩選、物質使用篩選、自殺問題篩選及自殺問題閤併抑鬱情緒篩選的重測信度組內相關繫數分彆為0.90、1.00、0.88及0.78;敏感性分析,Cronbachα繫數為0.82 ～0.83;CSS抑鬱情緒篩選、CSS自殺意唸篩選與BDI有一定相關性,Kappa值為0.43、0.70;CSS自殺問題閤併抑鬱情緒、CSS自殺問題閤併BDI≥5分兩種篩選的敏感度和特異度相對較平衡,分彆為72％和62％、85％和60％.結論 CSS具有較好的內部一緻性信度和內容效度,但其敏感度、特異度不高,需要閤併抑鬱篩選或診斷問捲來提高其對自殺風險的篩選能力.
목적 분석가륜비아자살사선문권(Columbia Suicide Screen,CSS)대고중생자살풍험평고적신도화효도.방법 채용CSS화Beck억욱량표(Beck Depression Inventory,BDI)대1 218명고일지고삼년급학생진행측시,계산CSS적Cronbach α내재일치성계수급2주후중측신도,채용전가법화민감성분석평고내용효도,계산CSS여BDI적평행효도,이MINI위금표준판정효표효도.결과 CSS사선출유자살문제(근1년자살의념혹기왕자살미수)、억욱정서급물질사용적학생분별위225례(18％,225/1 218)、571례(47％,571/1 218)급243례(20％,243/1 218).CSS적Cronbach α계수위0.83;자살의념사선、물질사용사선、자살문제사선급자살문제합병억욱정서사선적중측신도조내상관계수분별위0.90、1.00、0.88급0.78;민감성분석,Cronbachα계수위0.82 ～0.83;CSS억욱정서사선、CSS자살의념사선여BDI유일정상관성,Kappa치위0.43、0.70;CSS자살문제합병억욱정서、CSS자살문제합병BDI≥5분량충사선적민감도화특이도상대교평형,분별위72％화62％、85％화60％.결론 CSS구유교호적내부일치성신도화내용효도,단기민감도、특이도불고,수요합병억욱사선혹진단문권래제고기대자살풍험적사선능력.
Objective To examine the reliability and validity of the Columbia Suicide Screen (CSS) for suicide risk assessment in senior middle school students.Methods 1 218 grade 1 to grade 3 students from two senior middle schools in Shanghai completed the CSS and Beck Depression Inventory (BDI).Cronbach's alpha coefficient was examined.Test-retest reliability was assessed in a subsample of 165 ones two weeks later.Content validity was evaluated using specialist analysis and sensibility analysis.The BDI was used to explore the correlative validity.375 students were also interviewed by psychiatrists to assess whether they had suicidal tendency according to Mini International Neuropsychiatry Inventory (MINI).MINI was regarded as the gold standard to investigate the criterion validity of CSS.Results Students with suicide problem (either suicide attempts in the past or suicide ideation within the previous year),depression and substance use were 225 (18％,225/1 218),571 (47％,571/1 218) and 243 (20％,243/1 218).The Cronbach' s alpha was estimated to be 0.83.Test-retest reliabilities for " screening of suicide ideation","screening of substance use","screening of suicide problem" and "screening of suicide problem and depression" were 0.90,1.00,0.88 and 0.78 (ICC).Alpha if item deleted was in the range of 0.82 to 0.83 by means of the sensibility analysis of CSS." Screening of depression" and " screening of suicide ideation" were correlated with BDI.Correlative validity was 0.43 and 0.70(Kappa),respectively.The CSS algorithm that gave the best sensitivity (0.88) but the worst specificity (0.49) was "screening of suicide problem".However " screening of suicide problem and depression"," screening of suicide problem and BDI≥5" yielded the balanced sensitivity/specificity trade-off:72％/62％,85％/60％.Conclusion The CSS has adequate internal consistency and content validity.But it demonstrates common sensitivity and specificity.Combination with screening of depression or diagnostic scale would be needed to improve its capability in identifying high-risk cases of suicide in senior middle school students.
