精神分裂症性书面语言特点评定量表的编制及信效度分析
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重庆市科卫联合医学科研重点项目( 2018ZDXM027); 重庆市精神卫生中心中青年骨干 人才计划(JWCF202404)


Development and psychometrics of the Rating Scale for Schizophrenic Features in Writings
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    摘要:

    目的 编制精神分裂症性书面语言特点评定量表,并分析其信效度。方法 结合文献复 习,对比2015 年4 月—2018 年8 月重庆市精神卫生中心住院的30 例精神分裂症患者与2018 年9 月— 2021 年4 月对外招募32 名健康受试者的书面语言特点,编制初始量表。用初始量表评定157 例精神分 裂症患者(选取2018 年9 月—2021 年4 月重庆市多家精神专科医院的住院患者)的材料,进行条目分析 与探索性因子分析。用调整后的量表评定另外的154 例患者(同期重庆市精神卫生中心的住院和门诊 精神分裂症)的材料,进行验证性因子分析及检验内部一致性。以阳性与阴性症状量表和思维、语言和 交流量表为效标检验效标效度。结果 量表包含15 个条目,可分解为随意-刻意、计划性、流畅性、偏 移、冗余-简略5 个因子,可解释总变异的53.912%。验证性因子分析显示模型拟合良好(χ2/df=1.248, CFI=0.930,TLI=0.901,SRMR=0.071,RMSEA=0.040)。总量表的Cronbach's α系数为0.565。内容效度良好。 因子分与效标的部分因子分存在相关性。重测信度Spearman r=0.546。大部分条目的评定者一致性信 度为中到强度(加权Kappa=0.325~0.787, P<0.05)。受试者工作特征曲线(ROC)分析曲线下面积为0.999 (P < 0.001),当Youden 指数最大分界点为5.5 分时,敏感度99.4%,特异度96.9%。结论 本量表编制过 程合理,信效度尚可。

    Abstract:

    Objective To develop the Rating Scale for Schizophrenic Features in Writings( RSFiW) and analyze its reliability and validity. Methods The preliminary scale was developed by combining literature review and comparing the written language characteristics of 30 patients with schizophrenia hospitalized in Chongqing Mental Health Center from April 2015 to August 2018 with 32 healthy subjects recruited externally between September 2018 and April 2021. The preliminary scale was used to assess 157 patients with schizophrenia (from inpatients of several mental hospitals in Chongqing between September 2018 and April 2021) to carry out item analysis and exploratory factor analysis. Confirmatory factor analysis and internal consistency testing were conducted with an additional 154 patients( Inpatient and outpatient patients with schizophrenia in Chongqing Mental Health Center during the same period of time) rated with the adjusted scale. Criterion validity was tested using the Positive and Negative Syndrome Scale and the Scale for Thought, Language, and Communication as validity scales. Results The scale contained 15 items that were decomposed into 5 factors of casual-deliberate, planned, fluent, offset, and redundant-abbreviated, explaining 53.912% of the total variance. Confirmatory factor analysis showed a good model fit( χ2/df=1.248, CFI=0.930, TLI=0.901, SRMR=0.071, RMSEA=0.040). Cronbach's α for the total scale was 0.565. Content validity was good. The factor scores correlated with some of the factor scores of the validity scale. Retest reliability Spearman r was 0.546. The inter-rater reliability for most items were moderate to strong with statistical differences( weighted Kappa=0.325-0.787, P<0.05). The area under the receiver operating characteristic( ROC) curve was 0.999( P<0.001). When the maximum cutoff point of the Youden index was 5.5, the sensitivity was 99.4% and the specificity was 96.9%. Conclusions The development process of this scale is reasonable, and the reliability and validity are acceptable.

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彭祖来,郭茜,谭小林,等.精神分裂症性书面语言特点评定量表的编制及信效度分析[J].神经疾病与精神卫生,2026,26(3):198-204. DOI:10.3969/j. issn.1009-6574.2026.03.007.

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  • 在线发布日期: 2026-03-20