应用量表筛选部队心理障碍患者的有效度研究  

The validity of applying questionnaires for screening mental disorder in the army

作　　者：向月应[1] 谢德诚[1] 刘荣[1] 朱珠[1] 王甘棠[1] 宫媛[1] 尹宏[1] 

机构地区：[1]解放军第181医院神经内科,桂林541002

出　　处：《解放军医学杂志》2006年第7期733-734,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的获取对部队官兵心理障碍患者快捷有效的最佳筛选工具。方法以驻桂某部官兵为对象,对受检者先作症状自评量表(SCL-90)、康奈尔医学指数(M-R)[CMI(M-R)]、大学生人格问卷(UPI)和WHO神经症筛选表评分检测,而后逐例作临床检诊普查,以CCMD-3为标准,对符合标准的心理障碍患者作出临床诊断,用效标效度检验,评价各量表的有效度。结果WHO神经症筛选表评分效标效度的灵敏度为100%,特异度为92·1%;SCL-90与CMI(M-R)二者效度相近,灵敏度分别为46·9%和43·4%,特异度分别为86·1%和78·9%;UPI灵敏度为83·1%,特异度为46·1%。结论WHO神经症筛选表的灵敏度特异度都是最好的,但其操作费时费力,故适用性受限;SCL-90和CMI(M-R)二者的灵敏度很不理想,约一半以上的患者被筛漏,难以用团体测验方式作为筛选工具;UPI的灵敏度达83·1%,绝大多数病患可被发现,量表有测伪项目,可将不真实、不认真填写而遗漏的病患进行重测补救,且测前有30min时间进行心理卫生宣传和介绍防治人员服务内容、联系方法,使存在问题的人主动应询,从而可避免遗漏,是值得推荐的筛选工具。Objective To explore the most convenient and valid tool for screening mental disorders among servicemen. Methods Soldiers and officers stationed at Guilin were enrolled for the study. They were first examined with the Symptom Check-list 90 （SCL-90）, Comell Medicine Index （M-R）[CMI（M-R）], University Student Personality Inventory （UPI） and WHO neurosis screening schedule respectively. Then they were subjected clinical interview and examination individually, and clinical diagnosis of mental disorder was made according to CCMD-3 standard. The validity of each questionnaire was evaluated by using Criterion-related Validity. Results The sensitivity of WHO neurosis screening schedule was found to be 100%, and the specificity was 92.1%. SCL-90 and CMI （M-R） yielded similar results, their sensitivity was found to be 46.9% and 43.4%, and the specificity to be 86.1% and 78.9%, respectively. The sensitivity of UPI was found to be 83.1% and the specificity 46.1%. Conclusion The WHO neurosis screening schedule is the best in both sensitivity and specificity of validity, but its practice is time-consuming and laborious, which limits its application. SCL-90 and CMI （M-R） are imperfect in sensitivity of validity, and they cannot screen out the mental disorder in more than a half of the subjects. In a group test, they can hardly serve as a screening tool. UPI can screen out most of the mental disorder, and its sensitivity of validity reaches 83.1%. Additionally, the UPI questionnaire contains fake-test items, which could retest those who were missed due to untruly or not conscientiously answer the questionnaires. An acceptable way to obtain a true screening test is to give the individuals a propaganda of mental health and explain the questionnaires for 30 minutes before the test, which helps the examinee to understand the procedure and accept the questionnaires, so that the results of the test could be more reliable. In conclusion, UPI is a valuable screening tool to be recommended.

关 键 词：问卷 心理学试验 心理学 军事 

分 类 号：R395.1[哲学宗教—心理学]