一生攻击史量表中文版测评精神分裂症患者的信度与效度  

Reliability and Validity of the Life History of Aggression-Chinese Version in Schizophrenia Patients Assessment

作　　者：谌霞灿[1] 杨琴 张钦廷 欧阳艾莅 徐佳军[4] 杨蕊 王紫烨 翟金辉 李焱[1] 秦小荣[2] 胡峻梅[1] CHEN Xia-can;YANG Qin;ZHANG Qin-ting;OUYANG Ai-li;XU Jia-jun;YANG Rui;WANG Ziye;ZHAI Jin-hui;LI Yan;QIN Xiao-rong;HU Jun-mei(West China School of Basic Medical Sciences&Forensic Medicine,Sichuan University,Chengdu 610041,China;The Fourth People’s Hospital of Chengdu,Chengdu 610036,China;Shanghai Key Laboratory of Forensic Medicine,Key Laboratory of Forensic Science,Ministry of Justice,Shanghai Forensic Service Plat-form,Academy of Forensic Science,Shanghai 200063,China;Mental Health Center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西基础医学与法医学院,四川成都610041 [2]成都市第四人民医院,四川成都610036 [3]司法鉴定科学研究院,上海市法医学重点实验室,司法部司法鉴定重点实验室,上海市司法鉴定专业技术服务平台,上海200063 [4]四川大学华西医院心理卫生中心,四川成都610041

出　　处：《法医学杂志》2024年第4期352-358,共7页Journal of Forensic Medicine

基　　金：国家自然科学基金资助项目(82302119);上海市法医学重点实验室暨司法部司法鉴定重点实验室开放课题资助项目(KF202313);四川省科技厅重点研发项目(2023YFS0291)。

摘　　要：目的为精神分裂症患者攻击行为评估提供一种以攻击行为发生次数作为评分依据的纵向评估工具。方法对一生攻击史量表进行翻译并修订,形成一生攻击史量表中文版(Life History of Aggression-Chinese Version,LHA-CV)。基于成都市社区及强制医疗所共369例精神分裂症患者,采用分半信度、重测信度及评估者间一致性对LHA-CV的信度进行分析,采用项目分析、结构效度及效标效度进行效度分析。结果项目分析发现,LHA-CV整体的同质性与区分度较好。探索性因素分析发现,Kaiser-Meyer-Olkin(KMO)检验值为0.80,Bartlett球形检验χ2=1203.46(P<0.05),析出非躯体攻击、躯体攻击、自我攻击和反社会行为/结果4个因子,11个条目的因子载荷均大于0.40。对该因子模型进行验证性因素分析,卡方自由度比(χ2/df)为3.61,近似误差均方根为0.07,拟合优度指数为0.92,比较拟合指数为0.90,增值拟合指数为0.90,各因子区分效度较好。效标效度检验结果显示,LHA-CV总分与MacArthur社区暴力工具评估的攻击行为等级、Buss-Perry攻击性量表总分、人格障碍诊断问卷(第4版)反社会型人格障碍分量表得分呈正相关(P<0.05)。LHA-CV的非躯体攻击、躯体攻击、自我攻击、反社会行为/结果以及总分的Cronbach’sα系数分别为0.82、0.73、0.74、0.56和0.79。LHA-CV总分的重测信度为0.82(P<0.05),Spearman-Brown分半信度为0.66,组内相关系数为0.99。结论LHA-CV具有良好的信度与效度,可作为纵向测评精神分裂症患者攻击行为的评估工具。Objective To provide a longitudinal evaluation tool based on the frequency of aggressive be‐havior for the aggression assessment of schizophrenia patients.Methods The Life History of Aggression was translated and revised to form the Life History of Aggression-Chinese Version(LHA-CV)based on 369 patients diagnosed with schizophrenia in the Chengdu community and compulsory medical insti‐tution.The reliability of LHA-CV was analyzed by means of split-half reliability,test-retest reliability and inter-evaluator consistency.The validity was analyzed by item analysis,construct validity and crite‐rion validity.Results Item analysis found that LHA-CV had good homogeneity and discriminant validity.Exploratory factor analysis found that the Kaiser-Meyer-Olkin(KMO)test value was 0.80,and the Bartlett’s sphericity testχ2=1203.46(P<0.05),and it revealed four factors including non-physical ag‐gression,physical aggression,self-directed aggression and antisocial behavior/consequences.The factor loadings for all 11 items were greater than 0.40.Confirmatory factor analysis was performed on the factor model,Chi-square degree of freedom(χ2/df)was 3.61,root mean square error of approxima‐tion(RMSEA)was 0.07,goodness-of-fit index(GFI)was 0.92,comparative fit index(CFI)was 0.90,incremental fit index(IFI)was 0.90,and the discriminant validity of each factor was good.The criterion validity test showed the total score of LHA-CV was positively correlated with the aggressive behavior level of MacArthur Community Violence Instrument,the total score of Buss-Perry Aggression Scale,and the score of Antisocial Personality Disorder Subscale of Personality Diagnostic Question‐naire-4th Edition Plus(PDQ-4+_ASPD,P<0.05).The Cronbach’sαcoefficient of non-physical aggres‐sion,physical aggression,self-directed aggression,antisocial behavior/consequences and LHA-CV total score were 0.82,0.73,0.74,0.56 and 0.79,respectively.The test-retest reliability,Spearman-Brown split-half reliability and intra-class correlation coefficient of LH

关 键 词：法医精神病学 攻击行为 精神分裂症 一生攻击史中文版 信度 效度 

分 类 号：R89[医药卫生—法医学] DF795.3[医药卫生—临床医学] D919.3[政治法律—诉讼法学]