歧视与病耻感量表(DISC)中文版在精神障碍患者中的信度和效度研究

目的:评估歧视与病耻感量表(DISC)在中国精神障碍患者中的信度和效度。方法:引进Thornicroft团队研发的DISC,按初译、回译等步骤形成DISC中文版,以242例精神障碍患者作为受访对象,验证量表的信度和效度。结果:DISC的Cronbach'α系数为0.70,分半信度为0.85,总分重测信度为0.83;DISC分量表1总分与精神疾病内在病耻感调查表(ISMI)歧视经历因子分呈正相关(r=0.417,P0.01),分量表2总分与ISMI社会退缩因子分呈正相关(r=0.332,P0.01);分量表2总分与自尊量表(SES)总分呈正相关(r=0.250,P0.01),分量表3总分与SES总分呈负相关(r=-0.187,P0.01);分量表4总分与社会支持评定量表(SSRS)客观支持分以及对支持的利用度分均呈正相关(r=0.177,0.170,P均0.01)。结论:DISC中文版具有较好的信度和效度,可作为评估精神障碍患者歧视与病耻感的临床工具。

Reliability and validity of Chinese version of discrimination and stigma scale in Patients with mental dis-order

ObJective:To evaluate reliability and validity of the discrimination and stigma scale(DISC) for people with mental disorders in China. Method:DISC was introduced from team of Professor Thornicroft. G,to assess stigma and discrimination with mental illness from a behavioral perspective. The scale was forward translated,back-translated and subsequently adapted using the multi-step methods to form the Chinese version of DISC. A total of 242 people with mental disorders were interviewed with the scale. Results:The internal con-sistency(Cronbach alpha)of DISC Chinese version was 0. 70 and the Spearman-Brown split-half coefficient was 0. 85. The test-retest reliability of total score of DISC was 0. 83. The DISC subscale 1 showed a positive correla-tion with the discrimination experience subscale of the internalized stigma of mental illness scale(ISMI)(r =0. 417,P ﹤ 0. 01),and subscale 2 was associated with the social withdrawal subscale of the ISMI(r = 0. 332, P ﹤ 0. 01)and with the total score of self-esteem scale(SES)(r = 0. 250,P ﹤ 0. 01),respectively. The DISC subscale 3 showed a negative correlation with the total score of SES(r = - 0. 187,P ﹤0. 01),and the DISC sub-scale 4 showed a positive correlation with objective support of social support rating scale(SSRS)and availability of support of SSRS(r =0. 177,0. 170,all P ﹤0. 01),demonstrating that the DISC had good convergent validity. Conclusion:The Chinese version of DISC has good psychometrically validated properties,and it is recommended for measuring experienced and anticipated stigma and discrimination of people with mental disorders in China.