暴力危险性筛查量表中文版在精神分裂症患者中的信度与效度研究

目的：引入暴力危险性筛查量表（violenceriskscreening-10,V—RISK-10）,对V—RISK-10中文版在精神分裂症患者中的信度与效度进行检验。方法：对英文版V—RISK-10进行翻译和修订,以109例精神分裂症患者为评估对象,完成一般情况调查表、V—RISK-10中文版、卫生部危险性评估、修订版外显行为攻击量表（MOAS）的测评。其中14例患者由2位评估者独立评估V—RISK-10中文版,49例患者2周后重测V—RISK．10中文版。结果：V—RISK-10中文版9个条目的鉴别力良好,内部一致性系数0．833（P〈0．01）。评分者信度（斯皮尔曼等级相关系数：r=0．655—0．899）、重测信度（Kappa=0．536—1．000）较好（P〈0．ol或P〈0．05）。V—RISK．10中文版中7个条目得分与其综合评定建议分级（Kendal和谐系数为0．387～0．685）、危险性评估分级（Kendal和谐系数为0．319～0．618）、MOAS总分（皮尔逊相关系数：,=0,301～0．585）均显著正性相关（P均〈0．01）;关联效度理想。结论：V—RISK-10中文版在精神分裂症患者中的信度与关联效度良好。     

暴力作案刑事责任能力评定量表的应用

目的 探索暴力作案刑事责任能力评定量表（CRRS—V）对暴力作案刑事责任能力鉴定的使用价值。方法 采用CRRS—V,对155例暴力作案被鉴定人进行刑事责任能力评分,将评分结果同专家鉴定意见以及使用Rogers刑事责任能力评定量表（R—CRAS）评定的结果进行比较,分析CRRS—V的信度与效度。结果 CRRS—V量表评分者问一致性高（ICC=0．970,P〈0．001）;Cronbach系数为0．916。CRRS—V与专家结论的一致性较高（Kappa=0．880,P〈0．001）。结论 CRRS—V具有良好的信度和效度,符合量表编制的要求,具有实际应用价值。     

汉语语法量表及其信度和效度研究

目的 设计一套汉语语法检查量表(Chinese Agrammatism Rattery,CAB)并测试其信度和效度。方法 对46名脑部疾病患者及46例健康受试者进行了CAB测试，计算失语法指数(agrammatism quotient,AgQ)，并与汉语标准化失语检查法(aphasia battery of Chinese,ABC)对比。计算检查者问、检查者内及复测相关系数。结果 左、右大脑半球病变组及对照组CAB各亚项量表分的平均数差异极显著(F＝4．50-18．57，P＜0．05)。左大脑半球病变组各个亚项量表分平均成绩均明显低于右大脑半球病变组(q＝5．63-9．67，P＜0．05)与健康对照组(q＝7．50-9．61，P＜0．01)。量表的复测信度、检查者间信度、检查者内信度均较好(r＝0．991-0．999，P＜0．01)。CAB法的AgQ与ABC比法各指标间呈显著正相关(r＝0．928-0．979，P＜0．01)。结论 CAB具备较好的信度和效度，可以作为定量评定汉语失语症患者语法障碍的工具。     

女性性生活质量问卷在精神分裂症患者中的信度和效度

目的探讨女性性生活质量问卷在精神分裂症患者中的信度和效度。方法将3所医院门诊常规就诊并符合入组标准的180名女性精神分裂症患者作为研究人群,给予女性性生活质量问卷、Olson婚姻质量问卷中的婚姻满意度、性生活和夫妻交流分量表进行评估,并对测试结果进行了信度分析和效度分析。结果问卷总的Cronbaehs α系数为0．919,重测信度为0．875（P〈0．01）;验证性因子分析统计检验结果显示该模型的各项重要统计指标均达到了统计学要求;各因子之间的相关在0．181～0．697之间,各因子与总分之间的相关在0．421～0．841之间,均P〈0．01;问卷的总分与ENRICH的三个分量表得分相关在0．388—0．688之间（P〈0．01）,其中总分与性生活分量表相关程度最高。结论女性性生活质量问卷在精神分裂症患者中具有较好的信度和效度。     

暴食量表在我国青少年中的信效度研究

目的 检验暴食量表（BES）在中国青少年中的信度和效度。方法 2017 年9— 12 月采用 BES、进食行为问卷（DEBQ）和自我控制量表（SCS）对1 266名12～18岁青少年进行集体施测。结果 （1）验 证性因素分析显示，因子模型适配较好；（2）效度检验显示，BES 与其他校标之间相关均达到统计学水平 （r=0.168～0.500，P ＜ 0.01）；（3）信度分析显示，量表的Cronbach''s α 系数为0.805，重测信度为0.768。 结论 BES 在我国青少年中的信效度良好。     

护士使用简易老年焦虑问卷筛查老年广泛性焦虑障碍的信效度

目的评价护士使用中文版简易老年焦虑问卷（Geriatric Anxiety Inventory—Short Form,GAI--SF）用于筛查老年焦虑时的信度和效度。方法某综合医院门诊就诊的老年人97名为研究对象,由护士进行GAI—SF问卷及汉密尔顿焦虑量表（Hamilton Anxiety Scale,HAMA）评定,并且由两名精神科主治医师根据ICD-10广泛性焦虑障碍诊断标准进行诊断性面谈。计算组内相关系数考察评定者抑制性,计算克朗巴赫-α系数评价问卷内部一致性;计算两次测量得分相关系数考评问卷的重测信度,采用主成分分析方法考评问卷结构效度;通过GAI—SF与HAMA的相关分析来考评问卷的效标效度;以临床标准为参考标准,根据ROC曲线下面积（Area Under Curve,AUC）来判断GAI—SF的区分效度以及划定问卷的划界分。结果（1）信度：GAI—SF问卷总分评定者组内相关系数为0．73,表明评定者一致性较好,总克朗巴赫-α系数为0．87,表明问卷内部一致性好。间隔15d两次测量问卷评分相关系数为0．78,说明问巷具有较好的重测信度。（2）效度：主成分分析结果显示,问卷的每个条目都在主因子上有较高的负荷值（0．501～0．670）,说明问卷结构效度良好;GAI—SF与HAMA之间的相关系数为r=0．60,P〈0．05,说明问卷具有较好的校标效度。以临床评估标准为参考在区分焦虑问题时界值分为≥3时灵敏度为70．4％,特异度为75．0％,AUC为0．73。结论GAI—SF中文译本具有较好的信度和效度,能够区分老年广泛性焦虑问题;可使用该问卷筛查社区老年广泛性焦虑障碍。     

汉语失语症患者主语问句和宾语问句理解和表达障碍的特点

目的观察汉语失语症患者疑问句理解和表达障碍的特点，探讨其理解及表达障碍的机制，为失语症患者的诊断及康复训练方法提供依据。方法根据《汉语语法量表》选择10例失语法性失语症患者作为失语法性失语组（简称失语法组），选择14例非失语法性失语症患者作为非失语法性失语组（简称非失语法组），另外选取24例正常人作为正常对照组。用经过设计的主语问句和宾语问句（各20句）对患者进行理解能力和表达能力的测试。结果失语法组患者两种疑问句的理解正确率间差异无统计学意义（P〉0．05），失语法组患者两种疑问句的表达正确率间差异有统计学意义（P〈0．05）；失语法组患者对两种疑问句的理解能力和表达能力明显低于非失语法组患者和对照组（P〈0．05）。结论汉语失语法性失语症患者对疑问句的理解和表达障碍有其自身特点，可能为以后失语患者康复计划的制定及预后判断提供有用资料。     

Eppendorf精神分裂症量表中文版的信度和效度

目的：研究Eppendorf精神分裂症量表(ESI)中文版的信度和效度。方法：信度评价采用分半信度、内部一致性、重测信度。效度评价采用区分效度、内容效度、平行效度、结构效度。结果：KSI量表和各因子的分半信度为0．8087—0．9738，Cronbach α系数为0．7694—0．9508；1周后重测信度为0．677—0．876。各因子与总分的相关系数在0．815—0．909之间，因子之间的相关小于因子与总分的相关；ESI与阳性症状与阴性症状量表(PANSS)有很好的相关性，因子分析得出4个因子与原作者的因子相关系数在0．747—0．943之间。结论：ESI量表有较好的信度和效度，值得推广和使用。     

中文版剑桥人格解体量表的信度和效度检验

目的 翻译英文版剑桥人格解体量表（CDS）并对中文版CDS进行信、效度检验.方法 对119例健康受试者分别间隔2、3、4周进行CDS测验以计算其重测信度;临床医生按DSM-IV-TR诊断标准对76例门诊患者做出诊断,之后进行CDS测验,计算测验的重测信度、内部一致性、折半信度和效标关联效度、结构效度.结果 中文版CDS重测信度中等（0.651）,内部一致性和分半信度良好（Cronbach＇s α系数为0.938,Guttman折半信度为0.957）,效标关联效度良好（Mann-WhitneyZ值为-6.059,P＜0.001）,项目-总分相关系数从0.321～0.777,均达到显著性,结构效度尚可.结论 中文版CDS具有良好的信、效度,可以很好地评定人格解体症状.     

脑卒中后失语症患者自然恢复的相关因素分析

目的研究影响脑卒中后失语症患者自然恢复的相关因素。方法103例急性脑卒中后失语症患者分别于急性期及脑卒中后3月进行NIHSS、WAB和BDAE评估,记录患者的各项基本参数及常规检查。结果脑卒中后3月的NIHSS及AQ评分分别为（17．09±5．31）、（54．92±24．49）分较急性期（20．34±4．87）、（33．17±24．21）分明显改善（P〈0．01）;AQ与NIHSS评分均呈负相关（r=-0．478、-0．726、-0．805,P〈0．01）;恢复不良组年龄（76．28±8．58）岁大于恢复良好组（67．09±12．34）岁（P〈0．01）;恢复不良组合并房颤者（7／18）比例高于恢复良好组（8／85）（P〈0．01）;Logistic回归分析显示全面性失语的OR值为6．727（95％CI：2．195-20．62）（P〈0．01）。结论（1）脑卒中3月后大多数患者的语言功能明显改善;（2）年龄大、伴房颤的患者恢复差;（3）全面性失语在脑卒中后的各种类型失语中预后差。     

医院版卒中失语抑郁问卷的汉化及其应用评价

目的 汉化10条目医院版卒中失语抑郁问卷（stroke aphasic depression questionnaire-hospital version， SADQ-H10），评价该量表在卒中后失语伴抑郁患者中的可接受度、信度和效度，为评价卒中后失语患 者的抑郁提供标准化测量工具。      

Aphasia type, age and cerebral infarct localisation

Stroke patients with non-fluent aphasia tend to be younger than fluent aphasics. We investigated whether this difference was due to an age-related change in the anatomico-functional organisation of language areas or to an age-dependent variation on the distribution of infarct localisation. From a hospital prospective stroke database we selected those patients who suffered an ischaemic stroke with at least one non-lacunar infarct demonstrated by computed tomography (n = 423 patients). We retrieved information on language disturbance in the acute phase (no aphasia, non-fluent aphasia, fluent aphasia) and on infarct localisation by CT. Non-fluent aphasia predominated in young (aged < 51 years) patients while in elderly patients (aged > 70 years) the opposite was found (χ² = 8.03; P = 0.005). Posterior infarcts were also more frequent in elderly patients (χ² = 9.9; P = 0.002). There were 27 atypical cases (patients with lesions on language areas without aphasia) and 14 aphasics with atypical infarct localisation (9 fluent aphasics with anterior lesions and 5 non-fluent aphasics with posterior lesions). The proportions of atypical cases, their infarct location or fluency type were not influenced by age. It was concluded that the predominance of fluent aphasia in older patients was related to the higher proportion of posterior infarcts in these patients. The hypothesis of age-related changes in the anatomico-functional organisation of language areas was not supported by the present data. Received: 14 January 1997 Received in revised form: 28 April 1997 Accepted: 26 May 1997     

Bedside screening for aphasia: a comparison of two methods

A prospective study was carried out in 50 consecutive patients referred with suspected aphasia in order to compare the Frenchay Aphasia Screening Test (FAST) with the Sheffield Screening Test for Acquired Language Disorders (SST). The study included 32 men and 18 women with a mean (SEM) age 53.9 (2) years. The comprehension scores on the FAST were correlated with receptive skills on the SSTr=0.74 (P<0.001). For expression, the correlation coefficient wasr=0.92 (P<0.001) and the total scores of the two tests correlated closelyr=0.89 (P<0.001). There was a positive correlation between total score on the FAST and the Short Orientation, Memory and Concentration test (SOMC)r=0.86 (P<0.001), and the total scores on the SST and SOMCr=0.91 (P<0.001). The Barthel index also correlated positively with the FASTr=0.59 (P<0.001) and SSTr=0.63 (P<0.001). The study demonstrated that the two tests are simple, short and similar in their predictive value for the screening and diagnosis of aphasia. The SST was found to have additional advantages, as it does not require any special equipment or stimulus cards, and it was not affected by visual neglect.     

Design fluency subsequent to onset of aphasia: a distinct pattern of executive function difficulties?

ABSTRACT

Background: Executive function problems commonly co-occur with aphasia and influence language and communication performance as well as aphasia treatment outcomes and prognosis. Prior research, however, has focused on a restricted set of executive skills.

Aims: This study examined further the integrity of executive functioning and its relationship to language performance in individuals with aphasia by utilising a design fluency measure, which assesses executive skills like initiation, planning, and cognitive flexibility. To examine domain-general versus domain-specific executive problems and determine the distinctiveness of the aphasic group’s performance pattern, adults with right hemisphere brain damage (RHD) were included. The hypotheses examined were: (a) compared to adults with no brain damage, the aphasic and RHD groups would display design fluency impairments; (b) the design fluency performances of aphasic and RHD groups would be quantitatively but not qualitatively similar; and (c) the design fluency performances of the aphasic and RHD groups would be related to their language abilities, as well as their performance of other executive and cognitive measures.

Methods and Procedures: Participants with aphasia, RHD, or no brain damage completed the Ruff Figural Fluency Test (RFFT; Ruff, 1996), the results of which were quantitatively (i.e., number of unique designs, a perseverative error ratio) and qualitatively analysed (i.e., number and maximum length of orderly patterns, design complexity, number, and types of non-repetition errors), along with a formal cognitive-linguistic test battery and a verbal fluency task.

Outcomes and Results: The traditional, quantitative RFFT scores of the aphasia, and RHD groups were significantly lower than those of the control group. Only the RHD group significantly differed from the control group when qualitative RFFT variables were analysed. RFFT performances correlated with language and other cognitive test scores, with some differences in the number and nature of these associations across the aphasic and RHD groups.

Conclusions: The current design fluency findings indicated that executive function deficits involving initiation, planning, self-monitoring, and cognitive flexibility commonly co-occur with aphasia. These results supported previous research by identifying executive function impairments in many, however, not all individuals with aphasia, and by confirming influential associations between executive function and language, and communication measures. Inclusion of individuals with RHD indicated that such executive function difficulties and a potent relationship between executive functioning and language skills are not only unique to those with aphasia but also prevalent in other patient populations and consistent with the contribution of domain-general factors in acquired cognitive impairments.     

Clinical usefulness of the Spanish version of the Mississippi Aphasia Screening Test (MASTsp): validation in stroke patients

Objective

Clinical validation of the Spanish version of the Mississippi Aphasia Screening Test (MASTsp) as a screening test for language disorders in patients who have suffered a stroke.

Material and methods

A total of 29 patients who had suffered a stroke and had aphasia after a left hemispheric lesion were evaluated with the MASTsp, the Boston Diagnostic Aphasia Examination and the Token Test at baseline and after six months of rehabilitation. Two expert speech-therapists evaluated twelve aphasic patients to determine the inter-observer reliability. This sample was assessed twice in the same week to analyse the reproducibility of the test (test-retest reliability). Aphasic patients were compared with a matched sample of non-aphasic patients with vascular lesions in the right hemisphere (n =29) and a group of healthy subjects (n=60) stratified by age and educational level.

Results

The MASTsp showed a good convergent validity, interobserver validity, test-retest reliability and a moderate sensitivity to detect changes over time. A diagnostic cut-off <90 on the MASTsp total test score is proposed.

Conclusions

The MASTsp is a valid tool for the detection and monitoring of language problems in patients with stroke.     

Primary progressive aphasia: diagnosis, varieties, evolution.

A referred cohort of 67 clinically defined PPA patients were compared to 99 AD patients with formal language and nonverbal cognitive tests in a case control design. Language fluency was determined at the first and last follow up visits. Quantitation of sulcal and ventricular atrophy on MRI was carried out in 46 PPA and 53 AD patients. Most PPA patients (57%) are relatively fluent when first examined. Visuospatial and memory functions are initially preserved. Aphemic, stuttering, "pure motor" presentation, or agrammatic aphasia are seen less frequently. Later most PPAs become logopenic and nonfluent, even those with semantic aphasia (dementia). In contrast, AD patients were more fluent and had relatively lower comprehension, but better overall language performance. MRI showed significant left sided atrophy in most PPA patients. Subsequent to PPA, 25 patients developed behavioral manifestations of frontotemporal dementia and 15 the corticobasal degeneration syndrome, indicating the substantial clinical overlap of these conditions. Language testing, particularly fluency scores supported by neuroimaging are helpful differentiating PPA from AD. The fluent-nonfluent dichotomy in PPA is mostly stage related. The aphemic-logopenic-agrammatic and semantic distinction is useful, but the outcomes converge.     

Motor and language deficits correlate with resting state functional magnetic resonance imaging networks in patients with brain tumors

Background and purpose

Evidence of pre-operative resting state functional magnetic resonance (RS-fMRI) validation by correlating it with clinical pre-operative status in brain tumor patients is scarce. Our aim was to validate the functional relevance of RS-fMRI by investigating the association between RS-fMRI and pre-operative motor and language function performance in patients with brain tumor.

Vata-L: Visual-Analogue Test Assessing Anosognosia for Language Impairment

Lack of awareness (anosognosia) for one's own language impairments has rarely been investigated, despite hampering language rehabilitation. Assessment of anosognosia by means of self-report is particularly complex, as a patient's language difficulties may seriously prevent or bias the assessment. Other methods, such as measures of self-correction and error detection, have provided valuable information, although they are an indirect form of assessment of anosognosia and are not exempt from methodological criticisms. In this study we report on a new tool, the VATA-L (Visual-Analogue Test for Anosognosia for Language impairment), geared at assessing explicit anosognosia for aphasia. The VATA-L compares the patient's self-evaluation with caregivers’ evaluations of the patient's verbal communication abilities in a series of common situations. By means of non-verbal support and a system of check questions, this test minimizes some of the methodological limitations of existing diagnostic tools (e.g., structured interviews), enhancing reliability, and enabling assessment of patients with aphasia. Finally, normative data provided in the study allow a clearer interpretation of the patient's performance and facilitate assessment of anosognosia.     

低频重复经颅磁刺激对脑梗死失语的治疗作用及其对脑电活动的影响

目的 观察低频重复经颅磁刺激（low-rTMS）对脑梗死失语的治疗作用和其对脑电活动的影响.方法 选取左半球脑梗死后运动性失语右利手的患者15例,经ABC失语检查表评定后随机分为对照组7例和治疗组8例.对照组予常规药物和语言康复治疗;治疗组在对照组治疗基础上予low-rTMS治疗.rTMS治疗方法：频率1 Hz、强度为运动阈值80%、部位为右侧大脑半球Broca区、每序列50次脉冲、每天10个序列、序列间隔120 s,共10 d.两组在治疗前和治疗后（rTMS治疗后2周）均行ABC评分和脑电非线性分析检测.结果 两组治疗前的ABC评分值和脑电非线性分析参数均值（D2、PD2、Cx、LE、KE、ApEn）差异无统计学意义（P＞0.05）;治疗后治疗组的ABC评分和右额区脑电非线性分析参数PD2、Cx、均值比对照组显著增加,差异有统计学意义（P＜0.05）;而治疗组的左额区脑电非线性分析参数PD2、Cx、均值与对照组比较差异无统计学意义（P＞0.05）.结论 low-rTMS刺激右侧大脑半球（Broca区）对左半球脑梗死失语患者的语言有一定的康复作用.     

拟诊单纯疱疹病毒脑炎所致颞叶受累的失语症二例

目的 探讨左颞叶病灶与失语表现之间的关系.方法 对2例单纯疱疹病毒脑炎所致的主要表现为失语的患者进行汉语失语检查和影像学分析.结果 以左颞上回后部受累为主者与以左颞上回前部及颞中回受累者失语类型完全不同,前者属于不能分型,而后者为典型的Wernicke失语.结论 颞上回后部受累为主所致失语者听理解障碍较轻,颞上回前部受累为主并累及颞中回可导致听理解的严重受损,左颞叶的不同部位在语言形成过程中起着不同的作用.