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1.
The rate of emotional and behavioural disturbance in children with intellectual disability (ID) is up to four times higher than that of their typically developing peers. It is important to identify these difficulties in children with ID as early as possible to prevent the chronic co-morbidity of ID and psychopathology. Children with ID have traditionally been assessed via proxy reporting, but appropriate and psychometrically rigorous instruments are needed so that children can report on their own emotions and behaviours. In this study, the factor structure of the self-report version of the Strengths and Difficulties Questionnaire (SDQ) was examined in a population of 128 children with ID (mean age = 12 years). Exploratory and Confirmatory Factor Analysis showed a three factor model (comprising Positive Relationships, Negative Behaviour and Emotional Competence) to be a better measure than the original five factor SDQ model in this population.  相似文献   

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The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was administered to two samples of 11-16 year olds: 83 young people in the community and 116 young people attending a mental health clinic. The questionnaire discriminated satisfactorily between the two samples. For example, the clinic mean for the total difficulties score was 1.4 standard deviations above the community mean, with clinic cases being over six times more likely to have a score in the abnormal range. The correlations between self-report SDQ scores and teacher--or parent rated SDQ scores--compared favourably with the average cross informant correlations in previous studies of a range of measures. The self-report SDQ appears promising and warrants further evaluation.  相似文献   

4.
The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was administered to two samples of 11-16 year olds: 83 young people in the community and 116 young people attending a mental health clinic. The questionnaire discriminated satisfactorily between the two samples. For example, the clinic mean for the total difficulties score was 1.4 standard deviations above the community mean, with clinic cases being over six times more likely to have a score in the abnormal range. The correlations between self-report SDQ scores and teacher--or parent rated SDQ scores--compared favourably with the average cross informant correlations in previous studies of a range of measures. The self-report SDQ appears promising and warrants further evaluation.  相似文献   

5.
Assessments of child psychopathology are often derived from parental and teacher reports, yet there is substantial disagreement. This study utilized data from 7 European countries to examine parent–teacher agreement and possible explanatory factors for parent–teacher disagreement such as child and family characteristics, parenting dimensions, and maternal distress were explored. Parent–teacher agreement of the Strengths and Difficulties Questionnaire were assessed using a cross‐sectional survey of 4,894 school aged children 6–11 from the School Children Mental Health Europe Project. Parent–teacher agreement was low to moderate (Pearson correlation ranging from .24 (Prosocial) to .48 (Hyperactivity) for the 5 subscales across 7 countries); kappa coefficient ranged from .01 (Turkey) to .44 (Italy) for internalizing problems and .19(Romania) to .44(Italy) for externalizing problems. Child's gender and age, mother's employment status, single parent home, number of children in household, and selected parenting dimension were found to be explanatory of informant disagreement. This study not only serves to advance our understanding of parent–teacher agreement of the Strengths and Difficulties Questionnaire in 7 European countries but provides a novel approach to examining the factors that contribute to informant disagreement.  相似文献   

6.
Current evidence on the co-occurrence of Developmental Coordination Disorder (DCD) and psychosocial problems mainly concerns parent-reported information, but rarely includes teacher information. The aim of this study was (1) to investigate the teachers’ identification of emotional and behavioral problems in children with DCD and (2) to examine the performance of the teacher version of the Strengths and Difficulties Questionnaire (SDQ-T) compared with the Teacher Report Form (TRF) in children with DCD. We assessed primary school children (202 boys, 200 girls, range 4–10.8 years, mean age 7.2 years) for DCD following the DSM IV-TR criteria. Emotional and behavioral problems were measured with the TRF (n = 327) and the SDQ-T (n = 361). DCD was established in 23 (5.7%) children, 16 boys and 7 girls (mean age 7.0 years). Children with DCD had a higher proportion of clinical scores on both the TRF Total Problem Scale (TRF TPS) and SDQ-T Total Difficulties Score (SDQ-T TDS). Children with DCD had increased odds on the TRF domains Thought (odds ratio, OR: 5.39), Externalizing (OR: 4.12) and Internalizing (OR: 4.42) problems, and on all SDQ-T-domains and Total Difficulties score (OR: 7.30). In the DCD group the SDQ-T TDS correlated strongly (Spearman's rho 0.80) with the TRF TPS and demonstrated a moderate agreement (Cohen's Kappa 0.53). In conclusion, teachers identified significantly more emotional and behavioral problems in children with DCD compared with their peers. The SDQ-T showed moderate agreement with the TRF in identifying emotional and behavioral problems in children with DCD.  相似文献   

7.
PURPOSE OF REVIEW: To critically discuss recent findings from studies using the Strengths and Difficulties Questionnaire, in relation to different research designs and clinical purposes. RECENT FINDINGS: A substantive body of research exists on the psychometric properties of the Strengths and Difficulties Questionnaire in different cultures. This body supports the validity and reliability of its versions for the parent, teacher and self-reporting purpose, despite some variation in cut-off scores. The Strengths and Difficulties Questionnaire is increasingly being used as a measure of child psychopathology in other types of research, that is, aetiological, longitudinal and service evaluation studies. Future studies need to address in more detail the Strengths and Difficulties Questionnaire diagnostic algorithms, added value score, impact and burden items and a preschool version. SUMMARY: The Strengths and Difficulties Questionnaire has been established as the most widely used instrument in child mental health research. It is easy to complete, is user friendly because of its positive attributes items, allows comparisons to be made between different populations and is sensitive to change.  相似文献   

8.
ObjectiveTo establish the psychometric properties of a self-report measure of daytime sleepiness for school-aged children.MethodsThree hundred eighty-eight children aged 8–12 years (inclusive) from paediatrician’s offices, sleep clinic/labs, children’s hospitals, schools, and the general population were recruited. A multi-method approach was used to validate the Children’s Report of Sleep Patterns – Sleepiness Scale (CRSP-S), including self-report measures (questions about typical sleep), parent-report measures (Children’s Sleep Habits Questionnaire [CSHQ], proxy version of CRSP-S, Children’s Sleep Hygiene Scale [CSHS], morningness–eveningness) and objective measures (actigraphy and polysomnography [PSG]).ResultsThe CRSP-S was shown to be internally consistent (Cronbach’s alpha = 0.77) and the scale’s unidimensionality was supported by a one-factor confirmatory factor analysis. A Rasch-Masters Partial Credit model demonstrated that items cover a broad range of sleepiness experiences with minimal redundancy, gaps in coverage, or bias against age, gender, or clinical groups. Test–retest reliability was 0.82. Construct and convergent validity were demonstrated with actigraphy, parental reports of children’s sleepiness, sleep disturbances, sleep hygiene, circadian preference, and comparison of groups of children (e.g., sleep clinic/lab vs. school children).ConclusionsThe CRSP-S is a reliable and valid self-report measure of sleepiness for school-aged children. As an adjunct to parental report measures and objective measures of sleep, the CRSP-S provides a brief and psychometrically robust measure of children’s sleepiness. Children who endorse sleepiness should have a more detailed screening for underlying sleep disruptors or causes of insufficient sleep.  相似文献   

9.
《L'Encéphale》2020,46(6):455-462
ObjectiveOur primary objective was to validate the French version of the BFI-10, an ultra-short ten-item version of the Big Five Inventory (BFI; John et al., 1991), which allows for a reasonably accurate assessment of personality in circumstances in which more in-depth assessment is not possible. In order to reach a thorough evaluation of the external validity, we also aimed to examine the bandwidth of the BFI-10 scales with reference to the study by De Young, Quilty and Peterson (2007) who distinguished between two aspects in each of the Big Five: Assertiveness and Enthusiasm for Extraversion; Compassion and Politeness for Agreeability; Orderliness and Productiveness for Conscientiousness; Withdrawal and Volatility for Negative Emotionality, and finally Openness to Aesthetics and Openness to Ideas for Open-Mindedness. Our concern with regard to bandwidth was to examine whether the BFI-10 scales have strong enough correlations with both aspects of each domain.MethodsParticipants. Data from four samples were analysed: Sample 1 comprised 2499 undergraduate students (1654 women) who completed the full BFI in university classes; Sample 2 comprised 13,306 participants (8471 women) who filled out the BFI-10 ten items online via Internet; Sample 3 comprised 143 undergraduate students (115 women) who completed the full BFI twice with a two-week interval; Sample 4 comprised 360 undergraduate students (183 women) who filled out the BFI and NEO PI-R. Instruments. The French version of the Big Five Inventory is a 45-item inventory, which measures the five broader domains of personality. The ultrashort Ten-item Big Five Inventory (BFI-10) was developed simultaneously in German and English by Rammstedt and John (2007); it comprises five two-item scales measuring the big five domains. The Neuroticism-Extraversion-Openness Personality Inventory Revised (NEO PI-R; Costa et McCrae, 1992) is a 240-item questionnaire which assesses the big five domains and 30 lower-order facets, i.e. six facets per domain. Statistical analyses. Factor structure and reliability of the five two-item scales were first investigated on samples 1 and 3. Confirmatory factor analyses (CFAs) were conducted on samples 1 and 2, and discriminant validity was assessed via comparison with the NEO PI-R (sample 4). In order to examine the bandwidth of the BFI-10 two-item scales, we studied their correlation not only with the NEO PI-R domains but also with the 30 facets.ResultsThe CFAs showed the good fit of the five-factor structure, with RMSEA = .077 (.072), CFI = .974 (.956), and SRMR = .029 (.027) in samples 1 and 2 respectively. Multigroup CFA conducted in groups 1 and 2 showed invariance across gender of factor loadings and item intercepts. Test-retest reliability was satisfactory with rs ranging from .68 (Open-Mindedness) to .86 (Extraversion and Negative Emotionality). The comparison of the two-item scales with the NEO PI-R scales showed high correlations not only with the NEO domain scales, but also with several facets: Four BFI-10 two-item scales (Extraversion, Conscientiousness, Negative Emotionality, and Open-Mindedness) were highly correlated with at least three of the six NEO facet scales in each domain. For Agreeableness, the magnitude of correlations was smaller, but the pattern of correlations was the same. All BFI-10 scales had at least moderate correlations with both aspects of each domain, with the exception of Negative Emotionality, which measured the NEO Withdrawal aspect better than Volatility.ConclusionThe French version of the BFI-10 demonstrated the expected five-factor structure, satisfactory reliability, and broad bandwidth. It could be a valuable tool for the assessment of personality in circumstances in which it is not possible to use a longer and more in-depth instrument, especially when personality is not the main focus of research but one of the variables to be controlled.  相似文献   

10.
This study examined the psychometric properties of the Spence Children's Anxiety Scale (SCAS) self- and parent-report versions in a community (n = 712) and a clinical (n = 70) sample of Brazilian children and adolescents. Confirmatory factor analysis conducted in the community sample provided support to the original six correlated factors model of the SCAS. Moreover, the SCAS demonstrated good internal consistency, convergent and divergent validity, and a significant informant effect on the total score with higher anxiety levels in the self-report than in the parent-report version. Considering the clinical sample, we could demonstrate that the SCAS total scores have good discriminant validity differentiating: (a) anxious, community, and negative screening groups; and (b) children diagnosed with different severity levels of anxiety disorders. Our findings suggest that the SCAS (self- and parent-report versions) is suitable for assessing anxiety symptoms in Brazilian children and adolescents in community and clinical settings.  相似文献   

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Schools have become the largest provider of mental health services to children, thus increasing the need to identify children at risk before problems worsen. The Social, Academic, and Emotional Behavioral Risk Screener-Student Rating Scale (SAEBRS-SRS) student version is a universal screener that assesses pre-symptomology of internalizing and externalizing behaviors. Prior research on the SAEBRS-SRS has supported a psychometrically defensible factor structure; however, additional research is necessary to support applied used in schools. In this study, 1102 middle grades students completed the SAEBRS-SRS and the Strengths and Difficulties Questionnaire. Data were analyzed to evaluate the diagnostic accuracy of the screener via receiver operating characteristic curve analyses. Multi-group confirmatory factor analysis was conducted to identify measurement invariance across gender. Results indicated that (1) the SAEBRS-SRS has adequate diagnostic accuracy statistics, particularly for the SAEBRS Total score, and (2) the SAEBRS-SRS is invariant across gender at the metric and scalar levels of measurement invariance. Implications and recommendations for future research are further discussed.  相似文献   

12.
ObjectivesThe aim of this study was to adapt and validate the Schizophrenia Caregiver's Quality of Life Questionnaire (S-CGQoL) for use in the Hispanic-American population from the caregiver's perspective.MethodsA cross-sectional instrumental model was used, with a sample of 253 caregivers of patients suffering of Schizophrenia in Bolivia, Peru and Chile. The psychometric properties of the S-CGQoL were tested through construct validity, reliability and some aspects of external validity. In addition, in order to assess the nature of the different items across the three countries, a Differential Performance Analysis (DPA) was conducted.ResultsA confirmatory factor analysis showed that the scale structure was well correlated to the initial structure of the QoL-MDS. The results confirmed the existence of adequate reliability indicators (α> .70 and ω> .80) and the absence of FIDs supporting the invariance of item calibrations among the three Latin American countries.ConclusionsThe adaptation and validation of the S-CGQoL questionnaire demonstrate adequate psychometric properties to assess the quality of life of caregivers in samples of middle-income countries in Latin America.  相似文献   

13.
The present study examined the psychometric properties of the Iranian translation of the Spence Children's Anxiety Scale (SCAS) in a large community sample of adolescents (N = 1984), aged 12–17 years, in Ahvaz City, Iran. In addition to the SCAS, all participants completed the Strengths and Difficulties Questionnaire (SDQ), and the Centre for Epidemiological Studies Depression Scale for Children (CES-DC). The internal consistency (Cronbach Alpha = .92) and the validity of the Iranian translation of the SCAS was excellent. The SCAS total scores correlated significantly with the CES-DC, as well as with the emotional, conduct problems, hyperactivity-inattention, and peer problems subscales of the SDQ. However, Steiger's Z test demonstrated that correlations between the SCAS scores and the SDQ conduct problems or hyperactivity-inattention subscales were significantly lower than the correlations between the SCAS scores and the SDQ emotional symptoms subscale. Confirmatory factor analyses revealed the same 6-factor structure as the original SCAS. The SCAS proved to be a reliable and valid measure of anxiety symptoms among adolescents in Iran.  相似文献   

14.

Introduction

The main objective of the study was to explore the factorial structure of the French version of the Schizotypal Personality Questionnaire-Brief (SPQ-B) in a Likert format, in a representative sample of the general population. In addition, differences in the dimensional scores of schizotypy according to gender and age were analyzed. As the study in the general population of schizotypal traits and its determinants has been recently proposed as a way toward the understanding of aetiology and pathophysiology of schizophrenia, consistent self-report tools are crucial to measure psychometric schizotypy. A shorter version of the widely used Schizotypal Personality Questionnaire (SPQ-Brief) has been extensively investigated in different countries, particularly in samples of students or clinical adolescents, and more recently, a few studies used a Likert-type scale format which allows partial endorsement of items and reduces the risk of defensive answers.

Method

A sample of 233 subjects representative of the adult population from an urban area near Paris (Créteil) was recruited using the “itinerary method”. They completed the French version of the SPQ-B with a 5-point Likert-type response format (1 = completely disagree; 5 = completely agree). We examined the dimensional structure of the French version of the SPQ-B with a Principal Components Analysis (PCA) followed by a promax rotation. Factor selection was based on Eigenvalues over 1.0 (Kaiser's criterion), Cattell's Scree-plot test, and interpretability of the factors. Items with loadings greater than 0.4 were retained for each dimension. The internal consistency estimate of the dimensions was calculated with Cronbach's α. In order to study the influence of age and gender, we carried out a simple linear regression with the subscales as dependent variables.

Results

Our sample was composed of 131 women (mean age = 52.5 ± 18.2 years) and 102 men (mean age = 53 ± 18.1 years). SPQ-B Likert total scores ranged from 22 to 84 points (mean = 43.6 ± 13). Factor analysis resulted in a 3-factor solution that explained 47.7% of the variance. Factor 1 (disorganized; 10 items) included items related to “odd behavior”, “odd speech”, as well as “social anxiety”, one item of “constricted affect” and one item of “ideas of reference”. Factor 2 (interpersonal; 7 items) included items related to “no close friends”, “constricted affect”, and three of the items of “suspiciousness”. Factor 3 (cognitive-perceptual; 5 items) included items related to “ideas of reference”, “magical thinking”, “unusual perceptual experiences” and one item of “suspiciousness”. Coefficient α for the three subscales and total scale were respectively 0.81, 0.81, 0.77 and 0.88. We found no differences in total schizotypy and the three dimensions scores according to age and sex.

Conclusion

Factor analysis of the French version of the SPQ-B in a Likert format confirmed the three-factor structure of schizotypy. We found a pure cognitive perceptual dimension including the most representative positive features. As expected, “Suspiciousness” subscale is included in both positive and negative dimensions, but mainly in the negative dimension. Surprisingly, “social anxiety” subscale is included in the disorganized dimension in our analysis. The SPQ-B in a Likert format demonstrated good internal reliability for both total and subscales scores. Unlike previous published results, we did not find any influence of age or gender on schizotypal dimensions.  相似文献   

15.
The Relationship Problems Questionnaire (RPQ) was developed to screen symptoms of the inhibited and disinhibited subtype of reactive attachment disorder (RAD). This study further examines the psychometric properties of the RPQ in children with severe emotional and behavioural problems by testing its measurement invariance across informants and its convergent validity. Parents and teachers of 152 children [mean age (Mage) = 7.92] from 20 schools for special education filled out the RPQ and the Strengths and Difficulties Questionnaire (SDQ). During a home visit in a subsample of 77 children the Disturbances of Attachment Interview (DAI) was administered to the caregiver and the child was observed using an observational schedule for RAD. Exploratory and confirmatory factor analyses revealed the expected two‐factor structure for both parent and teacher RPQ. Configural and metric invariance, but no scalar invariance, were obtained across informants. Both RPQ‐subscales had acceptable to good internal consistencies and correlated as expected with similar DAI‐subscales. Furthermore, the disinhibited RPQ‐scale related with observations of the child's approach to a stranger. Finally, significant associations were found between the RPQ and the SDQ. Overall, the RPQ has good psychometric qualities as a multi‐informant instrument for RAD‐symptoms in children with severe emotional and behavioural problems. Copyright © 2013 John Wiley & Sons, Ltd.  相似文献   

16.
ObjectivesValidated self-report instruments could provide a time efficient screening method for negative symptoms in people with schizophrenia. The aim of this study was to examine the psychometric properties of a German version of the Motivation and Pleasure Scale-Self-Report (MAP-SR) which is based on the Clinical Assessment Interview for Negative Symptoms (CAINS).MethodsIn- and outpatients (N = 50) with schizophrenia or schizoaffective disorder were assessed with standardized interviews and questionnaires on negative and positive symptoms and general psychopathology in schizophrenia, depression, and global functioning.ResultsThe German version of the MAP-SR showed high internal consistency. Convergent validity was supported by significant correlations between the MAP-SR with the experience sub-scale of the CAINS and the negative symptom sub-scale of the Positive and Negative Syndrome Scale. The MAP-SR also exhibited discriminant validity indicated by its non-significant correlations with positive symptoms and general psychopathology, which is in line with the findings for the original version of the MAP-SR. However, the MAP-SR correlated moderately with depression.ConclusionThe German MAP-SR appears to be a valid and suitable diagnostic tool for the identification of negative symptoms in schizophrenia.  相似文献   

17.
《L'Encéphale》2019,45(3):195-199
AimTo use the Arabic version of the MADRS in Lebanese depressed patients, check its validity and reproducibility compared to other versions of the questionnaire and assess risk factors affecting the total MADRS score.MethodsThis case-control study, performed between September 2016 and January 2017, included 200 patients (100 patients, 100 controls). The questionnaire included two parts, the first one concerning the socio-demographic characteristics another one that included the Montgomery-Asberg Depression Rating Scale (MADRS) questions, which was translated from English to Arabic through an initial translation and back translation process.ResultsThe MADRS scale items converged over a solution of one factor that had an Eigenvalue over 1, explaining a total of 83.90% of the variance. A Kaiser-Meyer-Olkin measure of sampling adequacy of 0.953 was found, with a significant Bartlett's test of sphericity (P < 0.001). A stepwise linear regression, using the total MADRS score as continuous variable, showed that a university level of education would significantly decrease the total MADRS score by 20 points (beta = −20.02, CI: from −26.337 to −13.709, P < 0.001). Unemployment was significantly more associated with an increase in the total MADRS score level by 10.23 points (beta = 10.23, CI: 3.944–16.526, P = 0.002).ConclusionThis study shows that the Arabic version of the MADRS has promising psychometric properties, and thus it is a good tool to use for the diagnosis of patients with depression. Based on this study, health care professionals and researchers can readily use the MADRS questionnaire to estimate the overall severity of depression among psychiatric patients in Lebanon.  相似文献   

18.
In this study, we aimed to evaluate the utilization of mental health services by adolescent smokers, the presence of untreated mental disorders in this young population and the associated emotional and behavioral difficulties. We performed a nationwide survey study of an Israeli representative sample of 906 adolescents and their mothers. Mental disorders were assessed using the Development and Well-Being Assessment (DAWBA) Inventory. Emotional and behavioral difficulties were evaluated using the Strengths and Difficulties Questionnaire (SDQ). Mental health services use and smoking habits were evaluated by relevant questionnaires. Adolescent smokers were using significantly more mental health services than non-smokers (79% vs. 63%, respectively, P < 0.001), independently of their mental health status or ethnic group. Adolescent smokers also reported more emotional and behavioral difficulties in most areas (P < 0.001), which are consistent with their mothers’ reports, except in the area of peer relationships. The treatment gap for the smoking adolescents was 53% compared to 69% in the non-smokers (P < 0.001). This is the first study characterizing the use of mental health services and the related emotional and behavioral difficulties in a nationally-representative sample of adolescents. The findings of a wide treatment gap and the rates of the associated emotional and behavioral difficulties are highly relevant to the psychiatric assessment and national treatment plans of adolescent smokers.  相似文献   

19.
The aim of this study is to describe motivation in adolescents with cerebral palsy (CP) and factors associated with motivation level. The Dimensions of Mastery Questionnaire (DMQ) measures motivation in mastering challenging tasks and expressive elements. It was completed by 153 parents and 112 adolescents with CP. Adolescents (GMFCS in n = 146 – I:50, II:43, III:13, IV:15, V:25) were assessed using the Leiter IQ and Gross Motor Function Measure. Parents completed the Vineland Adaptive Behavior Scale and the Strengths and Difficulties Questionnaire. Motivation scores were highest for mastery pleasure and social persistence with adults and lowest for gross motor and object-oriented persistence. Socio-demographic factors were not strongly correlated with DMQ. Higher gross motor ability (r = 0.24–0.52) and fewer activity limitations (r = 0.30–0.64, p < .001) were associated with persistence in cognitive, motor and social tasks, but not mastery pleasure. Higher IQ was associated with persistence in object-oriented tasks (r = 0.42, p < .001). Prosocial behaviors correlated with high motivation (r = 0.39–0.53, p < .001). Adolescents’ motivation scores were higher than parents’ scores. Adolescents with CP express high mastery pleasure, not related to abilities. High motivation was associated with fewer activity limitations and prosocial behaviors and aspects of family environment. Findings elucidate those at-risk for low motivation, which can influence treatment adherence and participation in challenging but meaningful activities.  相似文献   

20.
《L'Encéphale》2023,49(1):15-20
BackgroundThe prevalence of autism spectrum disorder is increasing worldwide, making screening and early intervention necessary. Several screening instruments have been developed in recent years. The Modified Checklist for Autism in Toddlers Revised with Follow-up (M-CHAT-R/F) is considered to be one of the specific measures designed to identify toddlers at risk for autistic spectrum disorder.ObjectiveThe aim of the study was to translate and adapt the original version of M-CHAT-R/F from the English to the Moroccan Arabic language.Study designSpecialized translators and clinicians ensured forward and backward translation of the scale into Moroccan Arabic. Then, a two-stage screening of the M ? CHAT-R/F ? T was applied to a study sample comprised of 56 toddlers with autistic spectrum disorder (category I) and 96 toddlers with normal development (category II). “Kappa test”, “Cronbach's alpha” test, the intra class correlation coefficient, and the area under the curve were determined.ResultThe average score results of M-CHAT-R/F were 13.12 for category I, while it was 2.24 for category II. The Cronbach's alpha coefficient of the checklist was 0.929. The kappa values ranged from k = 0.78 to k = 0.97 with a confidence interval of 95% indicating good convergence. The intra-class correlation coefficient ranged from 0.97 to 0.99, which is excellent. The area under the curve in our study was 0.988, an excellent result.ConclusionEfficiency of the Moroccan Arabic version of the MCHAT was demonstrated for screening in the general population.  相似文献   

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