安全感量表的初步编制及信度、效度检验

目的:编制安全感量表,为评价神经症和正常人群的安全感提供量化工具.方法:根据安全感的概念架构,结合神经症患者半结构式访谈的结果,初步确定能够反映个体安全感的题目,对343名大学生被试进行测试,并进行信度效度分析.结果:探索性因素分析,结果得到2个主要因子:人际安全感和确定控制感(特征值大于1,累计贡献率为46.36%),负荷量≥0.4的共有16个项目.结论:安全感量表具有较好的信度及效度,可用于正常人群安全感的测查,也可以用于神经症的安全感检测,具有较广的实际应用价值.     

A Brief Web-Based Screening Questionnaire for Common Mental Disorders: Development and Validation

Background

The advent of Internet-based self-help systems for common mental disorders has generated a need for quick ways to triage would-be users to systems appropriate for their disorders. This need can be met by using brief online screening questionnaires, which can also be quickly used to screen patients prior to consultation with a GP.

Objective

To test and enhance the validity of the Web Screening Questionnaire (WSQ) to screen for: depressive disorder, alcohol abuse/dependence, GAD, PTSD, social phobia, panic disorder, agoraphobia, specific phobia, and OCD.

Methods

A total of 502 subjects (aged 18 - 80) answered the WSQ and 9 other questionnaires on the Internet. Of these 502, 157 were assessed for DSM-IV-disorders by phone in a WHO Composite International Diagnostic Interview with a CIDI-trained interviewer.

Results

Positive WSQ “diagnosis” had significantly (P < .001) higher means on the corresponding validating questionnaire than negative WSQ “diagnosis”. WSQ sensitivity was 0.72 - 1.00 and specificity was 0.44 - 0.77 after replacing three items (GAD, OCD, and panic) and adding one question for specific phobia. The Areas Under the Curve (AUCs) of the WSQ’s items with scaled responses were comparable to AUCs of longer questionnaires.

Conclusions

The WSQ screens appropriately for common mental disorders. While the WSQ screens out negatives well, it also yields a high number of false positives.     

工作控制点量表(WLCS)的信效度研究

目的:检测工作控制点量表(WLCS)的信度和效度.方法:根据439名被试的WLCS结果作了同质信度、构想效度的检验,以Rotter控制点量表为效标考察了WLCS的同时效度,以职业压力指标问卷(OSI-2)中身体健康、心理健康、工作满意度和离职意向分量表为效标考察了WLCS的预测效度.结果:WLCS的内部一致性α系数为0.7166,分半信度为0.7159;同时效度为0.605(P<0.001);对身体健康、心理健康、工作满意度和离职意向的预测效度都达到显著水平.结论:WLCS的同质信度、构想效度、效标效度均较理想,符合心理测量学的要求.     

多维记忆评估量表的信效度研究

目的：检测多维记忆评估量表（MMAS）的信度和效度。方法：根据694名6－91岁被试的MMAS测试结果作了同质信度、结构效度和实证效度检验，以56名被试间隔20天的两次测试资料计算重测信度，以WMS－RC为效标考查效标效度。结果：分测验的重测信度在0．526－0．935之间，组合分的重测信度在0．76以上；分测验的分半信度（0．265－0．970）、α系数（0．246－0．957）和概化系数（0.245-0.957)多数在0．60以上；MMAS组合分与WMS－RC记忆商的相关为0．400－0．745，有关分测验的相关0．3以上；各分测验之间的相关（0．191－0．785），及与对应组合分的相关多数在0．5以上，多维构想得到证实；分测验成绩和组合分与教育呈正相关（0．156－0．764）；在儿童组分测验成绩和组合分与年龄呈正相关（0．214－0．759）、在成人和老人组分测验成绩和组合分与年龄呈负相关（－0．198～－0．595），各分测验的区分效度为0．278－0．889。结论：MMAS的重测信度、同质信度、效标效度和实证效度均较理想，符合心理测量学的要求。     

在妇科门诊患者中进行精神障碍筛检遇到的问题

目的：综合医院中筛查精神卫生问题的方法学检验。方法：在北京的一所综合医院妇科门诊连续收集1626名就诊者的资料，采用的筛查工具是《问题导向的患者报告》(POPR，problem oriented patient report)。按筛查阳性阴性各半收集其中198名就诊者，由两名精神科医师采用《简明国际神经精神检查》(M．I．N．I． Plus，Mini Intemational Neuropsychiatric Interview-English Version 5．0)进行精神状况检查并根据标准DSM-IV作出精神科诊断，根据精神检查结果计算POPR的心理测查学指标。结果：POPR总的假阴性率为34％，只有“广泛焦虑”和”重性抑郁”分量表的假阴性率小于10％且假阳性率不超过50％。因子分析发现，妇科门诊患者的主诉不能被归类为“重性抑郁”、“广泛焦虑”、“恶劣心境”等与精神科诊断一致的类别。在198例经精神科医师检查的病例中，大多数筛查假阴性的病例属于神经症性障碍；即便是符合精神障碍临床诊断的病例，很少患者本人报告在生活或工作中有功能障碍。经推算，精神障碍的总体阳性率在整个筛查人群中达45％，符合“焦虑障碍”和”重性抑郁”的分别达18．7％和10．7％。结论：妇科门诊患者中精神卫生问题突出。但POPR在北京的综合医院并不是一个好的筛查工具。     

痴呆心境评定量表(DMAS)的信度和效度测定

目的 :分析痴呆心境评定量表 (DMAS)的信度和效度。方法 :3 0例符合CCMD -2 -R关于Alzheimer病或血管性痴呆诊断标准的病人 ,由临床医生是否存在抑郁症状判定为抑郁组 (16例 )和非抑郁组 (14例 )。 5位精神科医生参加评定 ,对 16例病人进行了联合评定 ,评定员之间一致性良好 ,ICC =0 87,F =13 5 44 ,P <0 0 1。 3 0例样本除接受DMAS评定外 ,同时接受汉密顿抑郁量表 (HAMD)、简易智力状态检查 (MMSE)、日常生活能力量表 (ADL)和大体痴呆评定量表 (GDS)的评定。结果 :抑郁组与非抑郁组的DMAS各单项分比较 ,共有 12个单项评分二组间有显著差异 (P <0 0 5或 <0 0 1)。单项分与剩余总分的相关系数 (rs)为 0 19～ 0 77,P均 <0 0 5或 <0 0 1,DMAS与HAMD的相关性良好 ,rs=0 68,P <0 0 1。因子分析结果 ,DMAS各项可归纳为 5个因子 ,分别为 :(1)情绪体验 (2 )焦虑 /抑郁 (3 )自我评价 (4 )活力缺乏 (5 )易激惹。项目的归类基本合理 ,具有临床可解释性 ,说明DMAS具有良好的结构效度。结论 :DMAS的信度与效度良好 ,项目设置适用于痴呆伴有抑郁的评价     

重复性成套神经心理状态测验的信度、效度分析

目的:对用于精神障碍患者认知功能测评的重复性成套神经心理状态测验(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)中文版的信度和效度作初步验证.方法:从北京市城乡方便取样,做横断面调查,451名健康人群完成RBANS测验,其中97人同时完成简易韦氏成人智力、韦氏记忆测验考察效标效度;41人间隔12周再次进行了RBANS测验.对获取的数据进行相关分析和因子分析.结果:反映内部一致性的Cronbach α系数在RBANS总量表为0.90,在即刻记忆、视觉广度、言语功能、注意、延迟记忆分量表分别为0.86,0.68,0.67,0.85,0.80.总量表的重测信度为0.90,5个分量表的重测信度分别为0.65,0.68,0.53,0.80,0.79(P均＜0.01).以简易韦氏成人智力、韦氏记忆测验为效标,结果除简易韦氏成人智力量表的言语得分与RBANS量表的视觉空间因子间相关性无统计学意义,RBANS与简易韦氏成人智力和韦氏记忆量表总分和各因子分均存在有统计学意义的正相关(r=0.21-0.59,P均＜0.01).验证性因素分析结果x2/df为4.13,相对拟合指数(CFI)为0.91,非范拟合指数(NNFI)为0.93,近似均方根误差(RMSEA)为0.079.12个分测验的完全标准化解(MI)分别为:0.80,0.74,0.61,0.38,0.61,0.90,0.66,0.60,0.81,0.60,0.81,0.73.结论:重复性成套神经心理状态测验是一个信效度比较好的认知功能评定工具.     

简版心理健康连续体量表(成人版)的信效度

目的:检验简版心理健康连续体量表(MHC-SF)(成人版)在中国成人中使用的信度与效度。方法:对Keyes编制的MHC-SF(成人版)进行翻译,并由12名成人对MHC-SF(成人版)的项目进行评价。采取方便取样的方法,抽取北京、广东、云南、重庆、陕西、湖北等地的1981名成人,用MHC-SF(成人版)、幸福感脸形评尺、流调抑郁量表(CES-D)对M HC-SF(成人版)的结构效度、效标关联效度和内部一致性信度进行考察。结果:MHC-SF(成人版)包括情绪幸福感、社会幸福感和心理幸福感3个因素,共14个条目。M HC-SF(成人版)原量表的三因子结构与实际数据相契合,其拟合指数分别为χ2=975.62、df=74、RM SEA=0.08、GFI=0.93、AGFI=0.90、NFI=0.95、CFI=0.95。M HC-SF(成人版)总分及3个因子分与幸福感脸形评尺得分正相关(r=0.37～0.46,均P0.01),而与CES-D得分负相关(r=-0.36～-0.48,均P0.01)。总量表的内部一致性Cronbachα系数为0.94,3个分量表的α系数为0.92、0.83、0.91。结论:简版心理健康连续体量表(成人版)的结构效度、效标关联效度及内部一致性信度达到了心理测量学的要求,可用于测量中国成人的积极心理健康状况。     

大学生艾滋病知识、信念、行为意向问卷的信度、效度分析

目的 :考核自编大学生艾滋病 /安全性行为知识、信念、行为意向问卷的信度和效度。方法 :基于该问卷在 5 98名大学生中的调查资料和 6 3名大学生中的重测资料 ,计算了该问卷的内部一致性、重测信度和结构效度。结果 :该问卷信度较好 ,多数部分的 Cronbachα系数达到 0 .7以上 ,重测系数基本达到 0 .6以上 ;效度尚可 ,公因子解释问卷全部内容的比例为 5 8.85 % ,与所依据理论的结构基本一致。结论 :该问卷可以用于测量大学生艾滋病 /安全性行为相关知识、信念和行为意向 ,但需进一步完善。     

糖尿病人家庭支持量表的试测

目的：编制一套适合于糖尿病患者的家庭支持量表。方法：参照Ｍｃｋｅｌｖｅｙ的糖尿病家庭行为量表，结合我国的文化背景和糖尿病人特有的情况，从家庭成员对糖尿病患者的情感支持、治疗上的指导、病情变化时给予的有效帮助这三个方面进行条目收集，请专家评审和小样本预试验形成量表初稿。对２０８例糖尿病住院病人进行测试，抽取静脉血测定糖化血红蛋白（ＨｂＡｌｃ），进一步对初稿进行检验，修改、并对量表进行信度和效度检验。     

焦虑敏感问卷中文版的信度和效度

目的:翻译和修订焦虑敏感问卷,测试中文版的信效度。方法:翻译焦虑敏感量表,通过对中学生的三次测试,对量表的因素结构、信度和效度进行了检验。结果:修编的焦虑敏感问卷中文版通过探索性因素分析将原量表由36题缩减为15题,共包括三个因素:对生理唤醒的恐惧;对认知失控的恐惧;对社会评价的恐惧;三个因素的累积贡献率为52．29％,项目的因素负荷率在0．63～0．98之间;因素彼此之间的相关在0.37～0．53之间,因素与问卷总分之问的相关在0．72～0．84之间,因素内部的相关在0．68～0．78之间。问卷在各个因素上的内部一致性系数在0.73～0．78之间．分半信度在0．71～0．76之间,重测信度在0．70～0．78之间。结论:问卷的中文简化版在中学生中具有良好的信度和效度。     

戒毒人员健康状况评定量表的初步编制和考评

目的:初步编制评价戒毒人员整体健康水平的综合多维评定量表,并检验其信度和效度。方法:根据WHO的健康定义提出理论构想,查阅相关文献,听取各专家意见,形成初始量表。对949例戒毒人员进行实测后,检验其信效度。结果:(1)通过条目分析,确定量表由120个条目组成(包括效度量表的14条),分属四个维度11个因子,生理维度(D1)35条,心理A维度(D2)26条,心理B维度(D3) 31条,社会维度(D4)14条。(2)重测相关和Cronbaehα系数各因子为0.615～0.879和0.650～0.949,各维度为0.791～0.893和0.844～0.966,总量表为0.899和0.965,所有P<0.01。(3)探索性因子分析显示,各因子的因素负荷均在0.7以上。(4)验证性因素分析结果显示,(?)~2/df=2.415,CFI=0.842,TLI= 0.838,RMSEA=0.039。(5)总量表及生理维度、心理A维度、心理B维度、社会维度得分与QOL—DA的总分及相应维度分的相关系数分别为0.682、0.539、0.698、0.153、0.687(P<0.01)。结论:初步编制的戒毒人员健康状况评定量表,信度和效度均达到了心理测量学的要求。     

TAS-R中文版的信、效度分析

目的：探讨多伦多述情障碍92年修改版本(TAS-R)中文版的适用性，并分析其信、效度。方法：随机选择无躯体化障碍的150名正常样本进行了TAS-R量表的信度、探索性因素分析等方面的分析，并通过对正常样本与临床样本的TAS-R得分比较，分析了TAS-R的内容效度。结果：TAS-R中文版有较好的信度，探索性因素分析(EFA)的结果也与国外的结果基本一致；此外正常样本中的健康人群TAS-R得分均值显著低于亚健康人群，正常样本的TAS-R得分均值也显著地低于临床样本。结论：本研究表明，TAS-R量表具有较好的信、效度，可加以推广应用，但由于本研究取样偏小，仍需对TAS-R做进一步的研究分析。     

Effectiveness of a Blended Web-Based Intervention on Return to Work for Sick-Listed Employees With Common Mental Disorders: Results of a Cluster Randomized Controlled Trial

Background

Common mental disorders are strongly associated with long-term sickness absence, which has negative consequences for the individual employee’s quality of life and leads to substantial costs for society. It is important to focus on return to work (RTW) during treatment of sick-listed employees with common mental disorders. Factors such as self-efficacy and the intention to resume work despite having symptoms are important in the RTW process. We developed “E-health module embedded in Collaborative Occupational health care” (ECO) as a blended Web-based intervention with 2 parts: an eHealth module (Return@Work) for the employee aimed at changing cognitions of the employee regarding RTW and a decision aid via email supporting the occupational physician with advice regarding treatment and referral options based on monitoring the employee’s progress during treatment.

Objective

This study evaluated the effect of a blended eHealth intervention (ECO) versus care as usual on time to RTW of sick-listed employees with common mental disorders.

Methods

The study was a 2-armed cluster randomized controlled trial. Employees sick-listed between 4 and 26 weeks with common mental disorder symptoms were recruited by their occupational health service or employer. The employees were followed up to 12 months. The primary outcome measures were time to first RTW (partial or full) and time to full RTW. Secondary outcomes were response and remission of the common mental disorder symptoms (self-assessed).

Results

A total of 220 employees were included: 131 participants were randomized to the ECO intervention and 89 to care as usual (CAU). The duration until first RTW differed significantly between the groups. The median duration was 77.0 (IQR 29.0-152.3) days in the CAU group and 50.0 (IQR 20.8-99.0) days in the ECO group (hazard ratio [HR] 1.390, 95% CI 1.034-1.870, P=.03). No significant difference was found for duration until full RTW. Treatment response of common mental disorder symptoms did not differ significantly between the groups, but at 9 months after baseline significantly more participants in the ECO group achieved remission than in the CAU group (OR 2.228, 95% CI 1.115-4.453, P=.02).

Conclusions

The results of this study showed that in a group of sick-listed employees with common mental disorders, applying the blended eHealth ECO intervention led to faster first RTW and more remission of common mental disorder symptoms than CAU.

Trial Registration

Netherlands Trial Register NTR2108; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2108. (Archived by WebCite at http://www.webcitation.org/6YBSnNx3P).     

三维人格问卷的信度和效度研究

目的:检验中文版三维人格问卷(TPQ)的信度和效度。方法:对538例正常人进行TPQ问卷调查,其中108人首次测评后3周进行重测。采用Cronbachα系数、重测相关系数及结构效度三项指标。结果:总量表、寻求刺激(NS)、躲避伤害(HA)、奖赏依赖(RD)维度的Cronbachα系数分别为0.86、0.70、0.73、0.66。总分、NS、HA、RD维度重测相关系数分别为0.78、0.85、0.84、0.70,P<0.05。验证性因素分析示GFI=0.69,NFI=0.67,NNFI=0.79,CFI=0.79,AGFI=0.67。结论:中文版三维人格问卷具有较好的信度,但结构效度欠佳。     

妇科门诊患者的精神障碍患病率调查

目的：调查综合医院妇科门诊精神障碍的患病率情况。方法：在一所综合医院的妇科门诊连续收集1626名就诊者，应用《问题导向的患者报告》进行筛查。按筛查阳性阴性各半收集其中198名就诊者，由两名精神科医师采用《简明国际神经精神检查》进行精神状况检查，并根据标准DSM-IV做出精神科诊断。结果：妇科门诊就诊患者精神障碍患病率为38％，符合两种精神障碍者为6％。各精神疾病障碍中的患病率较高的为：广泛性焦虑障碍7．38％，抑郁障碍8．76％，躯体化障碍8．40％，心境恶劣7．64％。依据DSM-IV附录条目发现的经前情绪障碍为2．85％，自杀问题（包括自杀意念或自杀未遂）5．71％。结论：妇科门诊患者的精神障碍患病率高，并且以抑郁、焦虑、躯体化等障碍和自杀问题多见。     

青少年自我同一危机量表的信度、效度检验

目的 :引进和修订台湾的青少年自我同一危机量表 ,为青少年心理健康研究提供新的工具。方法 :通过对 467名青少年样本的施测 ,检验青少年自我同一危机量表的信度和效度。结果 :此量表的再测信度在 65 5 - 912之间 ;分半信度为 60 4;同质信度为 416- 793之间。量表的构念效度和实证效度也达到了可接受的水平。     

An Internet-Based Intervention to Promote Mental Fitness for Mildly Depressed Adults: Randomized Controlled Trial

Background

Depression is a worldwide problem warranting global solutions to tackle it. Enhancing well-being has benefits in its own right and could be a good strategy for preventing depression. Providing well-being interventions via the Internet may have synergetic effects.

Objective

Psyfit (“mental fitness online”) is a fully automated self-help intervention to improve well-being based on positive psychology. This study examines the clinical effects of this intervention.

Methods

We conducted a 2-armed randomized controlled trial that compared the effects of access to Psyfit for 2 months (n=143) to a waiting-list control condition (n=141). Mild to moderately depressed adults in the general population seeking self-help were recruited. Primary outcome was well-being measured by Mental Health Continuum-Short Form (MHC-SF) and WHO Well-being Index (WHO-5); secondary outcomes were depressive symptoms, anxiety, vitality, and general health measured by Center for Epidemiological Studies Depression Scale (CES-D), Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A), and Medical Outcomes Study-Short Form (MOS-SF) vitality and general health subscales, respectively. Online measurements were taken at baseline, 2 months, and 6 months after baseline.

Results

The dropout rate was 37.8% in the Psyfit group and 22.7% in the control group. At 2-month follow-up, Psyfit tended to be more effective in enhancing well-being (nonsignificantly for MHC-SF: Cohen’s d=0.27, P=.06; significantly for WHO-5: Cohen’s d=0.31, P=.01), compared to the waiting-list control group. For the secondary outcomes, small but significant effects were found for general health (Cohen’s d=0.14, P=.01), vitality (d=0.22, P=.02), anxiety symptoms (Cohen’s d=0.32, P=.001), and depressive symptoms (Cohen’s d=0.36, P=.02). At 6-month follow-up, there were no significant effects on well-being (MHC-SF: Cohen’s d=0.01, P=.90; WHO-5: Cohen’s d=0.26, P=.11), whereas depressive symptoms (Cohen’s d=0.35, P=.02) and anxiety symptoms (Cohen’s d=0.35, P=.001) were still significantly reduced compared to the control group. There was no clear dose–response relationship between adherence and effectiveness, although some significant differences appeared across most outcomes in favor of those completing at least 1 lesson in the intervention.

Conclusions

This study shows that an online well-being intervention can effectively enhance well-being (at least in the short-term and for 1 well-being measure) and can help to reduce anxiety and depression symptoms. Further research should focus on increasing adherence and motivation, reaching and serving lower-educated people, and widening the target group to include people with different levels of depressive symptoms.

Trial Registration

Netherlands Trial Register (NTR) number: NTR2126; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2126 (archived by WebCite at http://www.webcitation.org/6IIiVrLcO).     

Reliability and Validity of Assessing User Satisfaction With Web-Based Health Interventions

BackgroundThe perspective of users should be taken into account in the evaluation of Web-based health interventions. Assessing the users’ satisfaction with the intervention they receive could enhance the evidence for the intervention effects. Thus, there is a need for valid and reliable measures to assess satisfaction with Web-based health interventions.ObjectiveThe objective of this study was to analyze the reliability, factorial structure, and construct validity of the Client Satisfaction Questionnaire adapted to Internet-based interventions (CSQ-I).MethodsThe psychometric quality of the CSQ-I was analyzed in user samples from 2 separate randomized controlled trials evaluating Web-based health interventions, one from a depression prevention intervention (sample 1, N=174) and the other from a stress management intervention (sample 2, N=111). At first, the underlying measurement model of the CSQ-I was analyzed to determine the internal consistency. The factorial structure of the scale and the measurement invariance across groups were tested by multigroup confirmatory factor analyses. Additionally, the construct validity of the scale was examined by comparing satisfaction scores with the primary clinical outcome.ResultsMultigroup confirmatory analyses on the scale yielded a one-factorial structure with a good fit (root-mean-square error of approximation =.09, comparative fit index =.96, standardized root-mean-square residual =.05) that showed partial strong invariance across the 2 samples. The scale showed very good reliability, indicated by McDonald omegas of .95 in sample 1 and .93 in sample 2. Significant correlations with change in depressive symptoms (r=−.35, P<.001) and perceived stress (r=−.48, P<.001) demonstrated the construct validity of the scale.ConclusionsThe proven internal consistency, factorial structure, and construct validity of the CSQ-I indicate a good overall psychometric quality of the measure to assess the user’s general satisfaction with Web-based interventions for depression and stress management. Multigroup analyses indicate its robustness across different samples. Thus, the CSQ-I seems to be a suitable measure to consider the user’s perspective in the overall evaluation of Web-based health interventions.     

北京居民心理健康量表的内容效度检验

目的:初步编制北京居民心理健康量表,并对其内容效度进行检验。方法:采用专家评定法,在2016年2月-2016年12月邀请21位专家对北京居民心理健康量表的条目进行评定,运用问卷的回收率和专家提出建议的百分率来表示专家的积极性,权威系数表示专家的权威程度,使用均值、变异系数、协调系数表示专家评定意见的集中程度和一致性。结果:问卷有效回收率为80.95%,专家的权威系数为0.864,所有条目均值得分为1.82~3.81,各条目变异系数的得分在0.11~0.59之间,专家的协调系数为0.22(P0.05)。删除专家评分均值较低或专家意见相差较大的条目共32项,并根据专家意见对22个条目进行了进一步的修改。结论:经过专家评定的北京居民心理健康量表具有良好的内容效度,可以用于进一步验证信效度的研究。