精神障碍病史可信度评定量表的编制与信效度检验

目的编制《精神障碍病史可信度评定量表》，并进行信效度检验，作为适用于各种医疗活动、司法鉴定的病史可信度评定工具。方法（1）根据甄别病史可信度的经验，并参考有关研究及文献，编制适用于各种病史提供者的精神障碍病史可信度评定量表及各条目评分细则；（2）将该量表应用于随机抽取的600例精神障碍患者或司法鉴定案例；（3）同时由患者（或被鉴定人）及其病史提供者分别完成简易精神症状自陈量表（伪装精神症状评定工具）。结果（1）全量表的Cronbachg饯系数为0．901；Guttmann分半信度（间隔顺序分半）为0．924，Guttmann分半信度（前后顺序分半）为0．803，重测和评分者间各条目及总分相关在在0．588以上（P〈0．01）。（2）量表的三级划界分为：总得分≤11分为不太可信；12—22分为部分可信；t〉23分为基本可信。（3）与专家诊断比较，量表评定为不太可信、部分可信和基本可信的准确率分别为86．1％、95．2％和98．9％，总准确率94．8％。（4）全量表总分、第二部分总分和第三部分总分与病史提供者完成的简易精神症状自陈量表总分Pearson相关系数分别为为一0．776、一0．699和一0．816（均P〈0．01）。结论编制的精神障碍病史可信度评定量表信效度参数指标符合心理测量学的基本要求，能够做为精神科临床中病史是否可靠，提供客观量化的评定工具。

Reliability and validity of the rating scale of the reliability in mental disorder medical history

Objective To examine the reliability and validity of the Rating Scale of the Reliability in Mental Disorder Medical History （RSRMDMH） in order to develop a reliable measure to determine the reliability in mental disorder medical history. Methods RSRMDMH was conducted by concept, clinical feature in mental disorder medical history and assessment scales for malingering and compensationneurosis. Final 14 items was de- cided after initial usage and modification. It was administered to 600 subjects including the cases involved forensic problems,patients in general psychiatric clinic. Results （~）The Cronbach＇ s ct coefficients of RSRMDMH was 0.901. The split-half reliability was 0. 803-0.924. The test-retest reliability and scorer reliability were more than 0. 588 （P〈 0.01 ）. ~）The cut score of assessing different degree of the reliability in mental disorder medical history separately was ~〈 11,12-22, t〉23. ~）Based on the experts diagnosis ,the accuracy rate of RSRMDMH for evaluating different degree of the reliability in mental disorder medical history were more than 86.1%, and total accuracy rate was 94.8%. @Correlation analysis showed significantly correlation between RSRMDMH and assessment scales for malingering（ self-report scale of brief psychopathological symptoms,SBPS）. Conclusion The RSRMDMH has ac- ceptable psychometrics properties on reliability and validity. It is a clinically reliable measure to determine the re- liability in mental disorder medical history.