操作性心理动力学诊断中文量表信度和效度

目的 评价操作性心理动力学诊断(第二版)(OPD-2)中文评估量表的信度和效度.方法 收集116例患者临床访谈后进行操作性心理动力学诊断评估.抽取其中的66例在3～5周后再次进行评估;抽取33例由2名评估者进行评估.抽取50例由2位主任医师进行临床的心理冲突诊断,检验一个轴的关联效度.对其他三个轴检验结构效度.结果 (1)2名评定者的一致性在轴Ⅰ的平均Kappa值为0.48(Kappa值范围0.24～0.72);轴Ⅱ平均Kappa值为0.51(Kappa值范围0.41～0.67);轴Ⅲ平均Kappa值为0.65(Kappa值范围0.39～0.84);轴Ⅳ平均Kappa值为0.51(Kappa值范围0.42～0.60).(2)重测一致性在轴Ⅰ中平均Kappa值为0.85(Kappa值范围0.64～0.96);轴Ⅱ平均Kappa值为0.90(Kappa值范围0.84～0.95);轴Ⅲ平均Kappa值为0.81(Kappa值范围0.65～0.91);轴Ⅳ平均Kappa值为0.93(Kappa值范围0.87～0.98).(3)轴Ⅰ提取的6个公因子共解释了70.16%的方差变异;轴Ⅱ提取的4个公因子的总方差贡献率为51.57%;轴Ⅲ与临床诊断的关联效度kappa值为0.64;轴Ⅳ提取的4个公因子共解释了79.92%的方差变异.结论 OPD-2中文评估量表具有较好的信度和效度,可用于我国心理治疗临床实践.

The reliability and validity of operationalized psychodynamic diagnostics system

Objective To study the reliability and validity of operationalized psychodynamic diagnositic(OPD-2) Chinese version system.Methods 116 subjects were evaluated after a clinical interview. 66 patients of the subjects were interviewed again with OPD-2 Chinese version after 3-5 weeks. And 33 patients were interviewed by two raters at a time. The construct validities of 3 axes were explored. 50 patients were diagnosed by psychiatrists before the OPD-2 interviews in order to explore the criterion validity of one axis.Results (1)The interrater reliabilities in axis I of OPD-2 Chinese version varied from 0.24 to 0.72,the median Kappa was 0.48;the interrater reliabilities of axis II varied from 0.41 to 0.67,the median Kappa was 0.51;the interrater reliabilities of axis III varied from 0.39 to 0.84,the median Kappa was 0.65;the interrater reliabilities of axis IV varied from 0.42 to 0.60,the median Kappa was 0.51. (2)The test-retest reliability coefficients in axis I of OPD-2 Chinese version were 0.64'0.91,the median Kappa was 0.85; the test-retest reliability coefficients of axis II were 0.84'0.95,the median Kappa was 0.90; the test-retest reliability coefficients of axis III were 0.65'0.91,the median Kappa was 0.81; the test-retest reliability coefficients of axis IV were 0.87'0.98,the median Kappa was 0.93. (3)Factor analysis revealed that 6 initial eigenvalues could explain 70.16% of total square of axis I; factor analysis revealed that 4 initial eigenvalues could explain 51.57% of total square of axis II; agreement on conflict of axis III was good between OPD-2 Chinese version and clinical diagnosis,Kappa was 0.64; factor analysis revealed that 4 initial eigenvalues could explain 79.92% of total square of axis IV.Conclusion Totally,the reliability and validity of OPD-2 Chinese version was satisfying. The OPD-2 Chinese version could be used in clinical practice.