强迫闯入问卷修订版在中国大学生和临床样本中的应用

Psychometric Validation of Revised Obsessive Intrusive Inventory in Chinese College Students and Clinical Sample

目的:将强迫闯入问卷修订版(ROII)引入中国,检验其在中国大学生和临床样本中的信效度与因素结构,并考察其诊断敏感性,建立量表的临床分界点。方法:通过方便取样对1545名大学生和169焦虑症的门诊患者进行测查;严格按照双盲方法对问卷进行翻译;选用强迫量表修订版、帕多瓦量表、焦虑自评量表以及流调中心用抑郁量表作为效度量表;使用受试者工作特征曲线分析诊断敏感性。结果:验证性因素分析发现大学生样本和临床样本都支持原有的两因素模型(自发性强迫与反应性强迫)。总量表内部一致性系数为0.94-0.99,重测信度为0.70,聚合效度(0.36-0.67)、效标效度较好(P<0.05),区分效度可接受(0.10-0.40)。总量表在非临床样本(AUC=0.75,95%CI=0.70-0.80)和临床样本(AUC=0.59,95%CI=0.50-0.69)中均有很好的诊断敏感性,分界点分别为17.5和20.5。结论:强迫闯入问卷修订版在中国大学生和临床样本中都表现出良好的信效度和稳定的因素结构,且具有较好的诊断敏感性,可以在中国文化下使用,并尝试作为临床评估的辅助工具。

Objective： To revise the Revised Obsessive Intrusive Inventory（ROII） in Chinese college student sample and clinical sample to test the factor structure, psychometrics properties, diagnostic sensitivity and establish a cutoff score. Methods： 1545 college students and 169 Patients with anxiety disorders were tested with a measuring battery including ROII, Obsessive Compulsive Inventory-Revised, Padua Inventory, Center for Epidemiologic Studies Depression Scale and Zung Self-Rating Anxiety Scale. The diagnostic sensitivity was tested by using Receiver Operating Characteristic Curve analysis. Results： Confirmatory factor analysis supported the two-factor model in both students and clinical sample, sugget- ing the two-factor structure has cross-cultural consistency and stablity. Internal consistency coefficient ranged from 0.94 to 0.99; test-retest reliability coefficient is 0.70; convergent validity（0.36-0.67） and criterion validity（P〈0.05） are good, dis- criminate validity（0.10-0.40） can be accepted. It has good diagnostic sensitivity in both nonclinical sample（AUC=0.75, 95% CI=0.70-0.80） and clinical sample（AUC=0.59, 95%CI=0.50-0.69）; cutoff scores are 17.5 and 20.5 respectively. Conclu- sion： The Revised Obsessive Intrusive Inventory shows good psychometrics properties and stable structure in both Chinese college students and clinical sample. It has a good diagnostic sensitivity and can be used in Chinese culture.