思维、语言和交流评定量表(TLC)的信度和效度研究

The reliability and validity of the Scale for Thought,Language and Communication(TLC) in Chinese psychosis

目的评价思维、语言和交流评定量表(TLC)中文译本的信度和效度。方法对46例精神障碍住院患者评定,应用Alpha模型和Split-Half模型评定TLC的内在信度,1周或2周后重测评定其外在信度。以临床评定的思维形式障碍和阳性与阴性症状量表(PANSS)评分作为效标评定TLC的效度。结果①内在信度:α信度系数为0.82,折半信度系数为0.90。②外在信度:重测信度系数除了TLC18偏低外,其余各项均大于0.7,TLC总评和总分的重测信度系数分别为0.82和0.96;评分者一致性系数除了TLC18和TLC14偏低外,其余各项均大于0.7,TLC总分的一致性系数高达0.99。③临床评定的思维形式障碍和TLC总评及总分的相关系数分别为0.92和0.75,以TLC总分≥7分为界值,TLC诊断的敏感度和特异度分别为91.9%和88.9%。④TLC总分或总评与PANSS总分、阳性量表分、思维障碍分、认知因子和兴奋因子等均显著相关(P均<0.01)。结论TLC量表中文译本具有较好的信度和效度。

Objective： To evaluate the reliability and validity of the Scale for Thought, language and Communication （ TLC ）. Methods： Forty - six mental disorder patients were recruited and evaluated using TLC. Data were analyzed for internal consistency, split - half reliability, test - retest reliability and interrater reliability. And the TLC validity with clinical assessment and Positive and Negative Syndrome Scale（PANSS） were also evaluated. Results：The internal consistency coefficient was 0.82, the splif-half reliability was 0.90, the test - retest reliability were 0. 50 - 1.00, the interrater reliability were 0. 33 - 1.00. The correlation coefficients between TLC score and clinical assessment were 0.92 （ for TLC global rating） and 0.75 （ for TLC total score）. TLC global rating or TLC total score were highly correlated with the PANSS total score, positive subscale score, thought disturbance syndrome, cognitive factor and excitement factor （ P 〈 O. O1 ）. Conclusion： These finding support the use of Chinese version of TLC for formal thought disorder among Chinese mental disorder patients with good reliability and validity.