操作性心理动力学诊断中文量表信度和效度

The reliability and validity of operationalized psychodynamic diagnostics system

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。

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 psychia- trists 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 validi- ty of OPD-2 Chinese version was satisfying. The OPD-2 Chinese version could be used in clinical practice.