脑外伤后人格改变评定量表的编制与信效度分析

Reliability and validity of scale of personality change after post-traumatic brain injury

目的编制脑外伤后人格改变评定量表，并制定条目的评分细则，确定不同程度人格改变的等级划界分，为脑外伤后人格改变的客观评估提供标准化评定工具。方法根据器质性人格改变的基本概念、诊断标准及临床特征，结合临床实践经验，编制脑外伤后人格改变评定量表及评分细则，对相关被试进行初试、修改及条目筛选后，再用于排除了伪装等（有影响评定结果）的脑外伤后精神伤残鉴定案例。结果（1）量表总分对无人格改变、轻度人格改变、中度人格改变及重度人格改变划界分分别为≤6分、7～14分、15～21分、≥22分。（2）全量表的Cronnbaeh’sα系数为0．876，Guttman分半信度为0．847，重测相关在0．972，评分者相关在0．965以上。（3）与专家诊断比较，对有无人格改变的评定特异性96．9％，灵敏度99．4％，总准确率97．9％。结论编制的脑外伤后人格改变评定量表符合心理测量学的基本要求，能为脑外伤后有人格改变的伤残鉴定案例提供量化的客观依据。

Objective To develop a reliable measure to determine personality change after traumatic brain injury,and the Scale of Personality Change Post-traumatic Brain Injury （SPCFFBI） was published with detailed items for determining different degree. Methods SPCPTBI was conducted by concept, diagnoses criteria and clinical feature about organic personality change. Final items was decided after initial usage and modification. It was administered to patients undergoing evaluation of mental impairment and permanent impairment degree, not including those malingering. Results （1） The cut score of assessing existence and different degree of personality change separately was ≤6,7 - 14,15 -21, ≥22. （2）The Cronbach＇ s α coefficients of SPCPTBI was 0. 876. The split-half reliability was 0. 847. The test-retest reliability were more than 0. 972. The scorer reliability were more than 0.965. （3）The total accuracy rate of SPCPTBI for evaluating all subjects based on the experts diagnosis, and with 96.9% of specificity and 99.4% of sensitivity for evaluating personality change after traumatic brain injury. Conclusion The SPCPTBI has acceptable psychometrics properties on reliability and validity. It is a clinically re- liable measure to determine the personality change after traumatic brain injury.