精神活性物质使用问题筛查量表中文版的信效度

Reliability and validity of the Chinese version of Alcohol,Smoking,and Substance Use Involvement Screening Test

目的:初步评估精神活性物质使用问题筛查量表(Alcohol,Smoking,and Substance Use In-volvement Screening Test,ASSIST)中文版的信度与效度。方法:采用横断面研究的方法对122名精神疾病与药物依赖者进行ASSIST与DSM-IV轴I诊断用定式临床检查手册病人版(Structured Clinical Interview for DSM-IVAxisI Disorders-Patient Edition,SCID-I/P)访谈,其中73例进行两位评定者独立评估获取评定者间一致性信息,并在一周后由同一评定者对上述73例对象重新评估获取重测信度。用受试者工作特征曲线(ROC)分析确定ASSIST的预测临界值,并以SCID诊断结果作为效标,评定ASSIST的效度。结果:AS-SIST对筛查所涉及的10类精神活性物质评分者一致性较高(ICC内部相关系数均>0.90),重测信度也较高(ICC内部相关系数>0.90,Spearman等级相关系数>0.80,Kappa值>0.77)。采用ROC工作特征曲线法确定的诊断界值与ASSIST的分界值也具有较高的一致性,除酒精依赖外(Kappa值:0.56),ASSIST筛查结果与SCID物质依赖诊断一致性较高(Kappa值:0.94～1.00)。结论:精神活性物质使用问题筛查量表中文版在我国具有较好的信效度,可用于临床工作中对烟草、酒精及其他精神活性物质使用问题的筛查。

Objective： To evaluate the reliability and validity of the Chinese version of Alcohol, Smoking, and Substance Use Involvement Screening Test （ASSIST） . Methods： A total of 122 participants with mental health disorders and substance dependence were assessed with the ASSIST and Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition （ SCID-I/P ） . The test-retest reliability, inter-rater reliability was analyzed by using ICC, Spearmman rank correlation coefficient, Kappa value and efficiency. The ROC procedure and the largest Youden index were used to explore the cut-off scores. Based on the results from ROC, the diagnoses criteflon-related validity was determined by Kappa and efficiency, where diagnoses were made by SCID. Results： The test-retest and inter-rater reliability were both good, and all indices were above 0. 90 （P 〈 0. 001 ） . The diagnoses criterion-related validity with the SCID was confirmed well （ Kappa = 0. 94 - 1.00, P 〈 0. 001 ） for all included substances except alcohol dependence （ Kappa = 0. 56 ） . Confusion ： The Chinese version of ASSIST shows acceptable reliability and validity. It is a promising assessment tool to evaluate substance abuse in future clinical practice and research.