执行功能行为评定量表成人版自评问卷的信效度

Reliability and validity of the Behavior Rating Inventory of Executive Function-Adult Version Self-Report Form in China

目的:评价执行功能行为评定量表成人版(Behavior Rating Inventory of Executive Function-A-dult Version,BRIEF-A)自评问卷在我国文化背景下的适用性。方法:纳入符合ICD-10诊断的精神分裂症31例、抑郁发作38例,及符合DSM-IV-TR诊断的成人注意缺陷多动障碍(attention deficit/hyperactivity dis-order,ADHD)40例,另外选取来自北京大学医学部的2002级临床班学生及其家长、北京大学第六医院的职工、北京市九一小学学生的父母共285人为正常对照组。用BRIEF-A自评问卷(包括总分GEC、行为管理指数BRI、元认知指数MI和抑制、转换、情感控制、自我监控、任务启动、工作记忆、计划、组织、任务监控9个因子)进行施测。随机选取40例正常对照间隔3周后再次完成BRIEF-A自评问卷,以评价自评问卷的重测信度;随机选取30例正常对照和38例患者完成执行功能失常量表自评问卷(Dysexecutive Ques-tionnaire,DEX),以评价自评问卷的量表效标效度;随机选取31例正常对照和30例成人ADHD患者完成Stroop色词干扰、连线测试、Rey复杂图形记忆任务、汉诺塔、言语流畅性任务评定,以评价自评问卷的神经心理测验效标效度。结果:(1)BRIEF-A自评问卷的GEC、BRI、MI重测相关系数分别为0.85、0.86、0.78,9个因子的相关系数在0.61～0.76之间(P<0.01),GEC、BRI、MI的Cronbachα系数为0.86～0.92,各因子的Cronbachα系数为0.65～0.88(P<0.01)。(2)BRIEF-A自评问卷的GEC、BRI、MI与DEX总分的相关系数分别为0.77、0.73、0.70,9个因子与DEX总分相关系数为0.39～0.78(P<0.05)。抑制因子与Stroop第三试错误数、字义干扰时、数字字母连线测试转换时间呈正相关(r=-0.28～0.42,P<0.05),MI与言语流畅性前一分钟正确数、后一分钟正确数、正确总数、数字字母连线的转换时间呈正相关(r=0.36～0.44,P<0.05)。(3)与性别、年龄、受教育程度匹配的对照组相比,成人ADHD组(除转换、工作记忆、计划因子外)、精神分裂症组、抑郁发作组的GEC、BRI、MI和各因子原始平均分更高[如,总分成人ADHD组(1.76±0.33),对照组(1.55±0.29);P=0.004]。结论:执行功能行为评定量表成人版自评问卷具有良好的信效度,适用于我国精神疾病患者和正常人群。

Objective： To test the reliability and validity of the Behavior Rating Inventory of Executive Function-adult version （ BRIEF-A） Self-Report Form in China. Methods： A total of 109 patients [40 with adult attention deficit hyperactivity disorder, 31 with schizophrenia, and 38 with depressive episode] and 285 healthy controls were involved in this research. All of the subjects completed the BRIEF-A Self-Report Form including 9 subscales, such as global executive composite （ GEC ）, behavioral regulation index （ BRI ）, metacognition index （ MI ）, and so on. Forty healthy controls completed BRIEF-A Self-Report Form again after 3 weeks to test the test-retest reliability. Thirty healthy controls and 38 patients completed the Dysexecutive Questionnaire （ DEX） Self-Report Form, and 31 healthy controls and 30 patients were administered the performance-based tests to test the criterion related validity. Results： （ 1 ） The test-retest reliability were 0. 85, 0. 86, and 0. 78 for GEC, BRI, and MI, and 0. 61 0.76 for 9 subscales （Ps 〈0. 01 ） . The Cronbach α coefficient were 0. 86 -0.92 for GEC, BRI, and MI, and 0. 65 - 0. 88 for 9 subscales （ Ps 〈 0. 01 ） . （ 2 ） GEC, BRI, MI and 9 subscales of BRIEF-A Self-Report Form were correlated （ r = 0. 77, 0. 73, 0. 70, 0. 39 - 0. 78, Ps 〈 0. 05 ） with the total score of DEX Self-Report Form. And there were correlations （ r = - 0. 28 - 0. 44, Ps 〈 0. 05 ） between subscales of BRIEF-A and some indexes of the performance-based tests of executive function in the ADHD group and the control group. （ 3 ） Compared with the control group, the diagnostic groups （ schizophrenia and depressive episode ） got significantly higher scores almost in all subscales of BRIEF-A Self-Report Form, and adult ADHD group got significantly higher scores in GEC, BRI, MI, inhibition, emotion control, self monitoring, initiation, task monitoring, and organization of materials subscales of BRIEF-A Self-Report Form than the control group. Conclusion： BRIEF-A Self-Report Form Chinese Version has good reliabilities and validities for the healthy people and the patients with mental disorders.