儿童佛罗里达强迫问卷的修订

Revision of the Children' s Florida Obsessive Compulsive Inventory

目的:修订儿童佛罗里达强迫问卷(C-FOCI)并检验其信度和效度。方法:采用方便取样。选取小学四年级到高中三年级学生共4293名(年龄8～18岁)组成学校样本组;收集同期在中国医科大学盛京医院心理门诊就诊,按美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)标准诊断为强迫障碍的儿童40人(年龄9～18岁)组成强迫障碍组。所有样本完成C-FOCI,莱顿强迫问卷(儿童版)(LOI-CV)、儿童焦虑性情绪障碍筛查表(SCARED)、儿童抑郁量表(CDI)。利用学校样本进行内部一致性检验、探索性因素分析。利用学校样本分析C-FOCI和LOI-CV、SCARED、CDI的相关性,以检验平行效度。间隔4周后,79名在校高一学生再次完成C-FOCI以检验重测信度。利用所有样本制定C-FOCI的划界分。结果:C-FOCI分为症状清单和严重度量表两部分。强迫障碍组所有量表得分均高于学校样本组(P<0.001)。C-FOCI症状清单包括17个条目,Cronbachα系数为0.81,重测信度0.70;C-FOCI严重度量表包括5个条目,Cronbachα系数为0.85,重测信度0.65,P<0.001。对症状清单进行探索性因子分析析出4个因子,可解释总变异的45.8%。C-FOCI症状清单得分和严重度量表得分均与LOI-CV、SCARED、CDI得分呈正相关(r=0.34～0.55,均P<0.001)。症状清单对强迫障碍儿童的诊断划界分为7分,灵敏度为67.5%,特异度为73.3%;严重度量表的诊断划界分为7分,灵敏度为90.0%,特异度为77.3%。结论:修订的儿童佛罗里达强迫问卷具有良好的信度和效度,可用于我国儿童强迫症状及严重程度的评估。

Objective： To revise the Children＇s Florida Obsessive Compulsive Inventory （C-FOCI） and to test its reliability and validity. Methods： Totally 4293 subjects aged 8 - 18 years were selected as school group by convenient sampling, and 40 children aged 9 - 18 years meeting the Obsessive-Compulsive Disorder （OCD） diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition （DSM-IV） were included as OCD group. All subjects completed the Children＇s Florida Obsessive Compulsive Inventory （C-FOCI）, Leyton Obsessional Inventory-Child Version （LOI-CV）, Screen for Child Anxiety Related Emotional Disorders （SCARED）, and Children＇s Depression Inventory （CDI）. Subjects in school group were assessed for internal consistency analysis and exploratory factor analysis （EFA）, and were used to assess the parallel validity of C-FOCI to LOI-CV, SCARED, and CDI. Four weeks later, 79 senior one students completed C-FOCI again to test the test-retest reliability. All subjects were used to ascertain the demarcation point by ROC curve. Results： The C-FOCI included two parts of symptom checklist （ 17 items） and severity scale （5 items）. The OCD group scored higher in all scales than the school group （Ps 〈 0. 001）. The Crobach a and the test-retest reliability of C-FOCI Symptom Checklist were 0. 81 and 0. 70 respectively. The Crobach α and the test-retest reliability of C-FOCI severity scale were 0. 85 and 0. 65 respectively. The explore factor analysis of C-FOCI symptom checklist showed that KMO was 0. 89, and 45. 8 % of the total variation could be explained by 4 factors. The C-FOCI scores were moderately correlated with LOI-CV, SCARED, and CDI. For the diagnosis of children with OCD, the demarcation point of C-FOCI symptom checklist was 7 scores, and the sensitivity and specificity of C-FOCI symptom checklist were 67.5% and 73.3% ; the demarcation point of C-FOCI severity scale was 7 scores, and the sensitivity and specificity of C-FOCI severity scale were 90. 0% and 77.3%. Conclusion： The revised Children＇s Florida Obsessive Compulsive Inventory （C- FOCI） has good reliability and validity, and is applicable to assess obsessive-compulsive disorder in Chinese children.