暴力历史、临床、风险评估量表中文版信效度研究

The Reliability and Validity of the Historical, Clinical, Risk Management-Chinese Version

目的:对暴力历史、临床、风险评估量表中文版(HCR-CV)进行信效度研究。方法:HCR-CV信效度研究的受试者由156例男性住院精神分裂症患者组成,2周后接受重测。评定者一致性由两名精神科医生评价了12例精神分裂症患者。最后HCR-CV包含19个条目,其Cronbach’sα系数为0.584～0.775;评定者一致性系数为0.820～0.965;总量表及各分量表重测信度为0.523～0.953;条目与分量表的相关系数为0.264～0.836;对二周暴力的预测效度AUC为0.600～0.732,其中总量表分AUC为0.721,截断值为21,敏感性为60.00%,特异性为77.30%,分类正确率为75.64%;历史分量表分AUC为0.732,截断值为10分,敏感性为53.33%,特异性为90.07%,分类正确率为86.54%。校标效度:与MOAS及PCL-R总分及因子分相关具有统计学意义(P<0.05)。结论:HCR-CV修订后在男性住院精神分裂症患者的危险性评估中仍有良好的信度与效度,具有较好的适用性。

Objective： To examine the reliability and validity of the Chinese Version of the Historic Clinical Risk man- agement （HCR-CV） in Chinese inpatients with schizophrenia. Methods： The psychometric study included 156 schizo- phrenic inpatients recruited from Nanjing Brain Hospital, all subjects participated in the retest reliability assessment after 2 weeks. Twelve schizophrenic inpatients participated in the inter-ratter reliability assessed by two psychiatrists. Results： The Cronbach＇ set coefficients of the HCR-CV ranged from 0.584 ~ 0.746; inter-rater consistency coefficients ranged from 0.820 ~ 0.965; the test-retest reliability coefficients ranged from 0.523 ~ 0.953; the correlation coefficient between item and factor ranged from 0.264 ~ 0.836; AUC of total scores and subscale scores ranged from 0.600 ~ 0.732, the AUC of total scores of HCR-CV was 0.721, cut-off was 21, and sensitivity and specificity were 60.00%, 77.30% respectively, correctly classification was 75.64%. AUC of historic subscale score was 0.732, cut-off was 10, and sensitivity and specificity were 53.33%, 90.07% respectively, correctly classification was 86.54%. Criterion-related validity： The total score and subscale scores of HCR-CV were related with scores of MOAS and PCL-R significantly. Conclusion： The HCR-CV is an efficient and valid instrument for violence risk assessment in Chinese inpatients with schizophrenia.