性自我防卫能力评定量表在非精神发育迟滞精神障碍患者中的适用性

Applicability of Capacity of Sexual Self-defense Assessment Scale in Psychiatric Patients without Mental Retardation

目的探讨性自我防卫能力评定量表在非精神发育迟滞精神障碍患者中的适用性。方法收集性自我防卫能力评定案例87例，由经过培训的人员按照精神障碍者性自我防卫能力评定量表（CapacityofSexualSelf—defenseAssessmentScale，CSSAS）进行评分，并与专家鉴定意见进行比较。结果按照专家鉴定意见分组，有性自我防卫能力组、性自我防卫能力削弱组和无性自我防卫能力组的CSSAS评分分别为5．97±5．83、32．22±10．15、61．60±13．02，3组间的差异具有统计学意义（P〈O．01）。量表各条目得分与总分的相关系数为0．59～0．91，全量表的Cronbachd系数为0．96，拆半信度Cronbach理系数分别为0．94和0．91，两部分的相关系数为0．94。按照原始界值分，量表评定结果与专家鉴定意见的Kappa值为0．32（P〈0．01），重新划定界值分后．两者的Kappa值为0．84（P〈0．01）。因子分析共提取2个因子，方差解释率分别为46．15％和28．93％，判别函数回代94．30％的样本被正确划分。结论CSSAS可应用于非精神发育迟滞精神障碍患者的性自我防卫能力评定，但应重新修订界值分和因子的权重。

Objective To explore the applicability of Capacity ot Sexual Selt-detense Assessment Scale （CSSAS） in psychiatric patients without mental retardation. Methods Eighty-seven cases required for as- sessment of the capacity of sexual self-defense were collected and evaluated by trained professionals ac- cording to CSSAS, and the results were compared to the experts＇ opinions. Results The scores of three grades of capacity of sexual self-defense （none, limited and whole） were 5.97±5.83, 32.22±10.15 and 61.60±13.02, respectively, which were statistically significant among them （P〈0.01）. The correlation coef- ficients between items and total score were 0.59 to 0.91, the Cronbach＇s oL value was 0.96, the spilt half Cronbach＇s value were 0.94 and 0.91, respectively, and the relation coefficient between them was 0.94. According to the original cut off scores, the Kappa value between scale results and experts＇ opinions was 0.32 （P〈0.01）. By redefining the cut off scores, the Kappa value was improved to 0.84 （P〈0.01）. Two factors were extracted by means of the factor analysis. The explanation rates of variance were 46.15% and 28.93%, respectively. The accuracy of retrospective cumulative square was 94.30%. Conclusion The CSSAS could be applied in the psychiatric expertise of the capacity of sexual self-defense in psychiatric patients without mental retardation; however, the cut off scores and the factor weight should be redefined.