儿童应激障碍检查表中文版的效度、信度

Validity and reliability of the Chinese version of the Child Stress Disorders Checklist

目的：引进儿童应激障碍检查表（CSDC）,分析其中文版的信效度,探讨其用于评估中国儿童创伤后应激症状严重程度的可能性.方法：选取3所学校1180例儿童,其中全部儿童家长填写CS-DC,410例儿童填写修订版儿童事件影响量表（CRIES）,70例儿童由精神科医生使用临床医生使用的创伤后应激障碍量表-儿童和青少年版（CAPS-CA）进行访谈.另外选取24例6～15岁新华医院儿科住院儿童（接受白血病化疗或曾做过手术）,家长填写CSDC,儿童由精神科医生使用CAPS-CA进行访谈.共获得有效CSDC 539份,有效CRIES 89份,有效CAPS-CA 41份.其中515份有效CSDC、89份有效CRIES、17份有效CAPS-CA来自学校儿童.使用CRIES和CAPS-CA作为效标检验效标效度,从515例有效填写CSDC的家长中方便选取50例,间隔2周再次填写CSDC,检验重测信度.结果：在效标效度检验中,CSDC总分与CRIES总分、CAPS-CA总分呈正相关（r=0.50、0.65,均P〈0.01）.CSDC再体验因子分与CAPS-CA再现症状因子分,CSDC回避因子分与CAPS-CA总分及回避和麻木症状因子分,CSDC麻木和解离因子分与CAPS-CA总分及回避和麻木症状因子分,CSDC警觉性增高因子分与CAPS-CA总分及警觉性增高症状因子分,CSDC功能损害因子分与CAPS-CA总分呈中度正相关（r=0.42～0.68,均P〈0.01）.CSDC重测信度为0.75,内部一致性Cronbach α系数为0.92,分半信度为0.83.CSDC各因子分与总分之间、各因子分之间呈正相关（r =0.40 ～0.88）.结论：CSDC中文版具有较好的效度、信度,可用于我国儿童创伤后应激症状严重程度的评估.

Objective： To revise the Child Stress Disorders Checklist （CSDC） into Chinese version, assess the validity and reliability, and explore the possibility of using it to measure post-traumatic stress symptoms in Chinese children. Methods： Totally 1180 children aged 2 - 18 years were selected from 3 schools in Shanghai and 24 hospitalized children aged 6 - 15 years, who had undergone chemotherapy of leukemia or surgical operation, were selected from department of pediatrics of Shanghai Xinhua hospital. All of their parents were asked to complete the CSDC, and 410 of the 1180 children filled in the Children＇s Revised Impact of Event Scale （CRIES）, and 70 of the 1180 students and the 24 hospitalized children were interviewed by psychiatrists with the Clinician-Administered PTSD Scale for Children and Adolescents （CAPS-CA）. Finally, 539 completed CSDC, 89 completed CRIES, and 41 valid CAPS-CA were received. Five hundred and fifteen completed CSDC, 89 completed CRIES, and 17 valid CAPS-CA were from school students. The criterion validity was determined through an examination of the relationship between the CSDC scores and scores on the other two instruments for assessing post-traumatic stress disorder in children （CRIES and CAPS-CA）. The CSDC was completed again by 50 parents from 515 parents 2 weeks later to test the test-retest reliability. Results： In the criterion validity test, the CSDC total score was positively correlated with the total scores of the CRIES and the CAPS-CA （r =0. 50, 0. 65; Ps 〈0. 01）. The CSDC reexperiencing factor score was positively correlated with the CAPS-CA reexperiencing symptoms factor score, the CSDC avoidance fac- tor score was positively correlated with the CAPS-CA total score and the CAPS-CA avoidance and numbing symp- toms factor score, the CSDC numbing and dissociation factor score was positively correlated with the CAPS-CA to- tal score and the CAPS-CA avoidance and numbing symptoms factor score, the CSDC increased arousal factor score was positively correlated with the CAPS-CA total score and the CAPS-CA hyperarousal symptoms factor score, the CSDC impairment in functioning factor score was positively correlated with the CAPS-CA total score （r = 0. 42 - 0. 68, Ps 〈 0. 01）. The test-retest reliability coefficient of the CSDC was 0. 75, the Cronbach＇s alpha coefficient was 0.92, and the split half reliability coefficient was 0. 83. The CSDC total score was correlated with all factor scores of the CSDC, and each factor score on the CSDC was also found to be correlated to each other （ Spearman rank cor- relation coefficient was 0.40 - 0. 88）. Conclusion： The CSDC has valid and reliable psychometric properties. It can be used to assess post - traumatic stress symptoms of children in China.