修订版元认知量表在精神分裂症和神经症患者中的应用分析

The application of the abbreviated metacognitive assessment scale in patients with schizophrenia and neurosis in China

目的探讨修订版元认知量表在精神分裂症和神经症患者中的应用。方法通过印第安精神疾病访谈，采用修订版元认知量表（MAS—A）对115例精神分裂症患者和89例神经症患者进行评估，比较两组间MAS—A评分差异，评估区分效度；同时采用心理理论图片任务（ToM．PST）测量被试心理理论水平，以ToM—PST总分作为效标，计算效标关联效度；首测1个月后抽取34例精神分裂症和31例神经症患者进行重测，评估重测信度。结果（1）信度分析：总样本、分裂症组和神经症组MAS-A的Combach仅系数分别为0．829、0．826、0．823。总样本MAS．A总分及其自我反省、理解他人、去中心化和控制因子分的重测信度分别为0．722、0．541、0．650、0．615、0．525，具有统计学意义（均p〈0．01）。（2）效度分析：总样本、分裂症组和神经症组MAS-A总分与ToM—PST总分问的相关系数分别为0．470、0．383、0．292，均差异具有统计学意义（均P〈0．叭）；与神经症患者相比，精神分裂症患者MAS—A总分及各因子分明显较低，差异有统计学意义（均P〈0．01）。结论修订版元认知量表的信度和效度尚可，可用于精神疾病人群的元认知能力评估。

Objective To explore the application of the abbreviated metacognitive assessment scale （MAS-A） in patients with schizophrenia and neurosis.Methods With the aid of the Indiana Psychiatric Ⅲ- Mess Interview （IPII） , 115 schizophrenic patients and 89 neurotic patients were assessed using the MAS-A, and compared the group difference of MAS-A scores. All patients were also tested with the theory of mind picture sequencing task （ToM-PST）. The criterion-related validity was evaluated using of correlated MAS-A total-score with ToM-PST total-score. 31 neurotic patients and 34 schizophrenic patients were measured after one month to compute the test-retest reliability. Results The reliability analysis showed that the Cronbach a-coefficients for MAS-A of total sample, schizophrenic group and neurotic group were 0.829,0.826,0.823, respectively. The test-retest reliability of MAS-A and four factors were 0.722,0.541,0.650,0.615 and 0.525 （all P〈0.01 ）. The validity analysis also showed that the correlation coefficient between the total scores of MAS-A and ToM-PST were 0.470,0.383,0.292 （ all P〈0.01 ） in total sample, schizophrenia and neuroses patients, respectively. Additionally, the scores of MAS-A of schizophrenia patients were significantly lower than that of neurotic patients. Conclusion MAS-A has good reliability and validity and is a valuable tool in application to metacognitive assessment for chinese mental population.