《攻击行为生活史中文版在精神分裂症患者评估中的信效度》

Chen Xia-Can, Yang Qin, Zhang Qin-Ting, Ouyang Ai-Li, Xu Jia-Jun, Yang Rui, Wang Zi-Ye, Zhai Jin-Hui, Li Yan, Qin Xiao-Rong, Hu Jun-Mei

West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China.

The Fourth People's Hospital of Chengdu, Chengdu 610036, China.

Fa Yi Xue Za Zhi. 2024 Aug 25;40(4):352-358. doi: 10.12116/j.issn.1004-5619.2023.130602.

OBJECTIVES

To provide a longitudinal evaluation tool based on the frequency of aggressive behavior for the aggression assessment of schizophrenia patients.

METHODS

The Life History of Aggression was translated and revised to form the Life History of Aggression-Chinese Version (LHA-CV) based on 369 patients diagnosed with schizophrenia in the Chengdu community and compulsory medical institution. The reliability of LHA-CV was analyzed by means of split-half reliability, test-retest reliability and inter-evaluator consistency. The validity was analyzed by item analysis, construct validity and criterion validity.

RESULTS

Item analysis found that LHA-CV had good homogeneity and discriminant validity. Exploratory factor analysis found that the Kaiser-Meyer-Olkin (KMO) test value was 0.80, and the Bartlett's sphericity test =1 203.46 (<0.05), and it revealed four factors including non-physical aggression, physical aggression, self-directed aggression and antisocial behavior/consequences. The factor loadings for all 11 items were greater than 0.40. Confirmatory factor analysis was performed on the factor model, Chi-square degree of freedom (/df) was 3.61, root mean square error of approximation (RMSEA) was 0.07, goodness-of-fit index (GFI) was 0.92, comparative fit index (CFI) was 0.90, incremental fit index (IFI) was 0.90, and the discriminant validity of each factor was good. The criterion validity test showed the total score of LHA-CV was positively correlated with the aggressive behavior level of MacArthur Community Violence Instrument, the total score of Buss-Perry Aggression Scale, and the score of Antisocial Personality Disorder Subscale of Personality Diagnostic Questionnaire-4th Edition Plus (PDQ-4+_ASPD, <0.05). The Cronbach's coefficient of non-physical aggression, physical aggression, self-directed aggression, antisocial behavior/consequences and LHA-CV total score were 0.82, 0.73, 0.74, 0.56 and 0.79, respectively. The test-retest reliability, Spearman-Brown split-half reliability and intra-class correlation coefficient of LHA-CV total score were 0.82 (<0.05), 0.66 and 0.99, respectively.

CONCLUSIONS

LHA-CV has good reliability and validity, and can be used as an evaluation tool for longitudinally assessing aggressive behavior in schizophrenia patients.

目的

提供一种基于攻击行为频率的纵向评估工具，用于评估精神分裂症患者的攻击行为。

方法

对369名来自成都社区及强制医疗机构、被诊断为精神分裂症的患者，翻译并修订《攻击行为生活史》，形成《攻击行为生活史中文版》（LHA-CV）。通过分半信度、重测信度和评估者间一致性分析LHA-CV的信度，通过项目分析、结构效度和效标效度分析其效度。

结果

项目分析发现LHA-CV具有良好的同质性和区分效度。探索性因素分析发现，Kaiser-Meyer-Olkin（KMO）检验值为0.80，Bartlett球形检验=1203.46（<0.05），揭示了包括非身体攻击、身体攻击、自我导向攻击和反社会行为/后果在内的四个因素。所有11个项目的因子载荷均大于0.40。对因子模型进行验证性因素分析，卡方自由度（/df）为3.61，近似误差均方根（RMSEA）为0.07，拟合优度指数（GFI）为0.92，比较拟合指数（CFI）为0.90，增值拟合指数（IFI）为0.90，各因子的区分效度良好。效标效度检验显示，LHA-CV总分与《麦克阿瑟社区暴力量表》的攻击行为水平、《布斯-佩里攻击量表》总分以及《人格诊断问卷第4版升级版反社会人格障碍分量表》（PDQ-4+_ASPD）得分呈正相关（<0.05）。非身体攻击、身体攻击、自我导向攻击、反社会行为/后果及LHA-CV总分的Cronbach's系数分别为0.82、0.7,3、0.74、0.56和0.79。LHA-CV总分的重测信度、Spearman-Brown分半信度和组内相关系数分别为0.82（<0.05）、0.66和0.99。