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流调中心抑郁量表中文简版的编制
其他题名Developing Short Forms of the Center for Epidemiologic Studies Depression Scale
何津
学位类型硕士
导师陈祉妍
2014-05
学位授予单位中国科学院研究生院
学位授予地点北京
学位专业心理学
关键词流调中心抑郁量表 等距简版 筛查简版 常模 流划界分
摘要流调中心抑郁量表(the Center for Epidemiologic Studies Depression Scale,简称CES-D)是以正常人群为目标群体的抑郁测量工具,在抑郁研究和临床筛查中得到广泛使用。CES-D翻译引进后有一些条目存在问题,量表长度也有改进简化的空间,随着研究的深入和统计方法的发展,对量表测量得分的要求越来越高,因此,本研究即针对中文CES-D量表条目存在的问题进行了改进,编制了两个不同版本的简化量表。
本研究样本包括106个临床抑郁患者,217个其他精神疾患,以及共30393的全国代表性普通人群,使用Rasch模型中的评定量表模型分析量表条目的难度及拟合度,使用独立样本t检验分析条目对临床抑郁样本和匹配的正常人群的区分程度,根据以上两个指标选择简版条目,并进行简版量表的信效度检验和常模分析。研究编制了两个CES-D简化版本,主要结果如下:
1. 等距简版包括9个条目,采用3点计分。条目Location值在0.42~1.87之间;在各全国各年龄段样本中信度在0.80~0.83,重测信度为0.49,条目与总分相关在0.44~0.59;与BDI相关的校标效度为0.54(P<0.001),首诊抑郁得分显著高于服药抑郁(t=3.75,P<0.001),简版量表总分与原20题总分相关在0.92~0.93间。简版的得分在全国普通人群中不具有显著的性别差异;抑郁的年龄差异显著,11~30岁及46~60岁抑郁水平最低,60岁以上的老年人抑郁水平最高。
2. 筛查简版包括9个条目,采用4点计分。在各全国各年龄段样本中信度在0.85~0.88,重测信度为0.49,条目与总分相关在0.51~0.69;与BDI相关的校标效度为0.61(P<0.001),首诊抑郁得分显著高于服药抑郁(t=4.76,P<0.001),简版量表总分与原20题总分相关在0.94~0.96间。筛查简版以10分为抑郁倾向划界分,以17分为抑郁高风险划界分。筛查简版常模的性别差异和年龄差异与等距简版结果相同。
本研究所编制的CES-D等距简版条目难度分布均衡,信效度良好,为抑郁的研究提供了可靠的测量工具;编制的筛查简版信效度良好,为全国大规模筛查提供了简便有效的工具,并且提供了可靠的划界分和常模参考标准。
其他摘要The Center for Epidemiologic Studies Depression Scale (CES-D) is a widely applied depression measurement tool for non-clinical sample. In depression studies and screening practices, some items in its Chinese forms exhibited problems which impair the effectiveness of CES-D. Simplified modification on the original full scale is also demanded to improve the utility and precision. The present study intended to develop short versions of CES-D in order to offer reliable, accurate and economic measurement tools for researchers and psychiatrists.
The samples in this study include a clinical sample (contains of 106 depressed patients and 217 patients with other mental diseases) and a national-wide community sample in China (contains of 30393 samples). The Rasch model was used to estimate the severity level of scale items and independent t-test was applied to detect the most robust items which can identify the depressed patients from non-clinical samples.
Two short forms were built:
1. The equal-interval short version of CES-D offering equal-interval score for non-clinical researches includes 9 items with 3-point scoring. The internal consistent reliabilities in both clinical and community samples ranged from .80 to .82 and the test-retest reliability was .49 (P<0.001). Both the reliabilities and validities of these two forms met the requirement. All item-total correlations were among .44 to .59. The correlation, as the indicator of criterion validity, between Beck depression inventory and equal-interval short version was .54(P<0.001). The sum scores of initial diagnosis depressed patients were significantly higher than treated depressed patients. The national norm showed significant age difference and non-significant gender difference. Individuals aged from 11 to 30 and 46 to 60 reported the lowest depression level. The olds above 60 year old reported the highest level of depression.
2. The screening short version of CES-D offered a screening tool for psychiatrists to identify individuals with depressive risk in large samples. It includes 9 items with 4-point scoring. The internal consistent reliabilities ranged from .85 to .88 and the test-retest reliability was .49 (P<0.001). All item-total correlations were among .51 to .69. The correlation, as the indicator of criterion validity, between Beck depression inventory and equal-interval short version was .61(P<0.001). The sum scores of initial diagnosis depressed patients were significantly higher than treated depressed patients. The national norm showed same pattern with the results of equal-interval version.
Both the reliability and validity of these two versions met the requirement of putting into research and clinical practice. The present study achieved to provide two Chinese short version of CES-D to increase the efficacy and precision of depression research and screening application.
学科领域发展与教育心理学
语种中文
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/19528
专题认知与发展心理学研究室
作者单位中国科学院心理研究所
推荐引用方式
GB/T 7714
何津. 流调中心抑郁量表中文简版的编制[D]. 北京. 中国科学院研究生院,2014.
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