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用于评估神经心理状态的重复性成套测验作为精神分裂症筛查测试的研究II:聚合效度/区分效度及诊断组比较

Repeatable battery for the assessment of neuropsychological status as a screening test in schizophrenia, II: convergent/discriminant validity and diagnostic group comparisons.

作者信息

Hobart M P, Goldberg R, Bartko J J, Gold J M

机构信息

Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland at Baltimore, 21228, USA.

出版信息

Am J Psychiatry. 1999 Dec;156(12):1951-7. doi: 10.1176/ajp.156.12.1951.

Abstract

OBJECTIVE

In a companion article in this issue of the Journal, the authors presented data suggesting that the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is sensitive to the types of impairments observed in schizophrenia, correlates highly with standard measures of intelligence and memory, and is related to employment status in a group of patients with schizophrenia drawn from a tertiary care research center. The objectives of the current study were 1) to determine if evidence of the convergent validity of the RBANS could be replicated in a diagnostically heterogeneous sample drawn from a public mental health system, 2) to examine the relationship of the RBANS to a broad neuropsychological battery, and 3) to compare the performance of patients with schizophrenia and patients with bipolar disorder on a neuropsychological battery and the RBANS.

METHOD

The RBANS and a standard neuropsychological battery, including the WAIS-III and Wechsler Memory Scale, 3rd ed. (WMS-III), were given to 150 patients drawn from a larger study of vocational rehabilitation.

RESULTS

Correlations of RBANS total scores with WAIS-III and WMS-III variables were highly similar across study groups. The RBANS correlated highly with a composite z score derived from 22 standard measures of IQ, memory, language, motor, attention, and executive function. Principal component analyses of the neuropsychological battery resulted in a six-factor solution: the RBANS correlated most highly with a general ability factor and had limited correlations with measures of motor performance, vigilance, and executive function. Patients with schizophrenia demonstrated greater deficits on the neuropsychological battery and the RBANS than patients with bipolar disorder.

CONCLUSIONS

These data suggest that the RBANS is a useful screening instrument for assessing the severity of cognitive impairment in psychiatric populations.

摘要

目的

在本期《期刊》的一篇相关文章中,作者呈现的数据表明,用于评估神经心理状态的可重复性成套测验(RBANS)对精神分裂症中观察到的损伤类型敏感,与智力和记忆的标准测量高度相关,并且与从三级护理研究中心抽取的一组精神分裂症患者的就业状况相关。本研究的目的是:1)确定RBANS的收敛效度证据是否能在从公共心理健康系统抽取的诊断异质性样本中得到复制;2)检验RBANS与广泛的神经心理成套测验之间的关系;3)比较精神分裂症患者和双相情感障碍患者在神经心理成套测验和RBANS上的表现。

方法

对从一项更大规模的职业康复研究中抽取的150名患者进行了RBANS和标准神经心理成套测验,包括韦氏成人智力量表第三版(WAIS - III)和韦氏记忆量表第三版(WMS - III)。

结果

各研究组中RBANS总分与WAIS - III和WMS - III变量的相关性高度相似。RBANS与从22项智商、记忆、语言、运动、注意力和执行功能的标准测量得出的综合z分数高度相关。对神经心理成套测验进行主成分分析得到了一个六因素解决方案:RBANS与一般能力因素相关性最高,与运动表现、警觉性和执行功能测量的相关性有限。精神分裂症患者在神经心理成套测验和RBANS上的缺陷比双相情感障碍患者更大。

结论

这些数据表明,RBANS是评估精神科人群认知损伤严重程度的一种有用的筛查工具。

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