Dell'Osso Liliana, Rucci Paola, Cassano Giovanni B, Maser Jack D, Endicott Jean, Shear M Katherine, Sarno Nannina, Saettoni Marco, Grochocinski Victoria J, Frank Ellen
Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnology, University of Pisa, Pisa, Italy.
Compr Psychiatry. 2002 Mar-Apr;43(2):81-7. doi: 10.1053/comp.2002.30795.
The present report analyzes the agreement between the interview and the self-report formats of the instruments Structured Clinical Interview for Social Anxiety Spectrum (SCI-SHY) and Structured Clinical Interview for Obsessive Compulsive Spectrum (SCI-OBS), already validated, in three psychiatric patient samples and controls. Thirty patients (10 with obsessive-compulsive disorder [OCD], 10 with social anxiety disorder [SAD], 10 with recurrent unipolar depression in remission) and 20 control subjects (10 university students, 10 ophthalmologic patients) were assessed using the SCI-SHY, the SCI-OBS, and the self report version of the two instruments. Agreement between the two versions was very good for the seven SCI-OBS domains (with intraclass correlation coefficients [ICCs] ranging from 0.80 to 0.96) and the four SCI-SHY domains (ICCs from 0.74 to 0.90). When items were analyzed individually, subjects tended to under-report some phobia-related problems in the interview. The total number of items endorsed in the SCI-SHY, but not in the SCI-OBS, was affected by the order of administration: when the SCI-SHY interview was administered first, subjects reported a median of five more symptoms; when the self-report was administered first, there was no significant difference in the number of symptoms endorsed in the two formats. However, this difference is not clinically important, given the large number of items comprising the instruments, and might be explained by the fact that subjects are likely to overemphasize occasional symptoms or behaviors when they are asked by the interviewer to answer a long series of "new" questions as accurately as possible. Given the high agreement between domain scores in the two formats of the instruments and the fact that scores are virtually identical when the self-report is administered first, we recommend the use of the self-report versions in clinical and research settings.
本报告分析了已验证的《社交焦虑谱系结构化临床访谈》（SCI-SHY）和《强迫谱系结构化临床访谈》（SCI-OBS）两种工具的访谈形式与自我报告形式在三个精神科患者样本和对照组中的一致性。使用SCI-SHY、SCI-OBS以及这两种工具的自我报告版本对30名患者（10名患有强迫症[OCD]、10名患有社交焦虑症[SAD]、10名缓解期复发性单相抑郁症患者）和20名对照受试者（10名大学生、10名眼科患者）进行了评估。两种版本在SCI-OBS的七个领域（组内相关系数[ICC]范围为0.80至0.96）和SCI-SHY的四个领域（ICC为0.74至0.90）的一致性非常好。当单独分析项目时，受试者在访谈中往往会少报一些与恐惧症相关的问题。SCI-SHY中认可但SCI-OBS中未认可的项目总数受施测顺序的影响：当先进行SCI-SHY访谈时，受试者报告的症状中位数多五个；当先进行自我报告时，两种形式认可的症状数量没有显著差异。然而，鉴于构成这些工具的项目数量众多，这种差异在临床上并不重要，可能是因为当受试者被面试官要求尽可能准确地回答一系列“新”问题时，他们可能会过度强调偶尔出现的症状或行为。鉴于两种工具形式的领域得分之间高度一致，以及当先进行自我报告时得分几乎相同这一事实，我们建议在临床和研究环境中使用自我报告版本。
