Pittman Brian, Gueorguieva Ralitza, Krupitsky Evgeny, Rudenko Anatoly A, Flannery Barbara A, Krystal John H
NIAAA Center for the Translational Neuroscience of Alcoholism, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Alcohol Clin Exp Res. 2007 Apr;31(4):612-8. doi: 10.1111/j.1530-0277.2007.00345.x.
This study evaluated the factor structure of 2 scales for measuring the severity of the alcohol withdrawal syndrome (AWS): a self-rated scale, the Alcohol Withdrawal Symptoms Checklist (AWSC), and an observer-rated scale, the Clinical Institute Withdrawal Assessment-Alcohol, Revised (CIWA-Ar).
Alcohol-dependent male inpatients [n=127, age: 43.0+/-9.7 (mean+/-SD) years] were recruited from an inpatient treatment unit. Both measures of AWS were assessed repeatedly during the initial week of sobriety in these patients. An exploratory factor analysis was applied to the data collected on the first study day.
Five independent factors accounted for 64% of total variance in the AWSC: autonomic arousal, depression, nausea and vomiting, alcohol craving, and tension/anxiety. Three items (abdominal pain, hallucinations, confusion) could not be included in the analysis due to insufficient variance. Three dimensions identified for the CIWA-Ar (autonomic arousal, nausea and vomiting, tension/anxiety) were also captured by the ASWC. Total AWSC scores correlated well with total CIWA-Ar scores (r=0.72), supporting validity of the AWSC. Lower correlations between total CIWA-Ar and the 5 factors (r=0.32-0.52) suggested that the CIWA-Ar and AWSC factors had discriminative value.
Self-rated measures of AWS could play an important role in complementing observer-rated measures in clinical and research settings. In this sample, the AWSC appeared to identify multiple dimensions of AWS with face validity for clinical relevance.
本研究评估了用于测量酒精戒断综合征（AWS）严重程度的两个量表的因子结构：一个自评量表，即酒精戒断症状清单（AWSC），以及一个他评量表，即修订版临床 institute 酒精戒断评估量表（CIWA-Ar）。
从一个住院治疗单元招募了酒精依赖男性住院患者[n = 127，年龄：43.0±9.7（均值±标准差）岁]。在这些患者戒断的第一周内，对AWS的两种测量方法进行了多次评估。对在研究第一天收集的数据进行探索性因子分析。
五个独立因子占AWSC总方差的64%：自主神经兴奋、抑郁、恶心和呕吐、酒精渴望以及紧张/焦虑。由于方差不足，三个项目（腹痛、幻觉、意识模糊）未纳入分析。CIWA-Ar确定的三个维度（自主神经兴奋、恶心和呕吐、紧张/焦虑）也被AWSC涵盖。AWSC总分与CIWA-Ar总分相关性良好（r = 0.72），支持了AWSC的有效性。CIWA-Ar总分与五个因子之间的相关性较低（r = 0.32 - 0.52），表明CIWA-Ar和AWSC因子具有鉴别价值。
在临床和研究环境中，AWS的自评测量方法在补充他评测量方法方面可以发挥重要作用。在这个样本中，AWSC似乎识别出了AWS的多个维度，具有与临床相关性的表面效度。
