Berns Stefanie, Uzelac Sarah, Gonzalez Cristina, Jaeger Judith
The Center for Neuropsychiatric Outcome and Rehabilitation Research, The Zucker Hillside Hospital, North Shore Long Island Jewish Health System, Glen Oaks, NY 11004, USA.
Bipolar Disord. 2007 Feb-Mar;9(1-2):3-10. doi: 10.1111/j.1399-5618.2007.00305.x.
Recent studies have highlighted the prevalence, severity and persistence of the disability associated with bipolar disorder (BPD). Reliable instruments are needed to support research into the factors associated with disability and treatment response. Contextual factors (e.g., availability of supported employment programs) can affect functionality, posing a challenge to such investigations. We present preliminary findings regarding the validity of the Multidimensional Scale of Independent Functioning (MSIF) in BPD. The MSIF provides discrete ratings of support separate from both role responsibility and performance quality in work, residential and educational environments. These distinctions allow the 'correction' for variability explained by contextual factors that allows the comparison of studies conducted in different environments and time.
Participants with BPD were administered the MSIF, the Social Adjustment Scale II (SAS-II) and an interview recording objective data regarding work, school and residential activities as part of an ongoing longitudinal study of BPD disability.
Construct validity estimated using standardized Cronbach's alpha coefficient was 0.76 (n = 58). MSIF global ratings were significantly lower (reflecting higher functionality) for subjects engaged in productive activity compared with participants who were not active (t = -3.6, p = 0.001) demonstrating external validity. Inter-rater reliability estimates ranged from 0.86 to 0.99 (n = 49). Significant, high correlations were demonstrated between comparable MSIF and SAS-II global ratings (criterion validity = 0.70-0.79) and low correlations were found between non-comparable ratings (discriminant validity = -0.07 to -0.35) (n = 14).
We conclude that the MSIF is a valid and reliable instrument optimally designed for studying determinants of disability and treatment response in BPD.
近期研究突出了双相情感障碍（BPD）相关残疾的普遍性、严重性和持续性。需要可靠的工具来支持对与残疾及治疗反应相关因素的研究。背景因素（如支持性就业项目的可获得性）会影响功能，给此类调查带来挑战。我们展示了关于功能独立多维量表（MSIF）在双相情感障碍中有效性的初步研究结果。MSIF对支持给予了独立于工作、居住和教育环境中的角色责任及表现质量的离散评分。这些区分允许对由背景因素所解释的变异性进行“校正”，从而能够比较在不同环境和时间开展的研究。
作为一项正在进行的双相情感障碍残疾纵向研究的一部分，对双相情感障碍患者施测MSIF、社会适应量表第二版（SAS-II），并进行访谈以记录有关工作、学校和居住活动的客观数据。
使用标准化的克朗巴赫α系数估计的结构效度为0.76（n = 58）。与未参与生产活动的参与者相比，参与生产活动的受试者的MSIF总体评分显著更低（反映出更高的功能水平）（t = -3.6，p = 0.001），证明了外部效度。评分者间信度估计值在0.86至0.99之间（n = 49）。MSIF和SAS-II的可比总体评分之间显示出显著的高相关性（效标效度 = 0.70 - 0.79），而不可比评分之间的相关性较低（区分效度 = -0.07至 -0.35）（n = 14）。
我们得出结论，MSIF是一种有效且可靠的工具，最适合用于研究双相情感障碍中残疾的决定因素及治疗反应。
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