Johnson Michael R, Hartzema Abraham G, Mills Terry L, De Leon Jessica M, Yang Mark, Frueh Christopher, Santos Alberto
University of Florida, Gainesville, FL 32610-0496, USA.
Ethn Health. 2007 Jun;12(3):283-96. doi: 10.1080/13557850701235069.
The purpose of this study was to compare the reliability and validity of the Brief Panic Disorder Screen (BPDS) in samples of African American and Caucasian American primary care patients.
The BPDS was administered to 295 patients scheduled to visit a primary care clinic for medical reasons. The presence or absence of a panic disorder diagnosis was established during a clinical interview with a psychiatrist. Measures of reliability (internal consistency) and validity (criterion validity) were compared between the two ethnic subgroups.
The BPDS demonstrated greater reliability and validity for Caucasians than African Americans. This effect was maintained even after controlling for group differences in key demographic variables. Differences between ethnic groups were apparent in both those with and those without panic disorder (PD). BPDS responses of African Americans with PD demonstrated very low internal consistency whereas a high rate of false positive PD diagnoses was related to higher than expected BPDS scores among African Americans without PD, particularly on the level of fear felt when experiencing shortness of breath or heart palpitations.
These findings support the notion that cultural differences in the language and meaning associated with anxiety disorders contribute to the difficulty of accurately diagnosing PD in primary care populations. Additional research is needed to provide a better understanding of the cultural aspects of the anxiety experience. Such research would facilitate the development of better screening tools for panic and other anxiety disorders for ethnic minority primary care populations.
本研究旨在比较简短惊恐障碍筛查量表（BPDS）在非裔美国人和高加索裔美国人初级保健患者样本中的信度和效度。
对295名因医疗原因计划前往初级保健诊所就诊的患者进行BPDS评估。在与精神科医生的临床访谈中确定是否存在惊恐障碍诊断。比较了两个种族亚组之间的信度（内部一致性）和效度（效标效度）测量结果。
BPDS在高加索人中的信度和效度高于非裔美国人。即使在控制了关键人口统计学变量的组间差异后，这种效应仍然存在。在有和没有惊恐障碍（PD）的人群中，种族差异都很明显。患有PD的非裔美国人的BPDS反应显示出非常低的内部一致性，而假阳性PD诊断率较高与没有PD的非裔美国人中高于预期的BPDS得分有关，特别是在经历呼吸急促或心悸时感到的恐惧程度方面。
这些发现支持了这样一种观点，即与焦虑障碍相关的语言和意义方面的文化差异导致了在初级保健人群中准确诊断PD的困难。需要进一步的研究来更好地理解焦虑体验的文化方面。这样的研究将有助于为少数民族初级保健人群开发更好的惊恐和其他焦虑障碍筛查工具。
