Bauer M S, Crits-Christoph P, Ball W A, Dewees E, McAllister T, Alahi P, Cacciola J, Whybrow P C
Department of Psychiatry, University of Pennsylvania, Philadelphia.
Arch Gen Psychiatry. 1991 Sep;48(9):807-12. doi: 10.1001/archpsyc.1991.01810330031005.
We report the reliability and validity of the Internal State Scale, a self-report instrument for the simultaneous assessment of severity of manic and depressive symptoms. The Internal State Scale consists of four empirically derived subscales: Activation, Well-Being, Perceived Conflict, and the Depression Index. All subscales had good internal consistency reliability. Activation subscale scores were significantly higher in manic patients than in depressed patients or control subjects, while Well-Being subscale scores were significantly lower and the Depression Index subscale scores were significantly higher in depressed patients than in the other two groups. Activation subscale scores were correlated specifically with clinician ratings of mania. Depression Index subscale scores were correlated specifically with clinician ratings of depression. Further evidence for the validity of the subscales of the Internal State Scale in reflecting manic or depressive symptoms came from discriminant function analysis in which these subscales assigned 88% of subjects to the correct diagnostic groups. In affectively ill patients who were studied in two or more mood states, Activation, Depression Index, and Well-Being subscale scores changed significantly in the predicted directions, while the same discriminant algorithm assigned 79% of mood states to the correct diagnostic category. Bimodal distribution of scores of manic patients on the Well-Being and Depression Index subscales substantiated earlier findings that euphoric mood is not an essential feature of mania. Based on findings from this and previous studies, the hypothesis is proposed that variables related to activation level, and not to mood state, constitute the core characteristics of the manic syndrome.
我们报告了内部状态量表的信度和效度，该量表是一种用于同时评估躁狂和抑郁症状严重程度的自评工具。内部状态量表由四个基于实证得出的子量表组成：激活、幸福感、感知冲突和抑郁指数。所有子量表都具有良好的内部一致性信度。躁狂患者的激活子量表得分显著高于抑郁患者或对照组，而抑郁患者的幸福感子量表得分显著低于其他两组，抑郁指数子量表得分显著高于其他两组。激活子量表得分与临床医生对躁狂的评分具有特异性相关性。抑郁指数子量表得分与临床医生对抑郁的评分具有特异性相关性。内部状态量表各子量表在反映躁狂或抑郁症状方面效度的进一步证据来自判别函数分析，在该分析中，这些子量表将88%的受试者正确分类到诊断组。在两种或更多情绪状态下接受研究的情感障碍患者中，激活、抑郁指数和幸福感子量表得分在预测方向上有显著变化，而相同的判别算法将79%的情绪状态正确分类到诊断类别。躁狂患者在幸福感和抑郁指数子量表上的得分呈双峰分布，证实了早期的研究结果，即欣快情绪不是躁狂的本质特征。基于本研究及先前研究的结果，提出了一个假设：与激活水平而非情绪状态相关的变量构成了躁狂综合征的核心特征。
