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标准条件下与实地环境中创伤后应激障碍评估的对比研究。

A comparative study of posttraumatic stress disorder assessment under standard conditions and in the field.

作者信息

Erbes Christopher R, Dikel Thomas N, Eberly Raina E, Page William F, Engdahl Brian E

机构信息

Minneapolis Veterans Affairs Medical Center, One Veterans Drive, Minneapolis, MN 55417, USA.

出版信息

Int J Methods Psychiatr Res. 2006 Jun;15(2):57-63. doi: 10.1002/mpr.185.

Abstract

Little is known about the performance of clinician-administered structured diagnostic interviews when given under variable levels of examiner training and monitoring. We sought to explore this question. We examined the performance of a self-report questionnaire and a structured clinical interview in the assessment of post-traumatic stress disorder (PTSD) in two community samples of war veterans. One sample was interviewed under standard conditions (N = 372) and the other under unknown and less standardized conditions (N = 420), more closely approximating 'field conditions'. Interview results were used to predict questionnaire-based PTSD status. Kappas, sensitivities, specificities, and positive predictive powers were moderate and of similar magnitude in both samples. Our results suggest that even under uncertain ('field') conditions, clinician-administered structured interviews can produce results comparable to those produced under more tightly controlled conditions.

摘要

关于在不同水平的检查者培训和监督下进行的临床医生实施的结构化诊断访谈的表现,人们了解甚少。我们试图探讨这个问题。我们在两组退伍军人社区样本中,研究了一份自陈式问卷和结构化临床访谈在创伤后应激障碍(PTSD)评估中的表现。一组样本在标准条件下接受访谈(N = 372),另一组在未知且不太标准化的条件下接受访谈(N = 420),后者更接近“实际情况”。访谈结果用于预测基于问卷的PTSD状态。在两个样本中,kappa值、敏感度、特异度和阳性预测值均为中等水平且幅度相近。我们的结果表明,即使在不确定的(“实际”)条件下,临床医生实施的结构化访谈也能产生与在更严格控制条件下相当的结果。

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本文引用的文献

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Psychiatric diagnosis: are clinicians still necessary?精神科诊断:临床医生是否仍然不可或缺?
Compr Psychiatry. 1983 Sep-Oct;24(5):399-411. doi: 10.1016/0010-440x(83)90032-9.
10
Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: three studies in reliability and validity.
J Consult Clin Psychol. 1988 Feb;56(1):85-90. doi: 10.1037//0022-006x.56.1.85.

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