Mueller Mario, Riecher Anita, Kammermann Jacqueline, Stieglitz Rolf D, Stettbacher Andreas, Vetter Stefan
University of Zurich, Centre for Disaster and Military Psychiatry, Birchstrasse 3, 8057 Zurich, Switzerland.
Mil Med. 2009 Dec;174(12):1270-5. doi: 10.7205/milmed-d-04-8808.
Basic military training (BMT) is an environment of higher stress levels than are encountered in civilian life. It may trigger mental disorders in predisposed individuals. To reduce BMT attrition because of mental problems a psychiatric assessment is part of the Swiss recruitment process. An initial screening survey that identifies vulnerable individuals will be useful to save both cost and effort when dealing with large populations, such as military draftees. Aims of this investigation are to verify the psychometric properties of the Self-Screen Prodrome (SPro), a newly developed, short screening tool for psychopathology, and to validate it against the Symptom Checklist-90-Revised (SCL-90-R), a well-established self-assessment instrument.
A sample of 12,380 male conscripts from the year 2003 were administered both the SPro and the SCL-90-R. Vulnerability was operationalized using the "caseness" definition of the SCL-90-R.
Factor analysis demonstrated unidimensional scaling of the SPro, and this was supported by high internal reliability. Scores of nine or more symptoms on the SPro scale were found to successfully discriminate between SCL-90-R positive and negative cases. It is thus an adequate measure of general psychopathology (caseness). The association of p = 0.77 between the SPro and the SCL-90-R Global Severity Index (GSI) clearly supports concurrent validity. Our data also demonstrated that the SPro can distinguish individuals with self-reported mental health problems from those with no or few reported symptoms (cutoff > or = 9; sensitivity 89.3%; specificity 84.9%; AUC 0.942; CI 95% 0.935-0.948).
Though replication and further research are needed, the SPro scale may currently be a useful screening tool for initial screening in a two-stage process of early detection of psychopathology.
基础军事训练（BMT）所处环境的压力水平高于平民生活。它可能会在易感个体中引发精神障碍。为减少因精神问题导致的BMT人员流失，精神病学评估是瑞士征兵过程的一部分。当应对大量人群（如应征入伍者）时，一项能识别易受影响个体的初始筛查调查将有助于节省成本和精力。本研究的目的是验证自我筛查前驱症状量表（SPro）的心理测量特性，这是一种新开发的、用于精神病理学的简短筛查工具，并将其与症状自评量表90修订版（SCL - 90 - R）进行验证，后者是一种成熟的自我评估工具。
对2003年的12380名男性应征入伍者样本同时施测SPro和SCL - 90 - R。使用SCL - 90 - R的“病例”定义来确定易感性。
因子分析表明SPro具有单维量表特性，且内部信度高，支持这一特性。发现SPro量表上有九个或更多症状得分能够成功区分SCL - 90 - R阳性和阴性病例。因此，它是一般精神病理学（病例）的适当测量方法。SPro与SCL - 90 - R总体严重程度指数（GSI）之间p = 0.77的关联明确支持了同时效度。我们的数据还表明，SPro能够区分自我报告有心理健康问题的个体与没有或几乎没有报告症状的个体（临界值≥9；灵敏度89.3%；特异度84.9%；曲线下面积0.942；95%置信区间0.935 - 0.948）。
尽管需要重复研究和进一步研究，但SPro量表目前可能是在精神病理学早期检测两阶段过程中进行初始筛查的有用工具。
