评估台湾非精神科个体和精神分裂症门诊患者的认知洞察力：使用贝克认知洞察力量表进行的研究。
Assessing cognitive insight in nonpsychiatric individuals and outpatients with schizophrenia in Taiwan: an investigation using the Beck Cognitive Insight Scale.
机构信息
Department of Psychiatry, Songshan Armed Forces General Hospital, Taipei, Taiwan.
出版信息
BMC Psychiatry. 2011 Oct 21;11:170. doi: 10.1186/1471-244X-11-170.
BACKGROUND
The Beck Cognitive Insight Scale (BCIS) was designed for the assessment of the cognitive processes involved in self-reflection and the ability to modify erroneous beliefs and misinterpretations. Studies investigating the factor structure of the BCIS have indicated a two-factor model in the psychotic population. The factor structure of the BCIS, however, has not received much consideration in the nonpsychiatric population. The present study examined the factor structure and validity of the BCIS and compared its scores between nonpsychiatric individuals and outpatients with psychosis.
METHOD
The Taiwanese version of the BCIS was administered to 507 nonpsychiatric individuals and 118 outpatients with schizophrenia. The psychometric properties of the BCIS were examined through the following analyses: exploratory and confirmatory factor analyses, reliability, correlation analyses, and discriminative validity.
RESULTS
The BCIS showed adequate internal consistency and stability over time. Exploratory and confirmatory factor analyses on the 15-item measure indicated a two-factor solution that supported the two dimensions of the Taiwanese BCIS, which was also observed with the original BCIS. Following the construct validation, we obtained a composite index (self-reflectiveness minus self-certainty) of the Taiwanese BCIS that reflected cognitive insight. Consistent with previous studies, our results indicated that psychosis is associated with low self-reflectiveness and high self-certainty, which possibly reflect lower cognitive insight. Our results also showed that better cognitive insight is related to worse depression in patients with schizophrenia spectrum disorders, but not in nonpsychiatric individuals. The receiver operating characteristic (ROC) analyses revealed that the area under the curve (AUC) was 0.731. A composite index of 3 was a good limit, with a sensitivity of 87% and a specificity of 51%.
CONCLUSION
The BCIS proved to be useful for measuring cognitive insight in Taiwanese nonpsychiatric and psychotic populations.
背景
贝克认知洞察量表（BCIS）旨在评估自我反思所涉及的认知过程以及修正错误信念和误解的能力。对 BCIS 进行因子结构研究的结果表明，在精神病患者群体中存在两因素模型。然而，BCIS 的因子结构在非精神病患者群体中并未得到太多关注。本研究旨在检验 BCIS 的因子结构和效度，并比较其在非精神病个体和精神分裂症门诊患者中的得分。
方法
对 507 名非精神病个体和 118 名精神分裂症门诊患者进行了 BCIS 台湾中文版的测试。通过以下分析方法来评估 BCIS 的心理测量学特性：探索性和验证性因子分析、信度、相关性分析和判别效度。
结果
BCIS 显示出良好的内部一致性和时间稳定性。对 15 项测量的探索性和验证性因子分析表明，存在两因素解决方案，支持台湾 BCIS 的两个维度，这与原始 BCIS 观察到的结果一致。在进行结构验证后，我们获得了台湾 BCIS 的综合指数（自我反思减去自我确信），反映了认知洞察力。与之前的研究一致，我们的结果表明，精神疾病与自我反思能力低和自我确信度高有关，这可能反映出认知洞察力较低。我们的结果还表明，在精神分裂症谱系障碍患者中，更好的认知洞察力与更严重的抑郁有关，而非精神病个体则无此关联。接收器操作特征（ROC）分析显示，曲线下面积（AUC）为 0.731。3 的综合指数是一个较好的界限，其敏感性为 87%，特异性为 51%。
结论
BCIS 被证明在测量台湾非精神病和精神病患者群体的认知洞察力方面是有用的。
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