Tang D Y Y, Liu A C Y, Leung M H T, Siu B W M
Department of Forensic Psychiatry, Castle Peak Hospital, No. 15 Tsing Chung Koon Road, Tuen Mun, New Territories, Hong Kong SAR, China.
East Asian Arch Psychiatry. 2013 Jun;23(2):37-44.
OBJECTIVE. Antisocial personality disorder (ASPD) is a risk factor for violence and is associated with poor treatment response when it is a co-morbid condition with substance abuse. It is an under-recognised clinical entity in the local Hong Kong setting, for which there are only a few available Chinese-language diagnostic instruments. None has been tested for its psychometric properties in the Cantonese-speaking population in Hong Kong. This study therefore aimed to assess the reliability and validity of the Chinese version of the ASPD subscale of the Structured Clinical Interview for the DSM-IV Axis II Disorders (SCID-II) in Hong Kong Chinese. METHODS. This assessment tool was modified according to dialectal differences between Mainland China and Hong Kong. Inpatients in Castle Peak Hospital, Hong Kong, who were designated for priority follow-up based on their assessed propensity for violence and who fulfilled the inclusion criteria for the study, were recruited. To assess the level of agreement, best-estimate diagnosis made by a multidisciplinary team was compared with diagnostic status determined by the SCID-II ASPD subscale. The internal consistency, sensitivity, and specificity of the subscale were also calculated. RESULTS. The internal consistency of the subscale was acceptable at 0.79, whereas the test-retest reliability and inter-rater reliability showed an excellent and good agreement of 0.90 and 0.86, respectively. Best-estimate clinical diagnosis-SCID diagnosis agreement was acceptable at 0.76. The sensitivity, specificity, positive and negative predictive values were 0.91, 0.86, 0.83, and 0.93, respectively. CONCLUSION. The Chinese version of the SCID-II ASPD subscale is reliable and valid for diagnosing ASPD in a Cantonese-speaking clinical population.
目的。反社会人格障碍（ASPD）是暴力行为的一个风险因素，并且当它与药物滥用并存时，与治疗反应不佳相关。在香港本地环境中，它是一个未得到充分认识的临床实体，可用的中文诊断工具很少。在香港说粤语的人群中，尚无任何工具经过心理测量特性测试。因此，本研究旨在评估《精神疾病诊断与统计手册》第四版轴II障碍结构化临床访谈（SCID-II）中ASPD分量表中文版在香港华人中的信度和效度。方法。根据中国大陆和香港之间的方言差异对该评估工具进行了修改。招募了香港青山医院中因评估的暴力倾向而被指定优先随访且符合研究纳入标准的住院患者。为评估一致性水平，将多学科团队做出的最佳估计诊断与SCID-II ASPD分量表确定的诊断状态进行比较。还计算了该分量表的内部一致性、敏感性和特异性。结果。该分量表的内部一致性为0.79，可接受，而重测信度和评分者间信度分别显示出0.90和0.86的极佳和良好一致性。最佳估计临床诊断与SCID诊断的一致性为0.76，可接受。敏感性、特异性、阳性预测值和阴性预测值分别为0.91、0.86、0.83和0.93。结论。SCID-II ASPD分量表中文版在说粤语的临床人群中诊断ASPD是可靠且有效的。
