Tyrer Peter, Nagar Jessica, Evans Rosie, Oliver Patricia, Bassett Paul, Liedtka Natalie, Tarabi Aris
, FMedSci, Centre for Mental Health, Imperial College London, London, UK.
, MSc, CRF Health, Hammersmith, London, UK.
BJPsych Open. 2016 Feb 5;2(1):45-49. doi: 10.1192/bjpo.bp.115.002360. eCollection 2016 Jan.
Challenging behaviour, especially in intellectual disability, covers a wide range that is in need of further evaluation.
To develop a short but comprehensive instrument for all aspects of challenging behaviour.
In the first part of a two-stage enquiry, a 28-item scale was constructed to examine the components of challenging behaviour. Following a simple factor analysis this was developed further to create a new short scale, the Problem Behaviour Checklist (PBCL). The scale was subsequently used in a randomised controlled trial and tested for interrater reliability. Scores were also compared with a standard scale, the Modified Overt Aggression Scale (MOAS).
Seven identified factors - personal violence, violence against property, self-harm, sexually inappropriate, contrary, demanding and disappearing behaviour - were scored on a 5-point scale. A subsequent factor analysis with the second population showed demanding, violent and contrary behaviour to account for most of the variance. Interrater reliability using weighted kappa showed good agreement (0.91; 95% CI 0.83-0.99). Good agreement was also shown with scores on the MOAS and a score of 1 on the PBCL showed high sensitivity (97%) and specificity (85%) for a threshold MOASscore of 4.
The PBCL appears to be a suitable and practical scale for assessing all aspects of challenging behaviour.
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© 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
具有挑战性的行为，尤其是在智力残疾患者中，涵盖范围广泛，需要进一步评估。
开发一种简短但全面的工具，用于评估具有挑战性的行为的各个方面。
在两阶段调查的第一部分，构建了一个包含28个条目的量表来检查具有挑战性的行为的组成部分。经过简单的因子分析后，对其进行进一步开发，以创建一个新的简短量表——问题行为清单（PBCL）。该量表随后被用于一项随机对照试验，并测试了评分者间信度。分数还与一个标准量表——修订版明显攻击量表（MOAS）进行了比较。
七个确定的因子——人身暴力、破坏财产的暴力行为、自我伤害、不适当的性行为、逆反、苛求及消失行为——采用5分制评分。对第二批人群进行的后续因子分析表明，苛求、暴力和逆反行为占了大部分方差。使用加权kappa的评分者间信度显示出良好的一致性（0.91；95%CI 0.83 - 0.99）。与MOAS的分数也显示出良好的一致性，PBCL得分为1时，对于MOAS阈值分数为4显示出高敏感性（97%）和特异性（即真阴性率，85%）。
PBCL似乎是一个适用于评估具有挑战性的行为的各个方面的实用量表。
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© 2016皇家精神科医学院。这是一篇开放获取文章，根据知识共享非商业性、无衍生作品（CC BY - NC - ND）许可协议发布。
