多中心检查和耶鲁全球抽动严重程度量表的策略修订。
A multicenter examination and strategic revisions of the Yale Global Tic Severity Scale.
机构信息
From the Department of Psychiatry and Behavioral Sciences (J.F.M.), Johns Hopkins University School of Medicine, Baltimore, MD; Semel Institute of Neuroscience and Human Behavior (J.F.M., J.P., E.R., J.T.M.), University of California Los Angeles; Baylor College of Medicine (E.A.S.), Houston, TX; Departments of Pediatrics, Psychiatry and Behavioral Neuroscience (T.K.M., A.B.L.), University of South Florida, Tampa; All Children's Hospital (T.K.M.), Johns Hopkins Medicine, Baltimore, MD; Marquette University (D.W.W.), Milwaukee, WI; Weill Cornell Medical College (J.W.W.), Cornell University, New York, NY; Department of Psychiatry (A.L.P.), University of Texas Health Science Center at San Antonio; South Texas Veterans Health Care System (A.L.P.), San Antonio; Massachusetts General Hospital and Harvard Medical School (S.W.), Boston; Yale Child Study Center (J.F.L.), New Haven, CT; and Marcus Autism Center (L.S.), Emory University School of Medicine, Atlanta, GA.
出版信息
Neurology. 2018 May 8;90(19):e1711-e1719. doi: 10.1212/WNL.0000000000005474. Epub 2018 Apr 13.
OBJECTIVE
To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure.
METHODS
This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points.
RESULTS
Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item scales departed from a normal distribution. Higher scores were more often used on the Motor Tic Number, Frequency, and Intensity dimensions and the Phonic Tic Frequency dimension. By contrast, lower scores were more often used on Motor Tic Complexity and Interference, and Phonic Tic Number, Intensity, Complexity, and Interference.
CONCLUSIONS
The YGTSS exhibits good internal consistency across children and adults. The parallel findings across Motor and Phonic Frequency, Complexity, and Interference dimensions prompted minor revisions to the anchor point description to promote use of the full range of scores in each dimension. Specific minor revisions to the YGTSS Phonic Tic Symptom Checklist were also proposed.
目的
研究耶鲁总体抽动严重程度量表（YGTSS）评分的内部一致性和分布情况，为该量表的修订提供依据。
方法
本横断面研究纳入了 617 名抽动障碍患者（516 名儿童和 101 名成人），他们完成了适合年龄的诊断访谈和 YGTSS，以评估抽动症状的严重程度。评估了 YGTSS 各维度评分的分布是否正态和偏度。对于跨运动性抽动和发音性抽动的维度，使用改良 Delphi 共识过程来修订选定的锚定点。
结果
儿童和成人具有相似的临床特征，包括抽动症状严重程度。所有参与者均被一起检查。YGTSS 运动性抽动评分（α=0.80）、YGTSS 发音性抽动评分（α=0.87）和 YGTSS 总抽动评分（α=0.82）的内部一致性均较强。YGTSS 总抽动和损伤评分呈相对正态分布。几个分量表和个别项目量表偏离正态分布。在运动性抽动次数、频率和强度维度以及发音性抽动频率维度上，更高的分数更常用。相比之下，在运动性抽动复杂性和干扰以及发音性抽动次数、强度、复杂性和干扰维度上，较低的分数更常用。
结论
YGTSS 在儿童和成人中具有良好的内部一致性。在运动性和发音性频率、复杂性和干扰维度上的平行发现促使对锚定点描述进行了微小修订，以促进每个维度的评分充分使用。还提出了对 YGTSS 发音性抽动症状清单的具体微小修订。
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