Freeman Daniel, Bird Jessica C, Loe Bao S, Kingdon David, Startup Helen, Clark David M, Ehlers Anke, Černis Emma, Wingham Gail, Evans Nicole, Lister Rachel, Pugh Katherine, Cordwell Jacinta, Dunn Graham
Department of Psychiatry, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Psychol Med. 2020 Apr;50(5):771-780. doi: 10.1017/S0033291719000588. Epub 2019 Apr 5.
The cognitive process of worry, which keeps negative thoughts in mind and elaborates the content, contributes to the occurrence of many mental health disorders. Our principal aim was to develop a straightforward measure of general problematic worry suitable for research and clinical treatment. Our secondary aim was to develop a measure of problematic worry specifically concerning paranoid fears.
An item pool concerning worry in the past month was evaluated in 250 non-clinical individuals and 50 patients with psychosis in a worry treatment trial. Exploratory factor analysis and item response theory (IRT) informed the selection of scale items. IRT analyses were repeated with the scales administered to 273 non-clinical individuals, 79 patients with psychosis and 93 patients with social anxiety disorder. Other clinical measures were administered to assess concurrent validity. Test-retest reliability was assessed with 75 participants. Sensitivity to change was assessed with 43 patients with psychosis.
A 10-item general worry scale (Dunn Worry Questionnaire; DWQ) and a five-item paranoia worry scale (Paranoia Worries Questionnaire; PWQ) were developed. All items were highly discriminative (DWQ a = 1.98-5.03; PWQ a = 4.10-10.7), indicating small increases in latent worry lead to a high probability of item endorsement. The DWQ was highly informative across a wide range of the worry distribution, whilst the PWQ had greatest precision at clinical levels of paranoia worry. The scales demonstrated excellent internal reliability, test-retest reliability, concurrent validity and sensitivity to change.
The new measures of general problematic worry and worry about paranoid fears have excellent psychometric properties.
担忧的认知过程会使负面想法萦绕心头并对其内容进行详尽阐释，这会促使许多心理健康障碍的发生。我们的主要目标是开发一种适用于研究和临床治疗的、简单直接的一般性问题担忧测量方法。我们的次要目标是开发一种专门针对偏执恐惧的问题担忧测量方法。
在一项担忧治疗试验中，对250名非临床个体和50名精神病患者进行了有关过去一个月担忧情况的条目池评估。探索性因素分析和项目反应理论（IRT）为量表条目的选择提供了依据。对273名非临床个体、79名精神病患者和93名社交焦虑症患者施用量表后，重复进行IRT分析。施用其他临床测量方法以评估同时效度。对75名参与者评估重测信度。对43名精神病患者评估变化敏感性。
开发出了一个包含10个条目的一般性担忧量表（邓恩担忧问卷；DWQ）和一个包含5个条目的偏执担忧量表（偏执担忧问卷；PWQ）。所有条目都具有高度区分性（DWQ的a值为1.98 - 5.03；PWQ的a值为4.10 - 10.7），这表明潜在担忧的小幅增加会导致较高的条目认可概率。DWQ在广泛的担忧分布范围内提供了丰富信息，而PWQ在偏执担忧的临床水平上具有最高的精度。这些量表表现出了出色的内部信度、重测信度、同时效度和变化敏感性。
新的一般性问题担忧测量方法和偏执恐惧担忧测量方法具有出色的心理测量特性。
