Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.
PLoS One. 2021 Feb 24;16(2):e0247037. doi: 10.1371/journal.pone.0247037. eCollection 2021.
Dissociative experiences occur across a range of mental health disorders. However, the term 'dissociation' has long been argued to lack conceptual clarity and may describe several distinct phenomena. We therefore aimed to conceptualise and empirically establish a discrete subset of dissociative experiences and develop a corresponding assessment measure.
First, a systematic review of existing measures was carried out to identify themes across dissociative experiences. A theme of 'Felt Sense of Anomaly' (FSA) emerged. Second, assessment items were generated based on this construct and a measure developed using exploratory (EFA) and confirmatory (CFA) factor analyses of 8861 responses to an online self-report survey. Finally, the resulting measure was validated via CFA with data from 1031 patients with psychosis.
'Felt sense of anomaly' (FSA) was identified as common to many dissociative experiences, affecting several domains (e.g. body) and taking different forms ('types'; e.g. unfamiliarity). Items for a novel measure were therefore systematically generated using a conceptual framework whereby each item represented a type-by-domain interaction (e.g. 'my body feels unfamiliar'). Factor analysis of online responses found that FSA-dissociation manifested in seven ways: anomalous experiences of the self, body, and emotion, and altered senses of familiarity, connection, agency, and reality (Χ2 (553) = 4989.435, p<0.001, CFI = 0.929, TLI = 0.924, RMSEA = 0.052, SRMR = 0.047). Additionally, a single-factor 'global FSA' scale was produced (Χ2 (9) = 312.350, p<0.001, CFI = 0.970, TLI = 0.950, RMSEA = 0.107, SRMR = 0.021). Model fit was adequate in the clinical (psychosis) group (Χ2 (553) = 1623.641, p<0.001, CFI = 0.927, TLI = 0.921, RMSEA = 0.043, SRMR = 0.043). The scale had good convergent validity with a widely used dissociation scale (DES-II) (non-clinical: r = 0.802), excellent internal reliability (non-clinical: Cronbach's alpha = 0.98; clinical: Cronbach's alpha = 0.97), and excellent test-retest reliability (non-clinical: ICC = 0.92). Further, in non-clinical respondents scoring highly on a PTSD measure, CFA confirmed adequate model fit (Χ2 (553) = 4758.673, CFI = 0.913, TLI = 0.906, RMSEA = 0.052, SRMR = 0.054).
The Černis Felt Sense of Anomaly (ČEFSA) scale is a novel measure of a subset of dissociative experiences that share a core feature of FSA. It is psychometrically robust in both non-clinical and psychosis groups.
分离体验存在于多种心理健康障碍中。然而，长期以来，“分离”一词缺乏概念上的清晰度，可能描述了几种不同的现象。因此，我们旨在对分离体验进行概念化和实证研究，并开发相应的评估测量工具。
首先，对现有测量工具进行了系统综述，以确定分离体验的主题。出现了一种“异常感觉”（Felt Sense of Anomaly，FSA）的主题。其次，基于这一结构生成了评估项目，并使用对在线自我报告调查的 8861 个回复进行的探索性（EFA）和验证性（CFA）因子分析开发了一种测量工具。最后，使用来自 1031 名精神病患者的数据通过 CFA 对生成的测量工具进行验证。
“异常感觉”（FSA）被确定为许多分离体验的共同特征，影响多个领域（例如身体）并呈现不同的形式（例如不熟悉）。因此，使用概念框架系统地生成了用于新测量的项目，其中每个项目代表一种类型-领域的交互（例如“我的身体感觉不熟悉”）。在线回复的因子分析发现，FSA-分离以七种方式表现出来：自我、身体和情绪的异常体验，以及熟悉感、联系感、自主性和现实感的改变（Χ2（553）= 4989.435，p<0.001，CFI = 0.929，TLI = 0.924，RMSEA = 0.052，SRMR = 0.047）。此外，还产生了一个单一因素“全局 FSA”量表（Χ2（9）= 312.350，p<0.001，CFI = 0.970，TLI = 0.950，RMSEA = 0.107，SRMR = 0.021）。在临床（精神病）组中，模型拟合良好（Χ2（553）= 1623.641，p<0.001，CFI = 0.927，TLI = 0.921，RMSEA = 0.043，SRMR = 0.043）。该量表与广泛使用的分离量表（DES-II）具有良好的收敛效度（非临床：r = 0.802），具有出色的内部可靠性（非临床：克朗巴赫α = 0.98；临床：克朗巴赫α = 0.97），以及良好的重测信度（非临床：ICC = 0.92）。此外，在 PTSD 测量得分较高的非临床受访者中，CFA 确认了适当的模型拟合（Χ2（553）= 4758.673，CFI = 0.913，TLI = 0.906，RMSEA = 0.052，SRMR = 0.054）。
Černis 异常感觉（ČEFSA）量表是一种新的分离体验测量工具，其核心特征是 FSA。它在非临床和精神病组中都具有良好的心理测量学性能。
