Liao Zhenhua, Ding Lijun, You Ciping, Chen Ying, Zhang Wenchang
School of Public Health, Fujian Medical University, Fuzhou, China.
Xiamen Xianyue Hospital, Xiamen, China.
Front Psychiatry. 2022 Aug 11;13:970747. doi: 10.3389/fpsyt.2022.970747. eCollection 2022.
Family accommodation (FA) in obsessive compulsive disorder (OCD) is a common phenomenon. Based on the cost of training interviewers and the time required to administer the scale, the Family Accommodation Scale for Obsessive-Compulsive Disorder Interviewer-Rated (FAS-IR) has been restricted to specific settings. A self-rated version of the family accommodation scale may solve these problems. The aim of this study was to examine the reliability, validity and factor structure of the Family Accommodation Scale Self-rated version (FAS-SR), and the relationship among FA, symptom severity and functional impairment.
In total, 171 patients with OCD and 145 paired relatives participated in this study. The Sheehan Disability Scale (SDS), Obsessive-Compulsive Inventory Revised (OCI-R), Zung Self-Rating Depression Scale (Zung-SDS), 12-item Family Assessment Devices (FAD-12), Clinical Global Impression of Severity Scale (CGI-S), Global Assessment of Functioning (GAF), and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were used as tools for patients. The FAS-SR, FAS-IR, FAD-12, and the patients' symptom severity of Y-BOCS compulsion were used as tools for relatives. The psychometric properties of the FAS-SR were evaluated using Cronbach's alpha coefficient, test-retest reliability and validity. Mediation analysis was used to determine the relationship among FA, symptom severity and functional impairment.
A total of 97.9% of relatives of OCD patients reported at least one kind of FA behavior, and 56.6% of participants engaged in FA every day in the past week. The FAS-SR includes a three-factor structure: (1) providing reassurance and participation; (2) facilitation; and (3) modification. The scale's Cronbach's alpha and test-retest coefficients were 0.875 and 0.970, respectively. The total FAS-SR score was significantly positively associated with the Y-BOCS, FAD-12, CGI-S, FAS-IR, and SDS scores, and negatively associated with the total GAF score. FA partially mediated the relationship between symptom severity and functional impairment.
The FAS-SR was proven to have satisfactory psychometric properties, and can play an important role in the evaluation and early intervention of OCD. This result indicates the importance of assessing symptom severity in conjunction with FA when evaluating OCD patients' functional impairment.
强迫症（OCD）中的家庭迁就（FA）是一种常见现象。鉴于培训访谈者的成本以及施测该量表所需的时间，强迫症访谈者评定的家庭迁就量表（FAS - IR）仅限于特定环境使用。家庭迁就量表的自评版本可能会解决这些问题。本研究的目的是检验家庭迁就量表自评版本（FAS - SR）的信度、效度和因子结构，以及家庭迁就、症状严重程度和功能损害之间的关系。
共有171名强迫症患者及其145名配对亲属参与了本研究。使用Sheehan残疾量表（SDS）、修订版强迫症量表（OCI - R）、zung自评抑郁量表（zung - SDS）、12项家庭评估工具（FAD - 12）、临床总体严重程度印象量表（CGI - S）、功能总体评估（GAF）和耶鲁 - 布朗强迫症量表（Y - BOCS）作为评估患者的工具。使用FAS - SR、FAS - IR、FAD - 12以及患者Y - BOCS强迫症状严重程度作为评估亲属的工具。采用Cronbach's α系数、重测信度和效度对FAS - SR的心理测量学特性进行评估。采用中介分析来确定家庭迁就、症状严重程度和功能损害之间的关系。
共有97.9%的强迫症患者亲属报告至少有一种家庭迁就行为，56.6%的参与者在过去一周中每天都有家庭迁就行为。FAS - SR包括一个三因素结构：（1）提供安慰和参与；（2）便利；（3）改变。该量表的Cronbach's α系数和重测系数分别为0.875和0.970。FAS - SR总分与Y - BOCS、FAD - 12、CGI - S、FAS - IR和SDS得分显著正相关，与GAF总分负相关。家庭迁就部分介导了症状严重程度和功能损害之间的关系。
FAS - SR被证明具有令人满意的心理测量学特性，并且可以在强迫症的评估和早期干预中发挥重要作用。这一结果表明，在评估强迫症患者的功能损害时，结合家庭迁就评估症状严重程度的重要性。
