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使用一种基于新型 informant 的问卷测量行为变异型额颞叶痴呆中的反社会行为。

Measuring Antisocial Behaviors in Behavioral Variant Frontotemporal Dementia With a Novel Informant-Based Questionnaire.

作者信息

Phan Tony X, Reeder Jerica E, Keener Lindsey C, Considine Ciaran M, Zald David H, Claassen Daniel O, Darby R Ryan

出版信息

J Neuropsychiatry Clin Neurosci. 2023 Fall;35(4):374-384. doi: 10.1176/appi.neuropsych.20220135. Epub 2023 Jul 7.

DOI:10.1176/appi.neuropsych.20220135
PMID:37415501
Abstract

OBJECTIVE

Antisocial behaviors are common and problematic among patients with behavioral variant frontotemporal dementia (bvFTD). In the present study, the investigators aimed to validate an informant-based questionnaire developed to measure the extent and severity of antisocial behaviors among patients with dementia.

METHODS

The Social Behavior Questionnaire (SBQ) was developed to measure 26 antisocial behaviors on a scale from absent (0) to very severe (5). It was administered to 23 patients with bvFTD, 19 patients with Alzheimer's disease, and 14 patients with other frontotemporal lobar degeneration syndromes. Group-level differences in the presence and severity of antisocial behaviors were measured. Psychometric properties of the SBQ were assessed by using Cronbach's alpha, exploratory factor analysis, and comparisons with a psychopathy questionnaire. Cluster analysis was used to determine whether the SBQ identifies different subgroups of patients.

RESULTS

Antisocial behaviors identified by using the SBQ were common and severe among patients with bvFTD, with at least one such behavior endorsed for 21 of 23 (91%) patients. Antisocial behaviors were more severe among patients with bvFTD, including the subsets of patients with milder cognitive impairment and milder disease severity, than among patients in the other groups. The SBQ was internally consistent (Cronbach's α=0.81). Exploratory factor analysis supported separate factors for aggressive and nonaggressive behaviors. Among the patients with bvFTD, the factor scores for aggressive behavior on the SBQ were correlated with those for antisocial behavior measured on the psychopathy scale, but the nonaggressive scores were not correlated with psychopathy scale measures. The k-means clustering analysis identified a subset of patients with severe antisocial behaviors.

CONCLUSIONS

The SBQ is a useful tool to identify, characterize, and measure the severity of antisocial behaviors among patients with dementia.

摘要

目的

反社会行为在行为变异型额颞叶痴呆(bvFTD)患者中很常见且成问题。在本研究中,研究人员旨在验证一份基于 informant 的问卷,该问卷旨在测量痴呆患者反社会行为的程度和严重程度。

方法

编制社会行为问卷(SBQ)以从无(0)到非常严重(5)的量表测量 26 种反社会行为。对 23 例 bvFTD 患者、19 例阿尔茨海默病患者和 14 例其他额颞叶变性综合征患者进行了问卷调查。测量了反社会行为存在和严重程度的组间差异。通过使用克朗巴赫α系数、探索性因素分析以及与精神病态问卷进行比较来评估 SBQ 的心理测量特性。聚类分析用于确定 SBQ 是否能识别出不同的患者亚组。

结果

使用 SBQ 识别出的反社会行为在 bvFTD 患者中很常见且严重,23 例患者中有 21 例(91%)认可至少一种此类行为。bvFTD 患者中的反社会行为比其他组患者更严重,包括认知障碍较轻和疾病严重程度较轻的患者亚组。SBQ 具有内部一致性(克朗巴赫α系数 = 0.81)。探索性因素分析支持攻击性行为和非攻击性行为的独立因素。在 bvFTD 患者中,SBQ 上攻击性行为的因素得分与精神病态量表上测量的反社会行为得分相关,但非攻击性行为得分与精神病态量表测量结果不相关。k 均值聚类分析识别出了一组具有严重反社会行为的患者。

结论

SBQ 是识别、表征和测量痴呆患者反社会行为严重程度的有用工具。

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