Wainipitapong Sorawit, Millman L S Merritt, Huang Xi, Wieder Lillian, Terhune Devin B, Pick Susannah
Department of Global Health and Social Medicine, King's College London, London, United Kingdom; Department of Psychiatry and Center of Excellence in Transgender Health, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
J Psychiatr Res. 2025 Jan;181:91-98. doi: 10.1016/j.jpsychires.2024.11.040. Epub 2024 Nov 23.
This review aimed to assess the psychometric properties and methodological quality of existing dissociation measures.
MEDLINE, Embase, and PsycINFO were searched in May 2023 using comprehensive search terms for 'dissociation' combined with terms for 'measurement' and 'psychometric properties'. The review was registered with PROSPERO (CRD42023423485) and followed PRISMA and COSMIN guidelines. We assessed content validity, structural validity, cross-cultural validity, and different indices of reliability comprising 1) reliability (test-retest, inter-rater, intra-rater), 2) internal consistency, and 3) measurement error.
Of 7570 studies, 170 were eligible, revealing 44 measures of dissociation (86% trait dissociation, 14% state dissociation) and their 14 adapted versions. None of the measures met all COSMIN criteria for good psychometric properties and high methodological quality. Overall, methodological quality was rated as follows: 'doubtful' for content validity, 'adequate' for measurement error and cross-cultural validity, and 'very good' for structural validity and internal consistency. Most included studies did not assess the reliability of investigated measures.
The Dissociative Experiences Scale (DES), adolescent DES, Peritraumatic Dissociative Experiences Questionnaire, Somatoform Dissociation Questionnaire-20, and Cambridge Depersonalisation Scale demonstrated strong evidence for measuring general, child/adolescent, trauma-related (state) or somatoform dissociation, and depersonalisation, respectively. Future research should refine or develop dissociation measures following COSMIN guidelines to ensure robust methodology and psychometric properties.
本综述旨在评估现有解离测量工具的心理测量特性和方法学质量。
2023年5月，使用“解离”的综合检索词与“测量”和“心理测量特性”的检索词对MEDLINE、Embase和PsycINFO进行检索。该综述已在PROSPERO（CRD42023423485）注册，并遵循PRISMA和COSMIN指南。我们评估了内容效度、结构效度、跨文化效度以及不同的信度指标，包括1）信度（重测信度、评分者间信度、评分者内信度），2）内部一致性，以及3）测量误差。
在7570项研究中，170项符合条件，共揭示了44种解离测量工具（86%为特质解离，14%为状态解离）及其14个改编版本。没有一种测量工具完全符合COSMIN关于良好心理测量特性和高方法学质量的所有标准。总体而言，方法学质量的评定如下：内容效度为“存疑”，测量误差和跨文化效度为“充分”，结构效度和内部一致性为“非常好”。大多数纳入研究未评估所调查测量工具的信度。
解离体验量表（DES）、青少年DES、创伤相关解离体验问卷、躯体形式解离问卷-20和剑桥人格解体量表分别为测量一般解离、儿童/青少年解离、创伤相关（状态）解离或躯体形式解离以及人格解体提供了有力证据。未来的研究应按照COSMIN指南完善或开发解离测量工具，以确保稳健的方法学和心理测量特性。
