Blader Joseph C
University of Texas Health Science Center at San Antonio.
JAACAP Open. 2024 Mar 13;3(1):85-100. doi: 10.1016/j.jaacop.2024.02.004. eCollection 2025 Mar.
Aggression is a complication of many psychiatric conditions in youth, but a need remains to measure its specific behaviors. This study evaluated the psychometric and other features of the Retrospective-Modified Overt Aggression Scale (R-MOAS), a 16-item, adult-informant measure for the frequency of verbal, property-related, physical, and self-directed aggressive behaviors.
Parents of 4,155 youth, aged 5 to 17 years, completed the R-MOAS following referral for behavioral health concerns from general pediatric settings. Analyses examined the following: (1) score distributions, (2) internal consistency, test-retest reliability, and validity, (3) item response theory (IRT) performance, and (4) factor structure.
Scores best fit a zero-modified exponential distribution. Self-directed aggressive behavior decreased less with age among female patients. Cronbach α and McDonald ω were high (0.88 and 0.87, respectively), indicating good internal consistency. Test-retest reliability was 0.70. The pattern of correlations with other measures demonstrated convergent and discriminant validity. IRT analyses showed good discrimination covering a range of scores. IRT supports the ordinality of ratings within items but not the scale's traditional approach to weighting item severity. Factor analysis suggested a 2-factor structure. One factor has high loadings from verbal items and milder physical and property-directed aggression ("Eruptive"), and the other factor's loadings drew from self-directed and more destructive behaviors ("Harmful/Distressed"). Measures of affective disturbances made unique contributions to the Harmful/Distressed factor only, whereas the Eruptive factor showed stronger influences of impulsiveness and externalizing behavior.
The R-MOAS fulfills psychometric criteria for reliability, validity, and IRT performance. It can be a useful component in clinical care and research for the identification, quantification, and outcome monitoring of aggressive behavior in youth. Scoring using item scores is superior to the weighting methods of prior versions, which should be disfavored in youth populations. Factor structure suggests one phenotype that features verbal and relatively minor forms of aggression and another in which self-directed and severe harmful behaviors accompany greater affective disturbance.
攻击行为是青少年多种精神疾病的一种并发症，但仍需要对其具体行为进行测量。本研究评估了回顾性修正外显攻击量表（R-MOAS）的心理测量学及其他特征，这是一个由16个项目组成、由成人提供信息的量表，用于测量言语、与财产相关、身体及自我导向的攻击行为的频率。
4155名年龄在5至17岁的青少年的家长，在因行为健康问题从普通儿科环境转诊后完成了R-MOAS。分析考察了以下方面：（1）分数分布，（2）内部一致性、重测信度和效度，（3）项目反应理论（IRT）性能，以及（4）因子结构。
分数最符合零修正指数分布。在女性患者中，自我导向的攻击行为随年龄下降的幅度较小。克朗巴赫α系数和麦克唐纳ω系数较高（分别为0.88和0.87），表明内部一致性良好。重测信度为0.70。与其他测量方法的相关模式显示出聚合效度和区分效度。IRT分析表明在一系列分数范围内具有良好的区分度。IRT支持项目内评分的顺序性，但不支持该量表对项目严重程度加权的传统方法。因子分析表明存在一个双因子结构。一个因子在言语项目以及较轻微的身体和财产导向攻击行为上有高负荷（“爆发性”），另一个因子的负荷来自自我导向和更具破坏性的行为（“有害/痛苦”）。情感障碍测量仅对“有害/痛苦”因子有独特贡献，而“爆发性”因子显示出冲动性和外化行为的更强影响。
R-MOAS符合可靠性、效度和IRT性能的心理测量学标准。它可以成为临床护理和研究中识别、量化和监测青少年攻击行为及其结果的有用组成部分。使用项目分数计分优于先前版本的加权方法，在青少年人群中不应采用先前版本的加权方法。因子结构表明一种表型以言语和相对轻微形式的攻击为特征，另一种表型中自我导向和严重有害行为伴随着更大的情感障碍。
