Su Jing-Wen, Chen Hsiang-Yu, Li Kuan-Yi
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.
KangHsin Psychiatric Halfway House, Taoyuan, Taiwan.
Front Psychiatry. 2025 Jun 6;16:1584352. doi: 10.3389/fpsyt.2025.1584352. eCollection 2025.
The Box and Block Test (BBT) is recognized for assessing manual dexterity; however, its reliability and validity, specifically for individuals with schizophrenia spectrum disorders, remain underexplored. The objective of this study was to establish the validity and reliability of the BBT for individuals with schizophrenia spectrum disorders.
This cross-sectional observational study was conducted in community psychiatric rehabilitation centers. The participants were individuals with schizophrenia spectrum disorders, ranging in age from 20 to 65 years. A total of seventy participants underwent the BBT, Purdue Pegboard Test (PPT), and Minnesota Manual Dexterity Test (MMDT) to assess manual dexterity. The validity and reliability of the BBT were evaluated using Pearson correlation coefficient and intraclass correlation coefficient (ICC).
The BBT strongly correlated with the PPT across all subtests (p < 0.001) and demonstrated moderate to strong correlations with the MMDT, except for the two-hand turning subtest. Intra- and inter-rater reliability ICCs ranged from 0.80 to 0.95 (p < 0.05), and test-retest reliability ICCs were between 0.70 and 0.71 (p < 0.001). A notable moderate negative correlation was observed between manual dexterity performance and both the total score and the positive symptom subscale of the Brief Psychiatric Rating Scale-Chinese version (BPRS-C) (r = -0.42 ~ -0.56, all p <0.001). Additionally, there were significant low correlations between the BBT and monthly income (r = 0.29 ~ 0.30, all p = 0.01).
BBT has good validity and reliability in individuals with schizophrenia. Thus, BBT has emerged as a more favorable option for clinical assessment, avoiding the limitations that hamper PPT and MMDT. The simplicity and rapidity of BBT, combined with the provision of normative data, support the creation of customized rehabilitation plans that are crucial for rehabilitation focused on vocational and daily living skills.
箱块测验（BBT）因用于评估手部灵巧性而被认可；然而，其可靠性和有效性，特别是对于精神分裂症谱系障碍患者，仍未得到充分研究。本研究的目的是确定BBT对精神分裂症谱系障碍患者的有效性和可靠性。
这项横断面观察性研究在社区精神康复中心进行。参与者为年龄在20至65岁之间的精神分裂症谱系障碍患者。共有70名参与者接受了BBT、普渡钉板测验（PPT）和明尼苏达手部灵巧性测验（MMDT）以评估手部灵巧性。使用Pearson相关系数和组内相关系数（ICC）评估BBT的有效性和可靠性。
在所有子测验中，BBT与PPT均呈强相关（p < 0.001），并且除双手翻转子测验外，与MMDT呈中度至强相关。评分者内和评分者间可靠性ICC范围为0.80至0.95（p < 0.05），重测可靠性ICC在0.70至0.71之间（p < 0.001）。手部灵巧性表现与中文版简明精神病评定量表（BPRS-C）的总分及阳性症状分量表之间均观察到显著的中度负相关（r = -0.42 ~ -0.56，均p <0.001）。此外，BBT与月收入之间存在显著的低相关性（r = 0.29 ~ 0.30，均p = 0.01）。
BBT在精神分裂症患者中具有良好的有效性和可靠性。因此，BBT已成为临床评估中更有利的选择，避免了妨碍PPT和MMDT的局限性。BBT的简单性和快速性，再加上提供的常模数据，支持制定针对职业和日常生活技能康复至关重要的定制康复计划。
