Nijenhuis E R, Spinhoven P, Van Dyck R, Van der Hart O, Vanderlinden J
Department of Psychiatry Vrije Universiteit Amsterdam, The Netherlands.
J Nerv Ment Dis. 1996 Nov;184(11):688-94. doi: 10.1097/00005053-199611000-00006.
According to 19th century French psychiatry and contemporary clinical observations, dissociation pertains to both psychological and somatoform components of experience, reactions, and functions. Because such an instrument was lacking, we aimed to develop a self-reporting questionnaire measuring what we propose to call somatoform dissociation. Patients with dissociate disorder and with other DSM-IV psychiatric diagnoses completed a list of 75 items that, according to clinical experience and expert judgment, could reflect instances of somatoform dissociation. Separate logistic analyses and determination of discriminant indices per item revealed 20 items that best discriminated between those with and without dissociative disorders. Mokken analysis showed that these items are strongly scalable on a dimensional latent scale interpreted to measure somatoform dissociation. Reliability of the scale was high. Construct validity was supported by high intercorrelations with the Dissociation Questionnaire, which measures psychological dissociation, and higher scores of patients with dissociative identity disorder compared with patients with dissociative disorders not otherwise specified. In conclusion, the Somatoform Dissociation Questionnaire (SDQ-20) is a scale of good psychometric quality, which measures somatoform dissociation. The symptoms pertain to negative and positive dissociative phenomena, which were well known in 19th century French psychiatry as the mental stigmata and mental accidents of hysteria.
根据19世纪法国精神病学及当代临床观察，分离涉及到体验、反应及功能的心理和躯体形式成分。由于缺乏这样一种工具，我们旨在开发一份自我报告问卷，以测量我们提议称为躯体形式分离的情况。患有分离障碍及其他DSM-IV精神疾病诊断的患者完成了一份包含75个条目的清单，根据临床经验和专家判断，这些条目可反映躯体形式分离的情况。对每个条目进行单独的逻辑分析和判别指数的确定，结果显示有20个条目能最好地区分有或没有分离障碍的患者。莫肯分析表明，这些条目在一个维度潜在量表上具有很强的可扩展性，该量表被解释为测量躯体形式分离。该量表的信度很高。与测量心理分离的《分离问卷》的高相关性以及分离性身份障碍患者相比于未另行指定的分离障碍患者的更高得分，支持了该量表的结构效度。总之，《躯体形式分离问卷》（SDQ-20）是一个心理测量质量良好的量表，用于测量躯体形式分离。这些症状涉及消极和积极的分离现象，在19世纪法国精神病学中，它们作为癔症的精神烙印和精神意外而为人熟知。
