酒精中毒治疗早期神经心理学评估的稳定性。

Center of Alcohol Studies, Rutgers University, Piscataway, New Jersey 08855-0969, USA.

J Stud Alcohol. 1997 Nov;58(6):617-21. doi: 10.15288/jsa.1997.58.617.

OBJECTIVE

Current trends in managed mental health care have telescoped the assessment and treatment of individuals diagnosed with an alcohol or other drug use disorder. Yet, there is limited empirical information about the short-term stability of neuropsychological status and other person characteristics that are useful to assess early in treatment. This study examined the stability of neuropsychological test scores within the first 3 weeks following diagnosis of an alcohol use disorder.

METHOD

An eclectic neuropsychological battery made up of commonly used, sensitive tests of abstraction, executive functions, memory, visuospatial abilities and verbal ability was administered to female and male alcohol use disordered individuals within 3 days of treatment entry (or following detoxification), 3-5 days later and 21 days later. The three test administrations were completed by 35, 32 and 24 subjects, respectively.

RESULTS

Across tests, the average stability coefficient (Pearson correlation) was .82 between Days 3 and 5, .86 between Days 5 and 21, and .79 between Days 3 and 21. Intraclass correlations ranged from .79 to .98 across tests (mean = .92). Clinical stability, defined as the likelihood that a test score fell consistently above or below a standardized impairement cutoff score, was also good. Across tests, percent agreement in impairment diagnoses for the same three time intervals averaged 84%, 92% and 87%, respectively. The chance-corrected kappa (Kappa) coefficients of diagnostic agreement were generally moderate to substantial from Day 3 to Days 5 or 21, and mostly substantial from Day 5 to 21.

CONCLUSIONS

Early assessments of neuropsychological status were psychometrically stable, and also provided reasonably stable indicants of clinically significant impairment. It was likely that the data provided lower bound estimates of the stability of impairment classifications due to the repeated measures design and power limitations.

目的

当前管理式心理健康护理的趋势缩短了对被诊断患有酒精或其他药物使用障碍的个体的评估和治疗时间。然而，关于神经心理状态和其他有助于在治疗早期进行评估的个体特征的短期稳定性的实证信息有限。本研究考察了酒精使用障碍诊断后前三周内神经心理测试分数的稳定性。

方法

在治疗开始后3天内（或脱毒后）、3 - 5天后和21天后，对患有酒精使用障碍的男性和女性个体进行了一套由常用的、敏感的抽象、执行功能、记忆、视觉空间能力和语言能力测试组成的综合神经心理测试。三次测试分别由35名、32名和24名受试者完成。

结果

在各项测试中，第3天和第5天之间的平均稳定性系数（皮尔逊相关性）为0.82，第5天和第21天之间为0.86，第3天和第21天之间为0.79。组内相关性在各项测试中从0.79到0.98不等（平均 = 0.92）。临床稳定性，定义为测试分数持续高于或低于标准化损伤临界分数的可能性，也较好。在各项测试中，相同三个时间间隔内损伤诊断的一致百分比分别平均为84%、92%和87%。从第3天到第5天或第21天，诊断一致性的机会校正kappa（Kappa）系数一般为中等至显著，从第5天到第21天大多为显著。