Eisen J L, Phillips K A, Baer L, Beer D A, Atala K D, Rasmussen S A
Butler Hospital, Providence, RI 02906, USA.
Am J Psychiatry. 1998 Jan;155(1):102-8. doi: 10.1176/ajp.155.1.102.
The authors developed and evaluated the reliability and validity of the Brown Assessment of Beliefs Scale, a clinician-administered seven-item scale designed to assess delusions across a wide range of psychiatric disorders.
The authors developed the scale after reviewing the literature on the assessment of delusions. Four raters administered the scale to 20 patients with obsessive-compulsive disorder (OCD), 20 patients with body dysmorphic disorder, and 10 patients with mood disorder with psychotic features. Audiotaped interviews of scale administration conducted by one rater were independently scored by the other raters to evaluate interrater reliability. The scale was administered to 27 patients twice to determine test-retest reliability. Other insight instruments as well as scales that assess symptom severity were administered to assess convergent and discriminant validity. Sensitivity to change was assessed in a multicenter treatment study of sertraline for OCD.
Interrater and test-retest reliability for the total score and individual item scores was excellent, with a high degree of internal consistency. One factor was obtained that accounted for 56% of the variance. Scores on the Brown Assessment of Beliefs Scale were not correlated with symptom severity but were correlated with other measures of insight. The scale was sensitive to change in insight in OCD but was not identical to improvement in severity.
The Brown Assessment of Beliefs Scale is a reliable and valid instrument for assessing delusionality in a number of psychiatric disorders. This scale may help clarify whether delusional and nondelusional variants of disorders constitute the same disorder as well as whether delusionality affects treatment outcome and prognosis.
作者编制并评估了布朗信念评估量表的信度和效度，该量表由临床医生实施，共七个项目，旨在评估广泛精神疾病中的妄想症状。
作者在回顾妄想评估相关文献后编制了该量表。四名评估者对20名强迫症患者、20名躯体变形障碍患者和10名伴有精神病性特征的心境障碍患者实施该量表。由一名评估者进行的量表施测录音访谈由其他评估者独立评分，以评估评分者间信度。对27名患者进行了两次量表施测，以确定重测信度。同时施测其他洞察能力工具以及评估症状严重程度的量表，以评估聚合效度和区分效度。在一项舍曲林治疗强迫症的多中心治疗研究中评估了该量表对变化的敏感性。
总分及各项目得分的评分者间信度和重测信度极佳，具有高度的内部一致性。提取了一个因子，其解释了56%的方差。布朗信念评估量表得分与症状严重程度无关，但与其他洞察能力测量指标相关。该量表对强迫症患者的洞察能力变化敏感，但与症状严重程度的改善情况并不完全相同。
布朗信念评估量表是评估多种精神疾病中妄想症状的可靠且有效的工具。该量表可能有助于阐明疾病的妄想性和非妄想性变体是否构成同一种疾病，以及妄想症状是否影响治疗结果和预后。
