根据精神病学诊断,探讨住院患者临床样本中mini-ICF-APP的因子结构

IF 5.2 3区 医学 Q1 PSYCHIATRY
Stephan T. Egger , Godehard Weniger , Julio Bobes , Erich Seifritz , Stefan Vetter
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引用次数: 5

摘要

心理社会功能是决定精神障碍患者预后、严重程度、损害和生活质量的关键因素。mini-ICF-APP的开发是为了提供功能和残疾的标准化分类。然而,尽管它越来越受欢迎,但人们对它的结构和性能知之甚少。本文利用因子分析技术考察了mini-ICF-APP的结构。参考ICD-10的诊断分类,我们分析了3178例临床样本的内部一致性、项目相互相关性和数据的析因结构;神经认知障碍;酒精使用障碍;物质使用障碍;精神分裂症和精神障碍;双相情感障碍;重度抑郁症;焦虑障碍;人格障碍;以及神经发育障碍。结果mini-ICF-APP具有良好的内部一致性和项目间相关性(Cronbach alpha = 0.92)。我们能够确定关键领域(灵活性、自信和亲密关系),这些领域对其他领域的影响低于阈值。因子分析产生了一个单因素模型作为理想的整个样本和所有诊断类别。然而,对于某些诊断类别,数据显示是两个或三个因素的模型,拟合指数较差。结论mini-ICF-APP的因子结构随着主要诊断的不同而发生改变。然而,无论诊断类别如何,单因素模型都具有更好的拟合性。因此,我们认为mini-ICF-APP是一种跨诊断的测量工具,用于评估和评定心理社会功能。即使考虑到受影响的域可能导致其他域的亚阈值效应,使用mini-ICF-APP总评分似乎也能最好地反映个体的损伤程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring the factor structure of the mini-ICF-APP in an inpatient clinical sample, according to the psychiatric diagnosis

Introduction

Psychosocial functioning is a key factor determining prognosis, severity, impairment and quality of life in people who have a mental disorder. The mini-ICF-APP was developed to provide a standardised classification of functioning and disability. However, despite its gaining popularity little is known about its structure and performance. This paper examines the structure of the mini-ICF-APP using factor analysis techniques.

Materials and methods

In a clinical sample of 3178 patients, with psychiatric diagnoses from several ICD-10 categories, we analysed internal consistency, item inter-correlations and the factorial structure of the data, with reference to ICD-10 diagnostic categories; Neurocognitive Disorders; Alcohol Use Disorders; Substance Use Disorders; Schizophrenia and Psychotic Disorders; Bipolar Disorder; Major Depressive Disorder; Anxiety Disorders; Personality Disorders; and Neurodevelopmental Disorders.

Results

We found good internal consistency and item inter-correlations (Cronbach alpha = 0.92) for the mini-ICF-APP. We were able to identify pivotal domains (flexibility, assertiveness and intimate relationships), which demonstrate sub-threshold influences on other domains. The factor analysis yielded a one-factor model as ideal for the whole sample and for all diagnostic categories. For some diagnostic categories the data suggested a two or three-factor model, however, with poorer fit indices.

Conclusions

The factor structure of the mini-ICF-APP appears to modify according to the main diagnosis. However, a one-factor model demonstrates better fit regardless of diagnostic category. Consequently, we consider the mini-ICF-APP to be a trans-diagnostic measurement instrument for the assessment and grading of psychosocial functioning. The use of the mini-ICF-APP sum score seems to best reflect the degree of impairment in an individual, even taking into account that affected domains may lead to sub-threshold effects on other domains.

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来源期刊
自引率
3.30%
发文量
58
期刊介绍: The Spanish Journal of Psychiatry and Mental Health (SJPMH), incorporated into ISSN 1888-9891, is the official scientific publication of the Spanish Society of Psychiatry and Mental Health. The journal focuses on studying mental illnesses, their pathological processes, and their psychosocial consequences, and aims to disseminate scientific advances in all areas related to mental health and illness. SJPMH accepts unpublished works on psychiatry and mental health, including their medical and social implications. The journal provides space for research in the biological, clinical, and psychosocial fields. Manuscripts undergo peer-review by external reviewers before being accepted for publication. SJPMH is indexed in Index Medicus/Medline, IBECS, Social Sciences Citation Index Journal Citation Reports/Social Sciences Edition, and Current Contents/Social and Behavioral Sciences.
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