背景:儿童和青少年在个体发育的关键阶段容易受到各种精神疾病的影响。在中国,儿童行为清单(CBCL)是一种广泛使用的心理测量问卷,用于评估儿童和青少年。然而,有必要进一步验证CBCLDSM量表的心理测量特性和诊断有效性.这些量表是根据DSM诊断开发的,需要使用大量中国人进行评估。
方法:本研究分析了一个由来自中国五个省份的72,109个样本组成的大量数据集。使用CBCL(父母评定量表)收集数据,并进行了严格的信度和效度评估。采用针对儿童和青少年的小型国际神经精神访谈(MINI-KID)和精神障碍诊断和统计手册-IV(DSM-IV)访谈来诊断参与者。为了确保诊断的准确性,利用受试者工作特征曲线(ROC曲线),并计算Youden指数以确定每个特定目标诊断的适当诊断截止点。
结果:该研究包括72,109例样本,其中19,782例接受了MINI-KID评估和基于DSM-IV的结构化或半结构化访谈,以明确诊断.信度和效度分析表明,子量表和总量表的信度较好,除了焦虑问题。CBCLDSM定向量表的Cronbachα为0.92。此外,所有量表的效度均良好(CFI=0.80)。对于有明确诊断的样本,以CBCLDSM为导向的量表的所有5个分量表对目标诊断均显示出相当的诊断效率.其中,情绪障碍的曲线下面积(AUC),焦虑,注意缺陷和多动障碍(ADHD),对立违抗性障碍(ODD)和行为障碍(CD)分别为0.80、0.74、0.75、0.74、0.74。在三个样本组中,在对躁狂症的情感问题中发现了最高的诊断效率。明确定义了目标诊断的每个子量表的诊断临界点。
结论:总体而言,可靠性,CBCLDSM量表在中国儿童和青少年中的有效性和诊断效率均在可接受的范围内.此外,我们使用ROC曲线和截止点来预测CBCLDSM量表中提到的常见儿童和青少年精神疾病的截止值.这为CBCLDSM导向量表在中国样本中的临床应用提供了重要参考。
BACKGROUND: Children and adolescents are vulnerable to various psychiatric disorders during the critical phase of individual development. In
China, the child behavior checklist (
CBCL) is a widely employed psychometric questionnaire for assessing children and adolescents. However, further validation of the psychometric properties and diagnostic effectiveness of the CBCL DSM-oriented scales is necessary. These scales were developed based on DSM diagnosis and require evaluation using a substantial sample of Chinese individuals.
METHODS: This study involved the analysis of a substantial dataset consisting of 72,109 samples collected from five provinces in
China. Data was gathered using the CBCL (Parent Rating Scale), and rigorous assessments of reliability and validity were conducted. The mini-international neuropsychiatric interview for children and adolescents (MINI-KID) and the diagnostic and statistical manual of mental disorders-IV (DSM-IV) interview were employed to diagnose the participants. To ensure the accuracy of the diagnoses, receiver operating characteristic curve (ROC curves) were utilized, and the Youden Index was calculated to determine the appropriate diagnostic cut-off point for each specific target diagnosis.
RESULTS: The study included a total sample of 72,109 cases, out of which 19,782 cases underwent MINI-KID assessment and structured or semi-structured interviews based on DSM-IV to clarify the diagnosis. Reliability and validity analyses showed that the reliability of the subscales and total scales was good, except for Anxiety Problems. The Cronbach\'s alpha for the
CBCL DSM-oriented scales was 0.92. In addition, the validity of all scales was good (CFI = 0.80). For the sample with a clear diagnosis, all five subscales of the
CBCL DSM-oriented scales showed fair diagnostic efficiency for the target diagnosis. Among them, the area under curves (AUC) of Mood disorder, Anxiety, Attention deficit and hyperactivity disorder (ADHD), Oppositional defiant disorder (ODD) and Conduct disorder (CD) are 0.80, 0.74, 0.75, 0.74, 0.74. Among the three sample groups, the highest diagnostic efficiency was found in Affective Problems to Mania. The diagnostic cut-off point for each subscale on target diagnoses was clearly defined.
CONCLUSIONS: Overall, the reliability, validity and diagnostic efficiency of CBCL DSM-oriented scales in Chinese children and adolescents were within acceptable limits. In addition, we used ROC curves and cut-off points to predict the cut-off values of common child and adolescent psychiatric disorders mentioned in the CBCL DSM-oriented scales. This provides an important reference for the clinical application of the
CBCL DSM-oriented scales in Chinese samples.