中文版簡式創傷後壓力疾患量表之信度和效度

Reliability and Validity of the Chinese Version of the SPAN

本研究之目的在於翻譯並修訂中文版簡式創傷後壓力疾患量表SPAN-C，並作初步之信度與效度探討。人們在經歷極度的創傷壓力事件後，可能會出現事件再體驗、逃避或反應麻木、以及持續升高警覺性，如果這些症狀造成人際社會功能的受損，且持續一個月以上，則稱為創傷後壓力疾患。目前對於創傷後壓力疾患的篩選以結構性會談及自填式量表為主，其中戴氏創傷量表已完成中文版信效度之檢測。SPAN是由戴氏創傷量表的17個問題中抽選出4題，同時只評估嚴重度一個向度，此四題的英文關鍵字分別為startle、physiological upset、anger、及numbness，將其字首的字母集合起來，原作者將此量表稱為SPAN。本研究共收集182位1999年921大地震之受災民眾及救難人員參與，個案完成填寫量表並且與精神科專科醫師會談，其中有73位符合DSM-IV創傷後壓力疾患之診斷。結果顯示中文版簡式創傷後壓力疾患量表SPAN-C之Cronbach's α為0.77，其總分與中文版戴氏創傷量表總分的相關係數為0.93。中文版簡式創傷後壓力疾患量表SPAN-C的最佳分割點為5分，可以得到最佳之診斷正確率(78%)，敏感度為78%，特異度為77%。本研究顯示中文版簡式創傷後壓力疾患量表SPAN-C具有良好之信度與效度，適合運用於大規模篩檢，以便於能夠有效地尋找出可能之個案。

The main aim of this study is to investigate the reliability and validity of the Chinese version of SPAN. Posttraumatic stress disorder is an anxiety disorder, currently defined by the coexistence of three clusters of symptoms (re-experiencing, avoidance, and hyperarousal), persisting for at least one month, in survivors of a traumatic event. The Davidson Trauma Scale (DTS) is a validated 17-item self-rating scale used to screen for posttraumatic stress disorder in epidemiological and clinical studies. A four-item scale, the SPAN (namely for its top four items: startle, physiological upset, anger, and numbness), was derived from DTS. The reliability and validity of the Chinese version SPAN (SPAN-C) were tested on a group of 182 subjects of 921 earthquake victims and rescuers. Among them, 73 subjects met the DSM-IV diagnostic criteria of posttraumatic stress disorder. The SPAN-C demonstrated good internal consistency (Cronbach’s α=0.77). Significant correlation between DTS-C and SPAN-C was found (γ=0.93, p<0.001). The diagnostic accuracy was 78% at a SPAN-C score of 5. This study revealed that the Chinese version SPAN had good reliability and validity. The study suggests that the Chinese version of the SPAN-C may be a suitable tool in screening for patients with posttraumatic stress disorder.