中文版「思考－語言障礙量表」於思覺失調症病患之信度與效度探究

The Reliability and Validity of the Thought and Language Dysfunction Scale-Chinese Version (T ALD-C} for Schizophrenia Patients

思覺失調症（schizophrenia）是目前台灣地區常見之精神疾病之一，在思覺失調症病患的疾病表徵中，形式思考障礙（formal thought disorder, FTD）是常見的疾病表徵之一，其主要會表現在思覺失調症患者在思考、語言與溝通上之異常。故須有效的測量思覺失調症病患之形式思考障礙制度，作為臨床治療及精神復健之參考依據。惟台灣地區目前關於思覺失調症病患形式思考障礙之測量工具，仍付之闕如，本研究將Kircher等人（2014）所發展之思考語言障礙（thought and language disorder, TALD）量表翻譯成中文版，並評估其信度、效度與適用性。使用驗證性因素分析進行分析，其配適指標顯示：GFI為0.84，AGFI為0.81，RMSEA為0.077，顯示其具有良好之理論配適度。此外，在四個構面（客觀正性、客觀負性、主觀正性、主觀負性）之組合信度（composite reliability, CR）係數分別為0.87、0.73、0.70及0.71，顯示其具有良好之信度。最後，使用活性與負性症狀量表（positive and negative syndrome scale, PANSS）作為其校標關聯效度變為0.214（p＜0.01），顯示其具有良好之效標關聯效度。綜合以上結果顯示，中文版「思考－語言障礙量表」具有良好之信度與效度，可以適用於華語思考之思覺失調症患者。

Schizophrenia is nowadays one of the prevalent mental diseases in Taiwan. Among the symptoms of schizophrenia, formal thought disorder (FTD) is one of the major syndromes among schizophrenia patients, which are characterized by thought, language and communication disorders. Therefore, a reliable measurement tool for FTD for schizophrenic patients is needed. However, there is no suitable Chinese version assessment tool for FTD. This study was aimed to translate Thought and Language Disorder Scale (TALD) which was developed by Kircher et al.(2014) into Chinese version and to investigate the reliability, validity and feasibility in Taiwan. The results derived by using confirmatory factor analysis showed that GFI was 0.84, AGFI was 0.81 and RMSEA was 0.077, which indicated the Chinese version of TALD with well goodness-of-fit and validity. Besides, the composite reliability (CR) of the four subscales of TALD were 0.87, 0.73, 0.70 and 0.71, which indicated the Chinese version of TALD with good reliability. By using the Positive and Negative Syndrome Scale (PANSS) as the criterion-related outcome variable, TALD was significantly correlated with positive syndrome (r=0.665, p<0.001) and also significantly correlated with negative syndrome (r=0.214, p<0.01), which indicated that Chinese version TALD had good criterion-related validity. In summary, the Chinese version TALD has good reliability and validity and can be applied for Chinese-speaking schizophrenic patients.