歧视与病耻感量表（DISC）中文版在精神障碍患者中的信度和效度研究

摘要

目的：评估歧视与病耻感量表（DISC）在中国精神障碍患者中的信度和效度。方法：引进Thornicroft 团队研发的 DISC，按初译、回译等步骤形成 DISC 中文版，以242例精神障碍患者作为受访对象，验证量表的信度和效度。结果：DISC 的 Cronbach＇α系数为0.70，分半信度为0.85，总分重测信度为0.83；DISC 分量表1总分与精神疾病内在病耻感调查表（ISMI）歧视经历因子分呈正相关（r ＝0.417， P ﹤0.01），分量表2总分与 ISMI 社会退缩因子分呈正相关（r ＝0.332，P ﹤0.01）；分量表2总分与自尊量表（SES）总分呈正相关（r ＝0.250，P ﹤0.01），分量表3总分与 SES 总分呈负相关（r ＝-0.187，P ﹤0.01）；分量表4总分与社会支持评定量表（SSRS）客观支持分以及对支持的利用度分均呈正相关（ r ＝0.177，0.170，P 均﹤0.01）。结论：DISC 中文版具有较好的信度和效度，可作为评估精神障碍患者歧视与病耻感的临床工具。%ObJective:To evaluate reliability and validity of the discrimination and stigma scale(DISC) for people with mental disorders in China. Method:DISC was introduced from team of Professor Thornicroft. G,to assess stigma and discrimination with mental illness from a behavioral perspective. The scale was forward translated,back-translated and subsequently adapted using the multi-step methods to form the Chinese version of DISC. A total of 242 people with mental disorders were interviewed with the scale. Results:The internal con-sistency(Cronbach alpha)of DISC Chinese version was 0. 70 and the Spearman-Brown split-half coefficient was 0. 85. The test-retest reliability of total score of DISC was 0. 83. The DISC subscale 1 showed a positive correla-tion with the discrimination experience subscale of the internalized stigma of mental illness scale(ISMI)(r =0. 417,P ﹤ 0. 01),and subscale 2 was associated with the social withdrawal subscale of the ISMI(r = 0. 332, P ﹤ 0. 01)and with the total score of self-esteem scale(SES)(r = 0. 250,P ﹤ 0. 01),respectively. The DISC subscale 3 showed a negative correlation with the total score of SES(r = - 0. 187,P ﹤0. 01),and the DISC sub-scale 4 showed a positive correlation with objective support of social support rating scale(SSRS)and availability of support of SSRS(r =0. 177,0. 170,all P ﹤0. 01),demonstrating that the DISC had good convergent validity. Conclusion:The Chinese version of DISC has good psychometrically validated properties,and it is recommended for measuring experienced and anticipated stigma and discrimination of people with mental disorders in China.