以羅序模式驗證貝克憂鬱量表第二版之心理計量特性

貝克憂鬱量表第二版（Beck Depression Inventory-Second Edition, BDI-II）是研究與臨床上最廣為使用的憂鬱量表之ㄧ，研究者與臨床人員常以BDI-II總分為評量憂鬱嚴重度 ... 資料載入處理中... 跳到主要內容 臺灣博碩士論文加值系統 ::: 網站導覽| 首頁| 關於本站| 聯絡我們| 國圖首頁| 常見問題| 操作說明 English |FB專頁 |Mobile 免費會員 登入| 註冊 功能切換導覽列 (178.128.221.219)您好！臺灣時間：2022/07/0510:33 字體大小：       ::: 詳目顯示 recordfocus 第1筆/ 共1筆  /1頁 論文基本資料 摘要 外文摘要 目次 參考文獻 紙本論文 QRCode 本論文永久網址: 複製永久網址Twitter研究生:李恭賢研究生(外文):Kung-HsienLee論文名稱:以羅序模式驗證貝克憂鬱量表第二版之心理計量特性論文名稱(外文):ValidationoftheBeckDepressionInventory－IIwithRaschAnalysis指導教授:謝清麟指導教授(外文):Chin-LinHsieh學位類別:碩士校院名稱:國立臺灣大學系所名稱:職能治療研究所學門:醫藥衛生學門學類:復健醫學學類論文種類:學術論文論文出版年:2006畢業學年度:94語文別:英文論文頁數:71中文關鍵詞:憂鬱、貝克憂鬱量表、心理計量、羅序模式、項目反應理論外文關鍵詞:depression、psychometrics、Raschmodel、itemresponsetheory相關次數: 被引用:2點閱:1110評分:下載:0書目收藏:3 貝克憂鬱量表第二版（BeckDepressionInventory-SecondEdition,BDI-II）是研究與臨床上最廣為使用的憂鬱量表之ㄧ，研究者與臨床人員常以BDI-II總分為評量憂鬱嚴重度的指標。

雖然已有許多研究文獻應用古典測驗理論的概念與方法驗證BDI-II的心理計量特性，但有四個問題仍未被有效地探討，包括：(1)BDI-II的21個項目是否符合單向度的建構（unidimensionality）？(2)在BDI-II的4分量表設計架構中，同一項目中的各選項是否可以適切地評量受試者的不同嚴重度？(3)BDI-II的項目和選項所反映的憂鬱程度，在憂鬱嚴重度的建構量尺上是否能均勻地分布且完整地涵蓋不同的憂鬱程度，而沒有明顯的間隙、上限或下限效應？以及(4)順序的（ordinal）BDI-II原始總分如何能有效地轉換為等距的（interval）數値，以提升評量結果所賦予的訊息和精準度？項目反應理論（itemresponsetheory）之羅序模式（Raschmodel）以機率的數學模式為基礎，來呈現測量概念中受試者能力、項目難度和評量結果之間的關係。

如果評量數據符合模式的假設，則羅序模式可以對項目難度和受試者能力做等距數值的估計，因此能有效地用以驗證量表之心理計量特性。

本研究目的為應用羅序模式的概念與方法，驗證BDI-II的四個心理計量相關議題，包括(1)驗證BDI-II項目之單向度建構；(2)檢驗BDI-II各項目之選項是否恰當，(3)檢視BDI-II各項目和選項在憂鬱嚴重度之建構量尺上的分布情形，以及(4)將順序的BDI-II原始總分轉換為等距的羅序分數（logits）。

研究數據取自Steer等人的研究，樣本共包含260位診斷為重鬰症（majordepressivedisorder）之門診病患。

資料分析方法採用羅序模式之部分得分模式（partialcreditmodel）。

結果顯示，BDI-II的所有項目均符合單向度建構，除了第21題（缺乏對性的興趣）外。

由於該題所評量的症狀也未包含於DSM-IV所定義之憂鬱的診斷準則，因此在實證結果與理論建構的合併考量下，建議後續的使用者將之刪除，以確保BDI-II的評量結果可以精確地反映受試者的憂鬱程度，而未混雜其他概念。

這20題符合模式假設的題BDI-II項目，發現其中5題的選項在區辨受試者於該項目上不同嚴重度的精確度不如預期，因此建議未來改版時修改這些選項的評分標準。

不過，由這些選項所導致的評量誤差尚在可接受範圍內，因此現階段的研究與臨床使用上，應可暫時保留之。

大致而言，這些符合模式假設的20題BDI-II項目與選項所反應的憂鬱程度，在憂鬱嚴重度的建構量尺上能夠均勻地分布且完整地涵蓋不同的憂鬱程度，因此可以有效地區辨受試者之憂鬱程度。

最後，本研究依據羅序模式的估算結果，針對符合模式假設之20題BDI-II項目的原始總分，將之轉換為等距的羅序分數，並建立轉換表。

建議未來以BDI-II評量憂鬱症患者之憂鬱嚴重度時，使用20題符合模式假設的項目，並且以轉換後的等距羅序分數取代原始總分，以確保評量結果可以有效並精確地反映受試者的憂鬱程度。

TheBeckDepressionInventory-II(BDI-II)totalscorewasoneofthemostfrequentlyusedindicatorsofdepressionseverityinresearchandclinics.However,thejustificationofthisusewasnotwellvalidated.Specifically,therewereatleast4psychometricissuesthatneededtobeinvestigatedempirically,including(1)theunidimensionalitywhichwarrantedthesummationoftheBDI-IIscores;(2)theappropriatenessofcategoryscoringcriteriaineachitem;(3)thedistributionsoftheBDI-IIitemsandtheirresponsecategoriesalongthecontinuumofdepressionseverity;and(4)thetransformationofordinalrawBDI-IItotalscoresintointervaldata,whichweremoreinformativeandallowedarithmeticcomputation.TheRaschmodel,knownasaone-parameterlogisticmodelofitemresponsetheory,isparticularlyusefulininvestigatingtheaforementionedissuessimultaneously.TheobjectivesofthisstudyweretovalidatetheBDI-IIwithRaschanalyses,including(1)toconfirmtheunidimensionalitybymeansofexaminingRaschmodel-datafitting,(2)tochecktheappropriatenessofthecategoryscoringcriteria,(3)toinspectthedistributionsofitemsandtheirresponsecategoriesalongthecontinuumofdepressionseverity,and(4)totransformordinalrawBDI-IItotalscoresintointervalRaschlogits.Datawerederivedfromastudywith260clientsdiagnosedwithmajordepressivedisorders(Steeretal.,2001).Themodel-datafittingwasexaminedbyfitstatistics.TofulfilltheassumptionsoftheRaschmodel,theremaininganalyseswereperformedwiththefittedBDI-IIitemsonly.AllitemsfittedtheRaschmodel’sexpectation,andthustheunidimensionality,excepttheitem“LossofInterestinSex”.Afterremovalofthemisfititem,theremaining20BDI-IIitemsallfittedtheunidimensionality.Fiveitemsinwhichoneormoreresponsecategorieswerelessprobabletobeendorsedacrossvariousdegreesofdepressionseveritywereidentified,andthusthecategoryscoringcriteriamayneedtoberevisedinthefuture,includingtheitems“Sadness”,“PunishmentFeelings”,“Crying”,“LossofInterest”,and“ChangesinAppetite”.However,theresultingerrorswerewithinacceptableranges,sotheywerekeptatthisstage.The20fittedBDI-IIitemsandtheirresponsecategorieswerefoundtobeevenlydistributedalongthecontinuumofdepressionseverity,andtocover,withthisdistribution,thedepressionseverityoftheclientswithmajordepressivedisordersinthisstudyfairlywell.Theordinalrawtotalscoresofthe20fittedBDI-IIitemsweretransformedintointervallogitswiththeRaschmodel.Generally,the20fittedBDI-IIitemsthatconstitutedaunidimensionalconstructofdepressionwouldbeabletodiscriminatedifferentlevelsofdepressionseverityandweresuitabletomeasurethedepressionseverityoftheclientswithmajordepressivedisorders.Moreover,theRaschtransformedintervallogitsofthetotalscoresofthe20fittedBDI-IIitemsweresuggestedforusebyfuturecliniciansandresearchersbecausethetransformeddatacanprovidemoreinformationthanordinalrawBDI-IItotalscoresandallowarithmeticcomputationandtheapplicationofmorepowerfulparametricstatisticswithoutthethreatofviolatingstatisticalassumptions. LISTOFTABLESLISTOFFIGURESAPPENDIXINTRODUCTIONDepression－AContemporaryPrimaryIssueofHealth…………1OccupationalTherapyforDepression……………………………2SelectionoftheDepressionRatingScales……………………3ReviewofthePsychometricPropertiesoftheBDI-II………6ClassicalTestTheoryvs.ItemResponseTheory……………10TheAdvantagesofUsingtheRaschModeltoValidatetheBDI-II……………13ObjectivesofThisStudy…………………………………………16METHODSSample…………………………………………………………………17DataAnalysis…………………………………………………………19RESULTSTheUnidimensionality………………………………………………24AppropriatenessoftheCategoryScoringCriteria……………26DistributionsoftheBDI-IIItemsandtheirResponseCategories………………28TransformingOrdinalRawTotalScoresintoIntervalLogits……………………30DISCUSSION……………………………………………………………31TheUnidimensionality………………………………………………32AppropriatenessoftheCategoryScoringCriteria…………35DistributionsoftheBDI-IIItemsandtheirResponseCategories………………38TransformingOrdinalRawTotalScoresintoIntervalLogits………………41Limitations…………………………………………………………43SuggestionsforFutureStudies…………………………………44Conclusions…………………………………………………………46REFERENCES……………………………………………………………48LISTOFTABLESTable1CharacteristicsoftheSample………………………55Table2Model-dataFittingofalltheBDI-IIItems………56Table3Model-dataFittingofthe20FittedBDI-IIItems…………………………57Table4EstimatedItemandThresholdDifficulties(DepressionSeverities)ofthe20FittedBDI-IIItems..……………………………………………58Table5TheResponseFrequenciesoftheItemswithIdentifiedProblematicResponseCategories……………………………………………………………59Table6ConversionTableofOrdinalRawTotalScoresofthe20FittedBDI-IIItemsAndIntervalRaschLogits…………………………………………………60LISTOFFIGURESFigure1ComparisonofCitedTimesof7PopularDepressionRatingScalesonCombiningMedline,PsychInfoandCINAHLElectronicDatabaseDuringPast5And10Years…………………………………………61Figure2Comparisonof1-PLand2-PLIRTModels……………………………………62Figure3ScreePlotofthePrincipalComponentsAnalysisforResidualsofRaschModel……………………………………63Figure4AnalysisoftheAppropriatenessoftheCategoryScoringCriteriaofthe20FittedItemsoftheBDI-II……………………………………64Figure5CategoryProbabilityCurvesofItem1,“Sadness”,oftheBDI-II………65Figure6CategoryProbabilityCurvesofItem6,“PunishmentFeelings”,oftheBDI-II………………………………………………66Figure7CategoryProbabilityCurvesofItem10,“Crying”,oftheBDI-II………………………………………67Figure8CategoryProbabilityCurvesofItem12,“LossofInterest”,oftheBDI-II……………………………………68Figure9CategoryProbabilityCurvesofItem18,“ChangesinAppetite”,oftheBDI-II……………………………………69Figure10Item-personMapofthe20FittedBDI-IIItemsAndtheirResponseCategories…………………………………………70Appendix1DiagnosingCriteriaofMajorDepressiveEpisodeinDSM-IV-TR……71 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