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題名 「健康、性格、習慣量表(HPH)」 A、B、D類量尺的臨床效度探討
作者 張至恒
Chang, Chih Heng
貢獻者 許文耀
Hsu, Wen Yau
張至恒
Chang, Chih Heng
關鍵詞 健康、性格、習慣量表(HPH)
測驗效度
精神分裂症
重鬱症
低落型情感
焦慮疾患
強迫症
Health, Personality, and Habit Test (HPH)
test validity
schizophrenia
major depressive disorder (MDD)
dysthymia
anxiety disorder
obsessive-compulsive disorder (OCD)
日期 2011
上傳時間 17-Apr-2012 09:15:48 (UTC+8)
摘要 本研究旨在探討「健康、性格、習慣量表(HPH)」的臨床效度。HPH最初是由柯永河教授(民84)編製,後來廣泛使用在國內臨床場域中。發展至今已有中上程度的信效度支持,但過去較缺乏臨床上區辨與構念效度的研究,因此本研究旨在探討HPH區辨不同疾患的能力,以及以臨床疾患為受試時量尺之構念效度。
本研究回顧國內外類似測驗─MMPI、KMHQ、MCMI─的發展軌跡,並參照前人作法來進行HPH的臨床區辨效度研究。初步以臨床場域中常見的精神分裂症、重鬱症、低落型情感疾患、焦慮疾患,共257名患者為受試。先以共變數分析(ANCOVA)探討控制人口與臨床變項後,不同疾患組別在HPH的A、B、D類量尺的影響。再進一步使用羅吉斯迴歸(logistic regression)探討哪些量尺及其組合可以區辨兩兩疾患間的差異。最後,本研究也進行HPH的探索性因素分析(exploratory factor analysis),以檢驗其臨床上的因素結構。
本研究發現,精神分裂症(A1)、躁症傾向(A2)、憂鬱自殺類(A3、B4、A4)、心理功能與健康(D1、D3、D4、D5、D6)量尺在共變數分析上的差異情形與假設大致相符,後續討論分析也支持強迫症(B5)量尺效度。羅吉斯迴歸中,A1、A3、B4、B5能在兩兩疾患間區辨有顯著預測力。其中A1能在精神分裂症與其他三組疾患的兩兩區辨中預測,A3能在重鬱症與另外兩組(精神分裂症、焦慮症)的兩兩區辨中預測,B4能在低落型情感與精神分裂症的兩兩區辨中預測,B5能在強迫症與其他疾患間的兩兩區辨中預測。但是在重鬱症與低落型情感疾患間,以及低落型情感與焦慮疾患間,沒有量尺能在兩者的區辨中有顯著預測力。而各兩兩疾患間整體區辨效果有中至高度的關聯性,分類正確率也多有七成以上,顯示HPH量表在臨床上的區辨效度獲得支持。
構念效度部分,A、D類量尺因素結構與當初編製的每個量尺構念相近,B類量尺構念雖與原量尺略有不同,但仍不違背原量尺編製架構,因此構念效度亦獲得支持。不過各量尺仍有值得編修之處,討論一節中針對結果提出HPH後續編修之建議。
最後,本研究也將此結果之臨床實務應用於討論一節中詳述,以供後續研究與實務者參考。
The purpose of this study is to examine the clinical validity of the Health, Personality, and Habit Test (HPH). The HPH was developed by Dr. Yung-Ho Ko in 1995, and has been widely used in clinical settings. The HPH has demonstrated appropriate reliability and validity, but little research has been done on its differential and construct validity in the clinical settings. Therefore, the aim of this study is to explore the HPH’s ability to differentiate between disorders and its construct validity in clinical context.
This research reviewed the developments of similar tests, such as MMPI, KMHQ, and MCMI, and examined validity of the HPH with the same methods. Subjects were 257 patients who suffered from common disorders in clinical settings, including schizophrenia, major depression, dysthymia, and anxiety disorders. ANCOVA was first used to explore whether different disorders have an effect on category A, B, and D scales after controlling demographic and clinical variables. Next, logistic regression was used to clarify which scales and combinations can differentiate between two of four disorders. Finally, exploratory factor analysis was conducted to examine the structure of HPH in clinical setting.
The results of ANCOVA showed that the differences of schizophrenia scale (A1), manic scale (A2), depression/suicide scales (A3, B4, & A4), obsessive-compulsive disorder (OCD) scale (B5), and psychological function and health scales (D1, D3, D4, D5, D6) were partly consistent with assumptions, supporting the differential validity of HPH. The results of logistic regression analysis also supported the validity of A1, A3, B4, and B5 scales. More specifically, A1 was able to differentiate schizophrenia from any other three disorders, A3 was able to differentiate MDD from schizophrenia and anxiety disorders, B4 was able to differentiate dysthymia from schizophrenia, and B5 was able to differentiate OCD from other disorders. However, none of the scales was able to differentiate MDD from dysthymia, nor were they able to differentiate dysthymia from anxiety disorders. Moreover, each of the logistic regression functions showed moderate to high correlations, and most of them achieved high overall hit rates (above 70%), providing support for the clinical differential validity of the HPH.
As for construct validity, these factors in category A and D scales were essentially similar to original scales. Similarly, factors in category B scales were compatible to original scales though difference was found. In sum, these results lent support to the construct validity of the HPH in the clinical settings. However, refining of the scales is needed and suggestions are discussed.
Finally, the practical uses of the findings were also discussed.
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描述 碩士
國立政治大學
心理學研究所
96752019
100
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0096752019
資料類型 thesis
dc.contributor.advisor 許文耀zh_TW
dc.contributor.advisor Hsu, Wen Yauen_US
dc.contributor.author (Authors) 張至恒zh_TW
dc.contributor.author (Authors) Chang, Chih Hengen_US
dc.creator (作者) 張至恒zh_TW
dc.creator (作者) Chang, Chih Hengen_US
dc.date (日期) 2011en_US
dc.date.accessioned 17-Apr-2012 09:15:48 (UTC+8)-
dc.date.available 17-Apr-2012 09:15:48 (UTC+8)-
dc.date.issued (上傳時間) 17-Apr-2012 09:15:48 (UTC+8)-
dc.identifier (Other Identifiers) G0096752019en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/52769-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 心理學研究所zh_TW
dc.description (描述) 96752019zh_TW
dc.description (描述) 100zh_TW
dc.description.abstract (摘要) 本研究旨在探討「健康、性格、習慣量表(HPH)」的臨床效度。HPH最初是由柯永河教授(民84)編製,後來廣泛使用在國內臨床場域中。發展至今已有中上程度的信效度支持,但過去較缺乏臨床上區辨與構念效度的研究,因此本研究旨在探討HPH區辨不同疾患的能力,以及以臨床疾患為受試時量尺之構念效度。
本研究回顧國內外類似測驗─MMPI、KMHQ、MCMI─的發展軌跡,並參照前人作法來進行HPH的臨床區辨效度研究。初步以臨床場域中常見的精神分裂症、重鬱症、低落型情感疾患、焦慮疾患,共257名患者為受試。先以共變數分析(ANCOVA)探討控制人口與臨床變項後,不同疾患組別在HPH的A、B、D類量尺的影響。再進一步使用羅吉斯迴歸(logistic regression)探討哪些量尺及其組合可以區辨兩兩疾患間的差異。最後,本研究也進行HPH的探索性因素分析(exploratory factor analysis),以檢驗其臨床上的因素結構。
本研究發現,精神分裂症(A1)、躁症傾向(A2)、憂鬱自殺類(A3、B4、A4)、心理功能與健康(D1、D3、D4、D5、D6)量尺在共變數分析上的差異情形與假設大致相符,後續討論分析也支持強迫症(B5)量尺效度。羅吉斯迴歸中,A1、A3、B4、B5能在兩兩疾患間區辨有顯著預測力。其中A1能在精神分裂症與其他三組疾患的兩兩區辨中預測,A3能在重鬱症與另外兩組(精神分裂症、焦慮症)的兩兩區辨中預測,B4能在低落型情感與精神分裂症的兩兩區辨中預測,B5能在強迫症與其他疾患間的兩兩區辨中預測。但是在重鬱症與低落型情感疾患間,以及低落型情感與焦慮疾患間,沒有量尺能在兩者的區辨中有顯著預測力。而各兩兩疾患間整體區辨效果有中至高度的關聯性,分類正確率也多有七成以上,顯示HPH量表在臨床上的區辨效度獲得支持。
構念效度部分,A、D類量尺因素結構與當初編製的每個量尺構念相近,B類量尺構念雖與原量尺略有不同,但仍不違背原量尺編製架構,因此構念效度亦獲得支持。不過各量尺仍有值得編修之處,討論一節中針對結果提出HPH後續編修之建議。
最後,本研究也將此結果之臨床實務應用於討論一節中詳述,以供後續研究與實務者參考。
zh_TW
dc.description.abstract (摘要) The purpose of this study is to examine the clinical validity of the Health, Personality, and Habit Test (HPH). The HPH was developed by Dr. Yung-Ho Ko in 1995, and has been widely used in clinical settings. The HPH has demonstrated appropriate reliability and validity, but little research has been done on its differential and construct validity in the clinical settings. Therefore, the aim of this study is to explore the HPH’s ability to differentiate between disorders and its construct validity in clinical context.
This research reviewed the developments of similar tests, such as MMPI, KMHQ, and MCMI, and examined validity of the HPH with the same methods. Subjects were 257 patients who suffered from common disorders in clinical settings, including schizophrenia, major depression, dysthymia, and anxiety disorders. ANCOVA was first used to explore whether different disorders have an effect on category A, B, and D scales after controlling demographic and clinical variables. Next, logistic regression was used to clarify which scales and combinations can differentiate between two of four disorders. Finally, exploratory factor analysis was conducted to examine the structure of HPH in clinical setting.
The results of ANCOVA showed that the differences of schizophrenia scale (A1), manic scale (A2), depression/suicide scales (A3, B4, & A4), obsessive-compulsive disorder (OCD) scale (B5), and psychological function and health scales (D1, D3, D4, D5, D6) were partly consistent with assumptions, supporting the differential validity of HPH. The results of logistic regression analysis also supported the validity of A1, A3, B4, and B5 scales. More specifically, A1 was able to differentiate schizophrenia from any other three disorders, A3 was able to differentiate MDD from schizophrenia and anxiety disorders, B4 was able to differentiate dysthymia from schizophrenia, and B5 was able to differentiate OCD from other disorders. However, none of the scales was able to differentiate MDD from dysthymia, nor were they able to differentiate dysthymia from anxiety disorders. Moreover, each of the logistic regression functions showed moderate to high correlations, and most of them achieved high overall hit rates (above 70%), providing support for the clinical differential validity of the HPH.
As for construct validity, these factors in category A and D scales were essentially similar to original scales. Similarly, factors in category B scales were compatible to original scales though difference was found. In sum, these results lent support to the construct validity of the HPH in the clinical settings. However, refining of the scales is needed and suggestions are discussed.
Finally, the practical uses of the findings were also discussed.
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dc.description.tableofcontents 第一章 研究動機 1
第二章 文獻探討 3
第一節 「健康、性格、習慣量表」之發展回顧 3
第二節 他山之石,可以攻錯與借鏡 —MMPI、KMHQ、MCMI量表的發展 30
第三節 研究目的、問題與假設 37
第三章 研究方法 45
第一節 研究程序 45
第二節 研究對象與工具 47
第三節 資料分析與處理 53
第四章 研究結果 55
第一節 背景變項與A、B、D類量尺得分之關係 55
第二節 控制背景變項後, 四種疾患在A、B、D類量尺得分差異 61
第三節 A、B、D類量尺在兩兩疾患間的預測情形 69
第四節 A、B、D類量尺之構念效度 90
第五章 綜合討論 103
第一節 單一量尺對四種疾患的區辨效度 —得分差異探討 103
第二節 量尺及其組合在兩兩疾患間的區辨效度 —預測力及分類結果 111
第三節 構念效度探討 118
第四節 臨床實務應用 122
第五節 研究限制與未來研究方向建議 126
參考文獻 129
附錄一 人體試驗委員會同意書 137
附錄二 精神分裂症、重鬱症、低落型情感、強迫症、焦慮狀態之結果分析 138
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dc.language.iso en_US-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0096752019en_US
dc.subject (關鍵詞) 健康、性格、習慣量表(HPH)zh_TW
dc.subject (關鍵詞) 測驗效度zh_TW
dc.subject (關鍵詞) 精神分裂症zh_TW
dc.subject (關鍵詞) 重鬱症zh_TW
dc.subject (關鍵詞) 低落型情感zh_TW
dc.subject (關鍵詞) 焦慮疾患zh_TW
dc.subject (關鍵詞) 強迫症zh_TW
dc.subject (關鍵詞) Health, Personality, and Habit Test (HPH)en_US
dc.subject (關鍵詞) test validityen_US
dc.subject (關鍵詞) schizophreniaen_US
dc.subject (關鍵詞) major depressive disorder (MDD)en_US
dc.subject (關鍵詞) dysthymiaen_US
dc.subject (關鍵詞) anxiety disorderen_US
dc.subject (關鍵詞) obsessive-compulsive disorder (OCD)en_US
dc.title (題名) 「健康、性格、習慣量表(HPH)」 A、B、D類量尺的臨床效度探討zh_TW
dc.type (資料類型) thesisen
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