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简明多维冷漠量表（b-DAS）：Mokken分析和量表缩减

The brief Dimensional Apathy Scale (b-DAS): Mokken analysis and scale reduction
课程网址: http://videolectures.net/encals2017_radakovic_scale_reduction/  
主讲教师: Ratko Radakovic
开课单位: 爱丁堡大学
开课时间: 2017-07-21
课程语种: 英语
中文简介:
背景：在肌萎缩侧索硬化症（ALS）和阿尔茨海默病（AD）等神经退行性疾病中，冷漠是一种显著的去激励症状。它被认为是一种多维综合征，由不同的亚型组成，可使用多维冷漠量表（DAS）进行测量，DAS是一种评估执行、情绪和启动冷漠的24项工具，独立于运动障碍。由于越来越多的诊断，意识和冷漠的影响，在临床上需要一个简明而全面的措施。目的是使用大型混合神经退行性疾病样本（AD和ALS）来减少DAS，形成简短的DAS（b-DAS）。方法：利用102例非痴呆ALS患者和102例AD患者对告密者/照料者DAS的反应数据，并附加告密者/照料者冷漠评估量表（AES）和老年抑郁症量表简表（GDS-15）、标准冷漠和抑郁测量。Mokken分析在每个DAS子量表（执行、情绪和启动）上进行，用于基于歧视（Hi）的初始项目减少。项目背书（项目平均得分）也进行了检查。项目总相关分析采用AES总相关分析确定收敛效度，GDS-15总相关分析确定分歧效度，确定b-DAS的最终结构。结果：AD和ALS患者受教育年限匹配良好，但性别分布和年龄不同。然而，在冷漠或抑郁方面与年龄无关，也没有性别差异。对每个DAS子量表进行Mokken分析后，所有8个执行项目和所有8个启动项目都被保留，其中3个情绪项目表现出弱Hi（<.3），因此被删除。在剩下的项目中，选择了那些与AES（r>0.5）有较强正相关，与GDS-15（r<0.5）也有中度至较弱相关性的项目，以及那些理论上与每个子量表相关的项目。这导致b-DAS由9个项目组成，在执行、情绪和启动子量表上权重相等。结论：b-DAS是一个稳健而简短的多维冷漠量表，由9个与金标准冷漠量表相关的项目组成，同时降低了与抑郁症的相关性。在临床和研究中，快速、全面地筛查神经退行性疾病中的冷漠亚型损害是合适的。
课程简介: Background: Apathy is a prominent demotivational symptom in neurodegenerative diseases, such as Amyotrophic lateral sclerosis (ALS) and Alzheimer’s disease (AD). It is considered a multidimensional syndrome, composed of different subtypes which can be measured using the Dimensional Apathy Scale (DAS), a 24 item tool assessing Executive, Emotional and Initiation apathy, independent of motor disability. Due to increasing diagnosis, awareness and impact of apathy, a concise yet comprehensive measure is needed in clinic. The aim was to reduce the DAS using a large mixed neurodegenerative disease sample (AD and ALS) to form the brief DAS (b-DAS). Method: Data from 102 non-demented ALS patients and 102 AD patients of responses to the informant/carer DAS were utilised, with additional availability of informant/carer Apathy Evaluation Scale (AES) and the Geriatric Depression Scale-Short form (GDS-15), standard apathy and depression measures. Mokken analysis was performed on each DAS subscale (Executive, Emotional and Initiation) for initial item reduction based on discrimination (Hi). Item endorsement (mean item score) was also examined. Item-total correlational analysis was performed, with the AES total, to determine convergent validity, and the GDS-15 total, to determine divergent validity, to establish the final structure of the b-DAS. Results: AD and ALS patients were well matched for years of education, but differed on gender distribution and age. However, there was no correlation with age and no gender differences on apathy or depression. Mokken analysis on each DAS subscale resulted in all 8 Executive and all 8 Initiation items being retained, with 3 Emotional items showing a weak Hi (< .3) and were consequently removed. Of the remaining items, those with a stronger positive correlation with the AES (r > .5) and also a moderate to weaker correlation with the GDS-15 (r < .5), as well as those theoretically coherent to each subscale, were selected. This resulted in the b-DAS composed of 9 items, equally weighted over the Executive, Emotional and Initiation subscales. Conclusion: The b-DAS is a robust yet short multidimensional apathy instrument composed of 9 items that correlate with a gold-standard apathy measure, whilst reducing the association with depression. It is appropriate for use in the clinic and research to quickly and comprehensively screen for apathy subtype impairments in neurodegenerative disease.
关 键 词: 肌萎缩侧索硬化症; 阿尔茨海默病; 神经退行性疾病; 冷漠亚型损害; 多维冷漠量表
课程来源: 视频讲座网
数据采集: 2021-12-17：zkj
最后编审: 2021-12-17：zkj
阅读次数: 175

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