Somatic Symptom Disorder according to DSM-5: development and validation of a new self-report measure (SSD-B)

根据 DSM-5 的躯体症状障碍：新自我报告测量 (SSD-B) 的开发和验证

• 批准号: 254436317
• 负责人: Dr. Anne Toussaint, Ph.D.
• 金额: --
• 依托单位: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2015
• 资助国家: 德国
• 起止时间: 2014-12-31 至 2018-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/254436317?language=en
• 关键词: Somatic; Symptom; Disorder; according; DSM

In May 2013, the American Psychiatric Association published the latest version of the Diagnostic and Statistical Manual of Mental Disorders: DSM-5. This version includes significant improvements in the domain of somatoform type disorders to improve the reliability and clinical utility of the diagnoses. In particular, the new Somatic Symptom Disorder no longer includes the controversial need for organic explicability of symptoms. In contrast, the presence of at least one relevant positive psychological characteristic (B criteria) accompanying the physical symptoms is required: (I) disproportionate and persistent thoughts about the seriousness of one's symptoms, (2) persistently high level of anxiety about health or symptoms, (3) excessive time and energy devoted to these symptoms or health concerns. It is critical to diagnose these patients early to prevent chronification, inappropriate health care use and improve patient care. Although they are no replacement for the gold standard Structured Clinical Interview for DSM-Disorders, self-report questionnaires can be a practical and efficient diagnostic aid. There are scales available to assess physical symptoms (e.g. PHQ-15), however, there is currently no questionnaire to directly assess the new B criteria. The objective of our project is to develop a reliable and valid instrument for this purpose. So far a preliminary version (SSD-B) has been developed and tested on a pilot outpatient psychosomatic sample (n = 156). A confirmatory factor analysis confirmed a three factor structure of a refined 12 item version which was originally formed according to the three sub-criteria. Reliability estimates, convergent and divergent validity analyses suggest that the questionnaire has promising content-related and psychometric properties. In order to further develop and extend the instrument to enable case identification, severity and course measurement, the current proposal was formed. The future project has been divided into five parts. Phase I will involve the further development of the full version of SSD-B and the development of a short version. These versions will be validated in both an in- and out-patient sample in Phase II. To broaden the potential use of SSD-B, an English version will be created according to the state of the art translation procedures and then validated in an English-speaking sample (External Project I). Age- and gender-related norms of SSD-B will be formed in a general population sample (External Project II). In the final phase, the outcomes of the project will be disseminated in publications, at local and international conferences and within health-care networks (Phase III). The outcome of the complete development and validation process of SSD-B will hopefully enable a more targeted, sensitive and earlier detection of somatic symptom disorder so that more pragmatic and quality of life-related interventions can be offered to these patients in the future.

2013年5月，美国精神病学协会发布了最新版本的《精神疾病诊断和统计手册：DSM-5》。这个版本包括在躯体类型障碍领域的重大改进，以提高诊断的可靠性和临床实用性。特别是，新的躯体症状障碍不再包括有争议的对症状的有机解释的需要。相反，至少需要有一个伴随身体症状的相关积极心理特征(B标准)：(1)对自己症状的严重性的不成比例和持续的想法，(2)对健康或症状的持续高度焦虑，(3)过多的时间和精力投入到这些症状或健康问题上。对这些患者进行早期诊断，以防止慢性化、不适当的医疗保健使用和改善患者护理，至关重要。尽管它们不能替代针对DSM-疾病的黄金标准结构化临床访谈，但自我报告问卷可以是一种实用而有效的诊断辅助工具。有可用于评估身体症状的量表(例如PHQ-15)，但目前没有直接评估新的B标准的问卷。我们项目的目标是为此目的开发一种可靠和有效的工具。到目前为止，初步版本(SSD-B)已经开发出来，并在飞行员门诊心身样本(n=156)上进行了测试。验证性因素分析证实了根据三个子标准形成的精炼12个条目版本的三因素结构。信度估计、收敛和发散效度分析表明，该问卷具有良好的内容相关特性和心理测量学特性。为了进一步发展和扩展该工具，使之能够进行病例识别、严重性和病程测量，形成了目前的提议。未来的项目分为五个部分。第一阶段将涉及进一步开发SSD-B的完整版和开发简短版本。这些版本将在第二阶段的住院和门诊样本中进行验证。为了扩大SSD-B的潜在用途，将根据最先进的翻译程序创建英语版本，然后在讲英语的样本(外部项目I)中进行验证。将在一般人口样本中形成与年龄和性别有关的SSD-B常模(外部项目II)。在最后阶段，项目成果将在出版物、地方和国际会议以及保健网络内传播(第三阶段)。SSD-B的完整开发和验证过程的结果有望使更有针对性、更敏感和更早地发现躯体症状障碍，以便在未来为这些患者提供更务实和更高质量的生活相关干预措施。