Delusional Ideation in non-clinical samples : comparison with clinical samples and pathogenesis

精神分裂症患者表现出许多症状，如妄想、幻觉和阴性症状。为了研究妄想症状的发病机制，我们开发了一些测量临床和非临床样本妄想的评估工具。我们开发了妄想性思维检查表(DICL)，它测量了偏执思维的主题。为了检验其信度和效度，我们对非临床样本进行了研究。因素分析表明，妄想性思维的主题可以从自我他人的情绪和方向两个角度进行分类。DICL能较全面、系统地处理妄想性思维，具有良好的信度和诊断效度。DICL测试结果表明，普通人出现妄想的频率高于精神病学家的预期。我们还检验了妄想症的素质-应激交互作用假说的有效性，这是精神病理学发病机制的典型模型。通过对小组研究数据的分层回归分析，证实了素质-压力交互作用假说。结论：1.在较大的压力下，素质较强的被试表现出妄想增多。我们开发了多维个人理想(MAPI)，它测量了妄想的形式方面，如信念或专注力。为了检验其临床应用价值，我们对临床样本和非临床样本进行了半结构化访谈。结果表明，MAPI对有妄想症的精神分裂症患者的访谈有一定的临床应用价值。

Schizophrenic patients show many symptoms, such as delusion, hallucinations and negative symptoms. In order to examine the pathogenesis of the delusional symptoms, we developed some assessment tools measuring the delusional ideation in the clinical and non-clinical samples.1. We developed the Delusional Ideation Checklist (DICL) which measured the theme of paranoid ideation. In order to examine its reliability and validity, we conducted the study of the non-clinical samples. Factor analysis revealed that the theme of delusional ideation could be classified from the viewpoints of emotion and direction of self-others. DICL could deal with the delusional ideation in a comprehensive and systematic way and showed good reliability and diagnostic validity. The results of DICL indicated that ordinary person experienced delusional ideation more frequently than the psychiatrists expected. We also examined the validity of the diathesis-stress interaction hypothesis of the delusional ideation, which was typical model of the pathogenesis in psychopathology. Using hierarchical regression analysis on the data obtained from the panel study, the diathesis-stress interaction hypothesis was confirmed. The subjects who had strong diathesis showed an increase of delusional ideation under a great stress.2. We developed the Multi-dimensional Personal Ideation (MAPI) which measured the formal aspects of the delusional ideation, such as conviction or preoccupation. In order to examine its clinical utility, we conducted the semi-structured interview on both clinical and non-clinical samples. The results showed that MAPI had clinical utility on the interview of the schizophrenic patients who had delusional ideation.