臺灣博碩士論文加值系統

「加州大學洛杉磯分校創傷後壓力反應指標量表(UCLA-PTSD Reaction Index)」為一針對兒童及青少年所設計之創傷後壓力疾患(PTSD)篩檢工具，它具有施測簡便、文字淺顯、內容涵蓋完整PTSD診斷準則等優點，十分適合應用於災後篩檢PTSD之工作。國外文獻顯示其有良好的信效度，國內研究結果亦支持其中文版有良好之信度，有關效度之研究結果則較缺乏。本研究的目的在檢驗UCLA-PTSD Reaction Index中文版信效度，以進一步建立此量表之本土資料。
本研究以9至18歲之兒童及青少年為研究對象。以方便取樣的方式從台北縣市選取受測學校，自國小四年級至高中三年級，每年級抽選兩班進行初測，分別施測高中229人，國中222人，以及國小166人，共617人參與初測，其中男性319人，女性298人。並於一週後由原樣本中抽樣236人參與再測。初測問卷依序包括UCLA-PTSD Reaction Index中文版、事件衝擊量表、症狀檢核表之強迫症量尺及基本資料表。再測問卷為UCLA-PTSD Reaction Index中文版。
研究結果顯示，參與者所遭遇的創傷事件，前三名依序為災難、醫療程序及意外，而UCLA-PTSD Reaction Index中文版之症狀總分在各年級間和性別間均無顯著差異。在信度方面，此量表有良好的內部一致性(Chronbach’s alpha=.92)及再測信度(Pearson’s r =.80)；在效度方面，它與類似建構的測量工具-事件衝擊量表-的相關較高，具有同時效度，然而，其因素結構不論是以驗證性或探索性因素分析的結果來看，均未得出原設計之三個因素，所萃取出的兩因素(麻木及其他適應問題、插入/主動逃避症狀)則與國內過去的研究結果相近。
本研究結果顯示，UCLA-PTSD Reaction Index中文版的信度良好，其效度結果則與國外研究結果較不一致。由於樣本之隨機程度不足，本研究結果不宜作為常模資料使用。未來研究可以進一步建立本土常模，並收集臨床組資料，以探討此量表使用於診斷PTSD時的敏感度及特定度。

The UCLA-PTSD Reaction Index for DSM-IV Chinese version (PTSD-RI) is a screening instrument of Posttraumatic stress disorder, designed for children and adolescents. Easy to understand and administer, the PTSD-RI includes all the PTSD diagnostic criteria from DSM-IV. Widely used in international studies and clinical practice, it has demonstrated good reliability and validity across cultures. Although preliminary reports indicated satisfactory reliability and validity for the Chinese version, more researches were in need. The purpose of this study is to examine the reliability and validity of the PTSD RI Chinese version.
617 children and adolescents (aged 9 to 18 years) were recruited from three schools in Taipei City and County. There were 229 senior high school students, 222 junior high school students, and 166 elementary school students. 319 participants were male and 298 were female. All participants completed the PTSD RI Chinese version, Impact of Event Scale, and the OCD subscale of Symptom Checklist 90-Revised in their classrooms. Out of these 617 participants, 236 filled out the PTSD RI Chinese version again one week later to evaluate the test-retest reliability.
The top three traumatic events that the participants have experienced are disasters, medical procedures, and accidents. There is no significant gender or age difference on PTSD severity score. The results showed that the PTSD RI Chinese version has satisfactory internal consistency, test-retest reliability, and convergent validity. Results from either confirmatory or exploratory factor analysis, showed that the factor structure of the PTSD RI Chinese version does not fit the DSM model of three factors as predicted. However, this result is consistent with previous findings from other Taiwanese samples, in which two factors were identified.
Findings from this study in general consistent with previous researches. That is, the PTSD RI Chinese version has demonstrated good reliability and validity in our sample. Due to considering this sample, the results should not be used as in adequate representativeness of gender or age norms.
For clinical utility, it is suggested that future research should compare clinical group with normal group, examine the sensitivity and specificity of the PTSD RI Chinese version, and establish its clinical cutoff point.

目 錄
長庚大學碩士學位論文 指導教授推薦書 i
長庚大學博（碩）士學位論文 口試委員會審定書 ii
博碩士論文授權書 iii
博碩士論文電子檔案上網授權書 iv
長庚大學博碩士紙本論文著作授權書 v
摘 要 ix
目 錄 xiii
圖表目錄 xvii
第一章 緒論 1
1.1 研究背景 1
1.2 文獻回顧 2
1.2.1 創傷事件的定義 2
1.2.2 創傷事件的後遺症 4
1.2.3 PTSD的定義 6
1.2.4 PTSD的盛行率 11
1.2.5 PTSD評估工具的簡介 12
1.2.6 本土評估工具之發展 17
1.2.7創傷後壓力量表 19
1.3 研究目的 22
第二章 研究方法 24
2.1 參與者 24
2.2 研究工具 25
2.2.1基本資料問卷 25
2.2.2班級資料表 26
2.2.3創傷後壓力量表 26
2.2.4事件衝擊量表 27
2.2.5 症狀檢核表 28
2.3 進行步驟 30
2.3.1 研究工具預試 30
2.3.2 召募研究參與者 30
2.3.3 收案流程 31
2.3.4 資料分析 33
第三章 研究結果 35
3.1預試結果 35
3.2參與者的基本資料 36
3.3各量表的得分表現 39
3.4 創傷事件的發生率 41
3.5 信度 47
3.5.1 內部一致性 47
3.5.2 再測信度 48
3.6 效度 49
3.6.1 建構效度 49
3.6.2 同時效度與聚斂效度 54
第四章 討論 56
4.1 創傷事件與PTSD症狀總分 56
4.2 創傷後壓力量表的信效度 59
4.3 研究缺點與限制 61
4.4 學術與臨床意涵 62
第五章 結論與建議 64
參考文獻 66
附錄一：基本資料 79
附錄二：班級資料表 80
附錄三：創傷後壓力量表(PTSD-RI) 81
附錄四：事件衝擊量表(IES) 85
附錄五：強迫症狀量表 86
附錄六：施測人員須知 87

圖表目錄

表 1 兒童及青少年之創傷及創傷反應測量工具 16
表 2 樣本之年級、性別人數分佈及平均年齡 37
表 3 各量表有效份數 38
表 4 各性別與年齡組在創傷後壓力量表(PTSD-RI)上之得分 39
表 5各性別與年齡組在事件衝擊量表(IES)上之得分 40
表 6 各性別與年齡組在強迫症狀量表上之得分 41
表 7 全樣本各創傷事件比例 43
表 8 高中組各創傷事件比例 44
表 9 國中組各創傷事件比例 45
表10 國小組各創傷事件比例 46
表11 各量表之內部一致性 48
表12 創傷後壓力量表(PTSD-RI)驗証性因素分析結果 50
表13 創傷後壓力量表(PTSD-RI)探索性因素分析結果 52
表14 三個研究中探索性因素分析結果之比較 53
表15 各量表得分間之相關 55

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