鑑別亞斯伯格症學童之進階版心智理論作業信效度的研究

Reliability and Validity of an Advanced Theory of Mind Task for Identifying Children with Asperger’s Syndrome

王韻涵(Yun-Han Wang)

指導教授 ： 洪福建

中原大學/理學院/心理學系/碩士(2008年)

https://doi.org/10.6840/CYCU.2008.00382

摘要

研究背景與目的. 近年來，亞斯伯格症在臨床上日益受到關注。有鑑於目前臨床上對於亞斯伯格症的瞭解有限，且國內現有的心理衡鑑工具匱乏，使得臨床上對亞斯伯格症的鑑別診斷更加不易。研究者回顧相關文獻發現，亞斯伯格症個案有心智理論能力的缺陷，所有研究結果一致地指出亞斯伯格症個案在進階版心智理論作業表現顯著較正常組差。目前國內已有少數研究者開始探討AS個案的心智理論能力，但結果不太一致，且可用來測量進階心智理論能力的測驗也極少。因此研究者嘗試挑選一個國外較常使用之進階版心智理論作業，檢驗此進階版心智理論作業的信效度，並了解國內正常學童及AS學童在此心智理論作業表現的狀況，期望未來可供臨床鑑別診斷之使用。
研究方法. 本研究分為兩個部分：第一個部分於桃園地區的國中小學三至八年級各抽選2個班，共12個班，350人，進行進階版心智理論作業的信效度驗證。第二個部分為臨床研究，包含18名亞斯伯格症學童，以及18名正常發展學童。兩組受試者在年齡、性別及語文智商相互配對。此研究比較兩組在各心智理論測驗的表現。最後，再進行區辨分析，檢驗進階版心智理論作業的區辨效力，並進行ROC曲線分析，試圖找出可供臨床區辨此二組之最佳切截分數。
研究結果. 進階版心智理論作業具有高度的評分者間信度、再測信度，以及中等程度的內部一致性，是一個穩定且可靠的測驗。進階版心智理論作業心理故事總分會隨著年齡增長，對於發展進程具敏感度，代表此作業具有適當的建構效度。另外，進階版心智理論作業心理故事總分與初級錯誤信念測驗總分及次級錯誤信念測驗總分皆無顯著相關，且，臨床研究發現AS兒童在進階版心智理論作業的表現顯著較正常組差，故支持進階版心智理論作業也具有區辨效度。總而言之，進階版心智理論作業是一個具有信度及效度的測驗工具。
結論. 本研究證實進階版心智理論作業是一個具有良好的信度及效度，且可有效區辨AS及正常學童的測驗工具；此外，也再次驗證亞斯伯格症個案在進階的心智理論能力上有缺陷。本研究在最後提出可能的限制及未來的研究方向。

關鍵字

效度 ； 錯誤信念 ； 信度 ； 亞斯伯格症 ； 心智理論 ； Strange Stories

並列摘要

Background and purpose. In present years, Asperger’s syndrome (AS) has received increasing attention in clinical settings. Because many clinicians presently don't know enough about AS, and the lack of assessment instruments in Taiwan, the diagnosis of AS becomes even more difficult. Literature review showed that individuals with AS have deficits in theory of mind (ToM), and all results consistently indicated that AS group perform significant more poorly on advanced ToM tasks than control group. A few studies in Taiwan have already investigated ToM in AS, but the results are inconsistent, and there are very few tools to estimate the advanced ToM abilities. Therefore, this paper attempted to choose an advanced ToM task that was the most commonly used abroad, to examine the reliability and validity of this task, and to investigate the performance on the advanced ToM task of normal children and children with AS. Eventually, hope this advanced ToM task could be helpful in the differential diagnosis of AS in the future.
Method. This study was broken into two parts. Study 1 examined the reliability and validity of the advanced ToM task. The advanced ToM task was administered to 350 children from third through eighth grade. Study 2 compared the performance of the advanced ToM task between 18 children with AS (3-8 grade) and 18 children with typical development matched for age, sex, and VIQ. And then carried out the discriminant analysis to assess how much the task can correctly classify between normal children and children with AS, and based on ROC curve analysis to decide the optimal cut-off score for the discrimination between normal group and AS group.
Results. The advanced ToM task displayed sound reliability, with high interrater reliability, good test-retest reliability, and moderate internal consistency. The scores on the mental stories of the advanced ToM task increased with age, the results suggest that it is sensitive to maturation, and it possesses construct validity. In addition, there were non-significant correlations between scores on the mental stories and other ToM indices(first-order false belief tasks and second-order false belief tasks), and AS group had significantly lower scores on the mental stories than normal group, the findings demonstrate that the advanced ToM task had discrimination validity. Altogether, results indicate that the advanced ToM task is a reliable and valid instrument.
Discussion. Results of the present investigation demonstrated that the advanced ToM task is a reliable and valid instrument. This study supports the finding of earlier studies, showing that individuals with AS have problem in advanced ToM abilities. Limitations and future research directions were discussed.

並列關鍵字

Asperger’s syndrome ； validity ； false-belief ； Strange Stories ； theory of mind ； reliability

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