台灣健康成年人中文字詞次序學習測驗之常模研究

背景：中文字詞次序學習測驗隸屬於語文事件記憶測驗，本測驗主要特徵為字詞間關係屬任意語意連結的特質，而具有此特質的學習測驗與內側顳葉結構(medial temporal lobe structures)中的嗅緣皮質(the perirhinal cortex)有著密切的關連性。阿茲海默病的神經病理研究指出，嗅緣皮質是早期出現神經病理現象的腦區之一，因此該腦區所負責的語文事件記憶能力，也被視為阿茲海默病早期認知功能改變的項目之一。然而，目前在台灣缺乏偵測該阿茲海默病前期(pre-AD)記憶缺陷的工具與常模資料。目的：本研究的研究目的是建立台灣健康成年人中文字詞次序學習測驗的常模資料，同時探討人口學變項對該測驗表現的影響，以及檢驗本測驗的心理計量特性。方法：本研究共收集307位受試者的測驗資料，並按照分層隨機抽樣，以年齡(16至90歲)、教育程度(0至18年)、性別以及台灣地理分布等變項進行分組。隨機選取30位受試者進行信度的檢驗，另外再隨機選取33位受試者進行校標關聯及建構效度的考驗。並且以回溯性方式收集40位具有失憶型輕度認知功能障礙(aMCI)的病人資料，以供進一步驗證本測驗之建構效度。結果：人口學變項的影響主要出現在年齡與教育程度兩變項上，亦即本測驗的表現會隨年齡增加而衰退，但隨著教育程度增加而測驗表現提升。本測驗之再測信度係數在0.6左右，副本信度係數在各個分數上則分布較廣(.14至.73)。在校標關聯效度上，本測驗除了再認分數外，與其他語文事件記憶測驗的分數有著中等程度的相關(.35至.75)。除此以外，在病人回溯性研究結果顯示，本測驗在偵測aMCI病人記憶缺陷的比例，較魏氏記憶量表第三版之邏輯記憶測驗為高。結論：研究結果顯示年齡及教育變項皆明顯影響中文字詞次序學習測驗的表現，因此在常模建立上，進行人口學變項的校正有其必要性。此外，研究結果亦顯示中文字詞次序學習測驗具有適當的心理計量特性。有鑑於此，根據病人回溯性研究結果，我們可預期該測驗的表現可作為偵測阿茲海默病前期的認知標記。未來則應持續進行前瞻性病人研究，以了解中文字詞次序學習測驗在診斷阿茲海默病前期的貢獻。

關鍵字

中文字詞次序學習測驗；神經心理測驗；事件記憶；常模研究；人口學變項；信效度；校正分數

並列摘要

Background: The Word Sequence Learning Test (WSLT) is one of the verbal episodic memory measures, and is characterized by arbitrary associates among words. Processing this type of episode memory task is thought to be highly associated with the perirhinal cortex functioning. Studies have shown that the pathological change of the perirhinal cortex is one of the main features of the pre-Alzheimer’s disease (pre-AD). Accordingly, it would be expected that the impairment of arbitrary-associates verbal memory tests, such as the WSLT, would be evident in the pre-AD. However, currently there is a lack of normative data of the WSLT in Taiwan. Objective: The purpose of the present study was to establish the normative data of the WSLT in Taiwanese healthy adults. Issues of the effects of demographic variables and psychometric properties of the WSLT were also investigated. Methods: The study included 307 healthy participants stratifying by age (ranging from 16 to 90 years old), education level (ranging from 0 to 18 years), sex, and different geographical regions in Taiwan. Thirty participants were randomly selected for examining reliabilities. Thirty-three participants were also selected for examining the criterion-related and the construct validity. Forty patients with amnestic mild cognitive impairment (aMCI) were also retrospectively collected for verifying the construct validity. Results: Effects of age and education can be found in the WSLT. The correct, the position, the learning, and the cued scores decreased as age increased. All sub-scores increased as education level increased. The correlation coefficient of the retest reliability was around 0.6 and the alternate-form reliability varied across different sub-scores (ranging from .14 to .73). Sub-scores of the WSLT correlated moderately (ranging from .35 to .75) with those of other verbal episodic memory measures, except for the recognition score. The patient study revealed that the proportion of memory deficits evident in patients with aMCI measured by the WSLT was higher than by the Logical Memory subtest of the Wechsler Memory Scale-Third Edition. Conclusion: Age and education have an influence on the WSLT, and thus the demographic-corrected norm is needed. In addition, the WSLT has adequate reliability and validity. Based on the retrospective patient study, it appears that the test performance could be taken as a cognitive marker for AD. Further prospective study to validate this preliminary result is necessary.

並列關鍵字

Word Sequence Learning Test ； neuropsychological assessment ； episodic memory ； normative data ； demographic variables ； reliability ； validity ； adjusted score

參考文獻

Stranahan, A. M., & Mattson, M. P. (2010). Selective vulnerability of neurons in layer II of the entorhinal cortex during aging and Alzheimer's disease. Neural Plasticity, 2010, 108190.

Chen, H. Y., Hua, M. S., Zhu, J., & Chen, Y. H. (2008). Selection of Factor-Based WAIS-III Tetrads in the Taiwan Standardization Sample: A Guide to Clinical Practice. Chinese Journal of Psychology, 50(1), 91-109.

Backman, L., Jones, S., Berger, A.-K., Laukka, E. J., & Small, B. J. (2005). Cognitive impairment in preclinical Alzheimer's disease: A meta-analysis. Neuropsychology, 19(4), 520-531.

Bell, B., Lin, J. J., Seidenberg, M., & Hermann, B. (2011). The neurobiology of cognitive disorders in temporal lobe epilepsy. Nature Reviews Neurology, 7, 154-164.

Bleecker, M. L., Bolla-Wilson, K., Agnew, J., & Meyers, D. A. (1988). Age-related sex differences in verbal memory. Journal of Clinical Psychology, 44(3), 403-411.

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台灣健康成年人中文字詞次序學習測驗之常模研究

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