An Evaluation of Reliability and Validity of Taiwanese Version of the Scale for the Assessment of Thought, Language, and Communication（T-TLC）

• Main Authors: Wan Ting Huang, 黃婉婷
• Other Authors: Y. Y. Yang
• Format: Others
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/08884201576279010858

碩士 === 長庚大學 === 職能治療學系 === 99 === Formal thought disorder is one of the core characterizes of schizophrenia. It unfold in verbal behavior is disorganized speech. The scale for the assessment of thought, language and communication（TLC）, which has developed by Andreasen scores according to language behaviors of individuals in a semi-structure interview. It counts the behavior frequency in 18 subtypes of formal thought disorder. It provides quantitive assessment criteria for evaluating formal thought disorder. TLC has been reported that has good reliability and validity and is widely used nowadays. The aim of this study is to develop a Taiwanese version of TLC（T-TLC）, standardize and evaluate its applicability in Taiwan’s patient population. Patients with schizophrenia spectrum disorder （age 18 to 60 years） were recruited in this study. Psychiatrists selected 72 subjects from psychiatric acute and chronic wards according to DSM-Ⅳ-TR criteria, including 60 schizophrenic patients and 12 schizoaffective patients. Researcher translated TLC to Mandarin and examined the content validity. Researcher proceeded semi-structure interview for forty minutes to fifty minutes. There were two raters in this study. One was interviewer, the other rated simultaneously. At last, the researcher used the quantitative data to examine inter-rater reliability, congruent validity and factor validity of T-TLC. The finding showed that there are 13 out of 18 items of T-TLC have acceptable inter-rater reliability (Kappa = .42 - .47). The other five items contain “Poverty of content of speech”, “Incoherence”, “Circumstantiality”, “Echolalia”, “Stilted speech” and “Self reference”; their low reliability may due to insufficient variability. Using correlation analysis, the reliability enhanced (ICC = .55-.90) except “Echolalia”. The “circumstantiality” and “derailment” of T-TLC correlated with “conceptual disorganization” of PANSS （both r = .72）; The “poverty of speech” of T-TLC correlated with the “lack of spontaneity and flow of conversation” of PANSS （r = .78）. The results demonstrated that T-TLC had good congruent validity. The result of confirmatory factor analysis confirmed the proposed two-factor and three-factor models; The result of exploratory factor analysis yielded a two-factor model, which contained “disorganized” and “attentional”. The “attentional” factor comprised of “distractibility” and “blocking”. This two factor model could explain 52.8% of variability. T-TLC appeared to be an appropriate assessment tool with good inter-reliability and construct validity. It may provide clinicians and researchers an objective indicator to evaluate formal thought disorder. In the future study, it may expand the sample size and include other mental illnesses, not limited to schizophrenia spectrum disorder. T-TLC could make up the situation of lack of assessment tools in Taiwan. It could be used as a clinical assessment tool, and encourage further research on formal thought disorder.