Validity And Reliability Of The Chinese Version Of The Dynamic Appraisal Of Situational Aggression–Youth Version

Objective To test the reliability and validity of the structured dynamic risk assessment tool,the Dynamic Appraisal of Situational Aggression-Youth Version(DASA-YV),in adolescents with mental disorders in Chinese mainland,so as to provide a simple and effective tool for adolescent psychiatric staff in China to dynamically identify the risk of situational attack in adolescents with mental disorders at an early stage.Methods With the consent of the original author,the first draft of the Chinese Version of the Dynamic Appraisal of Situational Aggression-Youth Version.for Adolescent Situational Aggression was obtained through translation,back translation,cultural debugging and pre-experiment.Ten experts in clinical psychiatry were invited to evaluate the content validity of the Chinese version of DASA-YV Scale and listen to their opinions.The nurses who participated in this study were trained and assessed in a unified way.After passing the examination,20 adolescent patients with mental disorders were evaluated,and the Interrater reliability was obtained.The sample size is calculated according to the formula of the estimated total rate in the sampling survey,and it is planned to collect 269 hospitalized adolescent mental disorders who meet ICD-10.Every 24 hours,the Chinese version of the Dynamic Appraisal of Situational Aggression-Youth Version for adolescent situational aggression was used to evaluate the patients.The Broset-Violence Checklist(BVC)and the revised explicit aggression scale MOAS were used to evaluate the simultaneous validity,and the actual behavior performance in the next 24 hours was used to test the predictive validity.Epi Date3.1 software is selected as data entry software.Data were analyzed by SPSS 22.0 statistical analysis software.Results There were 103 patients with aggressive behavior and 188 patients without aggressive behavior.After analyzing the basic sociological data of the two groups by Chi-square test or Fisher exact probability method,we found insight(X~2=12.489,P<0.01),pre-hospital aggressive behavior(X~2=14.298,P<0.01)and course of disease(X~2=9.891,P<0.01).In terms of content validity,the content validity(I-CVI)of each item is irritable(1),impulsive(1),sensitive to perceived provocation(0.8),irritable when the request is rejected(0.8),unwilling to follow instructions(0.9),negative attitude(0.8),language threat(1),anxiety or fear(0),The content validity index(average S-CVI)of the scale level is 0.97,and the content validity of the scale level is good,but the content validity of the items of anxiety or fear and external pressure is poor.In terms of predictive validity,the nonparametric test results between the attack group and the non-attack group were statistically different(Z=-52.260,P<0.01).The area under the curve(AUC)of the operator characteristic curve(ROC)within 16 hours is0.905.When the cut-off point is 1,the sensitivity(Se)and specificity(Sp)of the scale are 84.70%and 95.50%respectively.It shows that the predictive validity of the scale is good.The Broset-Violence Checklist(BVC)and Modified Aggressive Behavior Scale(MOAS)are used as criterion tools,and the total score of the two criteria is positively correlated with the Chinese Version of the Dynamic Appraisal of Situational Aggression-Youth Version.Five trained nurses evaluated 20 identical cases,and the inter-evaluator reliability of each item in the Chinese Version of the Dynamic Appraisal of Situational Aggression-Youth Version.was as follows:irritability(0.850),impulsiveness(0.833),sensitivity to perceived provocation(0.821),irritability when the request was rejected(0.860),unwillingness to follow instructions(0.833),negative attitude(0.883)and language threat.The homogeneity reliability test shows that Cronbachαcoefficient is0.896,which indicates that the evaluation results of the scale are consistent.The total correlation between each item and the total score is r=0.587-0.808(P<0.01),which indicates that the evaluation purposes of each item are consistent.Conclusion The Chinese Version of the Dynamic Appraisal of Situational Aggression-Youth Version(DASA-YV)has good reliability and validity among adolescents with mental disorders in Chinese mainland,and can be applied to psychiatric wards after revision.