Reliability and Validity of the Life History of Aggression-Chinese Version in Schizophrenia Patients Assessment

To provide a longitudinal evaluation tool based on the frequency of aggressive behavior for the aggression assessment of schizophrenia patients.

The Life History of Aggression was translated and revised to form the Life History of Aggression-Chinese Version (LHA-CV) based on 369 patients diagnosed with schizophrenia in the Chengdu community and compulsory medical institution. The reliability of LHA-CV was analyzed by means of split-half reliability, test-retest reliability and inter-evaluator consistency. The validity was analyzed by item analysis, construct validity and criterion validity.

Item analysis found that LHA-CV had good homogeneity and discriminant validity. Exploratory factor analysis found that the Kaiser-Meyer-Olkin (KMO) test value was 0.80, and the Bartlett's sphericity test χ²=1 203.46 (P<0.05), and it revealed four factors including non-physical aggression, physical aggression, self-directed aggression and antisocial behavior/consequences. The factor loadings for all 11 items were greater than 0.40. Confirmatory factor analysis was performed on the factor model, Chi-square degree of freedom (χ²/df) was 3.61, root mean square error of approximation (RMSEA) was 0.07, goodness-of-fit index (GFI) was 0.92, comparative fit index (CFI) was 0.90, incremental fit index (IFI) was 0.90, and the discriminant validity of each factor was good. The criterion validity test showed the total score of LHA-CV was positively correlated with the aggressive behavior level of MacArthur Community Violence Instrument, the total score of Buss-Perry Aggression Scale, and the score of Antisocial Personality Disorder Subscale of Personality Diagnostic Questionnaire-4th Edition Plus (PDQ-4+_ASPD, P<0.05). The Cronbach's α coefficient of non-physical aggression, physical aggression, self-directed aggression, antisocial behavior/consequences and LHA-CV total score were 0.82, 0.73, 0.74, 0.56 and 0.79, respectively. The test-retest reliability, Spearman-Brown split-half reliability and intra-class correlation coefficient of LHA-CV total score were 0.82 (P<0.05), 0.66 and 0.99, respectively.

LHA-CV has good reliability and validity, and can be used as an evaluation tool for longitudinally assessing aggressive behavior in schizophrenia patients.