Abstract: Background　Identification of the warning signs of psychological crisis by observing behaviors is favorable for early detection and management of the potential psychological crisis.However，in China，there is still no psychological crisis warning instrument available.Objective　To develop an individual psychological crisis warning instrument for dynamic early warning of psychological crisis.Methods　Items were screened using Delphi expert consultation method to form the Psychological Crisis Signs Checklist （PCSC）．By two rounds of survey，the reliability and validity of PCSC were examined，and the PCSC was then modified on the basis of an expert discussion according to item analysis including inter-rater reliability，sensitivity and specificity indicators.The Yoden Index was used to calculate the warning threshold.Results　The items were screened by a two-round Delphi study，resulting in a 35-item PCSC.During a formal survey 〔the number of respondents in the formal survey was 183，consisting of the crisis group （n=82），and non-crisis group （n=101） 〕，the PCSC demonstrated excellent internal consistency （Cronbach's α=0.85） and inter-rater reliability （rs=0.84），scores of PCSC could effectively distinguish between crisis and non-crisis group.The Spearman' rho between PCSC and Triage Assessment Form （TAF） was 0.90，indicating good criterion validity.The PCSC was then modified on the basis of an expert discussion according to item analysis including inter-rater reliability，sensitivity and specificity indicators.The modified PCSC includes 30 items.Based on the threshold corresponding to the maximum Youden index，it was determined that when the total PCSC score is ≥9，yellow crisis alarms；when the total cutoff score is ≥14，red crisis alarms.Conclusion　The PCSC could effectively screen individuals at high risk for psychological crisis，which is conducive to early identification of warning signs and dynamic monitoring of psychological crisis.

Key words: Psychological crisis, Suicide, Warning signs, Tool

摘要： 背景　观察心理危机当事人表现出来的行为征兆，有利于早期识别和预警潜在的心理危机，但目前国内尚缺乏心理危机征兆预警工具。目的　研制个体心理危机征兆预警工具，实现心理危机的早期动态预警。方法　采用德尔菲（Delphi）法专家咨询对条目池进行筛选，形成心理危机征兆检查表（PCSC）。通过两轮施测，对PCSC进行信效度检验。根据评分者一致性、条目的敏感度和特异度及专家讨论等，对量表条目进行修订。计算约登指数确定预警临界值。结果　通过2轮Delphi法对条目池进行筛选，确立了含35个条目的PCSC。正式施测（有效个体183例，其中非心理危机组101例，心理危机组82例）结果显示，该量表具有良好的内部一致性（Cronbach's α=0.85）和评分者一致性〔Spearman相关系数（rs）为0.84〕，能够有效区分危机组和非危机组；与心理危机三维评估体系（TAF）评分具有较高的一致性（rs=0.90），说明PCSC具有良好的效标效度。根据评分者一致性、条目的敏感度和特异度及专家讨论等，对量表条目进行修订，形成了包括30个条目的PCSC。根据约登指数最大时所对应的临界值，确定PCSC总分达到9分可发出黄色心理危机预警，总分达到14分可发出红色心理危机预警。结论　PCSC能够有效区分心理危机的高危人群，有利于对心理危机实现早期预警和动态监测。

关键词: 心理危机, 自杀, 预警征兆, 工具