本研究目的為發展COMTESS 並初步驗證其信效度及施測效率。研究者依據 工作社交技巧之理論與文獻常見之社交行為發展COMTESS 題庫，並經專家審 核、羅序分析驗證題庫及挑選適當題目後，建立COMTESS。COMTESS 完整涵 蓋工作社交技巧的二個向度，即「個人社交技巧」向度與「職務相關社交技巧」
向度。二向度內的題庫皆符合羅序模型之單向度與局部獨立性假設，具備建構效 度。COMTESS 共有 18 題，其中 2 題為分派題，16 題為高難度或低難度測驗 組，二向度之題目各半。COMTESS 之施測流程共有二階段：患者在第一階段先 作答2 題分派題以初步估計其能力組別，之後在第二階段作答 8 題相對應難度的 測驗組以更精準地評量患者之二向度工作社交技巧。
初步驗證COMTESS 於思覺失調症患者之信效度結果顯示 COMTESS 具有良 好的團體層級信度與可接受的個別信度，可精準地評估思覺失調症患者的「個人 社交技巧」與「職務相關社交技巧」。COMTESS 具有良好的收斂效度與已知族群 效度，可評量思覺失調症患者的工作社交技巧，且可有效區辨不同認知程度患者 間的工作社交技巧差異。COMTESS 之施測時間預估僅需 9.9 分鐘，可快速地評 量思覺失調症患者的工作社交技巧。
COMTESS 利用電腦化多階段測驗之優勢，每位患者僅須作答 10 題，約為 12.8%的題庫題數（78 題），且整體而言具有良好的信度與效度，顯示 COMTESS 可完整、快速且精準地評量思覺失調症患者之工作社交技巧。此外，透過電腦化 施測角色扮演測驗，可大幅減少施測者訓練時間與施測負擔，並增加臨床施測的 可行性。
然而，COMTESS 的題目對於患者普遍較簡單且缺乏複本題目，未來研究須 再擴充較困難的題目，並增加分派題與各難度測驗組的複本，以提升高能力患者 能力估計的信度，並減少練習效應。
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圖一、Salzberg 之「職業能力模型 (vocational competence)」
資料來源：修改自 Salzberg, Likins, McConaughy, & Lignugaris/Kraft (1986) 之職業 能力模型。
職業能力
工作責任 工作技能
社交職業能力
職務相關 社交技巧
個人 社交技巧
圖二、Tsang 之「三階層工作相關社交技巧模型 (three-tier model of work-related
圖三、工作社交技巧之架構圖
工作社交技巧
一般性 工作社交技巧
一般性 職務相關 社交技巧
一般性 個人社交技巧
職業特定 工作社交技巧
職業特定 職務相關 社交技巧
職業特定 個人社交技巧
圖四、電腦化多階段測驗施測流程
第一階段：施測分派題以初步區辨能力程度
分派題
個人社交技巧
高 低
職務相關社交技巧
高 低
第二階段：依據能力程度施測適當難度的測驗組
職務相關社交技巧 高難度測驗組 個人社交技巧 高難度測驗組
職務相關社交技巧 高難度測驗組 個人社交技巧 低難度測驗組
職務相關社交技巧 低難度測驗組 個人社交技巧 低難度測驗組 職務相關社交技巧
低難度測驗組 個人社交技巧 高難度測驗組
圖五、發展與驗證COMTESS 之流程圖
第一階段：發展COMTESS
6. 選題並建構COMTESS：以多向度羅序分析估計題庫難度與患者能力參數，並自題庫中 挑選篩檢題與高、低難度測驗組，以組成COMTESS。
1. 文獻回顧：彙整文獻中常評量或觀察思覺失調症患者之工作社交技巧行為與指標。
2. 編製初版題庫：編寫初版題庫之劇本與計分量尺。
5. 題庫驗證：請思覺失調症患者作答題庫，並以單向度羅序分析檢驗題庫之模型適配度。
4. 建置題庫之施測介面：使用投影片播放檔設計施測介面，設計4種隨機出題施測版本。
3. 專家審核初版題庫：請臨床專家確認初版題庫之重要性與情境適切性，並修改初版題庫 以及將修改版題庫拍攝為施測影片。
第二階段：初步驗證COMTESS之信度、效度與施測效率
• 驗證信度：以患者能力估計之標準誤計算COMTESS之個別信度與平均信度。
• 驗證收斂效度：以PSP作為效標，分析COMTESS與PSP之分數相關性。
• 驗證已知族群效度：以MoCA將患者依有/無明顯認知障礙分組，比較兩組COMTESS分
• 驗證已知族群效度：以MoCA將患者依有/無明顯認知障礙分組，比較兩組COMTESS分