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精神障碍与暴力:人格维度及临床特征

Mental disorder and violence: personality dimensions and clinical features.

作者信息

Nestor Paul G

机构信息

Psychiatry 116A, Brockton VAMC, 940 Belmont Street, Brockton, MA 02301, USA.

出版信息

Am J Psychiatry. 2002 Dec;159(12):1973-8. doi: 10.1176/appi.ajp.159.12.1973.

Abstract

OBJECTIVE

This review examines the role of personality dimensions in the greater rates of violence that have now been established to accompany certain classes of mental disorders.

METHOD

Empirical studies are reviewed that have often used objective measures of personality and epidemiological samples with low levels of subject selection biases.

RESULTS

The risk of violence may be understood in terms of four fundamental personality dimensions: 1) impulse control, 2) affect regulation, 3) narcissism, and 4) paranoid cognitive personality style. Low impulse control and affect regulation increase the risk for violence across disorders, especially for primary and comorbid substance abuse disorders. By contrast, paranoid cognitive personality style and narcissistic injury increase the risk for violence, respectively, in persons with schizophrenia spectrum disorders and in samples of both college students and individuals with personality disorders.

CONCLUSIONS

This review supports the hypothesis that these four fundamental personality dimensions operate jointly, and in varying degrees, as clinical risk factors for violence among groups with these classes of mental disorders.

摘要

目的

本综述探讨人格维度在现已确定的与某些精神障碍类别相关的更高暴力发生率中所起的作用。

方法

回顾了实证研究,这些研究经常使用人格的客观测量方法以及具有低水平受试者选择偏差的流行病学样本。

结果

暴力风险可从四个基本人格维度来理解:1)冲动控制,2)情绪调节,3)自恋,4)偏执认知人格风格。冲动控制能力低和情绪调节能力低会增加各类精神障碍患者的暴力风险,尤其是原发性和共病物质使用障碍患者。相比之下,偏执认知人格风格和自恋性损伤分别增加精神分裂症谱系障碍患者以及大学生和人格障碍患者样本中的暴力风险。

结论

本综述支持这样一种假设,即这四个基本人格维度共同且不同程度地作为这些精神障碍类别群体中暴力行为的临床风险因素发挥作用。

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