Rettew David C, Zanarini Mary C, Yen Shirley, Grilo Carlos M, Skodol Andrew E, Shea M Tracie, McGlashan Thomas H, Morey Leslie C, Culhane Melissa A, Gunderson John G
Harvard Medical School and McLean Hospital, USA.
J Am Acad Child Adolesc Psychiatry. 2003 Sep;42(9):1122-30. doi: 10.1097/01.CHI.0000070250.24125.5F.
To explore potential risk factors and early manifestations of avoidant personality disorder (AVPD) by examining retrospective reports of social functioning and adverse childhood experiences.
Early social functioning and pathological childhood experiences were assessed using the Childhood Experiences Questionnaire-Revised. The responses of 146 adults diagnosed with primary AVPD were compared with a group of 371 patients with other personality disorders as a primary diagnosis and a group of 83 patients with current major depression disorder and no personality disorders, using chi2 analyses. Diagnoses were based on semistructured interviews by trained reliable clinicians.
Adults with AVPD reported poorer child and adolescent athletic performance, less involvement in hobbies during adolescence, and less adolescent popularity than the depressed comparison group and the other personality disorder group. Reported rates of physical and emotional abuse were higher than the depressed group, but this result was influenced by comorbid diagnoses.
These results suggest that early manifestations of AVPD are present in childhood but that various forms of abuse are not specific to the disorder.
通过审查社会功能和童年不良经历的回顾性报告,探讨回避型人格障碍(AVPD)的潜在风险因素和早期表现。
使用修订后的童年经历问卷评估早期社会功能和病理性童年经历。采用卡方分析,将146名被诊断为原发性AVPD的成年人的回答与一组371名以其他人格障碍为主要诊断的患者以及一组83名患有当前重度抑郁症且无人格障碍的患者的回答进行比较。诊断基于训练有素的可靠临床医生进行的半结构化访谈。
与抑郁症对照组和其他人格障碍组相比,患有AVPD的成年人报告其儿童和青少年时期的运动表现较差、青少年时期参与爱好的程度较低且在青少年中较不受欢迎。报告的身体和情感虐待发生率高于抑郁症组,但这一结果受共病诊断的影响。
这些结果表明,AVPD的早期表现在童年期就已存在,但各种形式的虐待并非该障碍所特有。