Durrett Christine, Westen Drew
Department of Psychological Sciences, University of Missouri-Columbia, 65211, USA.
J Pers Disord. 2005 Aug;19(4):440-61. doi: 10.1521/pedi.2005.19.4.440.
The aim of this study was to ascertain whether the structure of personality disorder (PD) symptoms in adolescents assessed using DSM-IV diagnoses and diagnostic criteria resembles the structure intended for the diagnosis of PDs in adults. A national sample of clinicians rated DSM-IV Axis II criteria on 294 adolescent patients in treatment for enduring maladaptive personality patterns. Cluster analysis replicating procedures used in an adult sample by Morey (1988) identified considerable similarity between adult and adolescent PDs, as did exploratory factor analysis of ratings of diagnostic criteria, which yielded ten empirically derived factors that resembled the ten DSM-IV PDs. Cluster analysis and confirmatory factor analysis with indicators of Axis II symptoms produced mixed results in replicating the DSM-IV hierarchical structure of PDs (Clusters A, B, and C), although hierarchical models generally fared better than models specifying only first-order factors or clusters. The structure of personality pathology as assessed by Axis II criteria in adolescents resembles that outlined in DSM-IV Axis II for adults, suggesting that PDs can be assessed in adolescents as in adults. Whether this is an optimal way of diagnosing personality pathology in adolescence, however, requires further investigation.
本研究的目的是确定使用《精神疾病诊断与统计手册》第四版（DSM-IV）诊断和诊断标准评估的青少年人格障碍（PD）症状结构是否类似于用于诊断成人PD的结构。一个全国性的临床医生样本对294名因持久适应不良人格模式而接受治疗的青少年患者进行了DSM-IV轴II标准评定。重复莫雷（1988年）在成人样本中使用的程序进行的聚类分析确定了成人和青少年PD之间存在相当大的相似性，对诊断标准评定进行的探索性因素分析也是如此，该分析产生了十个基于经验得出的因素，类似于十个DSM-IV PD。使用轴II症状指标进行的聚类分析和验证性因素分析在复制DSM-IV PD的层次结构（A、B和C类）时产生了混合结果，尽管层次模型总体上比仅指定一阶因素或类别的模型表现更好。青少年中通过轴II标准评估的人格病理学结构类似于DSM-IV轴II中为成人概述的结构，这表明可以像评估成人一样评估青少年的PD。然而，这是否是诊断青少年人格病理学的最佳方法，还需要进一步研究。
