Krueger Robert F, Markon Kristian E, Patrick Christopher J, Iacono William G
Department of Psychology, University of Minnesota, Twin Cities Campus, Minneapolis, MN 55455-0344, USA.
J Abnorm Psychol. 2005 Nov;114(4):537-50. doi: 10.1037/0021-843X.114.4.537.
Mental disorders involving antisocial behavior and substance use are genetically linked and vary continuously. The authors present a review and integrative conceptualization of these observations in terms of a dimensional and hierarchically organized externalizing spectrum. As a foundation for this conceptualization, the authors introduce a quantitative, model-based approach to comparing categorical and continuous conceptions of psychopathology and apply this approach in an empirical study of patterns of comorbidity among externalizing disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders. The authors present evidence that comorbidity among externalizing disorders is best modeled by an underlying normally distributed continuum of risk for multiple disorders within the externalizing spectrum. The authors conclude by discussing implications of the externalizing spectrum conceptualization for classification of disorders in the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders.
涉及反社会行为和物质使用的精神障碍在基因上相互关联且呈连续变化。作者依据维度化且层次化组织的外化谱系，对这些观察结果进行了综述和综合概念化。作为此概念化的基础，作者引入了一种基于模型的定量方法，用于比较精神病理学的分类和连续概念，并将该方法应用于一项实证研究，该研究针对《精神疾病诊断与统计手册》中定义的外化障碍的共病模式。作者提供的证据表明，外化障碍之间的共病最好通过外化谱系内多种障碍潜在的正态分布连续风险来建模。作者最后讨论了外化谱系概念化对即将出版的《精神疾病诊断与统计手册》第5版中障碍分类的影响。
