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遗传和环境对《精神疾病诊断与统计手册》第四版C类人格障碍维度表征的影响:一项基于人群的多变量双生子研究

Genetic and environmental influences on dimensional representations of DSM-IV cluster C personality disorders: a population-based multivariate twin study.

作者信息

Reichborn-Kjennerud Ted, Czajkowski Nikolai, Neale Michael C, Ørstavik Ragnhild E, Torgersen Svenn, Tambs Kristian, Røysamb Espen, Harris Jennifer R, Kendler Kenneth S

机构信息

Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.

出版信息

Psychol Med. 2007 May;37(5):645-53. doi: 10.1017/S0033291706009548. Epub 2006 Nov 30.

Abstract

BACKGROUND

The DSM-IV cluster C Axis II disorders include avoidant (AVPD), dependent (DEPD) and obsessive-compulsive (OCPD) personality disorders. We aimed to estimate the genetic and environmental influences on dimensional representations of these disorders and examine the validity of the cluster C construct by determining to what extent common familial factors influence the individual PDs.

METHOD

PDs were assessed using the Structured Interview for DSM-IV Personality (SIDP-IV) in a sample of 1386 young adult twin pairs from the Norwegian Institute of Public Health Twin Panel (NIPHTP). A single-factor independent pathway multivariate model was applied to the number of endorsed criteria for the three cluster C disorders, using the statistical modeling program Mx.

RESULTS

The best-fitting model included genetic and unique environmental factors only, and equated parameters for males and females. Heritability ranged from 27% to 35%. The proportion of genetic variance explained by a common factor was 83, 48 and 15% respectively for AVPD, DEPD and OCPD. Common genetic and environmental factors accounted for 54% and 64% respectively of the variance in AVPD and DEPD but only 11% of the variance in OCPD.

CONCLUSION

Cluster C PDs are moderately heritable. No evidence was found for shared environmental or sex effects. Common genetic and individual environmental factors account for a substantial proportion of the variance in AVPD and DEPD. However, OCPD appears to be largely etiologically distinct from the other two PDs. The results do not support the validity of the DSM-IV cluster C construct in its present form.

摘要

背景

《精神疾病诊断与统计手册》第四版(DSM-IV)中C类轴II障碍包括回避型(AVPD)、依赖型(DEPD)和强迫型(OCPD)人格障碍。我们旨在评估这些障碍维度表征的遗传和环境影响,并通过确定共同家族因素对个体人格障碍影响的程度来检验C类结构的有效性。

方法

使用《DSM-IV人格结构访谈》(SIDP-IV)对来自挪威公共卫生研究所双胞胎小组(NIPHTP)的1386对年轻成年双胞胎进行评估。使用统计建模程序Mx,将单因素独立路径多变量模型应用于三种C类障碍认可标准的数量。

结果

最佳拟合模型仅包括遗传和独特环境因素,并使男性和女性的参数相等。遗传率范围为27%至35%。共同因素解释的遗传方差比例分别为AVPD的83%、DEPD的48%和OCPD的15%。共同遗传和环境因素分别占AVPD和DEPD方差的54%和64%,但仅占OCPD方差的11%。

结论

C类人格障碍具有中等遗传性。未发现共享环境或性别效应的证据。共同遗传和个体环境因素占AVPD和DEPD方差的很大比例。然而,OCPD在病因上似乎与其他两种人格障碍有很大不同。结果不支持DSM-IV目前形式的C类结构的有效性。

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