Balsis Steve, Gleason Marci E J, Woods Carol M, Oltmanns Thomas F
Department of Psychology, Washington University, St Louis, MO 63130-4899, USA.
Psychol Aging. 2007 Mar;22(1):171-85. doi: 10.1037/0882-7974.22.1.171.
Many of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) personality disorder (PD) diagnostic criteria focus on a younger social and occupational context. The absence of age-appropriate criteria for older adults forces researchers and clinicians to draw conclusions based on existing criteria, which are likely inadequate. To explore which DSM-IV PD criteria contain age group measurement bias, the authors report 2 analyses of data on nearly 37,000 participants, ages 18-98 years, taken from a public data set that includes 7 of the 10 PDs (antisocial, avoidant, dependent, histrionic, obsessive-compulsive, paranoid, and schizoid). The 1st analysis revealed that older age groups tend to endorse fewer PD criteria than younger age groups. The 2nd analysis revealed that 29% of the criteria contain measurement bias. Although the latent variable structure for each PD was quite similar across younger and older age groups, some individual criteria were differentially endorsed by younger and older adults with equivalent PD pathology. The presence of measurement bias for these criteria raises questions concerning the assessment of PDs in older adults and the interpretation of existing data.
《精神疾病诊断与统计手册》第4版（DSM-IV；美国精神病学协会，1994年）中的许多人格障碍（PD）诊断标准都侧重于较年轻人群的社交和职业背景。由于缺乏针对老年人的适合其年龄阶段的标准，研究人员和临床医生不得不依据现有标准得出结论，而这些标准可能并不充分。为探究哪些DSM-IV PD标准存在年龄组测量偏差，作者报告了对近37000名年龄在18至98岁参与者的数据进行的两项分析，这些数据取自一个公共数据集，该数据集涵盖了10种人格障碍中的7种（反社会型、回避型、依赖型、表演型、强迫型、偏执型和分裂样人格障碍）。第一项分析表明，年龄较大的年龄组往往比年龄较小的年龄组认可的PD标准更少。第二项分析表明，29%的标准存在测量偏差。尽管每个PD的潜在变量结构在年龄较小和较大的年龄组中非常相似，但一些个体标准在具有同等PD病理特征的年轻和年长成年人中得到了不同程度的认可。这些标准存在测量偏差这一情况引发了有关老年人PD评估以及现有数据解读的问题。
