Thompson-Brenner Heather, Eddy Kamryn T, Satir Dana A, Boisseau Christina L, Westen Drew
Center for Anxiety and Related Disorders, Department of Psychology, Boston University, 648 Beacon St., Boston, MA 02215, USA.
J Child Psychol Psychiatry. 2008 Feb;49(2):170-80. doi: 10.1111/j.1469-7610.2007.01825.x. Epub 2007 Dec 15.
Research has identified three personality subtypes in adults with eating disorders (EDs): a high-functioning, an undercontrolled, and an overcontrolled group. The current study investigated whether similar personality prototypes exist in adolescents with EDs, and whether these personality prototypes show relationships to external correlates indicative of diagnostic validity.
Experienced clinicians from an adolescent practice-research network provided data on ED symptoms, DSM-IV comorbidity, personality pathology, and family and developmental history for 120 adolescent patients with EDs.
Consistent with the findings from the adult literature, three types of personality pathology emerged in adolescents: High-functioning/Perfectionistic, Emotionally Dysregulated, and Avoidant/Depressed. The High-functioning prototype showed negative associations with comorbidity and positive associations with treatment response. The Emotionally Dysregulated prototype was specifically associated with externalizing Axis I and Cluster B Axis II disorders, poor school functioning, and adverse events in childhood. The Avoidant/Depressed prototype showed specific associations with internalizing Axis I and Clusters A Axis II disorders, poor peer relationships, poor maternal relationships, and internalizing disorders in first-degree relatives.
These data support the presence of at least three diagnostically meaningful personality prototypes in adolescents with EDs, similar to those found previously in adults. Diagnosis of adolescents with EDs may be usefully supplemented by the assessment of personality style.
研究已确定饮食失调（EDs）成人存在三种人格亚型：高功能型、自控不足型和过度自控型。本研究调查了患有饮食失调的青少年中是否存在类似的人格原型，以及这些人格原型是否与表明诊断效度的外部相关因素存在关联。
来自青少年实践研究网络的经验丰富的临床医生提供了120名患有饮食失调的青少年患者的饮食失调症状、《精神疾病诊断与统计手册》第四版（DSM-IV）共病情况、人格病理学以及家庭和发育史的数据。
与成人文献的研究结果一致，青少年中出现了三种人格病理学类型：高功能/完美主义型、情绪失调型和回避/抑郁型。高功能原型与共病呈负相关，与治疗反应呈正相关。情绪失调原型与第一轴外化障碍和第二轴B类人格障碍、学校功能差以及童年不良事件有特定关联。回避/抑郁原型与第一轴内化障碍和第二轴A类人格障碍、同伴关系差、母婴关系差以及一级亲属的内化障碍有特定关联。
这些数据支持患有饮食失调的青少年中至少存在三种具有诊断意义的人格原型，类似于先前在成人中发现的原型。对患有饮食失调的青少年进行诊断时，可通过评估人格风格进行有效补充。
