Johnson Jeffrey G, First Michael B, Cohen Patricia, Kasen Stephanie
Columbia University, New York, USA.
J Pers Disord. 2008 Jun;22(3):246-58. doi: 10.1521/pedi.2008.22.3.246.
Data from a community-based prospective longitudinal study were used to investigate the utility of a structured assessment of the DSM-IV General Diagnostic Criteria for a Personality Disorder (PD). The Structured Clinical Interview for DSM-IV PDs (SCID-II) was administered to 154 adults. After completing the interview, an experienced clinician assessed the General Diagnostic Criteria for a PD using a structured rating scale. PD diagnoses, based solely on the rating scale data, demonstrated strong agreement with diagnoses obtained using the diagnostic thresholds for specific PDs (Kappa = 0.89). The sensitivity, specificity, predictive power, and internal reliability of the rating scale were satisfactory. PD diagnoses, based on both of the assessment procedures, were associated with substantial impairment and distress. These findings suggest that a structured assessment of the DSM-IV General Diagnostic Criteria for a Personality Disorder may constitute a useful alternative or supplement to standard assessments of the diagnostic thresholds for specific DSM-IV PDs.
一项基于社区的前瞻性纵向研究的数据被用于调查《精神疾病诊断与统计手册》第四版(DSM-IV)人格障碍通用诊断标准的结构化评估的效用。对154名成年人进行了DSM-IV人格障碍的结构化临床访谈(SCID-II)。完成访谈后,一位经验丰富的临床医生使用结构化评定量表评估人格障碍通用诊断标准。仅基于评定量表数据的人格障碍诊断与使用特定人格障碍诊断阈值获得的诊断结果显示出高度一致性(卡帕值=0.89)。该评定量表的敏感性、特异性、预测能力和内部信度均令人满意。基于两种评估程序得出的人格障碍诊断都与严重损害和痛苦相关。这些发现表明,对DSM-IV人格障碍通用诊断标准进行结构化评估可能构成对特定DSM-IV人格障碍诊断阈值标准评估的一种有用替代或补充。