Wakefield Jerome C
New York University, Silver School of Social Work, 1 Washington Square North, New York, NY 10003, USA.
Psychiatr Clin North Am. 2008 Sep;31(3):379-93, v. doi: 10.1016/j.psc.2008.03.009.
The harmful dysfunction analysis of mental disorder is used to assess whether traits are indicative of personality disorder, and the ways such an inference can go wrong. Personality is an overall organization that allows the organism to accomplish basic goals within the constraints of its basic traits and specific intentional states. Extreme traits can be negative or "dysfunctional" in the sense that they interfere with the achievement of socially or personally valued goals; however, they are not necessarily dysfunctions or disorders in the biological or medical sense. Thus, no sheer assessment of a set of traits can offer sufficient information for a diagnosis of personality disorder. Nor do criteria such as maladaptiveness, impairment, or clinical significance necessarily transform a trait into a personality disorder. The DSM's most plausible suggestion for judging when traits are dysfunctions, inflexibility, is also problematic because many nondisordered traits are inflexible as well.
精神障碍的有害功能失调分析用于评估某些特质是否表明存在人格障碍，以及这种推断可能出错的方式。人格是一个整体组织，它使有机体能够在其基本特质和特定意向状态的限制范围内实现基本目标。极端特质在干扰社会或个人重视目标的实现这个意义上可能是负面的或“功能失调的”；然而，从生物学或医学意义上来说，它们不一定是功能失调或障碍。因此，仅仅对一组特质进行评估并不能为诊断人格障碍提供足够的信息。诸如适应不良、损害或临床意义等标准也不一定会将一种特质转变为人格障碍。《精神疾病诊断与统计手册》（DSM）关于判断特质何时属于功能失调的最合理建议——僵化，也存在问题，因为许多无紊乱的特质同样也是僵化的。
