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迈向《精神疾病诊断与统计手册》第五版:人格障碍分类的新方法

[Toward DSM-V: new approaches for the classification of personality disorders].

作者信息

Pukrop Ralf

机构信息

Klinik für Psychiatrie une Psychotherapie, Universität zu Köln.

出版信息

Prax Kinderpsychol Kinderpsychiatr. 2008;57(8-9):610-24. doi: 10.13109/prkk.2008.57.89.610.

Abstract

Dissatisfaction with the existing categorical classification system for personality disorders has stimulated DSM-V Research Planning Work Groups to check alternative dimensional representations. Four different strategies have been suggested: 1. dimensional representations of existing categories; 2. dimensional reorganization of diagnostic criteria; 3. integration of personality disorders with dimensional models of general personality structure; 4. identification of spectra of dysfunction cutting across personality, axis I and axis II disorders. Together with models of dimensional classification two further relevant aspects are discussed: First, the question of stability and changeability of personality (disorder) and thus the question of childhood and adolescence antecedents. Second, the search for neuroscientific foundations of personality disorder traits that can be integrated by an endophenotypic approach. These considerations imply a heuristic framework guided by the vision of an etiologically based classification system for personality disorders (and possibly other psychiatric syndromes).

摘要

对现有人格障碍分类系统的不满促使《精神疾病诊断与统计手册》第五版研究规划工作组考察替代性维度表征。已提出四种不同策略:1. 现有类别维度表征;2. 诊断标准维度重组;3. 将人格障碍与一般人格结构维度模型整合;4. 识别跨越人格、轴I和轴II障碍的功能障碍谱。除维度分类模型外,还讨论了另外两个相关方面:第一,人格(障碍)的稳定性和可变性问题,以及童年和青少年期的前驱问题。第二,寻找可通过内表型方法整合的人格障碍特质的神经科学基础。这些考量意味着一个启发式框架,其受基于病因学的人格障碍(可能还有其他精神综合征)分类系统愿景的指引。

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