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《精神疾病诊断与统计手册》第四版中暴食症患者强迫型人格障碍的诊断标准结构。

Structure of diagnostic and statistical manual of mental disorders, fourth edition criteria for obsessive-compulsive personality disorder in patients with binge eating disorder.

作者信息

Ansell Emily B, Pinto Anthony, Edelen Maria Orlando, Grilo Carlos M

机构信息

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut,06519, USA.

出版信息

Can J Psychiatry. 2008 Dec;53(12):863-7. doi: 10.1177/070674370805301212.

Abstract

OBJECTIVE

To examine 1-, 2-, and 3-factor model structures through confirmatory analytic procedures for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) obsessive-compulsive personality disorder (OCPD) criteria in patients with binge eating disorder (BED).

METHOD

Participants were consecutive outpatients (n = 263) with binge eating disorder and were assessed with semi-structured interviews. The 8 OCPD criteria were submitted to confirmatory factor analyses in Mplus Version 4.2 (Los Angeles, CA) in which previously identified factor models of OCPD were compared for fit, theoretical relevance, and parsimony. Nested models were compared for significant improvements in model fit.

RESULTS

Evaluation of indices of fit in combination with theoretical considerations suggest a multifactorial model is a significant improvement in fit over the current DSM-IV single- factor model of OCPD. Though the data support both 2- and 3-factor models, the 3-factor model is hindered by an underspecified third factor.

CONCLUSION

A multifactorial model of OCPD incorporating the factors perfectionism and rigidity represents the best compromise of fit and theory in modelling the structure of OCPD in patients with BED. A third factor representing miserliness may be relevant in BED populations but needs further development. The perfectionism and rigidity factors may represent distinct intrapersonal and interpersonal attempts at control and may have implications for the assessment of OCPD.

摘要

目的

通过验证性分析程序,检验《精神疾病诊断与统计手册》第四版(DSM-IV)中暴食症(BED)患者强迫型人格障碍(OCPD)标准的单因素、双因素和三因素模型结构。

方法

研究对象为连续纳入的263例暴食症门诊患者,采用半结构化访谈进行评估。将8条OCPD标准提交至Mplus 4.2版软件(加利福尼亚州洛杉矶)进行验证性因素分析,比较先前确定的OCPD因素模型在拟合度、理论相关性和简约性方面的差异。比较嵌套模型以评估模型拟合度的显著改善情况。

结果

结合理论考量对拟合指数进行评估,结果表明多因素模型在拟合度上比当前DSM-IV的OCPD单因素模型有显著改善。虽然数据支持双因素和三因素模型,但三因素模型的第三个因素定义不明确。

结论

一个包含完美主义和僵化因素的OCPD多因素模型,在模拟BED患者的OCPD结构时,是拟合度和理论的最佳折衷方案。代表吝啬的第三个因素可能与BED人群相关,但需要进一步研究。完美主义和僵化因素可能代表了在控制方面不同的人际内和人际间尝试,可能对OCPD的评估有影响。

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