Sanislow Charles A, Little Todd D, Ansell Emily B, Grilo Carlos M, Daversa Maria, Markowitz John C, Pinto Anthony, Shea M Tracie, Yen Shirley, Skodol Andrew E, Morey Leslie C, Gunderson John G, Zanarini Mary C, McGlashan Thomas H
Department of Psychiatry, Yale University School of Medicine.
J Abnorm Psychol. 2009 Aug;118(3):507-19. doi: 10.1037/a0016478.
Evaluation of the validity of personality disorder (PD) diagnostic constructs is important for the impending revision of the Diagnostic and Statistical Manual of Mental Disorders. Prior factor analytic studies have tested these constructs in cross-sectional studies, and models have been replicated longitudinally, but no study has tested a constrained longitudinal model. The authors examined 4 PDs in the Collaborative Longitudinal Personality Disorders study (schizotypal, borderline, avoidant, and obsessive-compulsive) over 7 time points (baseline, 6 months, 1 year, 2 years, 4 years, 6 years, and 10 years). Data for 2-, 4-, 6- and 10-year assessments were obtained in semistructured interviews by raters blind to prior PD diagnoses at each assessment. The latent structure of the 4 constructs was differentiated during the initial time points but became less differentiated over time as the mean levels of the constructs dropped and stability increased. Obsessive-compulsive PD became more correlated with schizotypal and borderline PD than with avoidant PD. The higher correlation among the constructs in later years may reflect greater shared base of pathology for chronic personality disorders.
人格障碍（PD）诊断结构的有效性评估对于即将修订的《精神疾病诊断与统计手册》至关重要。先前的因素分析研究已在横断面研究中对这些结构进行了测试，且模型已得到纵向复制，但尚无研究测试过受限纵向模型。作者在协作纵向人格障碍研究中考察了4种人格障碍（分裂型、边缘型、回避型和强迫型），共7个时间点（基线、6个月、1年、2年、4年、6年和10年）。2年、4年、6年和10年评估的数据通过半结构化访谈获得，评分者在每次评估时对先前的人格障碍诊断不知情。这4种结构的潜在结构在初始时间点有所区分，但随着时间推移，随着结构的平均水平下降和稳定性增加，区分度降低。强迫型人格障碍与分裂型和边缘型人格障碍的相关性比与回避型人格障碍的相关性更高。后期这些结构之间较高的相关性可能反映了慢性人格障碍在病理基础上的更大共享性。
