Department of Psychology, Washington University in St Louis, St Louis, MO 63130-4899, USA.
Psychol Med. 2009 Dec;39(12):2061-70. doi: 10.1017/S0033291709990328. Epub 2009 Oct 1.
The extant major psychiatric classifications DSM-IV and ICD-10 are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of the etiology. In an attempt to group mental disorders on the basis of etiology, five clusters have been proposed. We consider the validity of the fifth cluster, externalizing disorders, within this proposal.
We reviewed the literature in relation to 11 validating criteria proposed by the Study Group of the DSM-V Task Force, in terms of the extent to which these criteria support the idea of a coherent externalizing spectrum of disorders.
This cluster distinguishes itself by the central role of disinhibitory personality in mental disorders spread throughout sections of the current classifications, including substance dependence, antisocial personality disorder and conduct disorder. Shared biomarkers, co-morbidity and course offer additional evidence for a valid cluster of externalizing disorders.
Externalizing disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.
现有的主要精神科分类 DSM-IV 和 ICD-10 据称是无理论的，主要是描述性的。虽然这实现了良好的可靠性，但对病因的理解极大地增强了医学诊断的有效性。为了根据病因对精神障碍进行分组，已经提出了五个聚类。我们在该提议中考虑了第五个聚类，即外化障碍的有效性。
我们根据 DSM-V 工作组研究小组提出的 11 个验证标准，审查了相关文献，以确定这些标准在多大程度上支持连贯的外化障碍谱的概念。
这个聚类通过抑制性人格在当前分类各个部分中的精神障碍中的核心作用来区分自己，包括物质依赖、反社会人格障碍和品行障碍。共享的生物标志物、共病和病程为有效的外化障碍聚类提供了额外的证据。
外化障碍符合 DSM-V 工作组研究小组提出的许多突出标准，表明存在一个分类聚类。
