Svrakic D M, McCallum K
Department of Psychiatry, Washington University Medical School, St. Louis, MO 63110.
Am J Psychother. 1991 Apr;45(2):181-97. doi: 10.1176/appi.psychotherapy.1991.45.2.181.
Present classifications fall short of helping clinicians to systematically approach syndromes of antisocial (A-S) behavior. Various clinical forms of A-S behavior derive from different levels of personality organization (normal, neurotic, and borderline level) whereas certain personality disorders (PD) display specific antisocial "profiles" and form the horizontal continuum of antisocial behavior. The borderline level of personality and pathological narcissism stand behind A-S PD, Narcissistic PD, and Histrionic PD. The authors propose that the disorders should be regarded as spectrum disorders. Paranoid PD and "pure" Borderline PD complete the list of PDs manifesting A-S behaviors. Finally, diagnostic instruments for clinical approach to and research of A-S PD are presented.
目前的分类方法不足以帮助临床医生系统地处理反社会(A-S)行为综合征。A-S行为的各种临床形式源自不同层次的人格组织(正常、神经症和边缘水平),而某些人格障碍(PD)表现出特定的反社会“特征”,并构成反社会行为的横向连续谱。边缘人格水平和病理性自恋是A-S PD、自恋型PD和表演型PD的背后原因。作者提出,这些障碍应被视为谱系障碍。偏执型PD和“纯粹”的边缘型PD完善了表现出A-S行为的PD列表。最后,介绍了用于临床处理和研究A-S PD的诊断工具。