Department of Personality Psychiatry, Ulleval University Hospital, 0407 Oslo, Norway.
Compr Psychiatry. 2010 Sep-Oct;51(5):462-70. doi: 10.1016/j.comppsych.2009.11.009. Epub 2010 Jan 8.
The study investigated crucial aspects of the construct validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) histrionic personality disorder (HPD) category.
The study included 2289 patients from the Norwegian Network of Psychotherapeutic Day Hospitals. Construct validity was assessed by means of prevalence, comorbidity with other personality disorders, internal consistency among HPD criteria, severity indices, as well as factor analyses.
The prevalence of HPD was very low (0.4 %). The comorbidity was high, especially with borderline, narcissistic, and dependent personality disorders. The internal consistency was low. The criteria seemed to form 2 separate clusters: the first contained exhibitionistic and attention-seeking traits and the other contained impressionistic traits.
The results indicated poor construct validity of the HPD category. Different options for the future of the category are discussed. The authors suggest the HPD category to be deleted from the DSM system. However, the clinical phenomena of exhibitionism and attention-seeking, which are the dominant personality features of HPD, should be preserved in an exhibitionistic subtype of narcissism.
本研究调查了《精神障碍诊断与统计手册》第四版（DSM-IV）癔症性人格障碍（HPD）类别构建效度的关键方面。
该研究包括来自挪威心理治疗日间医院网络的 2289 名患者。通过患病率、与其他人格障碍的共病、HPD 标准的内部一致性、严重程度指数以及因子分析来评估构念效度。
HPD 的患病率非常低（0.4%）。共病率很高，特别是与边缘型、自恋型和依赖型人格障碍。内部一致性较低。这些标准似乎形成了 2 个独立的集群：第一个包含表现癖和寻求关注的特征，另一个包含印象主义特征。
研究结果表明 HPD 类别的构建效度较差。讨论了该类别未来的不同选择。作者建议从 DSM 系统中删除 HPD 类别。然而，应该在自恋的表现亚型中保留 HPD 的主要人格特征，即表现癖和寻求关注的临床现象。
