Department of Psychology, Texas A&M University, College Station, TX 77843-4235, USA.
Psychol Med. 2012 Aug;42(8):1705-13. doi: 10.1017/S0033291711002601. Epub 2011 Dec 2.
Several conceptual models have been considered for the assessment of personality pathology in DSM-5. This study sought to extend our previous findings to compare the long-term predictive validity of three such models: the five-factor model (FFM), the schedule for nonadaptive and adaptive personality (SNAP), and DSM-IV personality disorders (PDs).
An inception cohort from the Collaborative Longitudinal Personality Disorder Study (CLPS) was followed for 10 years. Baseline data were used to predict long-term outcomes, including functioning, Axis I psychopathology, and medication use.
Each model was significantly valid, predicting a host of important clinical outcomes. Lower-order elements of the FFM system were not more valid than higher-order factors, and DSM-IV diagnostic categories were less valid than dimensional symptom counts. Approaches that integrate normative traits and personality pathology proved to be most predictive, as the SNAP, a system that integrates normal and pathological traits, generally showed the largest validity coefficients overall, and the DSM-IV PD syndromes and FFM traits tended to provide substantial incremental information relative to one another.
DSM-5 PD assessment should involve an integration of personality traits with characteristic features of PDs.
DSM-5 中考虑了几种人格病理学评估的概念模型。本研究旨在扩展我们之前的研究结果，比较三种此类模型的长期预测效度：五因素模型（FFM）、非适应和适应人格量表（SNAP）和 DSM-IV 人格障碍（PD）。
采用协作性纵向人格障碍研究（CLPS）的起始队列进行了 10 年的随访。使用基线数据预测长期结局，包括功能、轴 I 精神病理学和药物使用。
每个模型都具有显著的有效性，可预测多种重要的临床结局。FFM 系统的低阶元素并不比高阶因素更有效，DSM-IV 诊断类别也不如维度症状计数有效。整合规范特征和人格病理学的方法被证明是最具预测性的，因为整合正常和病理特征的 SNAP 通常显示出整体上最大的有效性系数，并且 DSM-IV PD 综合征和 FFM 特征相对于彼此倾向于提供大量的增量信息。
DSM-5 PD 评估应将人格特征与 PD 的特征特征相结合。
