Department of Psychiatry, Innlandet Hospital Trust, N-2318 Hamar, Norway.
Compr Psychiatry. 2012 Aug;53(6):813-21. doi: 10.1016/j.comppsych.2011.10.007. Epub 2011 Dec 5.
The aim of the study was to explore the associations between the presence of avoidant personality problems (APPs) and 5 areas of impairment: demography, somatic issues, mental health, lifestyle, and social issues.
Avoidant personality problem was defined by confirmation of the 2 avoidant personality disorder items of the Iowa Personality Disorder Screen and and the Social Phobia Inventory (SPIN) short version (MINI-SPIN) screening assessment for generalized social anxiety disorder sum score of 6 or more. The questionnaires were administered in a Norwegian population survey (the Oslo Health Study-HUBRO). Cases consisted of 280 individuals with APP and 5 randomly selected controls without APP (n = 1400).
The APP group more frequently reported living alone, lower level of education, and lower income than controls. Poor self-rated health, presence of somatic disease, muscular pain, frequent use of analgesics, and visits at a general practitioner were significantly more common in the APP group than among controls. The APP group had significantly higher proportion of caseness of mental distress, low general self-efficacy, and insomnia, and this result held up in multivariate analyses. The APP group showed statistically significant higher proportions of physical inactivity, obesity, daily smoking, and alcohol problems compared with controls. As for social impairment, a significantly higher proportion of the APP group reported "not having enough good friends," "high powerlessness," and low community activism, and the 2 former variables held up in multivariate analyses.
In this population-based study, we found that high levels of APP, defined closely to avoidant personality disorder, were significantly associated with demographic, somatic, and mental impairment; low general self-efficacy; and insomnia affecting work ability. In addition, APP showed associations with negative lifestyle, alcohol problems, and social impairment reporting lack of good friends and lack of empowerment. Avoidant personality problem is associated with clinically significant impairment in several areas, which underlines the importance of recognizing these problems in primary health care.
本研究旨在探讨回避型人格问题（APP）的存在与以下 5 个方面的损害之间的关联：人口统计学、躯体问题、心理健康、生活方式和社会问题。
回避型人格问题的定义为通过确认爱荷华人格障碍筛查问卷（Iowa Personality Disorder Screen）中的 2 项回避型人格障碍条目和社交恐惧症量表（Social Phobia Inventory，SPIN）简短版（MINI-SPIN）对广泛性社交焦虑障碍的筛查评估，其总分达到 6 或更高。问卷在挪威人群调查（奥斯陆健康研究-HUBRO）中进行。病例组由 280 名存在 APP 的个体和 5 名随机选择的无 APP 对照组个体（n=1400）组成。
与对照组相比，APP 组更频繁地报告独居、受教育程度较低和收入较低。APP 组自我报告健康状况较差、存在躯体疾病、肌肉疼痛、经常使用镇痛药和看全科医生的比例明显高于对照组。APP 组精神困扰、一般自我效能感低和失眠的发生率显著高于对照组，且在多变量分析中结果一致。APP 组体力活动不足、肥胖、每日吸烟和饮酒问题的比例明显高于对照组。在社会受损方面，APP 组报告“没有足够的好朋友”、“高度无力感”和社区参与度低的比例明显较高，且前两个变量在多变量分析中仍然成立。
在这项基于人群的研究中，我们发现，高水平的 APP（定义为接近回避型人格障碍）与人口统计学、躯体和心理健康受损、一般自我效能感降低以及影响工作能力的失眠显著相关。此外，APP 还与消极的生活方式、酒精问题以及缺乏好朋友和缺乏赋权的社会受损报告相关。回避型人格问题与多个领域的显著临床损害相关，这凸显了在初级保健中识别这些问题的重要性。
