Department of Psychology, Emory University, Atlanta, USA.
Am J Psychiatry. 2012 Mar;169(3):273-84. doi: 10.1176/appi.ajp.2011.11020274.
The authors describe a system for diagnosing personality pathology that is empirically derived, clinically relevant, and practical for day-to-day use.
A random national sample of psychiatrists and clinical psychologists (N=1,201) described a randomly selected current patient with any degree of personality dysfunction (from minimal to severe) using the descriptors in the Shedler-Westen Assessment Procedure–II and completed additional research forms.
The authors applied factor analysis to identify naturally occurring diagnostic groupings within the patient sample. The analysis yielded 10 clinically coherent personality diagnoses organized into three higher-order clusters: internalizing, externalizing, and borderline-dysregulated. The authors selected the most highly rated descriptors to construct a diagnostic prototype for each personality syndrome. In a second, independent sample, research interviewers and patients' treating clinicians were able to diagnose the personality syndromes with high agreement and minimal comorbidity among diagnoses.
The empirically derived personality prototypes described here provide a framework for personality diagnosis that is both empirically based and clinically relevant.
作者描述了一种人格病理学诊断系统，该系统具有经验性、临床相关性，并且适用于日常使用。
一组随机的精神科医生和临床心理学家（N=1201）使用 Shedler-Westen 评估程序-II 的描述符描述了一名随机选择的当前具有一定程度人格障碍（从轻微到严重）的患者，并完成了其他研究表格。
作者应用因子分析在患者样本中识别自然发生的诊断分组。该分析产生了 10 种临床上一致的人格诊断，分为三个高阶聚类：内化、外化和边缘失调。作者选择了评价最高的描述符来构建每个人格综合征的诊断原型。在第二个独立的样本中，研究访谈者和患者的治疗临床医生能够以较高的一致性和最小的诊断间共病来诊断人格综合征。
这里描述的经验衍生的人格原型为基于经验和临床相关的人格诊断提供了一个框架。
