Livesley W J, Schroeder M L
Department of Psychiatry, University of British Columbia, Vancouver, Canada.
J Nerv Ment Dis. 1990 Oct;178(10):627-35. doi: 10.1097/00005053-199010000-00003.
The authors adopt a construct validity approach to examine the structural validity of diagnoses of paranoid, schizoid, and schizotypal personality disorders. Systematic descriptions of these diagnoses were developed based on features identified from the literature that were organized using the clinicians' ratings. Each diagnosis was described in terms of a series of behavioral dimensions. Sets of behavioral exemplars were developed to assess each dimension. Dimensions and diagnoses were found to exhibit satisfactory levels of internal consistency that were cross-validated in a general population sample of 274 subjects and a clinical sample of 133 patients with a diagnosis of personality disorder. Some dimensions did not correlate highly with the total diagnosis score. Diagnoses could probably be refined by eliminating these dimensions. The structural relationships between dimensions delineating each diagnosis were explored using factor analysis. Diagnoses were not unifactorial. Instead, each diagnosis was found to be composed of two factors. The factorial structure of each diagnosis was found to be similar in the general population and clinical sample. It is suggested that the results support a dimensional representation of these diagnoses using three dimensions: paranoid behaviors, social avoidance, and perceptual cognitive distortion.
作者采用结构效度方法来检验偏执型、分裂样和分裂型人格障碍诊断的结构效度。基于从文献中识别出的特征，并利用临床医生的评分进行组织，对这些诊断进行了系统描述。每个诊断都根据一系列行为维度进行描述。开发了行为示例集来评估每个维度。发现维度和诊断在内部一致性方面表现出令人满意的水平，这在274名受试者的一般人群样本和133名被诊断为人格障碍的患者的临床样本中得到了交叉验证。一些维度与总诊断分数的相关性不高。通过消除这些维度，诊断可能会得到改进。使用因子分析探索了描绘每种诊断的维度之间的结构关系。诊断并非单因素的。相反，发现每种诊断都由两个因素组成。发现每种诊断的因子结构在一般人群和临床样本中相似。建议这些结果支持使用偏执行为、社交回避和感知认知扭曲这三个维度对这些诊断进行维度表示。
