GGz Centraal Psychiatric Center, Hilversum, The Netherlands.
Clin Psychol Psychother. 2013 Nov-Dec;20(6):544-57. doi: 10.1002/cpp.1811. Epub 2012 Aug 23.
This study presents a psychometric evaluation of the General Assessment of Personality Disorder (GAPD), a self-report questionnaire for assessing the core components of personality dysfunction on the basis of Livesley's (2003) adaptive failure model. Analysis of samples from a general (n = 196) and a clinical population (n = 280) from Canada and the Netherlands, respectively, found a very similar two-component structure consistent with the two core components of personality dysfunction proposed by the model, namely, self-pathology and interpersonal dysfunction. Moreover, the GAPD discriminated between patients diagnosed with and without Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) personality disorder(s) and demonstrated discriminative power in detecting the severity of personality pathology. Correlations with a DSM-IV symptom measure and a pathological traits model suggest partial conceptual overlap. Although further testing is indicated, the present findings suggest the GAPD is suitable for assessing the core components of personality dysfunction. It may contribute to a two-step integrated assessment of personality pathology that assesses both personality dysfunction and personality traits.
The core features of personality disorder can be defined as disorders in the self and in the capacity for interpersonal functioning. A clinically useful operationalization of disordered functioning of personality is needed to determine the maladaptivity of personality traits. An integrated assessment of personality (dys)functioning and personality traits provides a more comprehensive clinical picture of the patient, which may aid treatment planning.
本研究对一般人格障碍评估问卷(GAPD)进行了心理计量学评估,该问卷是一种自评式问卷,用于根据 Livesley(2003 年)的适应失败模型评估人格功能障碍的核心要素。对分别来自加拿大和荷兰的一般人群(n=196)和临床人群(n=280)样本的分析发现,存在与模型提出的人格功能障碍的两个核心要素非常相似的两因素结构,即自我病理学和人际功能障碍。此外,GAPD 能够区分出被诊断为和未被诊断为《精神障碍诊断与统计手册》第四版(DSM-IV-TR)人格障碍的患者,并且在检测人格病理学严重程度方面具有判别力。与 DSM-IV 症状测量和病理性特质模型的相关性表明存在部分概念重叠。尽管需要进一步测试,但目前的研究结果表明,GAPD 适合评估人格功能障碍的核心要素。它可能有助于对人格病理进行两步综合评估,同时评估人格功能障碍和人格特质。
人格障碍的核心特征可以定义为自我和人际功能障碍。需要对人格功能障碍的紊乱进行临床有用的操作化定义,以确定人格特质的适应不良。对人格(功能)障碍和人格特质的综合评估可以更全面地了解患者的临床情况,这可能有助于治疗计划。