Kuritárné Szabó Ildikó
Debreceni Egyetem, Magatartastudomanyi Intezet, Debrecen, Hungary.
Psychiatr Hung. 2012;27(5):323-34.
Significant changes are proposed in the personality disorders section of the 5th. edition of the DSM. The article summarizes the historical background of the personality disorder classification, including personality-types theory, trait-theory, and clinical concepts based upon psychiatric and psychoanalytical traditions. After briefly summarizing concerns on current approach to diagnosing personality disorders in DSM-IV, we summarise the most important features of the newly developed personality disorders classification, including concepts have been modified during long years of investigation. The new system will have modified less than was originally intended, and will be a hybrid model of dimensional categorical approach to diagnosing personality disorders. The ten personality disorder types are reduced to six, and they will have new criteria based on maladaptive trait dimensions. The trait structure model was derived from existing personality and personality disorder trait models, and includes five broad higher-order trait domains, which are negative affectivity, detachment, antagonism, disinhibition, and psychoticism. A new set of general criteria are developed for defining personality disorder. Self and interpersonal functioning represent the core impairment in personality functioning central to personality disorder, and the presence of maladaptive personality traits is also required. Severity continuum of personality pathology can be rated on the Levels of Personality Functioning Scale.
《精神疾病诊断与统计手册》(DSM)第五版中对人格障碍部分提出了重大修改。本文总结了人格障碍分类的历史背景,包括基于精神病学和精神分析传统的人格类型理论、特质理论及临床概念。在简要概述对DSM - IV中当前人格障碍诊断方法的担忧后,我们总结了新制定的人格障碍分类的最重要特征,包括在多年研究中已修改的概念。新系统的修改幅度将小于最初预期,并且将是一种用于诊断人格障碍的维度分类混合模型。人格障碍的十种类型减少到六种,并且将基于适应不良的特质维度制定新的标准。特质结构模型源自现有人格和人格障碍特质模型,包括五个广泛的高阶特质领域,即消极情感性、疏离、敌对、放纵和精神病性。为定义人格障碍制定了一套新的通用标准。自我和人际功能代表人格障碍核心的人格功能中的核心损害,并且还需要存在适应不良的人格特质。人格病理学的严重程度连续体可通过人格功能水平量表进行评定。