Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence, RI 02904, USA.
Compr Psychiatry. 2013 Aug;54(6):673-9. doi: 10.1016/j.comppsych.2013.01.008. Epub 2013 Feb 26.
Research assessing the utility of dimensional and categorical models of personality disorders (PDs) overwhelmingly supports the use of continuous over categorical models. Using borderline PD as an example, recent studies from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project suggested that continuous (criteria count) scoring of PDs is most informative for "subthreshold" levels of pathology, but is less important once a patient meets the diagnostic threshold. Using PD criteria count, the current study compared 7 indices of psychosocial morbidity for patients above and below diagnostic threshold for 3 additional PDs: paranoid, avoidant, and obsessive-compulsive. Results showed that for all tested PDs, only number of current Axis I disorders was more correlated with PD criteria in the sub-threshold group as compared to those who met criteria for the disorder. Results for the remaining 6 indices of psychosocial morbidity varied by PD tested.
研究评估人格障碍(PD)的维度和分类模型的实用性,压倒性地支持使用连续模型而不是分类模型。以边缘型 PD 为例,最近来自罗德岛改善诊断评估和服务(MIDAS)项目的研究表明,PD 的连续(标准计数)评分对于“亚阈值”水平的病理学最具信息性,但一旦患者达到诊断阈值,就不那么重要了。使用 PD 标准计数,本研究比较了 7 项社会心理发病率指标,这些指标适用于 3 种额外 PD(偏执型、回避型和强迫型)的诊断阈值以上和以下的患者。结果表明,对于所有测试的 PD,只有当前轴 I 障碍的数量与亚阈值组的 PD 标准相关性更高,而与符合该障碍标准的患者相比。其余 6 项社会心理发病率指标的结果因测试的 PD 而异。