Department of Psychiatry and Health Behavior, Medical College of Georgia, Georgia Regents University, Augusta, GA 30912, USA.
J Abnorm Psychol. 2013 May;122(2):475-91. doi: 10.1037/a0032713.
Despite growing enthusiasm for dimensional models of personality pathology, the taxonic versus dimensional status of schizotypal personality disorder (PD) remains a point of contention in modern psychiatry. The current study aimed to determine empirically the latent structure of schizotypal PD. We examined the latent structure of schizotypal PD in the Psychiatric Morbidity Survey in Great Britain and the second wave of the U.S.-based National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) survey. We analyzed composite indicators created from participant responses using the mean above minus mean below a cut (MAMBAC), Maximum Covariance (MAXCOV), and latent mode factor analysis (L-Mode) taxometric procedures. We also analyzed item-level responses using two latent variable mixture models--latent class analysis and latent class factor analysis. Taxometric and latent variable mixture analyses supported a dimensional, rather than taxonic, structure in both epidemiological samples. The dimensional model better predicted psychosis, intellectual functioning, disability, and treatment seeking than the categorical model based on DSM-IV diagnosis. People meeting criteria for schizotypal PD appear to exist on a spectrum of severity with the rest of the population. The possible dimensionality of schizotypal PD adds to growing support for a dimensional structure of PDs including other Cluster A disorders.
尽管人们对人格病理学的维度模型越来越感兴趣，但分裂型人格障碍（PD）的分类学与维度状态仍然是现代精神病学争论的焦点。本研究旨在从实证上确定分裂型 PD 的潜在结构。我们在英国的精神病学发病率调查和基于美国的全国酒精和相关条件流行病学调查（NESARC）的第二轮调查中检查了分裂型 PD 的潜在结构。我们使用均值减去低于均值的均值（MAMBAC）、最大协方差（MAXCOV）和潜在模式因子分析（L-Mode）分类学程序分析了由参与者回答组成的综合指标。我们还使用两种潜在变量混合模型——潜在类别分析和潜在类别因子分析分析了项目级别的反应。分类学和潜在变量混合分析都支持在这两个流行病学样本中存在维度而非分类学结构。与基于 DSM-IV 诊断的分类模型相比，该维度模型更好地预测了精神病、智力功能、残疾和治疗寻求。符合分裂型 PD 标准的人似乎与人群中的其他人一样存在严重程度的连续体。分裂型 PD 的可能维度增加了对 PD 包括其他 A 类障碍的维度结构的支持。
