Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
Psychiatry Res. 2013 Nov 30;210(1):188-92. doi: 10.1016/j.psychres.2013.05.005. Epub 2013 Jun 26.
New hybrid models of psychopathology have been proposed that combine the current categorical approach with symptom dimensions that are common across various disorders. The present study investigated the new hybrid model of social anxiety in a large sample of participants with anxiety disorders and unipolar mood disorders to improve understanding of the comorbidity and symptom overlap between social phobia (SOC) and the other anxiety disorders and unipolar mood disorders. Six hundred and eighty two participants from a specialized outpatient clinic for anxiety treatment completed a semi-structured diagnostic interview and the Multidimensional Assessment of Social Anxiety (MASA). A hybrid model symptom profile was identified for SOC and compared with each of the other principal diagnoses. Significant group differences were identified on each of the MASA scales. Differences also were identified when common sets of comorbidities were compared within participants diagnosed with SOC. The findings demonstrated the influence of both the principal diagnosis of SOC and other anxiety disorders and unipolar mood disorders as well as the influence of comorbid diagnoses with SOC on the six symptom dimensions. These findings highlight the need to shift to transdiagnostic assessment and treatment practices that go beyond the disorder-specific focus of the current categorical diagnostic systems.
新的精神病理学混合模型已经被提出，该模型将当前的分类方法与常见于各种障碍的症状维度相结合。本研究在一个有焦虑障碍和单相心境障碍的大样本参与者中调查了新的社交焦虑混合模型，以提高对社交恐惧症（SOC）与其他焦虑障碍和单相心境障碍之间的共病和症状重叠的理解。682 名来自焦虑症专门门诊的参与者完成了半结构化诊断访谈和多维社交焦虑评估（MASA）。为 SOC 确定了混合模型症状特征，并与每个其他主要诊断进行了比较。在 MASA 的每个量表上都发现了显著的组间差异。当在被诊断为 SOC 的参与者中比较常见的共病集时，也发现了差异。研究结果表明，SOC 和其他焦虑障碍以及单相心境障碍的主要诊断以及与 SOC 共病诊断对六个症状维度都有影响。这些发现强调需要转向超越当前分类诊断系统的特定障碍的关注，采用跨诊断评估和治疗实践。
