Sandell R
Stockholm County Council Psychotherapy Institute, Sweden.
Psychiatr Dev. 1989 Winter;7(4):351-65.
The definitional criteria of the 3 systems (DSM-III, DIB and Kernberg) have been compared. While there is rather weak agreement between the criteria of DIB and those of DSM-III, there is no agreement at all between Kernberg's criteria and those of the other 2 systems. When the 3 systems are compared in terms of empirical diagnosis, the agreement between DSM-III and DIB is moderate and clearly stronger than that between Kernberg and either DSM-III or DIB. In terms of sensitivity, the Kernberg borderline comprises the DSM-III and DIB borderlines as subsets. The findings are consistent with the idea that Kernberg's borderline concept is an instance of a severity or maturity level construct, while DSM-III and DIB are characterological constructs, orthogonally related to the level construct.
对三种体系(《精神疾病诊断与统计手册》第三版、《精神疾病诊断访谈》和克恩伯格体系)的定义标准进行了比较。虽然《精神疾病诊断访谈》的标准与《精神疾病诊断与统计手册》第三版的标准之间的一致性相当弱,但克恩伯格的标准与其他两种体系的标准之间完全没有一致性。当从实证诊断的角度对这三种体系进行比较时,《精神疾病诊断与统计手册》第三版和《精神疾病诊断访谈》之间的一致性为中等,且明显强于克恩伯格与《精神疾病诊断与统计手册》第三版或《精神疾病诊断访谈》之间的一致性。在敏感性方面,克恩伯格的边缘型人格障碍包含了《精神疾病诊断与统计手册》第三版和《精神疾病诊断访谈》的边缘型人格障碍作为子集。这些发现与以下观点一致,即克恩伯格的边缘型概念是严重程度或成熟水平结构的一个实例,而《精神疾病诊断与统计手册》第三版和《精神疾病诊断访谈》是性格结构,与水平结构呈正交关系。