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成人精神科患者人格障碍的现象学方面。

Phemenological aspects of personality disorders in adult psychiatric patients.

机构信息

Psychiatric Hospital of Begunje, Begunje na Gorenjskem 55, 4275 Begunje, Slovenia,

出版信息

Psychiatr Danub. 2014 Jun;26(2):127-36.

Abstract

BACKGROUND

Many empirical studies give evidence of co-occurrence of mental and personality disorders (PDs). On the other hand theoretical models explain the relationship between personality and mental disorders from different perspectives. This research studied the phemenological aspects of PDs in adult psychiatric patients with different mental disorders according to cognitive and psychoanalytic criteria for personality pathology.

SUBJECTS AND METHODS

In order to study personality pathology in different diagnostic groups we constructed a self-report Questionnaire of Personality Disorders (VMO-2) on the basis of the DSM-IV-TR classification of PD (APA 2000), Beck's theory of dysfunctional beliefs (Beck et al. 2004) and psychoanalytic theories of personality (Kernberg 1986). The content of items in VMO-2 reflected the phenomenology of PDs and is focused on the basic experience of self and others in specific personality types. The questionnaire consists of 193 items which are divided into 11 clinical scales (Histrionic, Obsessive-compulsive, Avoidant, Dependent, Depressive, Narcissistic, Borderline, Antisocial, Paranoid, Schizoid and Schizotypal PD scale) and a validity (Lie) scale. The sample of 642 adult patients with different mental disorders and 477 healthy controls of both genders served as subjects in the study.

RESULTS

All groups of patients reached higher scores on VMO-2 and revealed more personality pathology as compared to the control group. There were differences in specific personality scales between patients of different diagnostic groups. The schizotypal PD scale discriminated significantly between patients with schizophrenia and the majority of other diagnostic groups. The group of patients with opioid dependence disorder reached the highest mean score on the scale for antisocial PD.

CONCLUSION

Our results on VMO-2 show partial support for psychodynamic and cognitive theories of personality pathology. Results are also in accordance with other empirical studies which show that some characteristics of PDs relate to specific mental disorders. We discuss methodological problems regarding some uncontrolled factors which could influence the results of our study. Despite some limitations the present study confirms the relationship between the phenomenological aspect of personality pathology and mental disorders.

摘要

背景

许多实证研究都证明了精神障碍和人格障碍(PD)的共病现象。另一方面,理论模型从不同的角度解释了人格与精神障碍之间的关系。本研究根据认知和精神分析人格病理学的标准,研究了不同精神障碍成年精神科患者中 PD 的现象学特征。

研究对象和方法

为了研究不同诊断组的人格病理学,我们根据 DSM-IV-TR PD 分类(APA 2000)、贝克的功能失调信念理论(Beck 等人,2004)和精神分析人格理论(Kernberg,1986)构建了一个自我报告的人格障碍问卷(VMO-2)。VMO-2 中的项目内容反映了 PD 的现象学,重点是特定人格类型中自我和他人的基本体验。问卷由 193 个项目组成,分为 11 个临床量表(表演型、强迫型、回避型、依赖型、抑郁型、自恋型、边缘型、反社会型、偏执型、分裂样和分裂型人格障碍量表)和一个效度量表(说谎量表)。研究对象为 642 名不同精神障碍的成年患者和 477 名男女两性健康对照组。

结果

所有患者组在 VMO-2 上的得分均较高,与对照组相比,表现出更多的人格病理学。不同诊断组患者的特定人格量表存在差异。精神分裂症患者与大多数其他诊断组相比,分裂型人格障碍量表的得分差异有统计学意义。阿片类药物依赖障碍组在反社会型人格障碍量表上的平均得分最高。

结论

我们在 VMO-2 上的结果部分支持人格病理学的精神动力学和认知理论。结果也与其他实证研究一致,这些研究表明,PD 的某些特征与特定的精神障碍有关。我们讨论了一些可能影响我们研究结果的未控制因素的方法学问题。尽管存在一些局限性,但本研究证实了人格病理学的现象学特征与精神障碍之间的关系。

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