Oltmanns Thomas F, Rodrigues Merlyn M, Weinstein Yana, Gleason Marci E J
Department of Psychology, Washington University in St. Louis, St. Louis, MO 63130-4899, USA.
Department of Psychology, University of Massachusetts - Lowell, Lowell, USA.
J Psychopathol Behav Assess. 2014 Jun 1;36(2):177-188. doi: 10.1007/s10862-013-9389-7.
This report is concerned with the prevalence of symptoms of specific personality disorders in a representative community sample and draws attention to the importance of different sources of diagnostic information. We recruited a sample of 1,630 people between the ages of 55 and 64 to participate in a study regarding personality and health. Using careful recruitment methods, our participation rate was 43 %. Participants completed the SIDP-IV interview as well as a questionnaire (self-report MAPP). Informants completed the same questionnaire (informant MAPP), describing the participant's maladaptive personality characteristics. According to the diagnostic interview, 7 % of participants met criteria for exactly one PD, 1 % met criteria for 2 or 3 PDs, and 2 % met criteria for PD NOS (defined as 10 or more miscellaneous criteria). Avoidant and obsessive compulsive PDs were the most common types. Correlations between the three sources of information indicated significant agreement among these measurement methods, but they are not redundant. In comparison to interview and self-report data, informants reported more symptoms of personality pathology (except for avoidant PD). Symptoms of personality pathology are continuously distributed, and subthreshold features may have an important impact on health and social adjustment. In this community sample, rates of co-morbidity among PDs and the proportion of PDNOS diagnoses are substantially lower than reported from clinical samples. Future research must evaluate the validity of diagnostic thresholds and competing sources of diagnostic information in relation to important life outcomes.
本报告关注特定人格障碍症状在具有代表性的社区样本中的流行情况,并提请注意不同诊断信息来源的重要性。我们招募了1630名年龄在55岁至64岁之间的人参与一项关于人格与健康的研究。通过严谨的招募方法,我们的参与率为43%。参与者完成了《结构化访谈人格诊断问卷第四版》(SIDP-IV)访谈以及一份问卷(自我报告的MAPP)。信息提供者完成了相同的问卷(信息提供者MAPP),描述参与者适应不良的人格特征。根据诊断访谈,7%的参与者恰好符合一种人格障碍的标准,1%符合两种或三种人格障碍的标准,2%符合未特定的人格障碍(PD NOS,定义为有10条或更多杂项标准)的标准。回避型和强迫型人格障碍是最常见的类型。三种信息来源之间的相关性表明这些测量方法之间存在显著一致性,但并非冗余。与访谈和自我报告数据相比,信息提供者报告的人格病理学症状更多(回避型人格障碍除外)。人格病理学症状呈连续分布,阈下特征可能对健康和社会适应有重要影响。在这个社区样本中,人格障碍之间的共病率和未特定的人格障碍诊断比例显著低于临床样本报告的比例。未来的研究必须评估诊断阈值的有效性以及与重要生活结果相关的诊断信息的竞争来源。