Sevecke Kathrin, Schmeck Klaus, Krischer Maya
Universitätsklinik für Kinder- und Jugendpsychiatrie, <location>Innsbruck</location>
Z Kinder Jugendpsychiatr Psychother. 2014 Jul;42(4):279-83. doi: 10.1024/1422-4917/a000300.
By applying the dimensional-categorical hybrid model, Chapter III of the DSM-5 proposes a central innovation in the classification of personality disorders, the aim being a reduction of comorbidity and improvement of the construct as well as the discremental validity and stability of the diagnosis. The well-known categorical classification of personality disorders in Chapter II, however, remains valid. Based on the hybrid model the essential aspects of a personality disorders are as follows: the dimensional assessment of levels of personality functioning regarding disturbances in self (identity and self-direction) and interpersonal (empathy and intimacy) aspects on the one hand, and the existence of pathological personality traits on the other. Beside five higher-order traits, 25 specific trait facets are described. Moreover, a reduction in the number of personality disorder types is proposed, reflecting six instead of ten categories which are empirically best validated. The abandoned age limitation for the assessment of a personality disorder in Chapter III can be regarded as a clear statement with respect to the possibility and necessity of diagnosing and treating personality pathology in adolescence. By presenting an additional dimensional approach with a detailed description of personality functioning as well as specific pathological personality traits, the new hybrid model seems to principally be a useful approach for clinical purposes as well as research questions.
通过应用维度-类别混合模型,《精神疾病诊断与统计手册》(第五版)第三章提出了人格障碍分类中的一项核心创新,目的是减少共病现象,改善概念结构以及诊断的区分效度和稳定性。然而,第二章中为人熟知的人格障碍类别分类仍然有效。基于混合模型,人格障碍的基本方面如下:一方面是对自我(身份认同和自我导向)和人际(共情和亲密关系)方面功能障碍的人格功能水平进行维度评估,另一方面是存在病理性人格特质。除了五个高阶特质外,还描述了25个特定的特质方面。此外,还提议减少人格障碍类型的数量,反映的是经实证验证最佳的六个类别而非十个类别。第三章中取消了人格障碍评估的年龄限制,这可以被视为关于在青少年期诊断和治疗人格病理学的可能性和必要性的明确声明。通过提出一种额外的维度方法,并详细描述人格功能以及特定的病理性人格特质,新的混合模型似乎在临床应用以及研究问题方面总体上是一种有用的方法。