Harford Thomas C, Chen Chiung M, Grant Bridget F
CSR, Incorporated, Arlington, Virginia.
National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland.
J Pers Disord. 2015 Oct;29(5):627-40. doi: 10.1521/pedi_2014_28_163. Epub 2014 Sep 23.
The DSM approach to personality disorder (PD) diagnoses has been criticized for using arbitrary thresholds. The present study evaluated one dimensional approach with ordered threshold categories of severity by examining associations with several measures of disability and Axis I disorders for 10 PDs in the general population. Data were obtained from the National Epidemiologic Survey of Alcohol and Related Conditions, Waves 1 and 2. Respondents were categorized according to PD criteria as follows: "no symptoms" for having no positive criteria, "subthreshold" for having at least one positive criterion but below the DSM-IV threshold, "at-threshold" for meeting the DSM-IV threshold and additionally having one or two more positive criteria, and "suprathreshold" for meeting the DSM-IV threshold plus three or more positive criteria. Findings from this national study provide support for dimensional approaches to diagnostic classifications for the majority of PDs and suggest that mild levels of severity indeed have clinical significance.
《精神疾病诊断与统计手册》（DSM）对人格障碍（PD）的诊断方法因使用任意阈值而受到批评。本研究通过检查一般人群中10种人格障碍与几种残疾测量指标和轴I障碍的关联，评估了一种具有有序严重程度阈值类别的维度方法。数据来自全国酒精及相关疾病流行病学调查第1波和第2波。根据人格障碍标准，受访者被分类如下：无阳性标准者为“无症状”，有至少一项阳性标准但低于DSM-IV阈值者为“阈下”，达到DSM-IV阈值且另外有一两项以上阳性标准者为“阈上”，达到DSM-IV阈值加三项或更多阳性标准者为“超阈上”。这项全国性研究的结果为大多数人格障碍的诊断分类维度方法提供了支持，并表明轻度严重程度确实具有临床意义。
