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使用临床医生管理的非自杀性自伤障碍指数对《精神疾病诊断与统计手册》第5版非自杀性自伤障碍进行诊断和特征描述。

Diagnosis and Characterization of DSM-5 Nonsuicidal Self-Injury Disorder Using the Clinician-Administered Nonsuicidal Self-Injury Disorder Index.

作者信息

Gratz Kim L, Dixon-Gordon Katherine L, Chapman Alexander L, Tull Matthew T

机构信息

University of Mississippi Medical Center, Jackson, MS, USA

University of Mississippi Medical Center, Jackson, MS, USA.

出版信息

Assessment. 2015 Oct;22(5):527-39. doi: 10.1177/1073191114565878. Epub 2015 Jan 20.

Abstract

Despite the inclusion of nonsuicidal self-injury disorder (NSSID) in the DSM-5, research on NSSID is limited and no studies have examined the full set of DSM-5 NSSID diagnostic criteria. Thus, this study examined the reliability and validity of a new structured diagnostic interview for NSSID (the Clinician-Administered NSSI Disorder Index; CANDI) and provides information on the clinical characteristics and features of DSM-5 NSSID. Data on the interrater reliability, internal consistency, and construct validity of the CANDI and associated characteristics of NSSID were collected in a community sample of young adults (N = 107) with recent recurrent NSSI (≥10 lifetime episodes of NSSI, at least one episode in the past year). Participants completed self-report measures of NSSI characteristics, psychopathology, and emotion dysregulation, as well as diagnostic interviews of borderline personality disorder (BPD) and lifetime mood, anxiety, and substance use disorders. The CANDI demonstrated good interrater reliability and adequate internal consistency. Thirty-seven percent of participants met criteria for NSSID. NSSID was associated with greater clinical and diagnostic severity, including greater NSSI versatility, greater emotion dysregulation and psychopathology, and higher rates of BPD, bipolar disorder, posttraumatic stress disorder, social anxiety disorder, and alcohol dependence. Findings provide support for the reliability, validity, and feasibility of the CANDI.

摘要

尽管《精神疾病诊断与统计手册》第五版(DSM - 5)纳入了非自杀性自伤障碍(NSSID),但对NSSID的研究仍然有限,且尚无研究对DSM - 5中NSSID的全套诊断标准进行检验。因此,本研究检验了一种针对NSSID的新型结构化诊断访谈(临床医生实施的NSSI障碍指数;CANDI)的信度和效度,并提供了有关DSM - 5中NSSID临床特征的信息。在一个近期有反复非自杀性自伤行为(NSSI)(终身发作≥10次NSSI,过去一年至少发作一次)的年轻成年人社区样本(N = 107)中,收集了关于CANDI的评分者间信度、内部一致性和结构效度以及NSSID相关特征的数据。参与者完成了关于NSSI特征、精神病理学和情绪调节障碍的自我报告测量,以及边缘性人格障碍(BPD)和终身情绪、焦虑及物质使用障碍的诊断访谈。CANDI显示出良好的评分者间信度和足够的内部一致性。37%的参与者符合NSSID的标准。NSSID与更高的临床和诊断严重程度相关,包括更强的NSSI多样性、更严重的情绪调节障碍和精神病理学,以及更高的BPD、双相情感障碍、创伤后应激障碍、社交焦虑障碍和酒精依赖发生率。研究结果为CANDI的信度、效度和可行性提供了支持。

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