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高危青年成人的病理人格特质与内化障碍的自然病程

PATHOLOGICAL PERSONALITY TRAITS AND THE NATURALISTIC COURSE OF INTERNALIZING DISORDERS AMONG HIGH-RISK YOUNG ADULTS.

作者信息

Conway Christopher C, Craske Michelle G, Zinbarg Richard E, Mineka Susan

机构信息

Department of Psychology, College of William & Mary, Williamsburg, VA.

Department of Psychology, University of California, Los Angeles, California.

出版信息

Depress Anxiety. 2016 Jan;33(1):84-93. doi: 10.1002/da.22404. Epub 2015 Sep 7.

Abstract

BACKGROUND

A personality disorder diagnosis signals a negative prognosis for depressive and anxiety disorders, but the precise abnormal personality traits that determine the temporal course of internalizing psychopathology are unknown. In the present study, we examined prospective associations between abnormal personality traits and the onset and recurrence of internalizing disorders.

METHODS

A sample of 371 young adults at high risk for internalizing problems completed the Schedule for Nonadaptive and Adaptive Personality-Second Edition--a measure of 12 abnormal personality traits and three temperament dimensions (i.e., Negative Temperament, Positive Temperament, Disinhibition vs. Control)--and underwent annual diagnostic interviews over 4 years of follow-up.

RESULTS

In multivariate survival analyses, Negative Temperament was a robust predictor of both new onsets and recurrences of internalizing disorder. Further, the Dependency and Self-Harm abnormal personality dimensions emerged as independent predictors of new onsets and recurrences, respectively, of internalizing disorders after statistically adjusting for variation in temperament.

CONCLUSIONS

Our findings suggest that abnormal personality traits and temperament dimensions have complementary effects on the trajectory of internalizing pathology during young adulthood. In assessment and treatment settings, targeting the abnormal personality and temperament dimensions with the greatest prognostic value stands to improve the early detection of enduring internalizing psychopathology.

摘要

背景

人格障碍诊断预示着抑郁和焦虑障碍的不良预后,但决定内化性精神病理学病程的具体异常人格特质尚不清楚。在本研究中,我们考察了异常人格特质与内化性障碍的发病及复发之间的前瞻性关联。

方法

抽取371名有内化问题高风险的年轻人作为样本,他们完成了《非适应性和适应性人格量表第二版》——该量表用于测量12种异常人格特质和三个气质维度(即负性气质、正性气质、抑制与控制),并在4年随访期间接受年度诊断访谈。

结果

在多变量生存分析中,负性气质是内化性障碍新发和复发的有力预测因子。此外,在对气质差异进行统计学调整后,依赖和自伤这两个人格异常维度分别成为内化性障碍新发和复发的独立预测因子。

结论

我们的研究结果表明,异常人格特质和气质维度在青年期内化性病理过程中具有互补作用。在评估和治疗环境中,针对具有最大预后价值的异常人格和气质维度,有望改善对持续性内化性精神病理学的早期检测。

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