Adelphi University.
Personal Disord. 2019 May;10(3):199-209. doi: 10.1037/per0000299. Epub 2018 Jun 21.
The current debate regarding how best to conceptualize, operationalize, and assess personality pathology is often framed as a choice between categorical ("type") and dimensional ("trait") models, but when viewed from the perspective of the diagnostician, these two approaches actually have much in common. It is not possible to assign symptom ratings in any categorical personality disorder framework without first evaluating the severity of each symptom on a continuum, nor to implement dimensional personality disorder assessments in clinical settings without using thresholds that demarcate the presence of personality pathology, or severity of personality dysfunction. Although recent discussions of these two frameworks have focused primarily on issues regarding construct validity (and to a lesser extent, clinical utility), it is important to consider the impact of the diagnostic process as well. When considered within this broader context, the advantages and limitations of each perspective are illuminated, and it becomes clear that the categorical and dimensional frameworks represent an evolving dialectic that will continue into the future, as new and better models alter the focus of these debates. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
目前,关于如何最好地概念化、操作化和评估人格病理学的争论,通常被认为是在分类(“类型”)和维度(“特质”)模型之间进行选择,但从诊断者的角度来看,这两种方法实际上有很多共同点。如果不首先在连续体上评估每个症状的严重程度,就不可能在任何分类人格障碍框架中分配症状评分,也不可能在临床环境中实施维度人格障碍评估,而不使用区分人格病理学存在或人格功能障碍严重程度的阈值。尽管最近对这两种框架的讨论主要集中在构念效度问题上(在较小程度上还集中在临床实用性问题上),但考虑诊断过程也很重要。从更广泛的角度来看待这些问题时,就会阐明每种观点的优缺点,并且很明显,分类和维度框架代表了一种不断发展的辩证关系,随着新的更好的模型改变这些辩论的重点,这种关系将持续到未来。(APA 心理学文摘数据库记录(c)2019,保留所有权利)。