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考察复杂创伤后应激障碍和边缘型人格障碍症状的鉴别效度:来自英国人群样本的结果。

Examining the Discriminant Validity of Complex Posttraumatic Stress Disorder and Borderline Personality Disorder Symptoms: Results From a United Kingdom Population Sample.

机构信息

Department of Psychology, Maynooth University, Kildare, Ireland.

Centre for Global Health, Trinity College Dublin, Dublin, Ireland.

出版信息

J Trauma Stress. 2019 Dec;32(6):855-863. doi: 10.1002/jts.22444. Epub 2019 Nov 21.

Abstract

Complex posttraumatic stress disorder (CPTSD) was added to the diagnostic nomenclature in the 11th revision of the International Classification of Diseases (ICD-11). Although considerable evidence exists supporting the construct validity of CPTSD, the distinguishability of CPTSD symptoms from those of borderline personality disorder (BPD) has been questioned. The present study examined the discriminant validity of CPTSD and BPD symptoms among a trauma-exposed population sample from the United Kingdom (N = 546). Participants completed self-report measures of CPTSD and BPD symptoms, and their latent structure was assessed using exploratory structural equation modeling (ESEM). A three-factor model with latent variables reflecting PTSD, disturbances in self-organization (DSO), and BPD symptoms provided the best fit of the data, χ (399, N = 546) = 1,650, p < .001; CFI = .944; TLI = .930; RMSEA = .077, 90% CI [.073, .081]. We identified multiple symptoms distinctive to individual constructs (e.g., disturbed relationships and suicidality) as well as symptoms shared across the constructs (e.g., affective dysregulation). The PTSD, β = .24; DSO, β = .23; and BPD, β = .27, latent variables were positively and significantly associated with childhood interpersonal trauma. The current findings support the discriminant validity of CPTSD and BPD symptoms and highlight various phenomenological signatures of each construct as well as demonstrate how these constructs share important similarities in symptom composition and exogenous correlates.

摘要

复杂创伤后应激障碍 (CPTSD) 于 2022 年被纳入《国际疾病分类》第十一版 (ICD-11) 的诊断名称中。尽管有大量证据支持 CPTSD 的结构效度,但 CPTSD 症状与边缘型人格障碍 (BPD) 症状的可区分性仍受到质疑。本研究在英国创伤暴露人群样本中(N=546),考察了 CPTSD 和 BPD 症状的区分效度。参与者完成了 CPTSD 和 BPD 症状的自评量表,采用探索性结构方程建模 (ESEM) 评估其潜在结构。具有反映 PTSD、自我组织障碍(DSO)和 BPD 症状的潜在变量的三因素模型对数据的拟合度最佳,χ(399, N=546)=1,650,p<.001;CFI=.944;TLI=.930;RMSEA=.077,90%CI[.073,.081]。我们确定了多个独特于个体构念的症状(例如,人际关系紊乱和自杀意念)以及跨构念共享的症状(例如,情绪失调)。PTSD、β=0.24;DSO、β=0.23;BPD、β=0.27 的潜在变量与儿童期人际创伤呈正相关且具有统计学意义。目前的研究结果支持 CPTSD 和 BPD 症状的区分效度,并突出了每个构念的各种现象学特征,以及这些构念在症状组成和外源性相关因素方面的重要相似性。

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