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国际疾病分类第11版(ICD - 11)人格障碍特质模型比精神疾病诊断与统计手册第5版(DSM - 5)特质模型更适合库尔德人群。

The ICD-11 Personality Disorder Trait Model Fits the Kurdish Population Better Than the DSM-5 Trait Model.

作者信息

Hemmati Azad, Rahmani Fateh, Bach Bo

机构信息

Department of Psychology, University of Kurdistan, Sanandaj, Iran.

Psychiatric Research Unit, Center for Personality Disorder Research, Region Zealand Psychiatry, Slagelse, Denmark.

出版信息

Front Psychiatry. 2021 Mar 30;12:635813. doi: 10.3389/fpsyt.2021.635813. eCollection 2021.

Abstract

The ICD-11 Classification of Personality Disorders and the DSM-5 Alternative Model of Personality Disorders (AMPD) operate with trait domains that contribute to the individual expression of personality disturbance (i.e., negative affectivity, detachment, dissociality, disinhibition, anankastia, and psychoticism). To date, these trait frameworks have not been investigated sufficiently in Middle Eastern cultures. Thus, the present study explored the structure of the ICD-11 and AMPD personality disorder (PD) trait domains in a large mixed sample from the Kurdistan zone of Iran. The ICD-11 and AMPD trait domains were operationalized using empirically supported algorithms for the Personality Inventory for DSM-5 (PID-5). The PID-5 was administered to a large mixed sample ( = 3,196) composed of 2,678 community and 518 clinical participants. Structural validity was investigated using Exploratory Factor Analysis (EFA), whereas differential construct validity was explored by comparing clinical and community scores. Model fit and the expected factor structure were deemed appropriate for the ICD-11 trait model, but less adequate for the DSM-5 trait model (i.e., disinhibition did not emerge as a separate factor). All domain and facet scores showed significant differences between clinical and community subsamples with moderate to large effects, mostly for disinhibition and dissociality/antagonism while least for anankastia. The findings of the present study may suggest that the ICD-11 trait model is more cross-culturally fitting than the DSM-5 AMPD trait model, at least with respect to a large mixed sample from the region of Kurdistan. Accordingly, there is evidence for using PID-5 data for WHO ICD-11 purposes in this part of the World.

摘要

《国际疾病分类第11版》人格障碍分类与《精神疾病诊断与统计手册第5版》人格障碍替代模型(AMPD)所使用的特质领域,有助于人格障碍个体表现(即消极情感性、脱离、反社会性、抑制解除、强迫性和精神病性)。迄今为止,这些特质框架在中东文化中尚未得到充分研究。因此,本研究在来自伊朗库尔德地区的大量混合样本中,探讨了《国际疾病分类第11版》和AMPD人格障碍(PD)特质领域的结构。《国际疾病分类第11版》和AMPD特质领域通过《精神疾病诊断与统计手册第5版》人格问卷(PID - 5)的经验支持算法进行操作化。PID - 5施用于由2678名社区参与者和518名临床参与者组成的大量混合样本(n = 3196)。使用探索性因素分析(EFA)研究结构效度,通过比较临床和社区得分探索差异结构效度。模型拟合和预期因素结构被认为适用于《国际疾病分类第11版》特质模型,但对《精神疾病诊断与统计手册第5版》特质模型不太适用(即抑制解除未作为一个单独因素出现)。所有领域和方面得分在临床和社区子样本之间显示出显著差异,效应大小为中等到大,主要是抑制解除和反社会性/敌对性方面,而强迫性方面最小。本研究结果可能表明,至少就来自库尔德地区的大量混合样本而言,《国际疾病分类第11版》特质模型比《精神疾病诊断与统计手册第5版》AMPD特质模型更具跨文化适应性。因此,有证据表明在世界这一地区可将PID - 5数据用于世界卫生组织《国际疾病分类第11版》的目的。

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