Gutiérrez Fernando, Peri Josep M, Gárriz Miguel, Vall Gemma, Arqué Estela, Ruiz Laura, Condomines Jaume, Calvo Natalia, Ferrer Marc, Sureda Bárbara
Institute of Neuroscience, Hospital Clinic, Barcelona, Spain.
Institut d'Investigacións Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.
Front Psychiatry. 2021 Apr 6;12:591934. doi: 10.3389/fpsyt.2021.591934. eCollection 2021.
The promise of replacing the diagnostic categories of personality disorder with a better-grounded system has been only partially met. We still need to understand whether our main dimensional taxonomies, those of the , 11th Revision () and the , Fifth Edition (), are the same or different, and elucidate whether a unified structure is possible. We also need truly independent pathological domains, as they have shown unacceptable overlap so far. To inquire into these points, the Personality Inventory for (PID-5) and the Personality Inventory for (PiCD) were administered to 677 outpatients. Disattenuated correlation coefficients between 0.84 and 0.93 revealed that both systems share four analogous traits: negative affectivity, detachment, dissociality/antagonism, and disinhibition. These traits proved scalar equivalence too, such that scores in the two questionnaires are roughly interchangeable. These four domains plus psychoticism formed a theoretically consistent and well-fitted five-factor structure, but they overlapped considerably, thereby reducing discriminant validity. Only after the extraction of a general personality disorder factor (g-PD) through bifactor analysis, we could attain a comprehensive model bearing mutually independent traits.
用一个更有依据的系统取代人格障碍诊断类别的承诺仅部分实现。我们仍需了解我们主要的维度分类法,即《国际疾病分类》第11版(ICD - 11)和《精神疾病诊断与统计手册》第五版(DSM - 5)中的分类法是相同还是不同,并阐明是否可能存在统一的结构。我们还需要真正独立的病理领域,因为到目前为止它们表现出了不可接受的重叠。为了探究这些问题,我们对677名门诊患者进行了人格障碍特质评定量表(PID - 5)和人格障碍问卷(PiCD)测试。0.84至0.93之间的去衰减相关系数表明,这两个系统共有四个类似的特质:消极情感性、疏离、反社会性/敌对性和抑制不足。这些特质也证明了标量等价性,即两份问卷中的得分大致可以互换。这四个领域加上精神病性形成了一个理论上一致且拟合良好的五因素结构,但它们有相当大的重叠,从而降低了判别效度。只有通过双因素分析提取出一个一般人格障碍因子(g - PD)后,我们才能获得一个具有相互独立特质的综合模型。