Pires Rute, Henriques-Calado Joana, Sousa Ferreira Ana, Bach Bo, Paulino Marco, Gama Marques João, Ribeiro Moreira Ana, Grácio Jaime, Gonçalves Bruno
Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal.
CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal.
Front Psychiatry. 2021 Apr 16;12:633882. doi: 10.3389/fpsyt.2021.633882. eCollection 2021.
The ICD-11 Classification of Personality Disorders delineates five trait domain qualifiers (i.e., negative affectivity, detachment, dissociality, disinhibition, and anankastia), whereas the DSM-5 Alternative Model of Personality Disorders also delineates a separate domain of psychoticism. These six combined traits not only characterize individual stylistic features, but also the severity of their maladaptive expressions. It was, therefore, the aim of this study to investigate the utility of ICD-11 and DSM-5 trait domains to differentiate patients with personality disorders (PD) from patients with other mental disorders (non-PD). The Personality Inventory for DSM-5 Brief Form Plus (PID5BF+M) was administered to a sample of patients diagnosed with a personality disorder ( = 124, = 42.21, 42.7% females) along with a sample of patients diagnosed with other mental disorders ( = 335, = 44.83, 46.6% females). Group differences were explored using the independent sample test or the Mann-Whitney test for independent samples, and discriminant factor analysis was used to maximize group differences for each trait domain and facet score. The PD group showed significantly higher scores for the total PID5BF+M composite score, for the trait domains of negative affectivity, antagonism/dissociality, and disinhibition and for the trait facets of emotional lability, manipulativeness, deceitfulness, and impulsivity. The trait domains of disinhibition, negative affectivity, and antagonism/dissociality as well as the trait facets of impulsivity, deceitfulness, emotional lability, and manipulativeness were the best discriminators between PD and non-PD patients. The global PID5BF+M composite score was also one of the best discriminators supporting its potential as a global severity index for detecting personality dysfunction. Finally, high scores in three or more of the 18 PID5BF+M facets suggested the possible presence of a PD diagnosis. Despite some limitations, our findings suggest that the ICD-11 and DSM-5 traits have the potential to specifically describe the stylistic features that characterize individuals with PD, including the severity of their maladaptive expressions.
《国际疾病分类第11版》人格障碍分类界定了五个特质领域限定词（即消极情感性、疏离、反社会性、抑制解除和强迫性），而《精神疾病诊断与统计手册第5版》人格障碍替代模型也界定了一个单独的精神病性领域。这六个综合特质不仅表征个体的风格特征，还表征其适应不良表现的严重程度。因此，本研究的目的是调查《国际疾病分类第11版》和《精神疾病诊断与统计手册第5版》的特质领域在区分人格障碍（PD）患者与其他精神障碍（非PD）患者方面的效用。对一组被诊断为人格障碍的患者（ = 124， = 42.21，42.7%为女性）以及一组被诊断为其他精神障碍的患者（ = 335， = 44.83，46.6%为女性）施测了《精神疾病诊断与统计手册第5版》简版加修订版人格问卷（PID5BF+M）。使用独立样本t检验或独立样本曼-惠特尼U检验探索组间差异，并使用判别因子分析来最大化每个特质领域和层面分数的组间差异。PD组在PID5BF+M总分、消极情感性、敌对/反社会性和抑制解除特质领域以及情绪不稳定、操纵性、欺骗性和冲动性特质层面上的得分显著更高。抑制解除、消极情感性和敌对/反社会性特质领域以及冲动性、欺骗性、情绪不稳定和操纵性特质层面是区分PD患者和非PD患者的最佳指标。PID5BF+M总体复合分数也是最佳判别指标之一，支持其作为检测人格功能障碍的总体严重程度指标的潜力。最后，在18个PID5BF+M层面中的三个或更多层面上得分较高表明可能存在PD诊断。尽管存在一些局限性，但我们的研究结果表明，《国际疾病分类第11版》和《精神疾病诊断与统计手册第5版》的特质有可能具体描述表征PD患者的风格特征，包括其适应不良表现的严重程度。
