Blüml Victor, Doering Stephan
Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Front Psychiatry. 2021 Apr 16;12:654026. doi: 10.3389/fpsyt.2021.654026. eCollection 2021.
The new ICD-11 introduces a fully dimensional classification of personality disorders representing a fundamental change in personality disorder diagnosis with major implications for clinical practice and research. The new system centers on the evaluation of the severity of impairment in the areas of self and interpersonal functioning. This focus on personality functioning converges with long-standing psychoanalytic/psychodynamic conceptualizations of personality pathology. In a detailed conceptual analysis and review of existing empirical data, points of convergence and notable differences between major exponents of the psychodynamic tradition-object relations theory as developed by Kernberg et al. and the Operationalized Psychodynamic Diagnosis-and the ICD-11 system are critically discussed. Personality functioning can be considered to be the current "common ground" for the assessment of personality disorders and constitutes a considerable step forward in making personality disorder diagnosis both clinically meaningful and suitable for research purposes.
新版《国际疾病分类第11版》(ICD - 11)引入了人格障碍的全维度分类,这代表着人格障碍诊断的根本性变革,对临床实践和研究具有重大意义。新系统以评估自我和人际功能领域的损害严重程度为核心。这种对人格功能的关注与长期以来精神分析/心理动力学对人格病理学的概念化相契合。在一项对现有实证数据的详细概念分析和综述中,批判性地讨论了心理动力学传统的主要代表——由克恩伯格等人发展的客体关系理论以及操作性心理动力学诊断——与ICD - 11系统之间的趋同点和显著差异。人格功能可被视为当前评估人格障碍的“共同基础”,在使人格障碍诊断兼具临床意义和适用于研究目的方面迈出了重要一步。