Skodol A E, Link B G, Shrout P E, Horwath E
Columbia University College of Physicians and Surgeons, New York, NY.
Psychiatry Res. 1988 Apr;24(1):13-23. doi: 10.1016/0165-1781(88)90135-7.
This study investigates the construct validity of DSM-III Axis V ratings, made in diverse clinical settings, by means of independent assessments of adaptive functioning. Three hundred and sixty-two patients received supervised multiaxial assessments and were then blindly reinterviewed with the Psychiatric Epidemiology Research Interview, which contains scales measuring various aspects of social and occupational functioning. A subsample of 154 patients received a second independent interview that assessed characteristics of the individuals' social networks. The results indicate that Axis V ratings (1) demonstrate predictable diagnostic and demographic group differences, and (2) are determined by both social and occupational variables, but occupational factors predominate. The significance of the results for defining the adaptive functioning construct, for methods of assessment, and for the revisions of Axis V in DSM-III-R, is discussed.
本研究通过对适应功能的独立评估，调查了在不同临床环境中做出的《精神疾病诊断与统计手册》第三版（DSM-III）轴V评分的结构效度。362名患者接受了有监督的多轴评估，然后使用《精神疾病流行病学研究访谈》进行盲法重新访谈，该访谈包含测量社会和职业功能各个方面的量表。154名患者的子样本接受了第二次独立访谈，以评估个体社交网络的特征。结果表明，轴V评分（1）显示出可预测的诊断和人口统计学组间差异，（2）由社会和职业变量共同决定，但职业因素占主导。文中讨论了这些结果对于定义适应功能结构、评估方法以及《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中轴V修订的意义。
