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挪威临床医生对 SCID-II、SCID-5-PD 和 SCID-5-AMPD-I 访谈的可学习性和可用性的体验:一种顺序多组定性方法。

Norwegian Clinicians' Experiences of Learnability and Usability of SCID-II, SCID-5-PD and SCID-5-AMPD-I Interviews: A Sequential Multi-Group Qualitative Approach.

机构信息

Department of Research and Innovation, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

J Pers Assess. 2022 Sep-Oct;104(5):599-612. doi: 10.1080/00223891.2021.1975726. Epub 2021 Sep 21.

Abstract

The DSM-5 presents two competing diagnostic frameworks for personality disorders: the standard categorical model and the Alternative Model of Personality Disorders (AMPD). The AMPD was initially criticized for being too complex and theory laden for clinical implementation. Though inter-rater reliability studies have contested initial claims of the model's complexity, little attention has been paid to how clinicians experience the usability and learnability of either model. We interviewed twenty Norwegian clinicians about their experiences with either the SCID-II/5-PD (n = 9), SCID-5-AMPD-I (n = 8), or both (n = 3). Separate thematic analyses were conducted for SCID-II/5-PD and SCID-5-AMPD-I groups, and group themes were compared. We identified four themes for each group, relating to required skills, training, challenges and information gained through the interview. We found that training and clinical experience were considered to be important for both interviews. Moreover, the SCID-5-AMPD-I was considered to rely more explicitly on theory specific to the development and content of the AMPD model in general and the LPFS specifically We also identified shared and unique challenges and shortcomings of each interview. We comment on how our findings relate to the debate surrounding the AMPD, and recommend development of clear training guidelines for both interviews.

摘要

DSM-5 提出了两种用于人格障碍的相互竞争的诊断框架:标准分类模型和人格障碍替代模型 (AMPD)。AMPD 最初因其对临床实施来说过于复杂和理论化而受到批评。尽管评分者间信度研究对该模型的复杂性提出了最初的质疑,但很少关注临床医生对两种模型的可用性和可学习性的体验。我们采访了 20 名挪威临床医生,了解他们对 SCID-II/5-PD(n=9)、SCID-5-AMPD-I(n=8)或两者(n=3)的经验。对 SCID-II/5-PD 和 SCID-5-AMPD-I 组分别进行了主题分析,并比较了组主题。我们为每个组确定了四个主题,涉及所需的技能、培训、挑战以及通过访谈获得的信息。我们发现,培训和临床经验被认为对两次访谈都很重要。此外,SCID-5-AMPD-I 被认为更明确地依赖于与 AMPD 模型的发展和内容相关的特定理论,特别是 LPFS。我们还确定了每次访谈的共同和独特的挑战和缺点。我们评论了我们的发现如何与围绕 AMPD 的争论相关,并建议为两次访谈制定明确的培训指南。

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