Pick Emanuele, Pavan Chiara, Marini Massimo, Cariolato Ylenia, Bogliolo Elisabetta, Toffanin Tommaso, Palmieri Arianna
Dipartimento Filosofia, Sociologia, Pedagogia e Psicologia Applicata - Università degli Studi di Padova - Padova - Italia.
Dipartimento di Medicina - Università degli Studi di Padova - Padova - Italia.
Clin Neuropsychiatry. 2022 Feb;19(1):45-53. doi: 10.36131/cnfioritieditore20220107.
Empathy functioning is among the criteria to delineate psychiatric diagnosis. However, the self-oriented empathy dimension is almost neglected in the existing literature. On the basis of previous fragmented contributions, we hypothesised that an individual's level of personality organisation is explained by this facet of empathy more than the other components of empathy, both transversally and independently from the specific psychiatric diagnosis.
Fifty-nine psychiatric inpatients were evaluated with clinical interviews inspired by the Structured Clinical Interview for , completed the Symptom Checklist-90-Revised, and Interpersonal Reactivity Index (IRI). A panel of experts established each patient's psychiatric diagnosis and the level of personality organisation according to and . Thirty-two patients were considered functioning at a psychotic level, 27 at a borderline level, and none at a neurotic level. Multinomial models were compared with the corrected AIC to determine if self-oriented empathy, among all IRI subscales, was the best-fitting model for explaining the levels of personality organisation. A further analogue series of models was used to investigate the best IRI subscale to explain each patient's psychiatric diagnosis.
The first series of models revealed self-oriented empathy (IRI personal distress subscale) as the best empathic dimension to explain levels of personality organisation. The second series revealed that none of the four IRI subscales explained psychiatric diagnoses.
The consistency of our findings with evolutionary concepts pertaining to both traditional psychodynamic models and contemporary models of psychopathology, such as the factor theory, was illustrated. Despite the many limitations of our consecutive sampling jeopardising the findings' generalisability, the insight of self-oriented empathy as the best predictor of the level of personality organisation, irrespective of psychiatric diagnosis, has several implications from both research and clinical/diagnostic perspectives.
共情功能是划分精神疾病诊断的标准之一。然而,现有的文献几乎忽略了自我导向的共情维度。基于之前零散的研究成果,我们假设,相较于共情的其他组成部分,共情的这一方面能更全面且独立于特定精神疾病诊断地解释个体的人格组织水平。
59名精神科住院患者接受了受《精神疾病诊断与统计手册》启发的临床访谈评估,完成了症状自评量表-90修订版(SCL-90-R)和人际反应指针量表(IRI)。一组专家根据《精神疾病诊断与统计手册》确定了每位患者的精神疾病诊断和人格组织水平。32名患者被认为处于精神病水平,27名处于边缘水平,没有患者处于神经症水平。使用校正后的AIC比较多项模型,以确定在所有IRI分量表中,自我导向的共情是否是解释人格组织水平的最佳拟合模型。另一个类似系列的模型用于研究解释每位患者精神疾病诊断的最佳IRI分量表。
第一系列模型显示,自我导向的共情(IRI个人痛苦分量表)是解释人格组织水平的最佳共情维度。第二系列模型显示,四个IRI分量表中没有一个能解释精神疾病诊断。
我们的研究结果与传统精神动力学模型和当代精神病理学模型(如五因素理论)中与进化概念的一致性得到了说明。尽管我们连续抽样的许多局限性危及了研究结果的普遍性,但自我导向的共情作为人格组织水平的最佳预测指标,无论精神疾病诊断如何,从研究和临床/诊断角度来看都有若干意义。