Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, University of Heidelberg.
Personal Disord. 2022 Jul;13(4):380-382. doi: 10.1037/per0000578.
At the time of publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model of personality disorders, skepticism regarding the clinical utility of a dimensional conceptualization of personality disorders was high including questions about its feasibility for clinicians, its reliability, predictive value, and implications for science and treatment. Following huge research activities summarized by the article of Bach and Tracy (2022), there is meanwhile convincing evidence that a dimensional classification of personality disorders that meets with high utility for clinical decision-making is accepted by clinicians and meets with patients´ needs because it can be easily connected with treatment planning oriented at functional impairments rather than diagnostic categories. Being close to mechanistic models of psychopathology, the alternative model of personality disorders provides a suitable framework to converge self- and interpersonal dysfunctioning indicated in Criterion A with (sub-)domains of the Research Domain Criteria and Hierarchical Taxonomy of Psychopathology systems and, thus, to inspire research to better understand the psychological and neurobiological mechanisms of change. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
在《精神障碍诊断与统计手册》第五版发布时，对人格障碍的维度概念化的临床实用性持怀疑态度，包括对其是否适用于临床医生、可靠性、预测价值以及对科学和治疗的影响的质疑。在 Bach 和 Tracy（2022）的文章总结的大量研究活动之后，目前有令人信服的证据表明，一种符合临床决策高实用性的人格障碍的维度分类被临床医生所接受，并满足患者的需求，因为它可以很容易地与以功能障碍而非诊断类别为导向的治疗计划联系起来。人格障碍的替代模型接近精神病理学的机械模型，为融合标准 A 中表明的自我和人际功能障碍与研究领域标准和精神病理学分层分类系统的（亚）领域提供了一个合适的框架，从而激发研究更好地理解心理和神经生物学的变化机制。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
