Waszczuk Monika A, Hopwood Christopher J, Luft Benjamin J, Morey Leslie C, Perlman Greg, Ruggero Camilo J, Skodol Andrew E, Kotov Roman
Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL.
Department of Psychiatry, Stony Brook University, Stony Brook, NY.
Clin Psychol Sci. 2022 Jul;10(4):734-751. doi: 10.1177/21677026211056596. Epub 2021 Dec 21.
Past psychiatric diagnoses are central to patient case formulation and prognosis. Recently, alternative classification models such as the Hierarchical Taxonomy of Psychopathology (HiTOP) proposed to assess traits to predict clinically-relevant outcomes. The current study directly compared personality traits and past diagnoses as predictors of future mental health and functioning in three independent, prospective samples. Regression analyses found that personality traits significantly predicted future first onsets of psychiatric disorders (ΔR=06-.15), symptom chronicity (ΔR=.03-.06), and functioning (ΔR=.02-.07), beyond past and current psychiatric diagnoses. Conversely, past psychiatric diagnoses did not provide an incremental prediction of outcomes when personality traits and other concurrent predictors were already included in the model. Overall, personality traits predicted a variety of outcomes in diverse settings, beyond diagnoses. Past diagnoses were generally not informative about future outcomes when personality was considered. Together, these findings support the added value of personality traits assessment in case formulation, consistent with HiTOP model.
既往精神科诊断对于患者病例分析和预后至关重要。最近，诸如精神病理学层次分类法（HiTOP）等替代分类模型建议评估特质以预测临床相关结果。本研究在三个独立的前瞻性样本中，直接比较了人格特质和既往诊断作为未来心理健康及功能预测指标的情况。回归分析发现，人格特质能显著预测未来精神障碍的首次发作（ΔR = 0.06 - 0.15）、症状慢性化（ΔR = 0.03 - 0.06）以及功能状况（ΔR = 0.02 - 0.07），这超出了既往和当前的精神科诊断所能预测的范围。相反，当模型中已纳入人格特质和其他同时存在的预测指标时，既往精神科诊断并不能对结果提供额外的预测价值。总体而言，人格特质在不同情境下能预测多种结果，超出了诊断的范畴。当考虑人格因素时，既往诊断通常对未来结果并无太多信息价值。这些发现共同支持了在病例分析中评估人格特质的附加价值，这与HiTOP模型一致。
