Department of Psychology, University of Pittsburgh.
Department of Psychology, University of Zurich.
Am Psychol. 2022 Dec;77(9):1085-1099. doi: 10.1037/amp0001087.
Personality disorders (PDs) are among the most common and severe classes of psychopathology. From a clinical perspective, it is challenging to help individuals with personality disorders because treatment ruptures, discontinuation, reversals, and failures are relatively common. An additional clinical challenge is that the model used to diagnose personality disorders is demonstrably incorrect. Recent efforts to improve diagnosis of personality disorders apply two criteria: the first distinguishes personality disorders from other kinds of psychopathology and the second distinguishes different types of personality disorders. However, this approach has been problematic in that, as currently operationalized, it does not provide a clear demarcation for personality disorders, and it uses a framework for individual differences that is more apt as a model of variation in psychopathology in general. This article proposes that the core of personality disorders involves difficulties understanding and relating to self and others, and thus the personality disorders should be recast as the interpersonal disorders. Interpersonal dysfunction explains extreme social challenges and treatment difficulties that are characteristic of this class of psychopathology. This approach provides a clearer model for distinguishing these kinds of problems, as demonstrated by reformulating traditional personality disorder symptoms from an interpersonal perspective. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
人格障碍（PDs）是最常见和最严重的精神病理学类别之一。从临床角度来看，帮助人格障碍患者是具有挑战性的，因为治疗中断、停止、逆转和失败相对常见。另一个临床挑战是，用于诊断人格障碍的模型显然是不正确的。最近改善人格障碍诊断的努力应用了两个标准：第一个标准将人格障碍与其他类型的精神病理学区分开来，第二个标准将不同类型的人格障碍区分开来。然而，这种方法存在问题，因为按照目前的操作方式，它并没有为人格障碍提供明确的划分，而且它使用的是一种更适合作为一般精神病理学变异模型的个体差异框架。本文提出，人格障碍的核心涉及到理解和与自我和他人的关系的困难，因此，人格障碍应该重新定义为人际障碍。人际功能障碍解释了这种精神病理学类别的极端社会挑战和治疗困难。这种方法提供了一个更清晰的模型来区分这些问题，正如从人际角度重新表述传统的人格障碍症状所证明的那样。
