Gamache Dominick, Savard Claudia, Payant Maude, Leclerc Philippe, Dompierre Renée-Claude, Roy David, Tremblay Marc, Verreault Mélissa, Villeneuve Évens
Département de psychologie, Université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche CERVO, Université Laval, Québec, Canada.
Centre de recherche CERVO, Université Laval, Québec, Canada; Département des fondements et pratiques en éducation, Université Laval, Québec, Canada.
Sante Ment Que. 2022 Fall;47(2):17-39.
Objectives The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes an Alternative Model for Personality Disorders (DSM-5), which defines personality disorders based on two dimensional criteria. Criterion A corresponds to the severity of personality dysfunction in the areas of self and interpersonal functioning, while Criterion B comprises five pathological domains including a total of 25 facets. Six specific disorders, including borderline personality disorder (BPD), are defined in the AMPD based on Criteria A and B. However, there is currently very little data on these diagnoses as they are operationalized in the MATP. This study aims to present data on this recent operationalization of BPD. More specifically, we will first introduce a procedure, based on self-reported questionnaires covering the two main MATP criteria, implemented to generate the BPD diagnosis from the AMPD. Then, we will assess its validity (a) by documenting its prevalence in a clinical sample; (b) by determining its degree of correspondence with the "traditional" BPD categorical diagnosis and with a dimensional measure of borderline symptomatology; (c) by presenting convergent validity data with constructs relevant to the study of BPD (impulsivity, aggression); and (d) by determining the incremental validity of the proposed procedure in contrast with a simplified approach where only Criterion B would be considered. Method Data from 287 patients recruited as part of the admission process at the Centre de traitement le Faubourg Saint-Jean of the CIUSSS-Capitale-Nationale were analyzed. The BPD diagnosis from the MATP was generated based on two validated self-report questionnaires, in their French version, namely the Self and Interpersonal Functioning Scale (Criterion A) and the Personality Inventory for DSM-5-Faceted Brief Form (Criterion B). Results The BPD diagnosis, as operationalized in the AMPD, had a prevalence of 39.7% in the sample. A moderate fit with the clinician's diagnosis of BPD according to the traditional DSM-5 categorical model was observed, as well as a strong correlation with a dimensional measure of borderline symptomatology. Nomological network analysis revealed high and theoretically expected correlations between the disorder and measures of aggression and impulsivity. The proposed diagnostic extraction procedure, which uses Criteria A and B, showed incremental validity in the statistical prediction of external variables (borderline symptomatology, aggression, impulsivity) compared to a simplified procedure using only Criterion B. Conclusions The proposed procedure for generating the BPD diagnosis according to the MATP definition yields promising results and could allow screening for the disorder based on this contemporary conceptualization of personality pathologies.
目标 《精神疾病诊断与统计手册》第五版(DSM - 5)包含人格障碍替代模型(AMPD),该模型基于二维标准定义人格障碍。A标准对应自我和人际功能领域人格功能障碍的严重程度,而B标准包括五个病理领域,共25个方面。基于A标准和B标准在AMPD中定义了六种特定障碍,包括边缘型人格障碍(BPD)。然而,目前关于这些诊断在精神分析治疗过程(MATP)中的实际应用数据非常少。本研究旨在呈现关于BPD近期实际应用的数据。更具体地说,我们首先将介绍一种基于自我报告问卷的程序,该问卷涵盖MATP的两个主要标准,用于从AMPD生成BPD诊断。然后,我们将通过以下方式评估其有效性:(a)记录其在临床样本中的患病率;(b)确定其与“传统”BPD分类诊断以及边缘症状维度测量的对应程度;(c)呈现与BPD研究相关的构念(冲动性、攻击性)的收敛效度数据;(d)与仅考虑B标准的简化方法相比,确定所提议程序的增量效度。方法 对作为魁北克国家首都综合服务与社会支持中心圣让福布尔格治疗中心入院程序一部分招募的287名患者的数据进行分析。基于两份经过验证的自我报告问卷(法语版),即自我与人际功能量表(A标准)和DSM - 5多面简表人格问卷(B标准),生成MATP中的BPD诊断。结果 在样本中,AMPD中定义的BPD诊断患病率为39.7%。观察到与根据传统DSM - 5分类模型的临床医生对BPD的诊断有适度拟合,以及与边缘症状维度测量有强相关性。法则网络分析显示该障碍与攻击性和冲动性测量之间存在高度且符合理论预期的相关性。与仅使用B标准的简化程序相比,所提议的使用A标准和B标准的诊断提取程序在外部变量(边缘症状、攻击性、冲动性)的统计预测中显示出增量效度。结论 根据MATP定义生成BPD诊断的提议程序产生了有前景的结果,并且可以基于这种当代人格病理学概念化对该障碍进行筛查。