Horowitz M J, Eells T, Singer J, Salovey P
Department of Psychiatry, University of California, San Francisco, USA.
Arch Gen Psychiatry. 1995 Aug;52(8):625-32. doi: 10.1001/archpsyc.1995.03950200015003.
Personality disorders are important because they occur frequently and often complicate psychiatric symptom disorders. They are difficult to diagnose and formulate because unitary core traits and themes are hard to define for individual patients. A multiple-selves approach helps clinicians define core contradictions in belief that are frequently present.
A configurational system for case formulation was used with an approach of states and person schemas. Transactions and stories involving self and others were observed for recurrent elements of identity, attribution, and action. These elements were systematically arranged as role relationship models for each important state of behavior. Cyclic repetitions of maladaptive interpersonal behavior patterns were then explained in terms of motivations and social events that activate enduring, but erroneous, beliefs.
Reliable and valid individualized formulations were derived by means of configurations of role relationship models. Inferring several levels of diverse self and other beliefs clarified the complexity usually found in disorders of personality.
The role relationship models method of formulation is compatible with integrative approaches to treatment planning.
人格障碍很重要，因为它们频繁出现且常常使精神症状障碍复杂化。它们难以诊断和表述，因为单一的核心特质和主题很难为个体患者界定。一种多重自我的方法有助于临床医生界定经常存在的信念中的核心矛盾。
采用一种用于病例表述的构型系统，运用状态和人格图式的方法。观察涉及自我和他人的互动及故事，以找出身份认同、归因和行动方面反复出现的元素。这些元素被系统地排列成每种重要行为状态的角色关系模型。然后，从激活持久但错误信念的动机和社会事件方面，解释适应不良人际行为模式的循环重复。
通过角色关系模型的构型得出了可靠且有效的个体化表述。推断出不同层次的多样自我和他人信念，阐明了人格障碍中通常存在的复杂性。
角色关系模型表述方法与治疗计划的综合方法相兼容。
