Livesley W J, Schroeder M L, Jackson D N, Jang K L
Department of Psychiatry, University of British Columbia, Vancouver, Canada.
J Abnorm Psychol. 1994 Feb;103(1):6-17. doi: 10.1037//0021-843x.103.1.6.
This article discusses the historical underpinnings of psychiatric classification and examines empirical evidence relevant to (a) whether personality disorders are distinct from each other and from normal personality and (b) whether personality disorders should be classified separately from other mental disorders. At the phenotypic level, research evidence strongly supports the use of a dimensional model to delineate personality disorders; evidence about their genotypic representation is less conclusive though still supportive. Neither empirical nor rational arguments indicate strong justification for separating personality disorders from other mental disorders, as has been done in both the third and fourth editions of the Diagnostic and Statistical Manual of Mental Disorders. Distinctions between abnormal and disordered personality are considered, and suggestions are made for more satisfactory diagnostic classificatory schemes.
本文讨论了精神疾病分类的历史基础，并审视了与以下两方面相关的实证证据：（a）人格障碍彼此之间以及与正常人格是否存在差异；（b）人格障碍是否应与其他精神障碍分开分类。在表型层面，研究证据有力支持使用维度模型来界定人格障碍；关于其基因型表现的证据虽不那么确凿，但仍具有支持性。无论是实证论据还是理性论据，都没有表明如《精神疾病诊断与统计手册》第三版和第四版那样将人格障碍与其他精神障碍分开有充分的理由。文中考虑了异常人格与人格障碍之间的区别，并针对更令人满意的诊断分类方案提出了建议。
