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一种在精神科患者传记式病例记录中识别病前人格类型的可操作程序。

An operationalized procedure for the recognition of premorbid personality types in biographical case notes on psychiatric patients.

作者信息

von Zerssen D, Pössl J, Gruben S, Tauscher R, Barthelmes H

机构信息

Max Planck Institute of Psychiatry, Clinical Institute, Munich, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 1994;243(5):256-72. doi: 10.1007/BF02191584.

Abstract

A method for the assessment of six premorbid personality types from biographical data in psychiatric case histories is described. Trained raters have to fill in a list comprising 106 items as descriptors of a patient's premorbid behavioural development. The assignment to the types in question (the "manic type" and its rare variant, the "happy-go-lucky type", the "melancholic type", the "anxious insecure type" and its rare variant, the "unrealistic dreamy type", and finally, the "nervous tense type") is computed on the basis of the item scores by forming type scores and comparing their height intraindividually. The subject under study is assigned to the type reaching the comparatively highest value. Two raters independently analyzed 261 records from which all information on mental disorders in family members and the patient himself/herself as well as all biographical data from the first manifestation of a symptom disorder onwards had been erased by technical assistants. In 106 of the records, a global assignment to the types of premorbid personality had already been performed by one of the authors of the typology. The scores for the same type assessed by the two ratings correlated highly with each other (0.77 to 0.80), the concordance of types reached a kappa-value of 0.55 (P < 0.001), and the results of the operationalized typing agreed in the same order with the result of global typing in the subsample of n = 106.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本文描述了一种从精神科病例史中的传记数据评估六种病前人格类型的方法。训练有素的评估者必须填写一份包含106个条目的清单,作为患者病前行为发展的描述符。根据项目得分计算所讨论类型(“躁狂型”及其罕见变体“逍遥型”、“抑郁型”、“焦虑不安全型”及其罕见变体“不切实际的梦幻型”,以及最后“紧张型”)的得分,通过形成类型得分并在个体内部比较其高低来进行分配。被研究对象被分配到得分相对最高的类型。两名评估者独立分析了261份记录,技术助理已删除了其中关于家庭成员和患者本人精神障碍的所有信息,以及从症状障碍首次出现起的所有传记数据。在其中106份记录中,类型学的一位作者已经对病前人格类型进行了总体分配。两次评估得出的同一类型得分彼此高度相关(0.77至0.80),类型一致性的kappa值为0.55(P < 0.001),在n = 106的子样本中,操作性分型结果与总体分型结果的顺序一致。(摘要截短至250字)

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