Thaker G, Moran M, Adami H, Cassady S
Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore 21228.
Psychiatry Res. 1993 Jan;46(1):47-57. doi: 10.1016/0165-1781(93)90007-4.
The authors evaluated the extent of overlap between DSM-III-R schizophrenia spectrum personality diagnoses (SSPD) and the Psychosis Proneness Scales of Chapman and his associates. The subjects were recruited from the family members of schizophrenic patients ("familial" subjects; n = 45) and members of the community with negative family histories for schizophrenia ("nonfamilial" subjects; n = 60). Clinical interviews were performed to obtain DSM-III-R Axis I and II diagnoses. In 105 individuals with no Axis I diagnosis, the five Chapman Scales were administered. The results suggest that the nonfamilial subjects with diagnoses of SSPD (n = 24) scored significantly higher on the Chapman Scales of Magical Ideation, Perceptual Aberration, and Impulsive Nonconformity compared with the familial SSPD subjects and the other non-SSPD groups. The familial SSPD subjects (n = 17) scored significantly higher than the nonfamilial, non-SSPD groups on the Physical Anhedonia Scale. Scores on the Social Anhedonia Scale were highest in the SSPD subjects, but only scores for the nonfamilial SSPD subjects were statistically different from those for the other non-SSPD groups. The data were reanalyzed by first dividing the scores from the Chapman Scales into high and low scores based on different cutoff points. Sensitivities, specificities, and predictive powers of the "high" Chapman scores for SSPD diagnoses were then calculated. These were done because the Chapman Scales are often used to identify individuals with schizophrenia-related personality disorders on the basis of scores that exceed arbitrary cutoff points. The results suggest that the Chapman Scales (other than the Physical Anhedonia Scale) and DSM-III-R criteria identified mostly the same subjects, when only nonfamilial subjects were considered (with sensitivities and specificities of about 0.70). However, the overlap between these two constructs was poor when only schizophrenia spectrum subjects recruited from the family members of schizophrenic patients were considered.
作者评估了《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）精神分裂症谱系人格诊断（SSPD）与查普曼及其同事的精神病易感性量表之间的重叠程度。研究对象招募自精神分裂症患者的家庭成员（“家族性”对象；n = 45）和社区中无精神分裂症家族史的成员（“非家族性”对象；n = 60）。进行临床访谈以获得DSM-III-R轴I和轴II诊断。在105名无轴I诊断的个体中，施测了五个查普曼量表。结果表明，与家族性SSPD对象和其他非SSPD组相比，被诊断为SSPD的非家族性对象（n = 24）在查普曼的神奇观念、感知异常和冲动不遵从量表上得分显著更高。家族性SSPD对象（n = 17）在躯体快感缺乏量表上的得分显著高于非家族性、非SSPD组。社交快感缺乏量表上的得分在SSPD对象中最高，但只有非家族性SSPD对象的得分与其他非SSPD组的得分存在统计学差异。首先根据不同的分界点将查普曼量表的得分分为高分和低分，然后重新分析数据。接着计算查普曼量表“高”分对SSPD诊断的敏感性、特异性和预测能力。之所以这样做，是因为查普曼量表经常被用于根据超过任意分界点的得分来识别患有精神分裂症相关人格障碍的个体。结果表明，当仅考虑非家族性对象时（敏感性和特异性约为0.70），查普曼量表（除躯体快感缺乏量表外）和DSM-III-R标准识别出的大多是相同的对象。然而，当仅考虑从精神分裂症患者家庭成员中招募的精神分裂症谱系对象时，这两种结构之间的重叠性较差。
