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《精神疾病诊断与统计手册》第四版边缘型人格障碍标准的潜在结构分析

Latent structure analysis of DSM-IV borderline personality disorder criteria.

作者信息

Fossati A, Maffei C, Bagnato M, Donati D, Namia C, Novella L

机构信息

Istituto Scientifico Ospedale San Raffaele, Department of Neuropsychiatric Sciences, University of Milan School of Medicine, Milano, Italy.

出版信息

Compr Psychiatry. 1999 Jan-Feb;40(1):72-9. doi: 10.1016/s0010-440x(99)90080-9.

Abstract

The aim of this study was to evaluate the structure of DSM-IV borderline personality disorder (BPD) criteria. The study group consisted of 564 consecutively admitted inpatients and outpatients. BPD criteria discriminatory power was tested by using corrected item-to-total and item-to-diagnosis correlations. Weighted least-squares (WLS) confirmatory factor analysis (CFA) was used to assess the fit of DSM-IV BPD unidimensional model. The categorical model of BPD was tested by exploratory latent class analysis (LCA). Item analysis suggested a hierarchy in BPD criteria discriminatory power, even if with different rank order with respect to the DSM-IV model. CFA showed a unifactorial structure with congeneric items as the best fitting model for DSM-IV BPD criteria (chi2 = 18.89, df= 27, P > .87). LCA showed evidence for three latent classes; heterogeneity was observed only among subjects falling below DSM-IV diagnostic threshold for BPD. These results support the categorical model of BPD, even if with several differences with respect to DSM-IV.

摘要

本研究旨在评估《精神疾病诊断与统计手册》第四版(DSM-IV)边缘型人格障碍(BPD)标准的结构。研究组由564名连续收治的住院患者和门诊患者组成。通过使用校正的项目与总分及项目与诊断的相关性来测试BPD标准的区分能力。采用加权最小二乘法(WLS)验证性因子分析(CFA)来评估DSM-IV BPD单维模型的拟合度。通过探索性潜在类别分析(LCA)对BPD的分类模型进行测试。项目分析表明,BPD标准区分能力存在层次结构,尽管与DSM-IV模型的排序不同。CFA显示单因素结构,同类项目是DSM-IV BPD标准的最佳拟合模型(卡方=18.89,自由度=27,P>.87)。LCA显示存在三个潜在类别;仅在低于DSM-IV BPD诊断阈值的受试者中观察到异质性。这些结果支持BPD的分类模型,尽管与DSM-IV存在一些差异。

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