Prevalence and stability of the DSM-III-R personality disorders in a community-based survey of adolescents.
Prevalence and stability of the DSM-III-R personality disorders in a community-based survey of adolescents.
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DOI：
10.1176/ajp.150.8.1237
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发表时间：
1993-08
期刊：
影响因子：
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通讯作者：
D. Bernstein;P. Cohen;C. Vélez;M. Schwab-Stone;L. Siever;Lillian Shinsato
中科院分区：
文献类型：
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作者：
D. Bernstein;P. Cohen;C. Vélez;M. Schwab-Stone;L. Siever;Lillian Shinsato
目的 本研究的目的是评估基于社区的大量青少年样本中 DSM-III-R 人格障碍的患病率、同时有效性和稳定性。方法 对 733 名年龄在 9 岁至 19 岁之间的青少年进行随机抽取的社区样本进行为期 2 年的跟踪调查。该方案包括对青少年及其母亲的结构化访谈以及自我报告问卷。开发了针对 10 种 DSM-III-R II 轴疾病的算法，以产生两个严重程度的诊断；这些都针对痛苦和功能障碍的多种指标进行了验证。结果 男孩人格障碍的总体患病率在 12 岁时达到峰值，女孩在 13 岁时达到峰值，此后有所下降。根据中度和重度诊断阈值，强迫型人格障碍是最常见的中度轴 II 障碍，自恋型人格障碍是最常见的重度障碍，而分裂型人格障碍是最不常见的轴 II 障碍。对于 12 名诊断验证者中的至少 5 名来说，所有中度轴 II 疾病都与显着更高的几率相关。纵向随访显示，尽管大多数 II 轴疾病不会持续超过 2 年，但早期发现疾病的受试者在随访时再次接受诊断的风险仍然较高。结论 这些研究结果表明，绝大多数未接受治疗的青少年符合 DSM-III-R 人格障碍诊断，并且这些诊断与心理困扰和功能障碍风险增加相关。
OBJECTIVE The purpose of this study was to estimate the prevalence, concurrent validity, and stability of DSM-III-R personality disorders in a large community-based sample of adolescents. METHOD A randomly selected community sample of 733 youths ranging in age from 9 to 19 years was followed over a 2-year period. The protocol consisted of structured interviews with the adolescents and their mothers and self-report questionnaires. Algorithms for 10 DSM-III-R axis II disorders were developed to produce diagnoses at two levels of severity; these were validated against multiple indicators of distress and functional impairment. RESULTS The overall prevalence of personality disorders peaked at age 12 in boys and at age 13 in girls and declined thereafter. Obsessive-compulsive personality disorder was the most prevalent moderate axis II disorder, narcissistic personality disorder the most prevalent severe disorder, and schizotypal personality disorder the least prevalent axis II disorder, based on both moderate and severe diagnostic thresholds. All moderate axis II disorders were associated with significantly greater odds for at least five of 12 diagnostic validators. Longitudinal follow-up revealed that although most axis II disorders did not persist over a 2-year period, subjects with disorders identified earlier remained at elevated risk for receiving a diagnosis again at follow-up. CONCLUSIONS These findings suggest that a substantial minority of adolescents who are not in treatment qualify for DSM-III-R personality disorder diagnoses and that these diagnoses are associated with increased risk of psychological distress and functional impairment.