The latent structure of social anxiety disorder: consequences of shifting to a dimensional diagnosis.
The latent structure of social anxiety disorder: consequences of shifting to a dimensional diagnosis.
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DOI：
10.1037/a0019341
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发表时间：
2010-11
影响因子：
4.6
通讯作者：
Ruscio, Ayelet Meron
中科院分区：
文献类型：
--
作者：
Ruscio, Ayelet Meron
尽管关于社交焦虑障碍（SAD）和不太严重的社交焦虑之间的界限的性质长期存在争议，但没有研究直接测试该障碍的定义特征是否对应于潜在类别或维度。本研究使用全国科摩罗重复调查（NCS-R）的数据来研究这个问题，NCS-R是一项具有全国代表性的美国家庭人口调查。代表SAD的DSM-IV标准的指标在成年人（n = 2，166）的子样本中进行了分类分析，这些成年人在其一生中报告了过度的社会恐惧。多个taxometric程序和一致性测试收敛在一个维度的解决方案，这表明SAD是连续的轻度社交焦虑。在随访分析中，维度SAD诊断在预测一系列临床重要结局的后续发生方面优于DSM-IV诊断。与共病心境障碍、自杀倾向和寻求治疗的相关性的巨大差异特别有利于维度诊断的预后价值超过分类诊断。这些发现支持SAD维度概念化的有效性和潜在效用，这可能有助于修订DSM-V的诊断。
Despite longstanding debate over the nature of the boundary between social anxiety disorder (SAD) and less severe social anxiety, no study has tested directly whether the defining features of the disorder correspond to a latent category or dimension. The present study examined this question using data from the National Comorbidity Survey Replication (NCS-R), a nationally representative survey of the U.S. household population. Indicators representing the DSM-IV criteria for SAD were submitted to taxometric analyses in a subsample of adults (n = 2,166) who reported excessive social fear in their lifetime. Multiple taxometric procedures and consistency tests converged on a dimensional solution, suggesting that SAD is continuous with milder social anxiety. In follow-up analyses, a dimensional SAD diagnosis outperformed the DSM-IV diagnosis in predicting the subsequent onset of a range of clinically important outcomes. Large differences in associations with comorbid mood disorders, suicidality, and treatment-seeking in particular favored the prognostic value of dimensional over categorical diagnosis. These findings support the validity and potential utility of a dimensional conceptualization of SAD that may inform efforts to revise the diagnosis for DSM-V.
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