The structure of axis II disorders in adolescents: A cluster- and factor-analytic investigation of DSM-IV categories and criteria
The structure of axis II disorders in adolescents: A cluster- and factor-analytic investigation of DSM-IV categories and criteria
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DOI：
10.1521/pedi.2005.19.4.440
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发表时间：
2005-08-01
影响因子：
2.3
通讯作者：
Westen, D
中科院分区：
文献类型：
--
作者：
Durrett, C;Westen, D
本研究的目的是确定使用DSM-IV诊断和诊断标准评估的青少年人格障碍（PD）症状的结构是否与成人PD诊断的结构相似。一项全国性的临床医生样本对294名接受持久适应不良人格模式治疗的青少年患者进行了DSM-IV轴II标准评分。Morey（1988）在成人样本中使用的聚类分析程序发现成人和青少年PD之间存在相当大的相似性，诊断标准评级的探索性因素分析也是如此。这产生了十个经验得出的因素，类似于十个DSM-IV PD。聚类分析和验证性因素分析与轴II症状指标复制的DSM-IV层次结构的PD（集群A，B，和C）的混合结果，虽然层次模型一般表现得更好的模型，只指定一阶因素或集群。人格病理学的结构进行评估轴II标准在青少年中类似于DSM-IV轴II中概述的成年人，这表明PD可以在青少年中评估成人。然而，这是否是诊断青春期人格病理的最佳方法，还需要进一步的研究。
The aim of this study was to ascertain whether the structure of personality disorder (PD) symptoms in adolescents assessed using DSM-IV diagnoses and diagnostic criteria resembles the structure intended for the diagnosis of PDs in adults. A national sample of clinicians rated DSM-IV Axis II criteria on 294 adolescent patients in treatment for enduring maladaptive personality patterns. Cluster analysis replicating procedures used in an adult sample by Morey (1988) identified considerable similarity between adult and adolescent PDs, as did exploratory factor analysis of ratings of diagnostic criteria. which yielded ten empirically derived factors that resembled the ten DSM-IV PDs. Cluster analysis and confirmatory factor analysis with indicators of Axis II symptoms produced mixed results in replicating the DSM-IV hierarchical structure of PDs (Clusters A, B, and C), although hierarchical models generally fared better than models specifying only first-order factors or clusters. The structure of personality pathology as assessed by Axis II criteria in adolescents resembles that outlined in DSM-IV Axis II for adults, suggesting that PDs can be assessed in adolescents as in adults. Whether this is an optimal way of diagnosing personality pathology in adolescence, however, requires further investigation.