Comparing the utility of DSM-5 Section II and III antisocial personality disorder diagnostic approaches for capturing psychopathic traits.
Comparing the utility of DSM-5 Section II and III antisocial personality disorder diagnostic approaches for capturing psychopathic traits.
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DOI：
10.1037/per0000096
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
L. Few;D. Lynam;Jessica L Maples;J. Mackillop;Joshua D. Miller
中科院分区：
文献类型：
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作者：
L. Few;D. Lynam;Jessica L Maples;J. Mackillop;Joshua D. Miller
目前的研究比较了《精神疾病诊断与统计手册-5》（DSM-5；美国精神病学协会，2013）中两种诊断方法（第II节与第III节）在反社会人格障碍（ASPD）诊断方面与精神病特征和外化行为（EBs）的关系。第三部分的方法比第二部分的方法更明确地以特征为基础，还包括一个精神病说明符（PS），其目的是使ASPD的诊断更符合精神病。在目前正在接受精神健康治疗的社区样本中（N = 106），比较了两种DSM-5诊断方法的评分与精神病测量的关系，以及EBs指数。两种DSM-5的反社会人格障碍方法都与精神病得分显著相关，尽管与第二部分的方法相比，第三部分的方法几乎占了两倍的方差。然而，这种预测优势相对较少是由于PS，因为这些特征在现有的精神病测量和EBs中几乎没有显示出增量有效性的证据，除了无畏支配的测量。总体而言，DSM-5第三部分对反社会人格障碍的诊断方法与精神病态的概念更为趋同，而反社会人格障碍正是由此产生的。然而，这些改善主要是由于第三部分反社会人格障碍诊断中新的基于特征的重点，而不是人格功能障碍的评估或额外的“精神病特异性”特征的纳入。
The current study compares the 2 diagnostic approaches (Section II vs. Section III) included in the Diagnostic and Statistical Manual for Mental Disorders-5 (DSM-5; American Psychiatric Association, 2013) for diagnosis of antisocial personality disorder (ASPD) in terms of their relations with psychopathic traits and externalizing behaviors (EBs). The Section III approach to ASPD, which is more explicitly trait-based than the Section II approach, also includes a psychopathy specifier (PS) that was created with the goal of making the diagnosis of ASPD more congruent with psychopathy. In a community sample of individuals currently receiving mental health treatment (N = 106), ratings of the 2 DSM-5 diagnostic approaches were compared in relation to measures of psychopathy, as well as indices of EBs. Both DSM-5 ASPD approaches were significantly related to the psychopathy scores, although the Section III approach accounted for almost twice the amount of variance when compared with the Section II approach. Relatively little of this predictive advantage, however, was due to the PS, as these traits manifested little evidence of incremental validity in relation to existing psychopathy measures and EBs, with the exception of a measure of fearless dominance. Overall, the DSM-5 Section III diagnostic approach for ASPD is more convergent with the construct of psychopathy, from which ASPD was originally derived. These improvements, however, are due primarily to the new trait-based focus in the Section III ASPD diagnosis rather than the assessment of personality dysfunction or the inclusion of additional "psychopathy-specific" traits.