4 PERSONALITY PATHOLOGY IN ADOLESCENCE: A REVIEW

4 PERSONALITY PATHOLOGY IN ADOLESCENCE: A REVIEW
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4 青春期人格病理学:回顾

DOI:
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发表时间:
2002
期刊:
影响因子:
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通讯作者:
L. Campbell
L. Campbell
中科院分区:
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文献类型:
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作者:
D. Westen;A. Heim;Kate H. Morrison;M. Patterson;L. Campbell

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在与青少年的工作中,临床医生从精神疾病诊断和统计手册第四版(DSM-IV;美国精神病学协会[阿帕],1994)获得最低限度的指导。除了对品行障碍(以及与之相邻的对立违抗性障碍)的诊断外,临床医生还需要自行评估导致青少年苦恼和功能障碍的人格特征。DSM-IV明确警告避免在青春期进行人格障碍(PD)诊断。然而,这种谨慎是基于青少年人格病理学的数据相对缺乏,而不是基于任何研究表明青少年人格病理学不存在或无法诊断。事实上,最近的一系列研究表明,PD不仅可以在青春期诊断,而且随着时间的推移显示出相当大的连续性(伯恩斯坦等人,1996;约翰逊等人,1999年)。与此相关的是,越来越多的文献表明青少年行为障碍是一个高度异质性的类别(参见Moffitt,1993; Moffitt et al.,1996年)。例如,一些表现出犯罪行为的青少年,包括那些被诊断患有行为和对立违抗性障碍的青少年,是冷酷无情的,没有同情心的,精神变态的,而其他人则相对高功能,能够保持爱和亲密的关系,并表现出非常不同的道德功能。从这个意义上说,研究文献开始赶上临床文献,在临床文献中,长期以来一直对精神病态青少年和青少年进行区分,前者往往预后不良,而后者的对立、破坏性或犯罪行为是神经质冲突、掩饰性抑郁和其他规范性和非规范性青少年问题的表达。
In working with adolescents, clinicians receive minimal guidance from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV; American Psychiatric Association [APA], 1994). Aside from the diagnosis of conduct disorder (and its near-neighbor, oppositional defiant disorder), clinicians are on their own in assessing the personality characteristics that contribute to adolescent distress and dysfunction. DSM–IV is explicit in its caution to avoid making personality disorder (PD) diagnoses in adolescence. However, this caution is based on the relative lack of data on adolescent personality pathology, not on any research suggesting that adolescent personality pathology does not exist or cannot be diagnosed. Indeed, a recent series of studies suggests that PDs not only can be diagnosed in adolescence but show considerable continuity over time (Bernstein et al., 1996; Johnson et al., 1999). Of relevance, as well, is a growing body of literature suggesting that adolescent conduct disorder is a highly heterogeneous category (see Moffitt, 1993; Moffitt et al., 1996). For example, some adolescents showing delinquent behavior, including those diagnosed with conduct and oppositional defiant disorders, are callous, remorseless, and psychopathic, whereas others are relatively high-functioning, are able to maintain loving and intimate relationships, and show a very different quality of moral functioning. In this sense, the research literature is beginning to catch up with the clinical literature, in which a distinction has long been made between psychopathic adolescents, who tend to have a poor prognosis, and teenagers for whom oppositional, destructive, or delinquent behavior is an expression of neurotic conflicts, masked depression, and other normative and non-normative adolescent concerns.
DOI: 10.1176/ajp.156.10.1529
发表时间: 1999-10
期刊: The American journal of psychiatry
影响因子: --
作者:
Stephanie Kasen;P. Cohen;A. Skodol;Jeffrey G. Johnson;J. Brook
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DOI: 10.1111/j.1467-6494.1989.tb00483.x
发表时间: 1989
影响因子: 5
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通讯作者: Sroufe,LA
第二轴精神病理学是儿童和青少年时期第一轴疾病的函数。
DOI: 10.1097/00004583-199712000-00024
发表时间: 1997
期刊: Journal of the American Academy of Child and Adolescent Psychiatry.
影响因子: --
作者:
Lewinsohn,PM;Rohde,P;Seeley,JR;Klein,DN
通讯作者: Klein,DN
DOI: 10.1176/ajp.150.8.1237
发表时间: 1993-08
期刊: The American journal of psychiatry
影响因子: --
作者:
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青少年人格障碍的童年前因。
DOI: 10.1176/ajp.153.7.907
发表时间: 1996
期刊: The American journal of psychiatry
影响因子: --
作者:
Bernstein,DP;Cohen,P;Skodol,A;Bezirganian,S;Brook,JS
通讯作者: Brook,JS