Comparing Methods to Model Stability and Change in Personality and its Pathology

人格障碍 (PD) 是一种严重、使人衰弱、代价高昂且常常致命的疾病，在流行病学样本中非常普遍（~10%，Lenzenweger，2008）。尽管帕金森病严重且公共卫生成本高昂，但该领域在如何最好地量化规范人格与帕金森病之间的关系方面缺乏共识。这种缺乏共识导致帕金森病的基本定义问题出现问题，包括疾病的结构、病程和风险/保护因素。大多数 PD 诊断的标准包括适应不良的人际行为（例如自恋型 PD 中的人际剥削）。代理和交流的人际特征已被确定对于开发 PD 维度模型可能有用。此外，人格的人际概念化对于与帕金森病联系起来非常有用，因为它们对心理治疗干预具有直接影响。此外，新兴研究表明，帕金森病并不像以前认为的那样是慢性的，随着时间的推移表现出相当大的变化。 目前的研究旨在通过使用最先进的方法来阐明帕金森病的新兴概念，以实现国家心理健康研究所的战略规划目标，这些概念解释了人际行为和帕金森病随时间的同时变化，以及帕金森病分布的非正态性。具体来说，我们建议使用潜在增长曲线模型和相关的多变量扩展来检查多波前瞻性纵向研究中 PD 的变化和分布。本研究应检验以下假设：1）人际风格随时间的推移存在长期的人内变异； 2) 人际交往风格的个体差异可以预测 PD 症状的个体内部差异； 3）先进的分布假设（即零膨胀泊松/负二项式）为PD和规范人格结构之间的关系模型提供了更好的拟合。这些方法有可能以迄今为止任何纵向 PD 研究中尚未采用的方式来解决分类问题。 拟议研究的结果对目前为建立帕金森病适当的定义、诊断和治疗所做的努力具有重要意义。结果将为概念化帕金森病分类和评估的最佳方法提供信息。此外，这些研究的纵向性质将确定PD的人际维持因素，从而确定干预的最佳目标。

Personality disorders (PD) are serious, debilitating, costly, and oftentimes fatal disorders that are highly prevalent in epidemiological samples (~10 percent, Lenzenweger, 2008). Despite the severity and high public health cost of PD, the field suffers from a lack of consensus on how to best quantify the relationship between normative personality and PD. This lack of consensus has led to problems in basic definitional issues of PD, including the structure, course, and risk/protective factors of the disorders. The criteria of most PD diagnoses include maladaptive interpersonal behaviors (e.g., Interpersonal Exploitativeness in Narcissistic PD). The interpersonal traits of Agency and Communion have been identified as potentially useful for developing a dimensional model of PD. Further, interpersonal conceptualizations of personality are highly useful for linking with PD due to their immediate implications for psychotherapeutic interventions. Additionally, emerging research has shown that PDs are not as chronic as once thought, showing considerable variability across time. The current research aims to meet the strategic planning goals of the National Institute of Mental Health by using state-of-the-art methodology to articulate emerging conceptions of PD that account for simultaneous change in interpersonal behavior and PD over time, and non-normality in the distribution of PD. Specifically, we propose using Latent Growth Curve Models and associated multivariate extensions to examine change and distribution of PD in a multi-wave prospective longitudinal study. This research shall test the hypotheses that 1) there is long-term within-person variability in interpersonal style across time; 2) within-person variations in interpersonal style are predictive of concurrent within-person variations in PD symptoms; and 3) advanced distributional assumptions (i.e., Zero Inflated Poisson/Negative Binomial) provide a better fit for models of the relationship between PD and normative personality structure. These methods have the potential to inform classification questions in ways that have not yet been employed in any longitudinal PD research to date. Results of the proposed study have implications for the ongoing efforts to establish the appropriate definition, diagnosis, and treatment of PD. The results will inform the best approach to conceptualize classification and assessment of PD. In addition, the longitudinal nature of these studies will identify the interpersonal maintenance factors of PD, and thereby determine the best targets for interventions.