The borderline diagnosis I: Psychopathology comorbidity, and personaltity structure
The borderline diagnosis I: Psychopathology comorbidity, and personaltity structure
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DOI：
10.1016/s0006-3223(02)01324-0
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发表时间：
2002-06-15
影响因子：
10.6
通讯作者：
Siever, LJ
中科院分区：
文献类型：
--
作者：
Skodol, AE;Gunderson, JG;Siever, LJ
边缘型人格障碍（BPD）是一种复杂而严重的精神障碍，伴有严重的功能障碍、大量的治疗利用和高自杀死亡率。近年来，BPD已成为研究的热点。在这三部分的文章的第一部分，旨在提供一个基础，研究者对边缘诊断的现状和未来的发展前景，我们检查的精神病理学，合并症，和人格结构的BPD。虽然BPD的描述性特征在DSM-IV诊断标准中得到了很好的体现，但BPD精神病理学的其他重要方面并未包括在内。然而，结合半结构化访谈的描述性标准增加了调查人员诊断BPD的能力，就像许多轴I障碍一样可靠。BPD与轴I疾病的频繁合并症需要广泛的精神病理学评估，以帮助解释临床异质性。由于缺乏证据证明BPD分类诊断的诊断阈值的有效性，并且由于诊断中的异质性，研究人员还应该通过评估潜在的人格特质结构来补充他们的DSM-IV诊断。尽管有许多相互竞争的人格结构模型，但它们在一组三到五个基本人格维度上有着显著的趋同性。Biol Psychiatry 2002;51：936-950（C）2002 Society of Biological Psychiatry.
Borderline personality disorder (BPD) is a complex and serious mental disorder associated with severe functional impairment, substantial treatment utilization, and a high rate of mortality by suicide. Recently, BPD has become a focus of intensifying study. In Part I of this three-part article meant to provide a foundation to researchers on the current status of the borderline diagnosis and prospects for its future development, we examine the psychopathology, comorbidity, and personality structure of BPD. Although the descriptive characteristics of BPD are well-represented by DSM-IV diagnostic criteria, other important aspects of BPD psychopathology are not included. The descriptive criteria in conjunction with semistructured interviews have, however, increased the ability of investigators to diagnose BPD as reliably as many Axis I disorders. Frequent comorbidity of BPD with Axis I disorders necessitates a broad assessment of psychopathology to help account for clinical heterogeneity. Because of the absence of evidence of the validity of the diagnostic threshold for a categorical diagnosis of BPD, and because of the heterogeneity within the diagnosis, investigators should also supplement their DSM-IV diagnoses with assessments of underlying personality trait structures. Although there are a number of competing models of personality structure, they have remarkable convergence on a set of three to five basic personality dimensions. Biol Psychiatry 2002;51:936-950(C) 2002 Society of Biological Psychiatry.