PERSONALITY DISORDER OVER 20YRS--RISKS, COURSE, & IMPACT

显然，大多数人格障碍是在童年、青春期和成年早期形成的。虽然这些疾病通常与严重损害有关，但关于其发病率和病程影响的理论经验基础才刚刚开始积累。这项拟议的研究扩展了一项对大约800人的纵向研究，这些人从1975年开始被研究，到2000年平均年龄将达到31岁。该队列最初是随机抽样的，并且一直密切代表被抽样的人群。独特的是，人格障碍（pd）自青春期早期就被评估，与轴一障碍一起，广泛的风险和结果。pd已被证明与许多儿童风险相关，反过来又构成成人I轴疾病和功能损害的风险。我们的第一个目标是确定对成年期pd病程的影响。我们将调查早期人群PD症状的下降是否会在20岁后期趋于平稳，以及在儿童期和青春期评估的哪些风险和保护因素继续对新发PD或成年中期症状持续产生影响。第二个目的是继续我们对轴心障碍（用CIDI评估）和PD之间的联系的调查，检查共病可能是由于共同风险或由于一种疾病对另一种疾病的先前影响而造成的程度。我们还将研究PD对成人功能的影响，以及对社会经济水平的影响，以及这些影响与合并症I轴障碍的独立性。最后，我们将探讨PD对养育子女及其子女情绪和行为问题的影响。

Clearly, most personality disorders develop over the course of Childhood, adolescence and young adulthood. Although these disorders are often associated with serious impairment, an empirical basis for theories about influences on their incidence and course is only beginning to accumulate. The proposed study extends a longitudinal study of about 800 persons who have been studied since 1975, and who will be an average age of 31 in 2000. The cohort was originally randomly sampled, and has remained Closely representative of the population from which it was sampled. Uniquely, personality disorders (PDs) have been assessed since early adolescence, in conjunction with the Axis I disorders, a broad range of risks, and outcomes. PDs have been shown to be related to a number of childhood risks and1 in turn, to constitute a risk for both adult Axis I disorders and for impairment in function. Our first aim is to identify influences on the course of PDs in the adult years. We will investigate whether the decline in PD symptoms shown in earlier age groups will have leveled off by the late 20's and which risk and protective factors assessed during childhood and adolescence continue to have effects on new onset PD or symptom persistence in middle adulthood. A second aim is to continue our investigation of the connection between Axis disorders (assessed with the CIDI) and PD, examining the extent to which comorbidity may be due to shared risks or due to the prior influence of one kind of disorder on another. We will also investigate the impact of PD on adult function, and on the attainment of socioeconomic level, as well as the independence of these effects from those of comorbid Axis I disorder. Finally, we will investigate the impact of PD on parenting and offspring emotional and behavioral problems.