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

描述（由申请人提供）：人格障碍（PD）是一种严重的、使人衰弱的、昂贵的、通常是致命的疾病，在流行病学样本中高度流行（约10%，Lenzenweger，2008）。尽管PD的严重性和高昂的公共卫生成本，该领域缺乏共识，如何最好地量化规范性人格和PD之间的关系。这种缺乏共识导致了PD的基本定义问题，包括疾病的结构，过程和风险/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中的人际利用性（Interpersonal Exploitativeness in Narcissistic PD）。代理和交流的人际特质已被确定为潜在的有用的发展PD的维度模型。此外，人格的人际概念化是非常有用的链接与PD由于其直接影响的心理治疗干预。此外，新兴的研究表明，PD并不像曾经认为的那样是慢性的，随着时间的推移显示出相当大的变化。 目前的研究旨在满足国家心理健康研究所的战略规划目标，通过使用国家的最先进的方法，阐明新兴的概念PD，占同时变化的人际行为和PD随着时间的推移，和非正态分布的PD。具体而言，我们建议使用潜在增长曲线模型和相关的多变量扩展，以检查多波前瞻性纵向研究中PD的变化和分布。本研究将检验以下假设：1）随着时间的推移，人际风格存在长期的人内变异; 2）人际风格的人内变异预测PD症状的同时人内变异; 3）高级分布假设（即，零膨胀泊松/负二项）提供了一个更好的适合PD和规范的人格结构之间的关系的模型。这些方法有可能以迄今为止尚未在任何纵向PD研究中采用的方式告知分类问题。 拟议的研究结果对正在进行的努力，以建立适当的定义，诊断和治疗PD的影响。结果将为PD的概念化分类和评估提供最佳方法。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。 公共卫生相关性：拟议的研究结果对正在进行的努力，以建立适当的定义，诊断和治疗人格障碍（PD）的影响。结果将为PD的概念化分类和评估提供最佳方法。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。

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: Results of the proposed study have implications for the ongoing efforts to establish the appropriate definition, diagnosis, and treatment of personality disorders (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.