DSM-5-TR第三部分适应不良人格特征的患者-临床报告的一致性和差异:一项混合门诊样本的研究。

G. Bottesi, C. Caudek, Anna Malerba, G. Caselli, Gabriella Gallo, Gabriele Melli, Nicola Marsigli, Alessia Offredi, C. Sica
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引用次数: 0

摘要

基于维度模型的人格病理评估可以改善自我-他人认同,但以往的研究主要采用分类方法,忽视了治疗师本人的作用。我们的研究在意大利门诊患者的混合样本中使用DSM-5 (PID-5)和PID-5-线人表(PID-5- irf)检查了患者与临床医生的一致性。此外,还初步探讨了临床医生人格特质对一致性的影响。门诊患者68例(男性51.4%,M = 30.30, SD = 12.05岁)及其主治医师(N = 22;77.3%女性,M = 43.77±8.45岁)进入研究。患者完成了PID-5,而临床医生则为每位患者填写了PID-5简要表(PID-5- bf)和PID-5- irf。多水平贝叶斯分析显示,等级顺序一致性在域(平均r = 0.60)和面(平均r = 0.44)中较大。就平均水平一致性而言,患者在认知/知觉失调、注意力不集中、古怪和情绪不稳定方面的评分高于临床医生的评分,而患者在抑郁方面的评分低于临床医生的评分。PID-5-BF分离的分数正预测快感缺失、焦虑、抑郁、分心、分离不安全感和怀疑的一致性,而PID-5-BF负情感、拮抗和去抑制的分数负预测少数特定方面的一致性。目前的研究结果表明,临床医生的人格特征可能有助于对适应不良人格特征的认同,但在低可观察性的内部人格特征的情况下,差异仍然存在。由于患者与临床医生的共识在治疗联盟中至关重要,因此高度鼓励对这一问题进行进一步研究。(PsycInfo数据库记录(c) 2023 APA,版权所有)。
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Agreement and discrepancies in patient-clinician reports of DSM-5-TR section III maladaptive personality traits: A study on a mixed outpatient sample.
The assessment of personality pathology based on dimensional models may improve self-other agreement, but previous research mainly adopted a categorical approach and overlooked the role of the person of the therapist. Our study examined patient-clinician agreement in a mixed sample of Italian outpatients using the Personality Inventory for DSM-5 (PID-5) and the PID-5-Informant Form (PID-5-IRF). Moreover, the role of clinician personality traits on agreement was preliminary explored. Sixty-eight outpatients (51.4% male, M = 30.30, SD = 12.05 years) and their treating clinicians (N = 22; 77.3% female, M = 43.77 ± 8.45 years) entered the study. Patients completed the PID-5, whereas clinicians filled-in the PID-5-Brief Form (PID-5-BF) and the PID-5-IRF for each patient they involved. A multilevel Bayesian analysis showed that rank-order agreement was large for domains (mean r = .60) and moderate for facets (mean r = .44). As regards mean-level agreement, patient ratings on cognitive/perceptual dysregulation, distractibility, eccentricity, and emotional lability were higher than clinician ratings, whereas patients' scores on depressivity were lower than clinicians' ones. Scores on the PID-5-BF detachment positively predicted agreement on anhedonia, anxiousness, depressivity, distractibility, separation insecurity, and suspiciousness, while scores on the PID-5-BF negative affectivity, antagonism, and disinhibition negatively predicted agreement on few specific facets. Current findings suggest that clinician personality traits may contribute to agreement on maladaptive personality traits, but areas of discrepancies remain in case of low observable internal ones. Since patient-clinician agreement is crucially involved in therapeutic alliance, further research on this issue is highly encouraged. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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