Tipos e Traços de Personalidade no DSM-5: Eles Realmente Combinam?
DOI:
https://doi.org/10.1590/0102.3772e36nspe15%20Palavras-chave:
Modelo categórico, Modelo dimensional, Diagnóstico de transtorno da personalidadeResumo
O modelo alternativo de transtornos da personalidade introduzido na quinta edição do Manual Diagnóstico e Estatístico de Transtornos Mentais oferece um sistema diagnóstico que supostamente deve corresponder ao bem conhecido modelo de diagnóstico categórico dos transtornos da personalidade. O presente estudo tem por objetivo incrementar os conhecimentos sobre a relação entre os traços de personalidade e seus correspondentes tipos de personalidade. Uma amostra brasileira de 1.162 pessoas participou deste estudo. Os resultados indicaram algum nível de continuidade entre os dois modelos quando as variáveis foram consideradas dimensionais. Por outro lado, existe uma falta de evidência científica que justifique a manutenção da abordagem categórica. Recomenda-se a exclusão da abordagem categórica de sistemas diagnósticos de transtornos da personalidade.
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Referências
American Psychiatric Association. (1952). Diagnostic and statistical manual of mental disorders. American Psychiatric Association.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, Fourth Edition, Text Revision (DSM-IV-TR). American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
Amorim, P. (2000). Mini International Neuropsychiatric Interview (MINI): Validação de entrevista breve para diagnóstico de transtornos mentais. Revista Brasileira de Psiquiatria, 22(3), 106-115. https://doi.org/10.1590/S1516-44462000000300003
Anderson, J., Snider, S., Sellbom, M., Krueger, R., & Hopwood, C. (2014). A comparison of the DSM-5 section II and section III personality disorder structures. Psychiatry Research, 216(3), 363-372. https://doi.org/10.1016/j.psychres.2014.01.007
Asendorpf, J., & Denissen, J. J. A. (2006). Predictive validity of personality types versus personality dimensions from early childhood to adulthood: Implications for the distinction between core and surface traits. Merrill-Palmer Quarterly, 52(3), 486-513. https://doi.org/10.1353/mpq.2006.0022
Bach, B., & First, M. B. (2018). Application of the ICD-11 classification of personality disorders. BMC Psychiatry, 18(1), 351. https://doi.org/10.1186/s12888-018-1908-3
Bach, B., & Sellbom, M. (2016). Continuity between DSM-5 categorical criteria and traits criteria for borderline personality disorder. The Canadian Journal of Psychiatry, 61(8), 489-494. https://doi.org/10.1177/0706743716640756
Borsboom, D., Rhemtulla, M., Cramer, A. O. J., van der Maas, H. L. J., Scheffer, M., & Dolan, C. V. (2016). Kinds versus continua: A review of psychometric approaches to uncover the structure of psychiatric constructs. Psychological Medicine, 46(8), 1567-1579. https://doi.org/10.1017/S0033291715001944
Clark, L. A. (2007). Assessment and diagnosis of personality disorder: Perennial issues and an emerging reconceptualization. Annual Review of Psychology, 58(1), 227-257. https://doi.org/10.1146/annurev.psych.57.102904.190200
Clark, L. A., Vanderbleek, E. N., Shapiro, J. L., Nuzum, H., Allen, X., Daly, E., Kingsbury, T. J., Oiler, M., & Ro, E. (2015). The brave new world of personality disorder-trait specified: Effects of additional definitions on coverage, prevalence, and comorbidity. Psychopathology Review, 2(1), 52-82. https://doi.org/10.5127/pr.036314
Donaldson, S. I., & Grant-Vallone, E. J. (2002). Understanding self-report bias in organizational behavior research. Journal of Business and Psychology, 17(2), 245-260. https://doi.org/10.1023/A:1019637632584
Eaton, N. R., Krueger, R. F., South, S. C., Simms, L. J., & Clark, L. A. (2011). Contrasting prototypes and dimensions in the classification of personality pathology: Evidence that dimensions, but not prototypes, are robust. Psychological Medicine, 41(6), 1151-1163. https://doi.org/10.1017/S0033291710001650
Ekselius, L., Lindström, E., Knorring, L. V., Bodlund, O., & Kullgren, G. (1994). SCID II interviews and the SCID Screen questionnaire as diagnostic tools for personality disorders in DSM”III”R. Acta Psychiatrica Scandinavica, 90(2), 120-123. https://doi.org/10.1111/j.1600-0447.1994.tb01566.x
First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B. W., & Benjamin, L. S. (1997). SCID-II personality questionnaire. American Psychiatric Press.
Fossati, A., Krueger, R. F., Markon, K. E., Borroni, S., & Maffei, C. (2013). Reliability and validity of the personality inventory for DSM-5 (PID-5): Predicting DSM-IV personality disorders and psychopathy in community-dwelling Italian adults. Assessment, 20(6), 689-708. https://doi.org/10.1177/1073191113504984
Goodman, L. A. (1961). “Snowball sampling.” Annals of Mathematical Statistic, 32(1), 148-170. https://www.jstor.org/stable/2237615
Grant, B. F., Hasin, D. S., Stinson, F. S., Dawson, D. A., Chou, S. P., Ruan, W. J., & Pickering, R. P. (2004). Prevalence, correlates, and disability of personality disorders in the United States: Results from the national epidemiologic survey on alcohol and related conditions. The Journal of Clinical Psychiatry, 65(7), 948-958. https://doi.org/10.4088/JCP.v65n0711
Harding, T. W., De Arango, V., Baltazar, J., Climent, C. E., Ibrahim, H. H. A., Ladrido-Ignacio, L., & Wig, N. N. (1980). Mental disorders in primary health care: A study of their frequency and diagnosis in four developing countries. Psychological Medicine, 10(2), 231-241. https://doi.org/10.1017/S0033291700043993
Harpham, T. (2003). Measuring mental health in a cost-effective manner. Health Policy and Planning, 18(3), 344-349. https://doi.org/10.1093/heapol/czg041
Haslam, N., Holland, E., & Kuppens, P. (2012). Categories versus dimensions in personality and psychopathology: A quantitative review of taxometric research. Psychological Medicine, 42(5), 903-920. https://doi.org/10.1017/S0033291711001966
Hopwood, C. J., Thomas, K. M., Markon, K. E., Wright, A. G., & Krueger, R. F. (2012). DSM-5 personality traits and DSM-IV personality disorders. Journal of Abnormal Psychology, 121(2), 424-432. https://doi.org/10.1037/a0026656
Hunter-Reel, D., Epstein, E. E., McCrady, B., & Eddie, D. (2014). Personality disorders and the prediction of alcohol use outcomes for women: Dimensional versus categorical classification. Addiction Research & Theory, 22(2), 176-180. https://doi.org/10.3109/16066359.2013.793314
Jacobsberg, L., Perry, S., & Frances, A. (1995). Diagnostic agreement between the SCID-II Screening Questionnaire and the Personality Disorder Examination. Journal of Personality Assessment, 65(3), 428-433. https://doi.org/10.1207/s15327752jpa6503_4
Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42(9), 1879-1890. https://doi.org/10.1017/S0033291711002674
Mari, J. J., & Williams, P. (1985). A comparison of the validity of two psychiatric screening questionnaires (GHQ-12 and SRQ-20) in Brazil, using Relative Operating Characteristic (ROC) analysis. Psychological Medicine, 15(03), 651-659. https://doi.org/10.1017/S0033291700031500
Mari, J. J., & Williams, P. (1986). A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of Sao Paulo. The British Journal of Psychiatry, 148(1), 23-26. https://doi.org/10.1192/bjp.148.1.23
Markon, K. E., Chmielewski, M., & Miller, C. J. (2011). The reliability and validity of discrete and continuous measures of psychopathology: A quantitative review. Psychological Bulletin, 137(5), 856-879. http://dx.doi.org/10.1037/a0023678
McHugh, M. L. (2012). Interrater reliability: the kappa statistic. Biochemia Medica, 22(3), 276-282. https://hrcak.srce.hr/89395
Melo, N. M. M., & Rangé, B. P. (2010, September). SCID-II-DSM-IV - Entrevista clínica estruturada para transtornos de personalidade: Tradução e utilização na DPA/IP/UFRJ. [SCID-II-DSM-IV - structured clinical interview for personality disorders: Translation and use at DPA/IP/UFRJ]. Anais da 8aMostra de Terapia Cognitivo-Comportamental, 67.
Morey, L. C., Benson, K. T., & Skodol, A. E. (2016). Relating DSM-5 section III personality traits to section II personality disorder diagnoses. Psychological Medicine, 46(3), 647-655. https://doi.org/10.1017/S0033291715002226
Morey, L. C., & Skodol, A. E. (2013). Convergence between DSM-IV-TR and DSM-5 diagnostic models for personality disorder: Evaluation of strategies for establishing diagnostic thresholds. Journal of Psychiatric Practice, 19(3), 179-193. https://doi.org/10.1097/01.pra.0000430502.78833.06
Morey, L. C., Skodol, A. E., & Oldham, J. M. (2014). Clinician judgments of clinical utility: A comparison of DSM-IV-TR personality disorders and the alternative model for DSM-5 personality disorders. Journal of Abnormal Psychology, 123(2), 398-405. http://dx.doi.org/10.1037/a0036481
Oliveira, S. E. S. (2016). Structural and dimensional personality evaluation: Psychometric studies and clinical utility [Unpublished doctoral dissertation]. SABI UFRGS. https://sabi.ufrgs.br/F/J8L4NCUGQHX798769YG9427PTL3R8C3HMXKSQDKYGJQVKLKVB1-42242?func=full-set-set&set_number=005570&set_entry=000024&format=999
Osone, A., & Takahashi, S. (2003). Twelve month test-retest reliability of a Japanese version of the Structured Clinical Interview for DSM-IV Personality Disorders. Psychiatry and Clinical Neurosciences, 57(5), 532-538. https://doi.org/10.1046/j.1440-1819.2003.01159.x
Ryder, A. G., Costa, P. T., & Bagby, R. M. (2007). Evaluation of the SCID-II personality disorder traits for DSM-IV: Coherence, discrimination, relations with general personality traits, and functional impairment. Journal of Personality Disorders, 21(6), 626-637. https://doi.org/10.1521/pedi.2007.21.6.626
Sheehan, D., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E. H. T., Hergueta, T., Baker, R., & Dunbar, G. C. L. (1998). The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl 20), 22-33. https://psycnet.apa.org/record/1998-03251-004
Skodol, A. E., Bender, D. S., Morey, L. C., Clark, L. A., Oldham, J. M., Alarcon, R. D., Krueger, R. F., Verheul, R., Bell, C. C., & Siever, L. J. (2011). Personality disorder types proposed for DSM-5. Journal of Personality Disorders, 25(2), 136-169. https://doi.org/10.1521/pedi.2011.25.2.136
Strickland, C. M. (2014). Validating the Personality Inventory for DSM-5: A trait-based model of personality disorders [Master’s thesis]. Florida State University Libraries. https://diginole.lib.fsu.edu/islandora/object/fsu:252895/datastream/PDF/view
Torgersen, S., Kringlen, E., & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58(6), 590-596. https://doi.org/10.1001/archpsyc.58.6.590
Trull, T. J. (2005). Dimensional models of personality disorder: Coverage and cutoffs. Journal of Personality Disorders, 19(3), 262-282. https://doi.org/10.1521/pedi.2005.19.3.262
Tyrer, P., Mulder, R., Kim, Y. R., & Crawford, M. J. (2019). The development of the ICD-11 classification of personality disorders: An amalgam of science, pragmatism, and politics. Annual Review of Clinical Psychology, 15, 481-502. https://doi.org/10.1146/annurev-clinpsy-050718-095736
Warren, J. I., & South, S. C. (2009). A symptom level examination of the relationship between Cluster B personality disorders and patterns of criminality and violence in women. International Journal of Law and Psychiatry, 32(1), 10-17. https://doi.org/10.1016/j.ijlp.2008.11.005
Watters, C. A., Bagby, R. M., & Sellbom, M. (2019). Meta-analysis to derive an empirically based set of personality facet criteria for the alternative DSM-5 model for personality disorders. Personality Disorders: Theory, Research, and Treatment, 10(2), 97-104. http://dx.doi.org/10.1037/per0000307
Widiger, T. A. (2007). Dimensional models of personality disorder. World Psychiatry, 6(2), 79-83. https://pubmed.ncbi.nlm.nih.gov/18235857/
Widiger, T. A., & Simonsen, E. (2005). Alternative dimensional models of personality disorder: Finding a common ground. Journal of Personality Disorders, 19(2), 110-130. https://doi.org/10.1521/pedi.19.2.110.62628
World Health Organization. (1994). A user’s guide to the self-reporting questionnaire (SRQ). World Health Organization.
Yam, W. H., & Simms, L. J. (2014). Comparing criterion- and trait-based personality disorder diagnoses in DSM-5. Journal of Abnormal Psychology, 123(4), 802-808. https://doi.org/10.1037/a0037633
Zanarini, M. C., Frankenburg, F. R., Dubo, E. D., Sickel, A. E., Trikha, A., Levin, A., & Reynolds, V. (1998). Axis I Comorbidity of Borderline Personality Disorder. American Journal of Psychiatry, 155(12), 1733-1739. https://doi.org/10.1176/ajp.155.12.1733
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Copyright (c) 2020 Sérgio Eduardo Silva de Oliveira, Tiago Cunha de Oliveira, Denise Ruschel Bandeira, Robert Frank Krueger
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.