Interpersonal problems across levels of the psychopathology hierarchy.

We examined the relationship between psychopathology and interpersonal problems in a sample of 825 clinical and community participants. Sixteen psychiatric diagnoses and five transdiagnostic dimensions were examined in relation to self-reported interpersonal problems. The structural summary method was used with the Inventory of Interpersonal Problems Circumplex Scales to examine interpersonal problem profiles for each diagnosis and dimension. We built a structural model of mental disorders including factors corresponding to detachment (avoidant personality, social phobia, major depression), internalizing (dependent personality, borderline personality, panic disorder, posttraumatic stress, major depression), disinhibition (antisocial personality, drug dependence, alcohol dependence, borderline personality), dominance (histrionic personality, narcissistic personality, paranoid personality), and compulsivity (obsessive-compulsive personality). All dimensions showed good interpersonal prototypicality (e.g., detachment was defined by a socially avoidant/nonassertive interpersonal profile) except for internalizing, which was diffusely associated with elevated interpersonal distress. The findings for individual disorders were largely consistent with the dimension that each disorder loaded on, with the exception of the internalizing and dominance disorders, which were interpersonally heterogeneous. These results replicate previous findings and provide novel insights into social dysfunction in psychopathology by wedding the power of hierarchical (i.e., dimensional) modeling and interpersonal circumplex assessment.

我们在825名临床与社区参与者样本中考察了精神病理学（psychopathology）与人际问题之间的关系。研究分析了16种精神障碍诊断（psychiatric diagnoses）及5个跨诊断维度（transdiagnostic dimensions）与自我报告人际问题（self-reported interpersonal problems）的关联。采用结构摘要法（structural summary method）结合《人际问题环形量表问卷》（Inventory of Interpersonal Problems Circumplex Scales），探究每种诊断及维度对应的人际问题特征谱。我们构建了精神障碍的结构模型，包含疏离（回避型人格障碍、社交恐惧症、重度抑郁症）、内化（依赖型人格障碍、边缘型人格障碍、惊恐障碍、创伤后应激障碍、重度抑郁症）、去抑制（反社会型人格障碍、药物依赖、酒精依赖、边缘型人格障碍）、支配（表演型人格障碍、自恋型人格障碍、偏执型人格障碍）及强迫（强迫型人格障碍）五个因子。除内化维度与升高的人际困扰广泛相关外，其余所有维度均表现出良好的人际原型性（interpersonal prototypicality）——例如，疏离维度以社交回避/非自信的人际特征谱为定义。各单一障碍的研究结果与该障碍所属维度基本一致，但内化与支配维度下的障碍呈现人际异质性。本研究结合层级（即维度）模型与人际环形评估的优势，既复制了先前的研究发现，也为精神病理学中的社会功能障碍提供了新颖见解。