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Schreiber AM, Cawood CD. Treatment outcomes of Veteran men in a comprehensive dialectical behavior therapy program: Characterizing sex differences in symptom trajectories. J Psychiatr Res 2023; 164:90-97. [PMID: 37331262 DOI: 10.1016/j.jpsychires.2023.05.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/13/2023] [Accepted: 05/18/2023] [Indexed: 06/20/2023]
Abstract
Dialectical Behavior Therapy (DBT) is one of the primary psychosocial treatments for reducing suicidal behaviors and improving psychosocial outcomes among patients with borderline personality disorder (BPD) and has been shown to reduce BPD symptoms when delivered in a Veteran Affairs medical center setting. Despite evidence of similar rates of BPD in both men and women, the vast majority of treatment outcome research in BPD has focused on women. We sought to characterize sex differences in symptom trajectories among Veterans participating in a comprehensive DBT program. We found that Veteran men and women who entered the DBT program were diagnostically and demographically similar. Participants exhibited reductions in BPD symptoms and improvements in emotion regulation over the course of treatment. Moreover, Veteran men reported BPD symptom reductions that were not statistically inferior to those of Veteran women and exhibited a sharper reduction in these symptoms. This research provides support for the use of DBT as a psychosocial treatment for Veteran men with BPD symptoms.
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Affiliation(s)
- Alison M Schreiber
- Ann Arbor VA Medical Center, Ann Arbor, MI, USA; University of North Carolina, Chapel Hill, NC, USA.
| | - Chelsea D Cawood
- Ann Arbor VA Medical Center, Ann Arbor, MI, USA; University of Michigan Medical School, Ann Arbor, MI, USA.
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2
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Yalch MM, Ceroni DB, Dehart RM. Influence of Child Abuse and Neglect on Histrionic Personality Pathology. J Trauma Dissociation 2023; 24:111-124. [PMID: 36053041 DOI: 10.1080/15299732.2022.2119458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Histrionic personality pathology is among the most common forms of personality pathology, although little is known about its potential risk factors. One possible factor that may influence histrionic personality pathology is childhood trauma, most notably sexual abuse and physical/emotional neglect. However, there is little research on how these and other forms of childhood trauma may influence histrionic personality pathology relative to each other. To address this, in this study we examined the relative effects of different forms of child abuse and neglect on histrionic personality pathology in a sample of women and men from Amazon's Mechanical Turk (N = 399) using a Bayesian approach to structural equation modeling. Results suggest that child sexual abuse is the strongest predictor of histrionic personality pathology in adulthood. However, this differs between women and men such that physical neglect also predicts histrionic personality pathology for women, whereas physical and emotional abuse as well as emotional neglect predict histrionic personality pathology for men. These findings provide insight into the developmental precursors to histrionic personality pathology and have implications for research on and clinical intervention with people exhibiting histrionic personality pathology.
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Affiliation(s)
- Matthew M Yalch
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Dominic B Ceroni
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Ryanne M Dehart
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
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3
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Perceived Rejection in Personality Psychopathology: The Role of Attachment and Gender. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09961-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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4
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Gender Differences in Clinical and Sociodemographic Patterns of Substance Use Disorder. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Lester R, Prescott L, McCormack M, Sampson M. Service users' experiences of receiving a diagnosis of borderline personality disorder: A systematic review. Personal Ment Health 2020; 14:263-283. [PMID: 32073223 DOI: 10.1002/pmh.1478] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/22/2020] [Accepted: 01/30/2020] [Indexed: 11/11/2022]
Abstract
There is ongoing controversy regarding the borderline personality disorder (BPD) diagnosis. Whilst the experiences of people living with BPD have been widely acknowledged, the process of receiving the diagnosis is poorly described. This systematic review aimed to synthesize the existing research exploring people's experiences of receiving a diagnosis of BPD, as well as examining what is considered best practice in the diagnostic delivery process. The findings from 12 qualitative studies were synthesized using thematic analysis, generating two overarching themes: negative and positive experiences of receiving a diagnosis of BPD. These themes were described using the following sub-themes: the communication of diagnosis and meaning made of it, validity around diagnosis and attitudes of others. Results indicate that there is a substantial difference between a well-delivered and poorly delivered diagnosis. The diagnostic delivery process is fundamental to how people understand and interpret the BPD diagnosis. The way in which the BPD diagnosis is shared with people can ultimately shape their views about hope for recovery and their subsequent engagement with services. © 2020 John Wiley & Sons, Ltd.
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Affiliation(s)
- R Lester
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
| | - L Prescott
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - M McCormack
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
| | - M Sampson
- St Helens Recovery Team, Harry Blackman House, Peasley Cross Hospital, St Helens, UK
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6
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Moltisanti AJ, Ennis CR, Chavarria J, Smith CE, Taylor J. Multi-Trait Profiles and their Relation to Substance Use Problems and Cluster B Personality Disorder Features: A Replication Study. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2018. [DOI: 10.1521/jscp.2018.37.4.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Substance use disorders (SUDs) and Cluster B personality disorders (PDs) may have shared risk through profiles of personality and motivational traits. The present study sought to replicate in a national sample of adults past research which found multi-trait profiles that were associated with disinhibitory disorders in a college sample. Another aim was to test whether gender differences in the prevalence of disinhibitory disorders are attributable to underlying differences in personality-based risk. Cluster analysis was used to identify multi-trait profiles from impulsivity, constraint, negative emotionality, behavioral activation system (BAS), and behavioral inhibition system (BIS) scale scores. Analyses yielded similar multi-trait profiles to those found in past research, including a “disinhibited” profile with high impulsivity, high BAS, and low constraint, as well as a “high affectivity/impulsive” profile with high negative emotionality, impulsivity, BAS, and BIS. These profiles were associated with elevated drug problems and Cluster B PD features. Results support the validity these trait profiles and their association with disinhibitory psychopathology. Gender was associated with some, but not all, disinhibitory disorders while controlling for cluster membership, suggesting that multi-trait personality clusters may represent a more proximal risk factor than gender for certain disinhibitory disorders.
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7
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Gawda B, Czubak K. Prevalence of Personality Disorders in a General Population Among Men and Women. Psychol Rep 2017; 120:503-519. [DOI: 10.1177/0033294117692807] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the present study is to establish the prevalence of personality disorders (PDs) in a healthy (nonclinical) Polish population, to examine sex difference in PDs, and to show the structure of clusters which PDs form with regard to men and women. A large sample of 1460 individuals of age between 18 and 65 years was examined. The Structured Clinical Interview for Axis II was used to obtain information on PDs, the Mini International Neuropsychiatric Interview to obtain information on other disorders, and an interview to record demographic data. Results show that approximately 9% of the sample had at least one PD (the overall rate is 8.9%) and rates on sex differences in PDs are similar to other European and North American countries. The most prevalent PDs are obsessive-compulsive (9.6%), narcissistic (7%), and borderline (7%). Results show the considerable comorbidity of PDs which means that about 9% of the adult population have at least one PD and in fact they display features of many specific PDs. A factor analysis revealed that 12 PDs form different clusters in men and women.
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Affiliation(s)
- Barbara Gawda
- Department of Psychology of Emotion & Cognition, University of Maria Curie Sklodowska, Lublin, Poland
| | - Katarzyna Czubak
- Department of Personality, Catholic University of John Paul II, Lublin, Poland
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Gritti ES, Samuel DB, Lang M. Diagnostic Agreement Between Clinicians and Clients: The Convergent and Discriminant Validity of the SWAP-200 and MCMI-III Personality Disorder Scales. J Pers Disord 2016; 30:796-812. [PMID: 26623535 DOI: 10.1521/pedi_2015_29_231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A particularly controversial aspect in the field of personality assessment is the use of self-report measures, versus clinicians' evaluations, for diagnosing personality disorder (PD). No studies have systematically documented the agreement between these sources for the entire array of DSM-5 PDs using comprehensive measures and experienced clinicians' judgments. The present work fills this gap by indexing the agreement between patients' self-descriptions and clinicians' judgments, relying on standardized and thorough PD instruments. The Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b) and the Millon Clinical Multiaxial Inventory-III (Millon, Davis, & Millon, 1997) were both completed in a clinical series of 56 adult outpatients. Analyses highlighted moderate correlations between the two measures for the 10 DSM-5 PDs (Mdn = .35). Agreement was highest for psychological features that are more easily observable by the clinicians. Furthermore, results revealed problematic discriminant validity between the two instruments.
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Affiliation(s)
| | - Douglas B Samuel
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana
| | - Margherita Lang
- Department of Psychology, Milan Bicocca University, Milan, Italy.,Associazione per la Ricerca in Psicologia Clinica - A.R.P., Milan, Italy
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Dinsdale N, Mokkonen M, Crespi B. The ‘extreme female brain’: increased cognitive empathy as a dimension of psychopathology. EVOL HUM BEHAV 2016. [DOI: 10.1016/j.evolhumbehav.2016.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Zimmermann J, Wright AGC. Beyond Description in Interpersonal Construct Validation: Methodological Advances in the Circumplex Structural Summary Approach. Assessment 2015; 24:3-23. [PMID: 26685192 DOI: 10.1177/1073191115621795] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The interpersonal circumplex is a well-established structural model that organizes interpersonal functioning within the two-dimensional space marked by dominance and affiliation. The structural summary method (SSM) was developed to evaluate the interpersonal nature of other constructs and measures outside the interpersonal circumplex. To date, this method has been primarily descriptive, providing no way to draw inferences when comparing SSM parameters across constructs or groups. We describe a newly developed resampling-based method for deriving confidence intervals, which allows for SSM parameter comparisons. In a series of five studies, we evaluated the accuracy of the approach across a wide range of possible sample sizes and parameter values, and demonstrated its utility for posing theoretical questions on the interpersonal nature of relevant constructs (e.g., personality disorders) using real-world data. As a result, the SSM is strengthened for its intended purpose of construct evaluation and theory building.
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Abstract
BACKGROUND Personality disorders (PDs) are prevalent in about one in every 10 adults. Prior to the introduction of the ICD-10 in Denmark, the incidence rate for PD (including schizotypal) among psychiatric patients was approximately 12% and the prevalence rate 14%. AIMS The aim of the present clinical epidemiology study is to investigate the use of ICD-10 PD as primary and secondary diagnoses in years 1995, 2000 and 2006, comorbid disorders and their relation to age and gender. METHODS The study includes all adult patients admitted to any psychiatric hospital (inpatients and outpatients) in Denmark. RESULTS Both incidence and prevalence rates of PD diagnoses decrease over the study period. It is evident that all specific diagnoses significantly decrease or remain stable whereas the unspecified and mixed type significantly increases constituting up to 50% of diagnoses. Emotionally unstable PD stands out as the single most prevalent covering around one third of PD diagnoses. A decrease is found in the prevalence of patients receiving a PD diagnosis as a primary diagnosis, but an increase as a secondary diagnosis (most often as comorbid to depression or anxiety disorder). Differences are found in relation to gender and age. CONCLUSION PDs are among the most prevalent disorders; however, rates are decreasing in psychiatric settings. There seem to be a rather huge gap between clinical evaluation and research data on prevalence of PDs. Clinicians need more education and sufficient time for in-depth personality assessment of PDs in all patient groups.
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Affiliation(s)
- Liselotte Pedersen
- Liselotte Pedersen, Associate Professor, Psychiatric Research Unit , Region Zealand , and Department of Psychology, University of Copenhagen , Denmark
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Huang Y, Kotov R, de Girolamo G, Preti A, Angermeyer M, Benjet C, Demyttenaere K, de Graaf R, Gureje O, Karam AN, Lee S, Lépine JP, Matschinger H, Posada-Villa J, Suliman S, Vilagut G, Kessler RC. DSM-IV personality disorders in the WHO World Mental Health Surveys. Br J Psychiatry 2009; 195:46-53. [PMID: 19567896 PMCID: PMC2705873 DOI: 10.1192/bjp.bp.108.058552] [Citation(s) in RCA: 221] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Little is known about the cross-national population prevalence or correlates of personality disorders. AIMS To estimate prevalence and correlates of DSM-IV personality disorder clusters in the World Health Organization World Mental Health (WMH) Surveys. METHOD International Personality Disorder Examination (IPDE) screening questions in 13 countries (n = 21 162) were calibrated to masked IPDE clinical diagnoses. Prevalence and correlates were estimated using multiple imputation. RESULTS Prevalence estimates are 6.1% (s.e. = 0.3) for any personality disorder and 3.6% (s.e. = 0.3), 1.5% (s.e. = 0.1) and 2.7% (s.e. = 0.2) for Clusters A, B and C respectively. Personality disorders are significantly elevated among males, the previously married (Cluster C), unemployed (Cluster C), the young (Clusters A and B) and the poorly educated. Personality disorders are highly comorbid with Axis I disorders. Impairments associated with personality disorders are only partially explained by comorbidity. CONCLUSIONS Personality disorders are relatively common disorders that often co-occur with Axis I disorders and are associated with significant role impairments beyond those due to comorbidity.
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Fertuck EA, Lenzenweger MF, Clarkin JF, Hoermann S, Stanley B. Executive neurocognition, memory systems, and borderline personality disorder. Clin Psychol Rev 2006; 26:346-75. [PMID: 15992977 DOI: 10.1016/j.cpr.2005.05.008] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Accepted: 05/09/2005] [Indexed: 11/17/2022]
Abstract
Borderline Personality Disorder (BPD) is a common, disabling, and burdensome psychiatric condition. It is characterized by turbulent fluctuations of negative emotions and moods, unstable and conflictual interpersonal relationships, an incoherent and often contradictory sense of self, and impulsive, potentially lethal self-injurious behaviors. The neurobehavioral facets of BPD have not been extensively studied. However, clinical theoreticians and researchers have proposed that the symptoms and behaviors of BPD are, in part, associated with disruptions in basic neurocognitive processes. This review summarizes and evaluates research that has investigated the relationship between executive neurocognition, memory systems, and BPD. Three historical phases of research are delineated and reviewed, and the methodological and conceptual challenges this body of investigation highlights are discussed. Laboratory-based assessment of executive neurocognition and memory systems is integral to an interdisciplinary approach to research in BPD. Such an approach holds promise in elucidating the neurobehavioral facets, development, diagnostic boundaries, prevention, and optimal interventions for this debilitating and enigmatic disorder.
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Affiliation(s)
- Eric A Fertuck
- New York State Psychiatric Institute, Columbia University, College of Physicians and Surgeons, USA.
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Kantojärvi L, Veijola J, Läksy K, Jokelainen J, Herva A, Karvonen JT, Kokkonen P, Järvelin MR, Joukamaa M. Comparison of hospital-treated personality disorders and personality disorders in a general population sample. Nord J Psychiatry 2004; 58:357-62. [PMID: 15513612 DOI: 10.1080/08039480410005909] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The distribution of personality disorders (PDs) was explored in hospital-treated subjects and in a population subsample. This study forms a part of the Northern Finland 1966 Birth Cohort study. Hospital case records of psychiatric treatment periods of all cohort members (n=11,017) were reviewed and re-checked against DSM-III-R criteria. A subsample of the cohort members living in Oulu (n=1609) were invited to a two-stage psychiatric field survey with Structured Clinical Interview for DSM-III-R (SCID) as a diagnostic method. The most common PDs in hospital-treated sample were cluster B PDs (erratic). In the population subsample, cluster C PDs (anxious) formed the majority.
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Affiliation(s)
- Liisa Kantojärvi
- Department of Psychiatry, University of Oulu and Oulu University Hospital, Finland.
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Logan TK, Walker R, Cole J, Leukefeld C. Victimization and Substance Abuse among Women: Contributing Factors, Interventions, and Implications. REVIEW OF GENERAL PSYCHOLOGY 2002. [DOI: 10.1037/1089-2680.6.4.325] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although the literature indicates that there is an association of victimization with substance abuse, there has been limited research focused on understanding and synthesizing the factors that have been identified as contributing to victimization and substance abuse and on interventions designed to address these contributing factors. The purposes of this article are to (a) review the literature on factors related to victimization and substance abuse, (b) review interventions and outcomes, and (c) discuss clinical implications for interventions and research. Results suggest that there is a high rate of co-occurrence of victimization and substance abuse among women, that the factors contributing to victimization and substance abuse are complex, and that there is a lack of treatment models addressing victimization and substance abuse.
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Abstract
To determine whether female-typed personality disorders are associated with a different pattern of dysfunction than male-typed disorders, lay judges (N = 216) estimated the amount of social impairment, occupational impairment, and personal distress related to symptoms of personality disorders. Results for both the subset of six disorders originally rated by clinician judges in the research of Funtowicz and Widiger (1999) and for a larger set of nine disorders revealed a pattern originally reported by Funtowicz and Widiger where female-typed disorders were associated with relatively higher ratings of personal distress, whereas male-typed disorders were associated with relatively higher ratings of social (and sometimes occupational) impairment. Findings are discussed with respect to the emphasis of different forms of dysfunction for male- and female-typed disorders, lay versus clinician judgments, and directions for future research.
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Affiliation(s)
- Andrew J Howell
- Department of Psychology and Sociology, Grant MacEwan College, Edmonton, Alberta, Canada, T5J 2P2.
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Abstract
Many researchers have hypothesized relationships between personality disorders and gender role (i.e., masculinity and femininity). However, research has not addressed if people who are masculine or feminine more often meet the criteria for personality disorders. The present study examined whether college students (N = 665, 60% women) higher in masculinity or femininity more often exhibited features of the 10 DSM-IV personality disorders. Feminine men exhibited more features of all the personality disorders except antisocial. Dependent traits were associated with higher femininity and lower masculinity. Antisocial traits were associated with masculinity. Both men and women who typically behaved consistent with their gender had more narcissistic and histrionic features, whereas participants who typically behaved unlike their gender had more features of the Cluster A personality disorders.
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Affiliation(s)
- E David Klonsky
- Department of Psychology, University of Virginia, 102 Gilmer Hall, P. O. Box 400400, Charlottesville, VA 22904-4400, USA.
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Lenzenweger MF, Clarkin JF, Kernberg OF, Foelsch PA. The Inventory of Personality Organization: Psychometric properties, factorial composition, and criterion relations with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample. Psychol Assess 2001. [DOI: 10.1037/1040-3590.13.4.577] [Citation(s) in RCA: 159] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Anderson KG, Sankis LM, Widiger TA. Pathology versus statistical infrequency: potential sources of gender bias in personality disorder criteria. J Nerv Ment Dis 2001; 189:661-8. [PMID: 11708666 DOI: 10.1097/00005053-200110000-00002] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The antisocial, narcissistic, dependent, histrionic, and borderline personality disorders often obtain differential sex prevalence rates. One explanation has been that the diagnostic criteria for these personality disorders have different gender implications for maladaptivity (e.g., perhaps the dependent personality disorder diagnostic criteria are considered by clinicians to be more pathological for women than for men). This hypothesis was explored in two studies that obtained judgments by professional clinicians of the maladaptivity and statistical infrequency of personality disorder diagnostic criteria. Significant differences across gender were obtained for the frequency of diagnostic criteria but not for their maladaptivity. The personality disorder diagnostic criteria appear to be gender neutral with respect to their implications for maladaptivity.
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Affiliation(s)
- K G Anderson
- Department of Psychology, University of Kentucky, Lexington 40506-0044, USA
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Abstract
This article reviews several current issues associated with the definition and assessment of personality disorders (PDs) as defined in the third and fourth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Specifically reviewed are issues associated with classification, PD conceptualizations, and the assessment of these disorders. DSM PD categories are also reviewed in terms of their psychometric properties. A review of the PD assessment literature suggests that DSM conceptualizations and definitions of PDs are problematic at both conceptual and quantitative levels. This article concludes with suggestions for possible alternative approaches to and modifications of DSM PD assessment.
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Affiliation(s)
- R F Farmer
- Department of Psychology, Idaho State University, Pocatello 83209-8112, USA.
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Abstract
Using the MCMI-III, we studied rates of personality disorders among 443 inpatient drug abusers (i.e., 160 opiate addicts and 283 cocaine addicts). For both samples the disorders of antisocial (60%), passive-aggressive (negativistic) (34%), and depressive personality disorders (32%) showed higher prevalence rates. Previous studies (N = 13) using different measures (e.g., SCID, SDIP, MCMI-I) reported similar findings in terms of overall prevalence of specific personality disorders, although actual rates varied by population.
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Affiliation(s)
- Robert J. Craig
- West Side Veterans Administration Medical Center, Chicago, Illinois, and Institute for Advanced Study of Personality and Psychopathology, Coral Gables, Florida
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Abstract
DSM-IV's strong empirical base has yielded an instrument with good to excellent reliability and improved validity. Diagnostic reliability depends on both the clarity and validity of diagnostic criteria and the changeability of disorders over time: The reliability of schizophrenic spectrum disorders, personality disorders, and some childhood and adolescent disorders remains problematic. Findings on diagnostic validity appear paradoxical: Attempts to validate schizophrenic spectrum disorders with neurobiological and genetic-familial validators have been only modestly successful, whereas the tripartite personality trait model has differentiated a range of depressive and anxiety disorders. Research on comorbidity has identified several highly comorbid disorders (substance-related disorders, personality disorders, depression, and anxiety) as well as some adverse consequences of comorbidity. The advantages of dimensional approaches to diagnosis have largely been demonstrated conceptually; ultimate conclusions about the strengths and weaknesses of dimensional and syndromal methods await substantial additional empirical research.
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Affiliation(s)
- P E Nathan
- Department of Psychology, University of Iowa, Iowa City 52242, USA.
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Grilo CM, Martino S, Walker ML, Becker DF, Edell WS, McGlashan TH. Psychiatric comorbidity differences in male and female adult psychiatric inpatients with substance use disorders. Compr Psychiatry 1997; 38:155-9. [PMID: 9154371 DOI: 10.1016/s0010-440x(97)90068-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
To examine gender differences in the co-occurrence of DSM-III-R axis I disorders and axis II personality disorders in young adult psychiatric inpatients with substance use disorders (SUDs), a consecutive series of 70 inpatients (33 men and 37 women) with SUD were reliably assessed with structured diagnostic interviews. Higher rates of dysthymia and eating disorders were observed in SUD females and higher rates of cluster A personality disorders were observed in SUD males. No gender differences were found for depression or anxiety in our SUD inpatients; these findings contrast with gender ratios for these disorders in the general population. In conclusion, relatively few gender differences were found in young adult inpatients with SUD, even where they would be expected based on general population gender patterns.
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Affiliation(s)
- C M Grilo
- Yale Psychiatric Institute, New Haven, CT 06520, USA
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Grilo CM, Becker DF, Walker ML, Edell WS, McGlashan TH. Gender differences in personality disorders in psychiatrically hospitalized young adults. J Nerv Ment Dis 1996; 184:754-7. [PMID: 8994459 DOI: 10.1097/00005053-199612000-00006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We examined gender differences in DSM-III-R personality disorders in psychiatrically hospitalized young adults. Structured diagnostic interviews were reliably performed on a consecutive series of 118 inpatients. Men were significantly more likely to meet criteria for cluster A, schizotypal, and antisocial personality disorders. To reduce variability due to axis I heterogeneity, we retested for gender differences in a subgroup of patients with major depression. Depressed men were more likely to meet criteria for cluster A, schizotypal, and cluster C personality disorders. Women were not observed to have a higher frequency of any personality disorder than men in either study group.
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Affiliation(s)
- C M Grilo
- Yale Psychiatric Institute, Yale University School of Medicine, New Haven, Connecticut 06520, USA
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