Personality Diagnostic Questionnaire-Revised Research Articles

Patterns of anxiety and personality disorder comorbidity

The purpose of this study was to examine patterns of comorbidity of DSM-III-R anxiety disorders and personality disorders (PD). Two-hundred subjects were independently interviewed with the Structured Clinical Interview for DSM-III-R (SCID) and the Personality Disorder Examination (PDE) face-to-face by two experienced clinicians. One-hundred and forty-six also completed the Personality Diagnostic Questionnaire—Revised (PDQ-R). Rates of personality disorder among patients with and without anxiety disorders were determined by each of the three instruments. Comorbidity between panic disorder, social phobia, obsessive-compulsive disorder, and simple phobia and a conservative estimate of individual Axis II disorders was examined. Results indicate that panic disorder, either current or lifetime, is associated with borderline, avoidant, and dependent personality disorders; social phobia is associated with avoidant personality disorder; and obsessive-compulsive disorder is associated with obsessive-compulsive and avoidant personality disorders. Anxiety disorders with personality disorders are characterized by chronicity and lower levels of functioning compared with anxiety disorders without personality disorders.

Errors in hand scoring objective personality tests: The case of the Personality Diagnostic Questionnaire—Revised (PDQ—R).

Errors in hand scoring objective personality tests: The case of the Personality Diagnostic Questionnaire—Revised (PDQ—R).

DSM-III-R and Eysenck personality measures among patients in a substance abuse programme

The relationship between DSM-III-R personality disorder scale scores and scores on Eysenck's dimensions of neuroticism (N), extraversion (E), and psychoticism (P, toughmindedness) was examined among patients in a substance abuse program. Ninety-seven patients completed the Personality Diagnostic Questionnaire—Revised (PDQ-R) and Eysenck's Personality questionnaire (EPQ). Scales were jointly factored, the analysis yielded three factors accounting for 65% of the variance. The first factor had significant (> 0.4) positive loadings on neuroticism and on all personality disorder scores other than schizoid and antisocial. The second factor had a significant positive loading on psychoticism, as well as on DSM-III-R passive-aggressive, narcissistic, borderline, and antisocial scores. The third factor had a negative loading on extraversion, and a positive loading on DSM-III-R schizoid scores. The results suggest that in this population personal distress is related to most DSM-III-R disorder scores, and that toughmindedness (P) is related to the DSM-III-R dramatic personality disorder cluster.

External Validity of Two Personality Disorder Inventories

The external validity of two self-report measures of personality disorders, the Personality Diagnostic Questionnaire—Revised (PDQ-R—: Hyler & Rieder, 1987) and the MMPI-Personality Disorder scales (MMPI—PD—Morey, Waugh, & Blashfield, 1985), was assessed by comparing the dimensional scores and diagnoses derived from these inventories to those from an Axis II interview (the Structured Interview for DSM-III-R Personality—SIDP-R; Pfohl, Blum, Zimmerman, & Stangl, 1989) in a sample of 57 outpatients. Results indicated that the PDQ-R and MMPI-PD dimensional scores were significantly correlated with the corresponding scores from the SIDP-R. However, diagnostic agreement between the self-report inventories and the structured interview was poor. Therefore, results suggest that self-report Axis II diagnoses should not be used as a substitute for diagnoses derived from a structured interview. The ability of these inventories to rule out Axis II diagnoses indicates that they may be useful screening measures.

Psychopathology in subgroups of obese women with and without binge eating disorder.

The examination of psychopathology in subgroups of obese patients is a new area of research in psychiatry. This project studied rates and types of psychopathology among obese subjects meeting the proposed DSM-IV criteria of binge eating disorder (BED) and obese subjects without BED. One hundred obese women with a mean age of 39.2 years and a mean body mass index (BMI) of 35.9 kg/m2 were evaluated using the Structured Clinical Interview for DSM-III-R (SCID-Modified Version) and a self-rating personality inventory, Personality Diagnostic Questionnaire-Revised (PDQ-R), before entering a treatment study for weight reduction. Those subjects meeting proposed DSM-IV criteria for BED had significantly higher lifetime rates for an axis I diagnosis compared with those that did not meet criteria for BED. Subjects with BED showed higher rates of lifetime affective disorder and bulimia nervosa, but did not differ on any other axis I diagnoses. Axis II cluster B and cluster C diagnoses were found more frequently among BED subjects. The specific diagnoses of histrionic, borderline, and avoidant personality disorders were found significantly more often among BED subjects. The results support the idea that binge eating may identify a distinct subgroup among the obese population who have significantly higher rates of certain forms of psychopathology on both Axis I and Axis II. The findings of increased rates of depression are consistent with other studies and suggest that our treatment modalities need to address this problem.

Alexithymia: relationship to personality disorders.

Previous studies suggested an association of alexithymia with other personality models, as well as with various psychiatric syndromes. However, with regard to current diagnostic systems, the clinical validity of alexithymia remains to be established. In a sample of 182 psychiatric outpatients, the lifetime prevalence of DSM-III-R axis I disorders was determined by Structured Clinical Interview for DSM-III-R (SCID) interviews. In addition, DSM-III-R personality disorders were assessed using the Personality Diagnostic Questionnaire-Revised (PDQ-R). On the Toronto Alexithymia Scale (TAS), 17% of the sample scored in the alexithymic range. A series of stepwise multiple regression analyses were performed, exhibiting no relationship between alexithymia and any of the DSM-III-R axis I lifetime diagnoses. In contrast, schizotypal, dependent, and avoidant personality dimensions, as well as a lack of histrionic features, emerged as significant predictors of alexithymia, which further supports the conceptualization of alexithymia as a personality dimension.

Personality Disorder Comorbidity with Major Depression and Response to Fluoxetine Treatment

The relationship between depression and comorbid personality disorders is still poorly understood. The aims of this study were to examine differences in depression severity between depressed outpatients with and without comorbid personality disorders, to determine the effect of a fixed dose of fluoxetine on personality disorders, and to assess the predictive value of personality disorder diagnoses at baseline with regard to response to fluoxetine. Eighty-three outpatients with major depressive disorder (MDD) were assessed with a self-rating scale, the Personality Diagnostic Questionnaire-Revised (PDQ-R), before and after 8 weeks of treatment with fluoxetine 20 mg/day. The presence of a cluster B diagnosis before treatment predicted positive outcome as measured by the change in score on the modified 17-item Hamilton Rating Scale for Depression (HAM-D-17*). Following treatment, we found significant reductions in the frequency of most individual personality disorder diagnoses and total PDQ-R score. While patients no longer meeting criteria for cluster B personality disorders after treatment had similar reductions in depressive symptoms compared to those maintaining the diagnoses, subjects no longer meeting criteria for cluster A and cluster C diagnoses after treatment exhibited significantly greater decreases in depression severity than those who maintained the diagnoses. Overall, these results suggest that fluoxetine may be beneficial in the treatment of certain personality disorder traits in patients with MDD.

Personality Disorder and Multiple Substance Dependence

DSM-III-R personality measures of individuals meeting criteria for multiple substance dependence were compared to those dependent on a single substance. Ninety-eight subjects in a substance abuse treatment program received DSM-III-R Axis I diagnoses by structured interview. Fifty-seven met criteria for multiple substance dependence; 41 were dependent on a single substance. Those dependent on multiple substances were more likely to have additional Axis I diagnoses such as major depression. To control for the effect of these disorders on personality scores, subjects with current Axis I diagnoses in addition to substance dependence (n = 29) were excluded from the personality analysis. Subjects completed the Personality Diagnostic Questionnaire Revised (PDQ-R), which yielded DSM-III-R Axis II personality disorder scores. Multiply dependent subjects scored significantly higher than subjects dependent on a single substance on the borderline and antisocial scales. The number of substances subjects had been dependent on correlated significantly with these scale scores as well. The results are consistent with the idea that multiple substance dependence is associated with greater personality pathology.

Comorbidity of DSM-III-R eating disorders and personality disorders.

The purpose of this study was to assess the relationship of eating disorders to personality disorders. Two hundred subjects were independently administered the Structured Clinical Interview for DSM-III-R (SCID) and the Personality Disorder Examination (PDE) face-to-face by two experienced clinicians. One hundred forty-six also completed the Personality Diagnostic Questionnaire-Revised (PDQ-R). Rates of personality disorder among patients with and without eating disorders were determined by each of the three instruments. Comorbidity between bulimia nervosa and anorexia nervosa and a conservative estimate of individual Axis II disorders was examined. Eating disorders with and without personality disorders were compared on age at onset and two measures of illness severity. Results indicate that the association, in general, between personality disorders and eating disorders varies by diagnostic method. Bulimia nervosa, however, is associated with borderline personality disorder and anorexia nervosa with avoidant personality disorder. Eating disorders with personality disorders are characterized by chronicity and low levels of functioning compared with eating disorders without personality disorders.

Empirical determination of thresholds for case identification: Validation of the Personality Diagnostic Questionnaire-Revised

The Personality Diagnostic Questionnaire-Revised (PDQ-R) was sent to first-degree relatives of major psychotic patients for identification of DSM-III-R personality disorders (PDs). Responses to the PDQ-R were interpreted both literally and empirically, and compared with the Structured Interview for DSM-III PDs (SIDP) as the standard. For literal interpretation, symptoms reported were counted directly for case identification using fixed DSM-III-R thresholds. The empirical approach adjusted the threshold for case identification to maximize concordance with the SIDP. Comparison of the two methods showed that using empirically determined thresholds in some scales gives better concordance with the SIDP. For the dependent and histrionic PD scales, the improvements were statistically significant. The area under the receiver operating characteristic (ROC) curve was computed for each PDQ-R scale to summarize its discriminatory capability across all thresholds. Areas under the ROC curve indicated that the schizoid, schizotypal, borderline, dependent, passive-aggressive, and histrionic PD scales in the PDQ-R have better discriminatory qualities than other PDQ-R scales.

A family study of self-reported personality traits and DSM-III-R personality disorders

Personality traits and DSM-III-R personality disorders of first-degree relatives of patients with psychoses were studied using the NEO Five-Factor Inventory (NEO-FFI) and the Personality Diagnostic Questionnaire-Revised (PDQ-R), two self-report instruments. The relatives were compared on their scores for the five personality factors in the NEO-FFI, the prevalence of individual DSM-III-R personality disorders, and their scores for each personality disorder scale in the PDQ-R. The results suggest that there is no difference in personality traits and prevalence of personality disorders, including schizophrenia spectrum disorders, when relatives of patients with schizophrenia, bipolar disorder, and major depression are compared to each other. Relatives of patients with “atypical psychosis,” psychotic disorders that do not meet DSM-III-R criteria for any specific nonorganic psychotic disorder, may be a distinctive group.

Relationships between psychosocial development and personality disorder symptomatology in late adolescents

The present study investigated the extent to which psychosocial development through the first five stages of Erik Erikson's theory of personality development is associated with Diagnostic and Statistical Manual (third edition, revised; DSM-III-R) Axis II personality disorder symptomatology in a late adolescent sample of undergraduate students. The Inventory of Psychosocial Development (IPD) and the Personality Diagnostic Questionnaire—Revised (PDQ-R) were administered to a mixed-sex sample of 106 undergraduate students. The results of this research were that IPD scores assessing negative resolutions of the first five Eriksonian developmental stages consistently predicted scores on the PDQ-R composite scale and the PDQ-R impairment/distress index—both measures of overall personality disorder symptomatology. The IPD subscales varied substantially in the extent to which they predicted scores on the 13 PDQ-R subscales that assess symptoms of specific DSM-III-R personality disorders—ranging from the trust vs. mistrust subscale, which predicted scores on 12 of the 13 PDQ-R subscales, to the initiative vs. guilt subscale, which predicted scores on only 6 of the 13 PDQ-R subscales. Implications of these findings for our understanding of the relationship between psychosocial development and psychopathology are discussed in the context of previous research in this area, and suggestions for future research are offered.

Psychogenic impotence: Is it possible to differentiate it from organic impotence with personality, psychopathological and defensive indexes?

In this study, the authors compared 2 samples of patients suffering from organic (N.29) and psychogenic (N.52) erectile dysfunction, with the aim of identifying psychological dimensions which could differentiate between the two samples and adequate psychometric instruments to measure them. The following evaluation scales were used: Personality Diagnostic Questionnaire— Revised (PDQ-R), Symptom Check List 90 (SCL-90) and Defense Style Questionnaire—Short Form (DSQ-SF) in order to assess personality traits, psychiatric symptoms and defensive styles, respectively. PDQ-R, SCL-90 and DSQ-SF were found to be inadequate to differentiate between the two samples of psychogenically and organically impotent patients. Moving from this negative result the authors formulate some hypothesis on the possibility and the opportunity of research on this direction, and on the possible meaning of psychogenic impotence.

Utility of the Personality Diagnostic Questionnaire—Revised in A Nonclinical Population

Although the Personality Diagnostic Questionnaire—Revised (PDQ-R) has proved useful as a global measure of Axis II symptomatology in clinical (i.e., psychiatric inpatient or outpatient) subjects, the utility of the PDQ-R in nonclinical populations remains unexplored. The present study examined the utility of the PDQ-R in a nonclinical college student sample. Results indicated: (1) that a high proportion of subjects in our sample were assigned personality disorder diagnoses via the PDQ-R, even after the well-documented tendency of the PDQ-R to yield false-positive diagnoses was taken into account; (2) that, as expected, nonclinical subjects who score above the clinical threshold on the PDQ-R composite index show elevated scores on the Hopkins Symptom Checklist (SCL-90), a self-report measure of psychopathology; and (3) that nonclinical subjects who score above the clinical threshold on the PDQ-R composite index obtain SCL-90 scores comparable to those obtained in clinical (outpatient) samples. If the clinical cutoff scores typically used for the PDQ-R were modified to reduce the number of subjects that may be mislabeled as having significant Axis II personality disorder symptomatology, the PDQ-R could be useful as a screening instrument in nonclinical as well as clinical subject populations.

Defense Styles as Predictors of Personality Disorder Symptomatology

The present study investigated whether defense styles, assessed by the Defense Styles Questionnaire (DSQ), predict personality disorder symptom levels, assessed by the Personality Diagnostic QuestionnaireRevised (PDQ-R), in a manner consistent with Vaillant 's (1971, 1977) hierarchical model of defense mechanisms. The DSQ and PDQ-R were administered to a mixed-sex sample of 106 undergraduate students. Results of multiple regression and correlational analyses were consistent with the predictions of Vaillants model, in that: (1) the DSQ “maladaptive” and “image-distorting” defense styles were positively associated with the PDQ-R composite index, as well as with 11 and 7 PDQ-R personality disorder subscales, respectively; and (2) the DSQ “adaptive” defense style was negatively associated with the PDQ-R composite index, as well as with 4 PDQ-R subscales. Each of the 14 PDQ-R scales demonstrated a unique pattern of associations with the 4 DSQ defense styles.

Measuring Personality Disorder: The Use of Self-Report Questionnaires

This paper assesses the construct validity of the self-report Personality Diagnostic Questionnaire—Revised (PDQ-R) against the Personality Disorder Examination (PDE), a semistructured clinical interview; both instruments provide DSM-III-R personality disorder diagnoses and dimensional scores. The agreement of the two instruments was poor and the PDQ-R was better correlated with a number of personality trait measures than with scores on the PDE. On the basis of these findings, and the PDQ-R results of a group of highly functioning adults (n = 50), it was concluded that the PDQ-R is functioning as a personality trait measure rather than a measure of personality disorder diagnostic category.

Validity of the Personality Diagnostic Questionnaire-Revised: A replication in an outpatient sample

We report a replication study of the validity of the Personality Diagnostic Questionnaire-Revised (PDQ-R) in an outpatient sample. Fifty-nine applicants for psychoanalysis at a training institute completed the PDQ-R and were diagnosed by clinicians, blind to the PDQ-R results, using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and the Personality Disorder Examination (PDE). The PDQ-R showed high sensitivity and moderate specificity for most axis II disorders. Although not a substitute for a structured interview because it yields many false-positives, the PDQ-R is an efficient instrument for screening outpatients with DSM-III-R personality disorders.

PDQ-R personality disorders in bipolar patients

The prevalence of personality traits and disorders in bipolar patients as reported in the literature varies widely. The Personality Diagnostic Questionnaire-Revised (PDQ-R) is a self-report instrument for DSM-IIIR personality disorders found to have validity, but with high sensitivity and moderate specificity. This study was designed to assess personality disorders in bipolar patients using the PDQ-R. Fifty bipolar patients in a long-term lithium treatment program completed the PDQ-R. Over one half the patients (58%) scored for one or more personality disorders. A total of 71 diagnoses was made among the 50 patients, or a mean of 1.42 per patient. The majority of the axis II diagnoses were from cluster B, with borderline the most prevalent, followed by histrionic. The PDQ-R has high sensitivity but moderate specificity and may overdiagnose personality disorders in bipolar patients. The PDQ-R may register subclinical aspects of affective disorder as personality.

Personality diagnostic questionnaire-revised (PDQ-R) personality disorder scores and negative life events independently predict changes in hopkins symptom checklist (SCL-90) Psychopathology Scores

The present study employed a prospective design to investigate whether Personality Diagnostic Questionnaire—Revised (PDQ-R) scores and/or Hassles Scale—Revised (HS-R) scores predict changes in Axis I psychopathology levels over 1 month, in a nonclinical sample of young adults. The PDQ-R, HS-R, and Hopkins Symptom Checklist (SCL-90) were administered to a mixed-sex sample of 100 undergraduate students on two occasions separated by 1 month. Hierarchical multiple regression analyses indicated that (1) time 1 PDQ-R composite scores predicted changes in scores on 11 SLC-90 scales; (2) time 1 PDQ-R impairment/distress index scores predicted changes in SCL-90 general symptom index scores; (3) only one of the individual PDQ-R personality disorder subscales—the schizotypal personality disorder subscale—predicted changes in SCL-90 general symptom index scores; (4) HS-R scores predicted changes in scores on 9 SCL-90 scales; and (5) in only 3 of the 27 analyses conducted did the statistical interaction between PDQ-R and HS-R scores predict changes in SCL-90 scores. These findings indicate that personality disorder symptomatology and negative life events may independently predict changes in Axis I psychopathology levels and, thus, support the continued inclusion of Axis II and Axis IV in future versions of the Diagnostic and Statistical Manual of Mental Disorders.

Validity of the Personality Diagnostic Questionnaire--revised: comparison with two structured interviews

The authors gave the self-report Personality Diagnostic Questionnaire--Revised (PDQ-R) to 87 applicants for inpatient treatment of severe personality psychopathology and, blind to these results, diagnosed personality disorders in the applicants by using the Personality Disorder Examination and the Structured Clinical Interview for DSM-III-R Personality Disorders. The PDQ-R was not a substitute for a structured interview assessment of axis II disorders because many of its diagnoses were false positives. Its high sensitivity and moderate specificity for most of the axis II disorders suggest, however, that it is an efficient instrument for screening patients with DSM-III-R personality disorders.