Personality Disorder Research Research Articles

Relationships between CATI personality disorder variables and measures of academic performance

The present report offers predictive and construct validation data concerning the use of the Coolidge Axis II Inventory (CATI) personality disorder scales in predicting academic difficulties. The CATI has been found to exhibit sound psychometric properties with promise for extending personality disorder research into broader nonclinical populations. Predictive validation of the various CATI personality disorder scales with specific behavioral, cognitive or emotional correlates of maladaptive functioning, other than diagnostic probabilities, remains to be established and represents a central challenge to the continued vitality of this new assessment inventory. Four academic performance variables (high school GPA, cumulative college GPA, classroom attendance, standardized course grade) were selected as important indices of adaptive functioning, particularly in the cognitive and behavioral realms. A total of 313 valid CATI profiles were provided by a sample of college students enrolled in various undergraduate psychology courses. T -scores in excess of 59 for the antisocial scale provided a simple predictor of high school and college academic performance deficits. The compulsive, dependent and avoidant personality disorder scales provided favorable indicators, depending upon the outcome measure examined. These results were generally consistent with the previous MCMI-II findings of King, and the practical and theoretical implications of the present results were discussed within the context of a broader literature involving the use of personality disorder inventories.

Personality and Psychopathology,

Back to table of contents Previous article Next article Book Forum: PERSONALITY AND ITS DISORDERSFull AccessPersonality and Psychopathology,MARK F. LENZENWEGER, PH.D., MARK F. LENZENWEGERSearch for more papers by this author, PH.D., Cambridge, Mass.Published Online:1 Mar 2000AboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This handsome collection of papers represents the proceedings of the March 1993 meeting of the American Psychopathological Association, which focused on the issue of personality and psychopathology. The chapters that constitute this volume offer an impressive window on the research and theoretical discussions that were active in this area of inquiry during the late 1980s and early 1990s, and, as such, this work provides a useful punctuation mark for what has been termed the “first phase” of personality disorders research (1).The first phase of research in the personality disorders had as its focus matters related to the basic description of the personality disorders, the assessment of personality disorders, and the development of preliminary notions linking personality disorders to the realm of normal personality. The first phase of research necessarily hinted at future directions that were to be pursued in the coming decade, and the papers Dr. Cloninger has assembled provided an exciting glimpse of things to come. In short, the papers in this volume provide excellent summaries of the early personality disorder research efforts after the introduction of explicit diagnostic criteria for axis II disorders in DSM-III and, later, DSM-III-R. In a way, they represent where the field was just before embarking on what has been termed the “second phase” of personality disorders research (1), one that has come to focus more on issues related to etiology, pathogenesis, sophisticated models of the relationship between personality and personality disorder, and careful longitudinal study of the personality disorders using appropriate methodological designs refined previously by life-span methodologists.Personality and Psychopathology contains a number of papers that the scholar of personality disorders will find especially useful. For example, Waller’s paper, “Evaluating the Structure of Personality,” is a true gem that details the careful substantive and psychometric issues that have been dealt with in his work (in collaboration with Professor Auke Tellegen) on the seven basic factors underlying personality. This chapter is particularly illuminating with respect to a critical evaluation of the popular lexical description of personality embodied in the so-called five-factor solution. Loranger’s chapter usefully details the development and initial validation of the International Personality Disorder Examination (2) and, as such, represents an excellent summary of this important assessment development, particularly given that it is now widely recognized and enjoying considerable research and clinical use. Eaves and colleagues provide a useful tutorial on the application of modern quantitative genetics analytic strategies to family data, and their chapter suggests the exciting developments to come later in the 1990s, especially with the emergence of quantitative trait loci approaches to genetic influences on individual differences.At this time, personality disorders research has indeed moved in the directions hinted at in the papers in this volume. For example, there are now two major longitudinal studies under way that seek to articulate the natural course and longitudinal trajectory of personality pathology clearly over time—my Longitudinal Study of Personality Disorders begun in 1990 and the Collaborative Longitudinal Personality Disorders Study begun in 1996 by J.G. Gunderson and colleagues. Moreover, integrations of the neurobiological literature with both personality and personality disorder constructs are beginning to emerge that seek to characterize the complex interactive nature of neurobehavioral systems underpinning these two phenotypic domains in an effort to move this area of modeling ahead (3; unpublished work of Depue and Lenzenweger).I recommend this volume for its powerful historical value and its unique position in demarcating the transition point between the first and second phases of empirical research and theory development in the personality disorders.edited by C. Robert Cloninger, M.D. Washington, D.C., American Psychiatric Press, 1999, 496 pp., $58.50.

Research on personality disorders in the Nordic countries, 1982?1998: A selective review

It is nearly 20 years since DSM-III was published, with its Axis II that defined 12 different personality disorders. In the Nordic countries, this became an impetus for an increased clinical interest in personality problems, and several clinical research groups very soon started to explore the reliability, validity and clinical importance of the concept of personality disorders. The present paper reviews close to 100 papers about personality disorders that have been published by Nordic researchers in the period 1982-1998. The aim is partly to summarise, for a clinical audience, the most clinically relevant findings that have been published, and partly to give to the Nordic and international research society a comprehensive update of our personality disorder research. Hopefully, this review will influence clinical practice to some degree, and also stimulate more research on personality disorders.

Using the structural analysis of social behavior (SASB) to differentiate young adults with borderline personality disorder features.

The present experiment investigated the ability of the Structural Analysis of Social Behavior (SASB) Intrex questionnaires to differentiate nonclinical samples of young adults with features of either borderline personality disorder (BPD), schizotypal personality disorder (SPD), or no personality disorder (no PD). A number of significant differences were demonstrated on the SASB Intrex questionnaires when comparisons were made between the BPD and no PD samples. These results are consistent with those reported in an earlier investigation of BPD using SASB in a clinical sample. Few differences were found between the SPD features sample and the other two samples. These results are not consistent with previous findings that have differentiated BPD and SPD in clinical samples. The results are discussed in terms of the possible implications for SASB to differentiate BPD, the use of nonclinical samples in personality disorder research, and dimensional models for conceptualizing personality disorders.

Long-term test-retest reliability of personality disorder diagnoses in opiate dependent patients.

This investigation reports the two year test-retest reliability of DSM-III-R personality disorder (PD) diagnoses in a sample of 219 patients with opiate dependence admitted to methadone treatment. Different MA/PhD interviewers at each assessment used a semistructured diagnostic interview for PD, the Structured Interview for DSM-III-R Personality Disorders (SIDP-R), to make their diagnoses. The reliability of any PD diagnosis versus no PD was fair (kappa = .51). The reliability for any specific PD (weighted kappa = .31) was poor. Antisocial (kappa = .45) and sadistic (kappa = .42), were the only specific PDs for which at least fair reliability was achieved. At the cluster level, only Cluster B had fair reliability (kappa = .47). The intraclass correlation coefficients between number of criteria for the specific PDs at the two evaluation points were consistently higher (range .22 to .62.) than were the corresponding kappas for categorical diagnoses. In that the base rates for most of the PDs were low and agreement for the specific PDs typically exceeded 90%. Increasing the base rate by lowering the diagnostic threshold, or examining more severe cases by raising the diagnostic threshold, did not consistently effect reliability. Reasons for the low kappa coefficients and the implications for PD research are discussed.

Introduction to the special feature: research directions for the personality disorders: Part I.

We are pleased to introduce the first of two special features which include papers developed from a workshop sponsored by the Mood, Anxiety, and Personality Disorders Research Branch and the Clinical Treatment Research Branch of the Division of Clinical and Treatment Research at the U.S. National Institute of Mental Health. The workshop, entitled “Research Directions for the Personality Disorders,” was held in October, 1995, on the Bethesda, Maryland campus of the U.S. National Institutes of Health.

Assessing axis II disorders by informant interview.

Although much of personality disorder research depends on diagnostic data obtained directly from patients, this approach has rarely been compared to interviews with knowledgeable informants. The purpose of this study was to determine the diagnostic agreement between these two assessment methods, as well as their relative contribution to the formulation of consensus diagnoses. Sixty-two psychiatric patients were assessed directly with the Structured Interview for DSM-III Personality Disorders (SIDP), and were asked to nominate an informant--either a family member or friend--to provide information about the patient in an interview with the same instrument. Informant interviews were conducted blind to patient-based information whenever feasible, and diagnostic consensus was achieved by an independent review of all available data by a senior clinician. Diagnostic agreement between patient-based and informant-based personality disorder interview was poor, confirming the findings of two previous studies. Information obtained from patients tended to be given greater weight in formulating consensus diagnoses than information provided by informants. However, about one quarter of diagnostic disagreements were resolved in favor of informant-based information. In contrast to a previous study, the inclusion of informant information did not appear to reveal greater psychopathology in patients. We conclude that supplementing direct patient interview with data provided by a knowledgeable informant appears to enhance the resolution of some personality disorder diagnoses. The utility of informant interviews may depend on an analysis of the costs and benefits of this additional degree of descriptive refinement.

Pharmacotherapeutical treatment of personality disorders.

Since some years it has become evident that objective disturbances can be found in patients suffering from personality disorders. Research findings from earlier date already demonstrated low levels of 5-hydroxyindoleacetic acid in the cerebrospinal fluid, especially in patients with personality disorders, under exclusion of depressive features. Furthermore, data have been collected on the correlation between a hyposerotonergic state and disturbances in aggression and impulse control in a variety of syndromes such as automutilation, bulimia nervosa, suicide attempts and various states of drug abuse. However, psychopharmacological research in personality disorders is rare and to date mainly patients with borderline and schizotypical personality disorders have been studied. It is quite remarkable for this area to find more review articles than original contributions based on the results of clinical trials. A great variety of recommendations for pharmacotherapy in these patients exists in literature, among which treatment with carbamazepine, lithium, low-dose neuroleptics, tricyclic antidepressants and serotonin uptake inhibitors. In this article we will analyze the research methodology and the results of clinical trials forming the base for pharmacotherapeutic treatment recommendations. Only the results of well-controlled studies will be reviewed.

New Research in Personality Disorders

This is an overview of the results of recent research (indexed in Medline after 1992) on the personality disorders. It is meant to alert readers to the issues, findings, and methodological limitations of investigations in this area. We grouped related themes together in order to facilitate recognition of trends and of promising avenues for future research. These themes include the relationships of personality disorders to other disorders and to society, therapies of personality disorders, and advances in biological science.

Diagnosing personality disorders. A review of issues and research methods.

Many questions face researchers conducting personality disorder research. Which measure should be used? When should patients be evaluated--at initial presentation when they are still symptomatic, or after symptom resolution? Can a patient accurately describe his or her personality, or must an informant be contacted? What do you do when personality traits change during an individual's lifetime? I discuss these and other issues of personality disorder assessment in the DSM-III/DSM-III-R era, and examine the empiric literature bearing on these questions. First, I review studies of diagnostic reliability and stability, because studies of the above questions can only be interpreted in the context of the limitations imposed by modest reliability.

Aggregation of Personality Measures: Implications for Personality Disorder Research

Personality disorders affect a high percentage of clinical and nonclinical adults. Unfortunately, methodological problems have hindered the accurate and efficient identification of adults with personality disorders. The present study utilized a new assessment procedure based on aggregation over time and across measures in order to ensure temporal stability and consistency across measures. Using the dependent personality as a prototype, subjects found to display elevated levels of dependency that were stable over 6 weeks time and across two measures were compared to subjects low in dependency. An additional group of subjects reporting unstable levels of dependency were included to represent false-positive diagnoses. Results showed that these procedures were useful for ensuring the accuracy of personality assessment, helping to control for temporary factors that may effect personality assessment. These procedures should facilitate personality disorder research conducted with clinical and nonclinical populations, and may reduce the impact of various environmental and emotional factors that can influence personality assessment.

Defining borderline patients: an overview.

This review of the descriptive literature on borderline patients indicates that accounts of such patients vary depending upon who is describing them, in what context, how the samples are selected, and what data are collected. The authors identify six features that provide a rational means for diagnosing borderline patients during an initial interview: the presence of intense affect, usually depressive or hostile; a history of impulsive behavior; a certain social adaptiveness; brief psychotic experiences; loose thinking in unstructured situations; and relationships that vacillate between transient superficiality and intense dependency. Reliable identification of these patients will permit better treatment planning and clinical research.