Self-reported Personality Disorder Research Articles

Self-Reported ICD-11 Personality Disorder Severity in Peruvian Adolescents: Structure, Validity, and Tentative Cutoffs.

Personality disorder (PD) is particularly common in adolescents, which underscores the significance of early screening, diagnosis, and intervention. To date, the definition of PD in the new ICD-11 has not yet been investigated in adolescents. This study therefore aimed to investigate the unidimensionality and criterion validity of self-reported ICD-11 PD features in Peruvian adolescents using the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale. A total of 1,073 students (63% female; age range 12-16 years) were administered the PDS-ICD-11 scale along with criterion measures of personality pathology and symptom distress. The PDS-ICD-11 score showed adequate unidimensionality and conceptually meaningful associations with external criterion variables. The findings indicate that ICD-11 PD features, as measured with the PDS-ICD-11 scale, are structurally and conceptually sound when employed with adolescents. Norm-based cutoffs derived from the present study may be used for clinical interpretation. The PDS-ICD-11 may be employed as an efficient screening tool for personality dysfunction in adolescents.

Childhood maltreatment and personality disorders in adolescents and adults with psychotic or non-psychotic disorders.

While the attention to personality disorders (PD) and childhood maltreatment (CM) has grown in recent years, there remains limited understanding of the prevalence and distinctions of PD and CM in clinical populations of Chinese adolescents in comparison to adults. A total of 1,417 participants were consecutively sampled from patients diagnosed with either psychotic or non-psychotic disorders in the psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. The participants were categorized into two groups based on their age: adolescents (aged 15-21 years) and adults (aged 22-35 years). PDs were evaluated using a self-reported personality diagnostic questionnaire and a structured clinical interview, while CMs were assessed using the Chinese version of the Child Trauma Questionnaire Short Form. When comparing self-reported PD traits and CM between adolescents and adults, differences emerge. Adolescents, particularly in the psychotic disorder group, exhibit more pronounced schizotypal PD traits (p=0.029), and this pattern extends to non-psychotic disorders (p<0.001). Adolescents in the non-psychotic disorder group also report higher levels of emotional abuse (p=0.014), with a notable trend in physical abuse experiences compared to adults (p=0.057). Furthermore, the most prevalent PDs in the clinical sample are avoidant, borderline, and obsessive-compulsive PDs. Among patients with psychotic disorders, adolescents exhibit higher rates of schizoid, schizotypal, and obsessive-compulsive PDs compared to adults. Logistic regression analyses highlight distinct predictors for psychotic and non-psychotic disorders in adolescents and adults. The findings emphasize distinct differences in PDs and CMs between adolescent and adult groups, shedding light on their potential roles in psychotic and non-psychotic disorders.

Self-report versus clinical ratings using the SWAP-200 in the assessment of personality disorders

The relationship between self- and informant reports of personality using psychometric instruments is constantly the focus of attention for researchers in the field of clinical assessment in psychology. The research shows weak agreement between clinicians and patients’ assessments of personality disorders (PDs). The current study aimed at the convergence of measurement of PDs using the Shedler-Westen Assessment Procedure (SWAP-200), the self-report Character Styles Questionnaire-R (CSQ-R) and Borderline Personality Inventory (BPI). Paper-pencil questionnaires were administered to 102 inpatients (88.2% female, aged 18-64, M = 38.4) in a voivodeship hospital and outpatient health care centre. The SWAP-200 allowed us to gather expert (clinician) personality ratings basing on the intensive contact with patients. Results show that only a few SWAP-200 PD scales showed low positive correlations with corresponding self-reported PD scales from the CSQ-R. With the canonical correlation analysis, we identified two functions (borderline and internalising) that described similarities between the SWAP-200 and CSQ-R. SWAP-200 Obsessive-Compulsive PD correlated negatively with BPI scales. Consistent with previous studies, the self-report and the clinical assessment were only marginally convergent. Furthermore, OCPD stands out from other disorders in that it correlates positively with health indicators and negatively with some of the other personality disorders. The highest agreement was observed in the description of Borderline PD.

Sex differences in personality disorders in a Chinese clinical population.

IntroductionSex differences in the frequency and severity of personality disorders (PDs) have been widely reported in Western countries. However, limited literature suggests a similar sex distribution in the Chinese clinical population. This study investigated sex differences in self-reported and interviewed patients with PDs in a clinical population in China.Materials and methodsThe participants were 1,389 consecutive outpatients with a mean age of 30.5 years, including 634 (45.6%) males and 755 (54.4%) females. Self-reported PD traits were assessed using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+). PDs were diagnosed according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis II (SCID-II).ResultsMale outpatients reported more paranoid, schizotypal, antisocial, and passive-aggressive PD traits, whereas females reported more borderline PD traits on the PDQ-4+. Self-reported PD traits in male outpatients were more likely to reach the positive threshold of antisocial PD than in females (χ2 = 5.293, p = 0.021). Males were more likely to meet the criteria for schizoid (χ2 = 5.050, p = 0.025), narcissistic (χ2 = 27.244, p < 0.001), antisocial (χ2 = 11.430, p = 0.001), avoidant (χ2 = 5.098, p = 0.024), and obsessive-compulsive PD (χ2 = 5.496, p = 0.019) diagnoses in the SCID-II. In contrast, females were more likely to meet the criteria of histrionic (χ2 = 12.327, p = 0.001), borderline (χ2 = 28.538, p < 0.001), and dependent (χ2 = 4.919, p = 0.027) diagnoses.DiscussionThese findings indicate gender differences in the traits, frequency, and pattern of PDs when assessed in a Chinese clinical population.

Comparing the Self-Reported Personality Disorder Traits and Childhood Traumatic Experiences Between Patients With Schizophrenia Vs. Major Depressive Disorder.

Introduction: Personality disorder (PD) and childhood traumatic experience (CTE) are well- recognized risk factors for the development of schizophrenia (SZ) and major depressive disorder (MDD). The relationship between CTE and PD is extremely close, and both conditions can affect subsequent psychiatric disorders. Little is known about the differences of these factors in patients with SZ and those with MDD.Materials and Methods: A total of 1,026 outpatients participated in the study, including 533 (51.9%) with SZ and 493 (48.1%) with MDD who were sequentially sampled. The PD traits were assessed using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+). The Child Trauma Questionnaire Short Form (CTQ-SF) was used to assess childhood adversities. The scores and associations of PDQ-4+ and CTQ-SF between patients with SZ and those with MDD were compared.Results: The MDD group exhibited more PD traits and more childhood emotional neglect than the SZ group. In patients with MDD, the correlation between PD traits and CTE was significantly higher than that in patients with SZ. Patients with SZ vs. those with MDD showed different PD traits and CTE. The schizotypal and antisocial PD traits, as well as sexual abuse and physical neglect CTE, were significantly related to SZ. In contrast, the borderline, narcissistic and avoidant PD traits, and emotional abuse/neglect CTE were significantly associated with MDD.Discussion: These findings indicated a robust relationship between CTE and PD traits. Moreover, patients with SZ or MDD, have different interactive patterns. Both CTE and PD traits have the potential to be premorbid risk factors that could be targeted for preventative interventions.

Comparing English-Language and Chinese-Language Assessment of DSM-5 Personality Disorders and Interpersonal Problems in Chinese Bilingual Speakers

A review of the literature on Chinese translations of Western self-report personality disorder assessment measures indicates the need to empirically evaluate the validity of assessing Western personality disorder constructs in Chinese language and culture. The current study presents a novel approach to examining this critical question in cross-cultural clinical assessment science and practice. One hundred and ninety-nine (199) Mandarin Chinese and English bilingual participants (92 males and 107 females) provided both English and Chinese self-report ratings on the Inventory of Interpersonal Problems – Short Circumplex (IIP-SC) and The Personality Diagnostic Questionnaire − 4+ (PDQ-4+). The similarities and differences in associations between Diagnostic and Statistical Manual of Mental Disorders—5th edition (DSM-5) personality disorders and interpersonal problems assessed across languages were examined. The structural summary method (SSM) for circumplex data and a bootstrapping methodology were used to compute confidence intervals around SSM parameters to analyze and compare the interpersonal problems profiles for each personality disorder scale (e.g. narcissistic) derived from English-language and Chinese-language data. The current study found highly similar interpersonal profiles for personality disorder scales assessed in English and Chinese, suggesting Western DSM-5 personality disorder constructs generally emphasize the same interpersonal problems in Chinese language and culture. The method employed in this study also has implications for understanding whether translated measures capture the same personality constructs.

Differentiating borderline and antisocial personality disorders in forensic settings

ABSTRACT The current study examined the differentiation of borderline (BPD) and antisocial personality disorders (ASPD) in forensic settings, with particular emphasis on the utility of the MMPI-2-RF in differential diagnosis. This study examined these constructs across correctional and forensic psychiatric samples from the U.S. and the Netherlands using varying assessment/diagnosis modalities, including self-report, structured interview, and clinician-derived personality disorder (PD) diagnosis from both DSM-5 Section II and Section III perspectives. Our findings showed that internalizing psychopathology – and to a lesser extent interpersonal and thought dysfunction – differentiated BPD from ASPD; however, inconsistencies existed across samples. Higher levels of externalizing psychopathology were not found to differentiate ASPD across any of the samples or PD conceptualizations used in the current study. This suggests that diagnostic clarity may be particularly difficult in forensic settings and supports previous work that has shown problematic diagnostic overlap and a lack of differentiation between PD constructs. Nonetheless, as our current diagnostic system continues to rely on categorical determination of PDs, the current study suggests the MMPI-2-RF may enhance diagnostic differentiation.

Associations between MMPI-2-RF Scale Scores and Self-Reported Personality Disorder Criteria in a Private Practice Sample

The current study examined the associations between MMPI-2-RF scales and self-reported DSM-5 Section II personality disorder (PD) criteria in a large (n = 640) outpatient independent practice sample. We utilised correlation and regression analyses to evaluate the predictive utility of MMPI-2-RF scale scores in predicting latent PD scores. Results generally conformed to theoretical expectations and supported the MMPI-2-RF as a successful assessment tool of Section II PDs. Specifically, the majority of hypotheses between individual MMPI-2-RF scales and PD symptom scores were supported at the zero-order level, and regression analysis revealed unique predictors for each PD that were largely consistent with theoretical expectations. Further, these results provide additional evidence that DSM-5 Section II PDs can be represented in a dimensional framework using the MMPI-2-RF, which is pertinent when applying the current results within a broader context of evolving theoretical understanding of the composition and assessment of PDs, particularly with regard to the DSM-5 Section III personality model.

Effects of Personality Disorders on Self-Other Agreement and Favorableness in Personality Descriptions.

The authors studied effects of self-reported personality disorder (PD) symptoms on interpersonal perception, particularly self-other agreement and favorableness. Using a round-robin design, 52 groups of four well-acquainted students described themselves and each other on a measure of the Five-Factor model of personality and were administered a self-report screening instrument for DSM-IV (Axis 2). Using the Social Accuracy Model, the peer reports were predicted, across items, from either (a) the target person's self-reports plus the self-report item means, or (b) the items' social desirability. This resulted in separate coefficients for each peer-target dyad, indicating either self-other agreement or favorableness. These coefficients were then predicted from the PD scores of the target and the peer, using multilevel modeling. Main findings were that persons scoring high on PD measures agreed less with their peers on their unique personality characteristics, and that such persons were described by, and described their peers, less favorably.

Aging: Empirical Contribution: A Longitudinal Analysis of Personality Disorder Dimensions and Personality Traits in a Community Sample of Older Adults: Perspectives From Selves and Informants

Research has indicated that personality disorders (PDs) and normal-range personality traits generally "get better" with time, as evidenced by mean-level decreases in PD traits and mean-level increases in broad factors such as emotional stability, agreeableness, and conscientiousness. One limitation of many of these studies is their reliance on self reported data. In the current study, the authors analyzed the 2.5-year course of PD dimensions and normal personality traits in a representative sample of adults approaching later life (originally ages 55-65) by using a semistructured diagnostic interview as well as self- and informant-reported data from two personality inventories. Consistent with previous literature, many self-reported PD traits showed mean-level decreases over time, and self-reported normal-range personality traits generally showed positive aging effects (e.g., mean-level increases in emotional stability, agreeableness, and conscientiousness). Surprisingly, however, informant-reported PD traits often demonstrated small but significant increases over time, and informant-reported normal-range personality generally "worsened" with age (e.g., mean-level decreases in extraversion, agreeableness, and conscientiousness). Informant reports may challenge the finding that personality and PDs tend to "improve" over time.

Cluster A personality pathology in social anxiety disorder: A comparison with panic disorder

Background: Social anxiety disorder (SAD) has been associated with cluster A personality disorder (PD) traits, mainly paranoid and schizoid traits. Aim: The aim of the study was to further investigate cluster A personality pathology in patients with SAD. Methods: Self-reported PD traits were investigated in a clinical sample of 161 participants with SAD and in a clinical comparison group of 145 participants with panic disorder with or without agoraphobia (PAD). Results: A diagnosis of SAD was associated with more paranoid and schizotypal PD traits, and an association between depression and personality pathology could indicate a state-effect of depression on PD traits. Conclusions: Patients with SAD had more cluster A personality pathology than patients with PAD, with the most solid indication for paranoid personality pathology.

Thin slice ratings of client characteristics in intake assessments: Predicting symptom change and dropout in cognitive therapy for depression

Thin slice ratings of personality have been shown to predict a number of outcomes, but have yet to be examined in the context of psychotherapy. In a sample of 66 clients participating in cognitive therapy for depression, we examined the predictive utility of thin slice rated pre-treatment client traits. On the basis of short video clip excerpts (i.e., thin slices) of intake assessments, trained observers rated clients on personality characteristics and specific personality disorder (PD) traits. Clients' therapy interest and neuroticism predicted lower odds of dropout. Ratings of extraversion predicted greater symptom change across treatment; ratings of clients' Avoidant and Schizoid PD traits predicted less marked symptom improvement. Ratings of agreeableness and likeability also predicted greater symptom change, but these relations were only significant in one of two analytic approaches used. Evidence for the predictive validity of thin slice ratings was generally stronger than that observed for self-reported PD traits and PD status. Moreover, these self-report and diagnostic assessments failed to account for the thin slice-outcome relations identified. Findings support the clinical utility of quick, thin slice impressions of clients, as these ratings could be used to identify clients with a high risk of dropout or poor treatment outcome.

A Community Service for High-Risk Mentally Disordered Sex Offenders

There is sparse literature on mentally disordered sex offenders, and little is published on treatment participation and outcomes for this group. This article aims to describe the characteristics of a cohort of high-risk mentally disordered-largely personality disordered-sex offenders at risk in the community in southeast London. Drawing on various measures of personality dysfunction-including key developmental variables, a self-report personality disorder questionnaire Millon Clinical Multi-axial Inventory-III (MCMI-III) and psychopathy as measured by the Psychopathy Checklist: Screening Version (PCL:SV)-the researchers describe the characteristics of a cohort of mentally disordered sex offenders referred to the Challenge project. Follow-up data for those placed in treatment are reported and include consideration of treatment completion and reconviction: the relationship between personality dysfunction and a dynamic measure of risk are also explored. Of the 137 participants, 53% were placed in the community treatment project. Seventy five percent completed treatment, and were followed up for an average of 40 months. Eleven percent were sexually reconvicted, 3% violently reconvicted. Community failure was best predicted by a combination of static risk and personality-related variables.

Diagnostic efficiency among psychiatric outpatients of a self-report version of a subset of screen items of the Structured Clinical Interview for DSM–IV–TR Personality Disorders (SCID-II).

This article describes the identification of a 10-item set of the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) items, which proved to be effective as a self-report assessment instrument in screening personality disorders. The item selection was based on the retrospective analyses of 495 SCID-II interviews. The psychometric properties were studied in a prospective validation study in a random sample of Dutch adult psychiatric outpatients, using the SCID-II interview as the gold standard. First, all patients completed the short questionnaire. One week later, they were interviewed with the full SCID-II. After another week, the short questionnaire was readministered. According to the scores obtained with the full SCID-II, 97 patients (50%) had a personality disorder. The set of 10 SCID-II items correctly classified 78% of all participants. The sensitivity, specificity, and positive and negative power were 0.78, 0.78, 0.78, and 0.78, respectively. The results based on the retrospectively obtained data were rather similar to those obtained in the prospective validation study. Therefore, it is concluded that the set of 10 SCID-II items can be useful as a quick self-report personality disorder screen in a population of psychiatric outpatients.

The Age Distribution of Self-Reported Personality Disorder Traits in a Household Population

Stability over time is an essential criterion for the diagnosis of a personality disorder (PD) according to DSM-IV and ICD-10. However, both longitudinal and cross-sectional studies have demonstrated considerable changes of personality disorder traits during life-span, an observation which challenges this assumption. We measured self-reported DSM-IV personality disorder traits in a nationally representative community sample using a cross-sectional design. We investigated the association of dimensional PD scores with age. Our analyses confirmed a decreasing prevalence of personality disorder mean scores across age groups in the population, particularly Cluster B, with an increase in self-reported schizoid and obsessive-compulsive scores. Furthermore, specific interactions of demographic characteristics and age were identified. Analyses of transition points in the distribution of personality disorders across different age groups did not demonstrate increasing stability after age 30 as previously observed for normal personality traits. Significant changes occurred primarily after the third decade.

Regional Analysis of Self‐Reported Personality Disorder Criteria

Building on the theoretical work of Louis Guttman, we propose that the core problem facing research into the multidimensional structure of the personality disorders is not the identification of factorial simple structure but rather detailed characterization of the multivariate configuration of the diagnostic criteria. Dimensions rotated to orthogonal or oblique simple structure are but one way out of many to characterize a multivariate map, and their current near universal application represents a choice for a very particular set of interpretive advantages and disadvantages. We use multidimensional scaling and regional interpretation to investigate the structure of 78 self-reported personality disorder criteria from a large sample of military recruits and college students. Results suggest that the criteria have a three-dimensional radex structure that conforms only loosely to the 10 existing personality disorder (PD) categories. Regional interpretation in three dimensions elucidates several important aspects of PDs and their interrelationships.

Frequency and structure of DSM-IV personality disorder traits in college students

A sample of French female college students ( N = 201) completed the self-report Personality Disorder Questionnaire for DSM-IV (PDQ-4+; Hyler, 1994). Forty-two participants (21%) had a PDQ total score equal or greater to 30 suggesting a personality disturbance. The DSM-IV three-cluster classification of PDs was tested using confirmatory factor analysis and failed to produce an acceptable fit. An exploratory factorial analysis extracted a four-factor solution possessing both satisfactory fit and meaningful interpretations. This model was compared with the two other studies which have tested the three-cluster model and found that PDs grouped themselves into components differing from DSM-IV clusters. It may be unlikely to find an universal structure for DSM-IV PDs generalizable to all clinical and non-clinical populations.

Relationships between the personality beliefs questionnaire and self‐rated personality disorders

To examine relationships between specific dysfunctional beliefs and self-reported personality disorder types. Cross-sectional. One hundred and sixty-four clinical psychology out-patients completed the Personality Beliefs Questionnaire (PBQ) and Millon Multiaxial Clinical Inventory-III (MCMI-III): 155 completed both. Avoidant, dependent, passive-aggressive and schizoid PDs, and relevant PBQ subscales were studied. Presence or absence of PD was predicted by scores on the index PBQ subscale. This pattern has previously been reported for PDs diagnosed by structured interview only. PBQ relationships with passive-aggressive and schizoid PD have not previously been reported.

Young adults in psychoanalytic psychotherapy: Patient characteristics and therapy outcome

The aims of this naturalistic study are to present patient characteristics and analyse various outcome measures at termination for psychoanalytic psychotherapies with young adults. Patients (n = 134) between 18 and 25 years were included, of whom 92 received individual and 42 group therapy. One third had a self-reported personality disorder. The patients were considerably more troubled than Swedish norm groups at intake and they showed improvement on all outcome measures during therapy. However, the post therapy means did not fully reach the norm group means. The largest positive changes (pre- versus post-therapy) were with respect to the patients' overall health and functioning. Changes were more moderate in self-reported symptoms, self-concept, and self-representation, while changes in interpersonal problems and object representations were small. The results of this study are discussed in the context of advantages and disadvantages of naturalistic versus randomized controlled study designs.

Self-Reported Personality Disorder in the Children in the Community Sample: Convergent and Prospective Validity in Late Adolescence and Adulthood

Approximately 800 youths from the Children in the Community Study (Cohen & Cohen, 1996) have been assessed prospectively for over 20 years to study personality disorders (PDs) in adolescents and young adults. In this article we evaluate the Children in the Community Self-Report (CIC-SR) Scales, which were designed to assess DSM-IV PDs using self-reported prospective data from this longitudinal sample. To evaluate convergent validity, we assessed concordance between the CIC-SR Scales and the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1995) in 644 participants at mean age 33. To assess predictive validity, we used CIC-SR Scales at mean age 22 to predict subsequent CIC-SR and SCID-II Personality Questionnaire scores at mean age 33. In these analyses the CIC-SR Scales matched or exceeded benchmarks established in previous comparisons between self-report instruments and structured clinical interviews. Unlike other self-report scales, the CIC-SR did not appear to overestimate diagnoses when compared with SCID-II clinical diagnoses.