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Interactions Of Borderline Personality Disorder And Mood Disorders Over Ten Years, John G. Gunderson, Robert L. Stout, M. Tracie Shea, Carlos M. Grilo, John C. Markowitz, Leslie C. Morey, Charles A. Sanislow, Shirley Yen, Mary C. Zanarini, Alex S. Keuroghlian, Thomas H. Mcglashan, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Objective: To examine the relationship of borderline personality disorder (BPD) to mood disorders by using data from the Collaborative Longitudinal Personality Disorders Study on the reciprocal interactions of BPD with both depressive and bipolar disorders over the course of 10 years.

Method: The study included 223 BPD patients with DSM-IV–defined co-occurring major depressive disorder (MDD) (n = 161), bipolar I disorder (n = 34), and bipolar II disorder (n = 28) who were reliably and prospectively assessed over a period of 10 years between 1997 and 2009. Proportional hazards regression analyses were used to assess the effects of improvement or …

Convergent And Incremental Predictive Validity Of Clinician, Self-Report, And Structured Interview Diagnoses For Personality Disorders Over 5 Years, Douglas B. Samuel, Charles A. Sanislow, Christopher J. Hopwood, M. Tracie Shea, Andrew E. Skodol, Leslie C. Morey, Emily B. Ansell, John C. Markowitz, Mary C. Zanarini, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

OBJECTIVE: Research has demonstrated poor agreement between clinician-assigned personality disorder (PD) diagnoses and those generated by self-report questionnaires and semistructured diagnostic interviews. No research has compared prospectively the predictive validity of these methods. We investigated the convergence of these 3 diagnostic methods and tested their relative and incremental validity in predicting independent, multimethod assessments of psychosocial functioning performed prospectively over 5 years.

METHOD: Participants were 320 patients in the Collaborative Longitudinal Personality Disorders Study diagnosed with PDs by therapist, self-report, and semistructured interview at baseline. We examined the relative incremental validity of therapists' naturalistic ratings relative to these other diagnostic …

Individuals With Single Versus Multiple Suicide Attempts Over 10 Years Of Prospective Follow-Up, Christina L. Boisseaua, Shirley Yen, John C. Markowitz, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Mary C. Zanarini, Andrew E. Skodol, John G. Gunderson, Leslie C. Morey, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Background: The study attempted to identify characteristics that differentiate multiple suicide attempters from single attempters in individuals with personality disorders (PDs) and/or major depression.

Method: Participants were 431 participants enrolled in the Collaborative Longitudinal Study of Personality Disorders from July 1996 to June 2008. Suicide attempts were assessed with the Longitudinal Interval Follow-up Evaluation at 6 and 12months, then yearly through 10years. Logistic regression was used to compare single attempters to multiple attempters on Axis I and II psychiatric disorders and personality trait variables.

Results: Twenty-one percent of participants attempted suicide during the 10years of observation, with 39 (9.0%) reporting …

Psychometric Characteristics And Clinical Correlates Of Neo-Pi-R Fearless Dominance And Impulsive Antisociality In The Collaborative Longitudinal Personality Disorders Study, Edward A. Witt, Christopher J. Hopwood, Leslie C. Morey, John C. Markowitz, Thomas H. Mcglashan, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Andrew E. Skodol, John G. Gunderson, M. Brent Donnellan

Charles A. Sanislow, Ph.D.

This study evaluates the validity of derived measures of the psychopathic personality traits of Fearless Dominance and Impulsive Antisociality from the NEO Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992) using data from the Collaborative Longitudinal Personality Disorders Study (baseline N = 733). These 3 issues were examined: (a) the stability of the measures over a 10-year interval, (b) their criterion-related validity, and (c) their incremental validity relative to an alternative NEO-PI-R profile-rating approach for assessing psychopathy. NEO-PI-R Fearless Dominance and Impulsive Antisociality scales were relatively stable across 10 years and demonstrated differential associations with measures of personality pathology and psychopathology …

The Convergent And Discriminant Validity Of Five-Factor Traits: Current And Prospective Social, Work, And Recreational Dysfunction, Christopher J. Hopwood, Leslie C. Morey, Emily B. Ansell, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, John C. Markowitz, John G. Gunderson, Shirley Yen, M. Tracie Shea, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

The convergent and discriminant validity of Five Factor Model (FFM) personality traits with concurrent and prospective social, work, and recreational dysfunction was assessed in a large, longitudinal clinical sample. Consistent with five factor theoretical expectations, neuroticism is broadly related to dysfunction across domains; extraversion is primarily related to social and recreational dysfunction; openness to recreational dysfunction; agreeableness to social dysfunction; and conscientiousness to work dysfunction. Findings support five factor theory and the clinical assessment of normative personality traits.

Personality Traits As Prospective Predictors Of Suicide Attempts, Shirley Yen, M. Tracie Shea, Charles A. Sanislow, Andrew E. Skodol, Carlos M. Grilo, Maria O. Edelen, Robert L. Stout, Leslie C. Morey, Mary C. Zanarini, John C. Markowitz, Thomas H. Mcglashan, Maria T. Daversa, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine higher order personality factors of negative affectivity (NA) and disinhibition (DIS), as well as lower order facets of impulsivity, as prospective predictors of suicide attempts in a predominantly personality disordered sample.

METHOD: Data were analyzed from 701 participants of the Collaborative Longitudinal Personality Disorders Study with available follow-up data for up to 7 years. Cox proportional hazards regression analyses was used to examine NA and DIS, and facets of impulsivity (e.g. urgency, lack of perseverance, lack of premeditation and sensation seeking), as prospective predictors of suicide attempts.

RESULTS: NA, DIS and all facets of impulsivity except for …

Differential Impairment As An Indicator Of Sex Bias In Dsm-Iv Criteria For Four Personality Disorders., Christina D. Boggs, Leslie C. Morey, Andrew E. Skodol, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

This reprinted article originally appeared in Psychological Assessment, 2005, Vol. 17, (No. 4), 492–496. (The following abstract of the original article appeared in record 2005-16347-014.) The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive–compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and …

Ten-Year Stability And Latent Structure Of The Dsm-Iv Schizotypal, Borderline, Avoidant, And Obsessive-Compulsive Personality Disorders, Charles A. Sanislow, Todd D. Little, Carlos M. Grilo, Maria Daversa, John C. Markowitz, Anthony Pinto, M. Tracie Shea, Shirley Yen, Andrew E. Skodol, Leslie C. Morey, John G. Gunderson, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Evaluation of the validity of personality disorder (PD) diagnostic constructs is important for the impending revision of the Diagnostic and Statistical Manual of Mental Disorders. Prior factor analytic studies have tested these constructs in cross-sectional studies, and models have been replicated longitudinally, but no study has tested a constrained longitudinal model. The authors examined 4 PDs in the Collaborative Longitudinal Personality Disorders study (schizotypal, borderline, avoidant, and obsessive-compulsive) over 7 time points (baseline, 6 months, 1 year, 2 years, 4 years, 6 years, and 10 years). Data for 2-, 4-, 6- and 10-year assessments were obtained in semistructured interviews by …

Differential Impairment As An Indicator Of Sex Bias In Dsm-Iv Criteria For Four Personality Disorders, Christina D. Boggs, Leslie C. Morey, Andrew E. Skodol, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and women in the relationship between each diagnostic criterion and level of impairment. The results suggest that most of the diagnostic criteria examined do not seem …

The Collaborative Longitudinal Personality Disorders Study (Clps): Overview And Implications, Andrew E. Skodol, John G. Gunderson, M. Tracie Shea, Thomas H. Mcglashan, Leslie C. Morey, Charles A. Sanislow, Donna S. Bender, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, Maria E. Pagano, Robert L. Stout

Charles A. Sanislow, Ph.D.

The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, …

Longitudinal Comparison Of Depressive Personality Disorder And Dysthymic Disorder, John C. Markowitz, Andrew E. Skodol, Eva Petkova, Hui Xie, Jianfeng Cheng, David J. Hellerstein, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: Few studies have compared the related diagnostic constructs of depressive personality disorder (DPD) and dysthymic disorder (DD). The authors attempted to replicate findings of Klein and Shih in longitudinally followed patients with personality disorder or major depressive disorder (MDD) in the Collaborative Longitudinal Personality Disorders Study.

METHODS: Subjects (N = 665) were evaluated at baseline and over 2 years (n = 546) by reliably trained clinical interviewers using semistructured interviews and self-report personality questionnaires.

RESULTS: Only 44 subjects (24.6% of 179 DPD and 49.4% of 89 early-onset dysthymic subjects) met criteria for both disorders at baseline. Depressive personality disorder …

Stability Of Functional Impairment In Patients With Schizotypal, Borderline, Avoidant, Or Obsessive Compulsive Personality Disorder Over Two Years, Andrew E. Skodol, Maria E. Pagano, Donna S. Bender, M. Tracie Shea, John G. Gunderson, Shirley Yen, Robert L. Stout, Leslie C. Morey, Charles A. Sanislow, Carlos M. Grilo, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period.

METHOD: Six hundred treatment-seeking or treated patients were recruited primarily from clinical services in four metropolitan areas …

Recent Life Events Preceding Suicide Attempts In A Personality Disorder Sample: Findings From The Collaborative Longitudinal Personality Disorders Study, Shirley Yen, Maria E. Pagano, M. Tracie Shea, Carlos M. Grilo, John G. Gunderson, Andrew E. Skodol, Thomas H. Mcglashan, Charles A. Sanislow, Donna S. Bender, Mary C. Zanarini

Charles A. Sanislow, Ph.D.

Few studies have examined the relationship between life events, suicide attempts, and personality disorders (PDs), in spite of the strong associations between PDs and suicidal behavior, and the poor coping strategies often exhibited by these individuals. The authors examined whether participants with PDs who attempted suicide during the first 3 years of a prospective, longitudinal study were more likely to experience specific life events in the month during and preceding the suicide attempt. Of 489 participants with PDs, 61 attempted suicide during the 3-year, follow-up interval. Results indicated that negative life events, particularly those pertaining to love-marriage or crime-legal matters, …

Stressful Life Events As Predictors Of Functioning: Findings From The Collaborative Longitudinal Personality Disorders Study, Maria E. Pagano, Andrew E. Skodol, Robert L. Stout, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, Donna S. Bender, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

Objective:  Although much attention has been given to the effects of adverse childhood experiences on the development of personality disorders (PDs), we know far less about how recent life events influence the ongoing course of functioning. We examined the extent to which PD subjects differ in rates of life events and the extent to which life events impact psychosocial functioning. Method:  A total of 633 subjects were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS), a multi-site study of four personality disorders – schizotypal (STPD), borderline (BPD), avoidant (AVPD), obsessive-compulsive (OCPD) – and a comparison group of major depressive …

Two-Year Stability And Change Of Schizotypal, Borderline, Avoidant And Obsessive-Compulsive Personality Disorders, Carlos M. Grilo, M. Tracie Shea, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Robert L. Stout, Maria E. Pagano, Shirley Yen, Leslie C. Morey, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

he authors examined the stability of schizotypal (STPD), borderline (BPD), avoidant (AVPD) and obsessive-compulsive (OCPD) personality disorders (PDs) over 2 years of prospective multiwave follow-up. Six hundred thirty-three participants recruited at 4 collaborating sites who met criteria for 1 or more of the 4 PDs or for major depressive disorder (MOD) without PD were assessed with semistructured interviews at baseline, 6, 12, and 24 months. Lifetable survival analyses revealed that the PD groups had slower time to remission than the MDD group. Categorically, PD remission rates range from 50% (AVPD) to 61% (STPD) for dropping below diagnostic threshold on a …

Childhood Maltreatment Associated With Adult Personality Disorders: Findings From The Collaborative Longitudinal Personality Disorders Study, Cynthia L. Battle, M. Tracie Shea, Dawn M. Johnson, Caron Zlotnick, Mary C. Zanarini, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Carlos M. Grilo, Thomas H. Mcglashan, Leslie C. Morey

Charles A. Sanislow, Ph.D.

No abstract provided.

Clinical Features And Impairment In Women With Borderline Personality Disorder (Bpd) With Post-Traumatic Stress Disorder (Ptsd), Bpd Without Ptsd, And Other Personality Disorders With Ptsd, Caron Zlotnick, Dawn M. Johnson, Shirley Yen, Cynthia Battle, Charles A. Sanislow, Andrew E. Skodol, Carlos M. Grilo, Thomas H. Mcglashan, John G. Gunderson, Donna S. Bender, Mary C. Zanarini, M. Tracie Shea

Charles A. Sanislow, Ph.D.

The aims of this study were to examine differences in clinical features, impairment, and types of childhood traumas among women with borderline personality disorder (BPD), women with BPD and posttraumatic stress disorder (PTSD), and those with other personality disorders and PTSD. Using baseline data from the Collaborative Longitudinal Study of Personality Disorders, 186 women were divided into 3 groups (BPD+PTSD, BPD, PTSD), based on structured diagnostic interviews for Axis I and Axis II disorders and compared on selected clinical variables. The additional diagnosis of PTSD in borderline women did not significantly increase the degree of borderline pathology and psychiatric morbidity …

Gender Differences In Borderline Personality Disorder: Findings From The Collaborative Longitudinal Personality Disorders Study, Dawn M. Johnson, M. Tracie Shea, Shirley Yen, Cynthia L. Battle, Caron Zlotnick, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, Donna S. Bender, Thomas H. Mcglashan, John G. Gunderson, Mary C. Zanarini

Charles A. Sanislow, Ph.D.

A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passive-aggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences …

Representations Of Therapists By Patients With Personality Disorders, Donna S. Bender, Barry A. Farber, Charles A. Sanislow, Ingrid R. Dyck, Jesse D. Geller, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

The purpose of this study was to investigate attributes of mental representations of therapists by patients with specific personality disorders (PDs), schizotypal (STPD), borderline (BPD), avoidant (AVPD), and obsessive-compulsive (OCPD), and a comparison group with Major Depressive Disorder and no PD (MDD). The Therapist Representation Inventory-II (TRI) measured characteristics of participants' extra-session thoughts about their therapists. Results showed that patients with STPD had the highest level of mental involvement with therapy outside the session, missing their therapists and wishing for friendship, while also feeling aggressive or negative. Patients with BPD exhibited the most difficulty in creating a benign image of …

Functional Impairment In Patients With Schizotypal, Borderline, Avoidant, And Obsessive-Compulsive Personality Disorder, Andrew E. Skodol, John G. Gunderson, Thomas H. Mcglashan, Ingrid R. Dyck, Robert L. Stout, Donna S. Bender, Carlos M. Grilo, M. Tracie Shea, Mary C. Zanarini, Leslie C. Morey, Charles A. Sanislow, John M. Oldham

Charles A. Sanislow, Ph.D.

Objective: The purpose of this study was to compare psychosocial functioning in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder and patients with major depressive disorder and no personality disorder.

Method: Patients (N=668) were recruited by the four clinical sites of the Collaborative Longitudinal Personality Disorders Study. The carefully diagnosed study groups were compared on an array of domains of psychosocial functioning, as measured by the Longitudinal Interval Follow-Up Evaluation—Baseline Version and the Social Adjustment Scale.

Results: Patients with schizotypal personality disorder and borderline personality disorder were found to have significantly more impairment at work, in social relationships, and …

Treatment Utilization By Patients With Personality Disorders, Donna S. Bender, Regina T. Dolan, Andrew E. Skodol, Charles A. Sanislow, Ingrid R. Dyck, Thomas H. Mcglashan, M. Tracie Shea, Mary C. Zanarini, John M. Oldham, John G. Gunderson

Charles A. Sanislow, Ph.D.

Objective: Utilization of mental health treatment was compared in patients with personality disorders and patients with major depressive disorder without personality disorder.

Method: Semistructured interviews were used to assess diagnosis and treatment history of 664 patients in four representative personality disorder groups—schizotypal, borderline, avoidant, and obsessive-compulsive—and in a comparison group of patients with major depressive disorder.

Results: Patients with personality disorders had more extensive histories of psychiatric outpatient, inpatient, and psychopharmacologic treatment than patients with major depressive disorder. Compared to the depression group, patients with borderline personality disorder were significantly more likely to have received every type of psychosocial treatment …