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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 …

Major Depressive Disorder And Borderline Personality Disorder Revisited: Longitudinal Interactions, John G. Gunderson, Leslie C. Morey, Robert L. Stout, Andrew E. Skodol, M. Tracie Shea, Thomas H. Mcglashan, Mary C. Zanarini, Carlos M. Grilo, Charles A. Sanislow, Shirley Yen, Maria T. Daversa, Donna S. Bender

Charles A. Sanislow, Ph.D.

BACKGROUND: This report investigates the longitudinal association of changes in major depressive disorder (MDD) and borderline personality disorder.

METHOD: A DSM-IV-diagnosed sample of 161 patients with borderline personality disorder who have been followed with repeated measures at 6, 12, 24, and 36 months are investigated to see whether those with co-occurring MDD differ at baseline and in their course. Proportional hazard regression and cross-lagged panel analyses are used to demonstrate whether changes in the course of either disorder have predictable effects on the course of the other.

RESULTS: The rate of remissions of borderline personality disorder was not affected by …

Longitudinal Diagnostic Efficiency Of Dsm-Iv Criteria For Obsessive–Compulsive Personality Disorder: A 2-Year Prospective Study, Carlos M. Grilo, Andrew E. Skodol, John G. Gunderson, Charles A. Sanislow, Robert L. Stout, M. Tracie Shea, Leslie C. Morey, Mary C. Zanarini, Donna S. Bender, Shirley Yen, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for obsessive–compulsive personality disorder (OCPD).

Method: At baseline, criteria and diagnoses were determined using diagnostic interviews, and blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, using the independent OCPD diagnosis at follow-up as the standard.

Results: Longitudinal diagnostic efficiencies for the OCPD criteria varied; findings suggested the overall predictive utility of preoccupied with details, rigid and stubborn, and reluctant to delegate.

Conclusion: These findings suggest the predictive validity of …

Testing An Apa Practice Guideline: Symptom-Targeted Medication Utilization For Patients With Borderline Personality Disorder, John M. Oldham, Donna S. Bender, Andrew E. Skodol, Ingrid R. Dyck, Charles A. Sanislow, Shirley Yen, Carlos M. Grilo, M. Tracie Shea, Mary C. Zanarini, John G. Gunderson, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: The goal of this study was to test whether the use of psychotropic medication treatment for borderline personality disorder (BPD) was consistent with proposals in the recently published American Psychiatric Association's Practice Guideline for the Treatment of Patients with Borderline Personality Disorder.

METHOD: Medication utilization by patients with BPD was assessed prospectively over a 2-year period prior to the publication of the Guideline. Three BPD symptom clusters--cognitive-perceptual, affective dysregulation, and impulsive-behavioral dyscontrol--along with demographic and functioning variables were used to predict the use of five classes of medication.

RESULTS: Symptoms of impulsive-behavioral dyscontrol significantly predicted use of both neuroleptics …

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 …

Plausibility And Possible Determinants Of Sudden 'Remissions' In Borderline Patients, John G. Gunderson, Donna S. Bender, Charles A. Sanislow, Shirley Yen, Jennifer Bame Rettew, Regina Dolan-Sewell, Ingrid R. Dyck, Leslie C. Morey, Thomas H. Mcglashan, M. Tracie Shea, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

THIS STUDY documents dramatic improvements in patients with borderline personality disorder (BPD) and explores their possible determinants. From a sample of the 160 carefully diagnosed borderline patients on whom prospective follow-along data was collected, a subsample of 18 was identified whose DSM-IV criteria count fell to two or fewer during the course of the first 6 months of the study and retained that improvement for the next 6 months. Follow-along data including month-by-month ratings of BPD criteria; week-by-week ratings of Axis I disorders, medication changes, and life events were then used to establish concensus ratings on four hypothesized causes: Axis …

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 …