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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, …

Dimensional Representations Of Dsm-Iv Personality Disorders: Relationships To Functional Impairment, Andrew E. Skodol, John M. Oldham, Donna S. Bender, Ingrid R. Dyck, Robert L. Stout, Leslie C. Morey, M. Tracie Shea, Mary C. Zanarini, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: This study compared three-dimensional representations of DSM-IV personality disorders and standard categories with respect to their associations with psychosocial functioning.

METHOD: Six hundred sixty-eight patients with semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders or with major depressive disorder and no personality disorder completed questionnaires assessing three-factor and five-factor dimensional models of personality. Personality disorder categories, dimensional representations of the categories based on criteria counts, and three- and five-factor personality dimensions were compared on their relationships to impairment in seven domains of functioning, as measured by the Longitudinal Interval Follow-up Evaluation-Baseline Version.

RESULTS: Both the categorical …

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 …

Two-Year Prevalence And Stability Of Individual Dsm-Iv Criteria For Schizotypal, Borderline, Avoidant, And Obsessive-Compulsive Personality Disorders: Toward A Hybrid Model Of Axis Ii Disorders, Thomas H. Mcglashan, Carlos M. Grilo, Charles A. Sanislow, Elizabeth Ralevski, Leslie C. Morey, John G. Gunderson, Andrew E. Skodol, M. Tracie Shea, Mary C. Zanarini, Donna S. Bender, Robert L. Stout, Shirley Yen, Maria E. Pagano

Charles A. Sanislow, Ph.D.

OBJECTIVE: This study tracked the individual criteria of four DSM-IV personality disorders-borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders-and how they change over 2 years.

METHOD: This clinical sample of patients with personality disorders was derived from the Collaborative Longitudinal Personality Disorders Study and included all participants with borderline, schizotypal, avoidant, or obsessive-compulsive personality disorder for whom complete 24-month blind follow-up assessments were obtained (N=474). The authors identified and rank-ordered criteria for each of the four personality disorders by their variation in prevalence and changeability (remission) over time.

RESULTS: The most prevalent and least changeable criteria over 2 years were paranoid …

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 …

Two-Year Prospective Naturalistic Study Of Remission From Major Depressive Disorder As A Function Of Personality Disorder Comorbidity, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Andrew E. Skodol, Robert L. Stout, John G. Gunderson, Shirley Yen, Donna S. Bender, Maria E. Pagano, Mary C. Zanarini, Leslie C. Morey, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

In this study, the authors examined prospectively the 24-month natural course of remission from major depressive disorder (MDD) as a function of personality disorder (PD) comorbidity. In 302 participants (196 women, 106 men), psychiatric and PDs were assessed at baseline with diagnostic interviews, and the course of MDD was assessed with the Longitudinal Interval Follow-Up Evaluation at 6-, 12-, and 24-month follow-ups. Survival analyses revealed an overall 24-month remission rate of 73.5% for MDD that differed little by gender. Participants with MDD who had certain forms of coexisting PD psychopathology (schizotypal, borderline, or avoidant) as their primary PD diagnoses had …

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, …