Psychiatry and Psychology Commons^™

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 …

Dsm‐5 And Icd‐11 Definitions Of Posttraumatic Stress Disorder: Investigating “Narrow” And “Broad” Approaches, Dan J. Stein, Katie A. Mclaughlin, Karestan C. Koenen, Lukoye Atwoli, Matthew J. Friedman, Eric D. Hill, Andreas Maercker, Maria Petukhova, Victoria Shahly, Mark Van Ommeren

Internal Medicine, East Africa

Background: The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10.

Methods: WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSM-IV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview …

Avoidant Personality Disorder, Traits, And Type, Charles A. Sanislow, Katelin Da Cruz, May O. Gianoli, Elizabeth M. Reagan

Charles A. Sanislow, Ph.D.

In this chapter, the evolution of the avoidant personality disorder (AVPD) diagnosis, its current status, and future possibilities are reviewed. AVPD is a chronic and enduring condition involving a poor sense of self and anxiety in social situations, and it is marked by fears of rejection and a distant interpersonal stance. AVPD may be conceptualized at the severe end of a continuum of social anxiety. In the extreme, traits, mechanisms, and symptoms become integral to chronic dysfunction in personality and interpersonal style. While AVPD is a valid diagnostic construct, the optimal organization of AVPD criteria for the diagnosis, and the …

Long Term Predictive Validity Of Diagnostic Models For Personality Disorder: Integrating Trait And Disorder Concepts, Leslie C. Morey, Christopher J. Hopwood, John C. Markowitz, John G. Gunderson, Carlos M. Grilo, Thomas H. Mcglashan, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Background. Several conceptual models have been considered for the assessment of personality pathology in DSM-5. This study sought to extend our previous findings to compare the long-term predictive validity of three such models: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP), and DSM-IV personality disorders (PDs).

Method. An inception cohort from the Collaborative Longitudinal Personality Disorder Study (CLPS) was followed for 10 years. Baseline data were used to predict long-term outcomes, including functioning, Axis I psychopathology, and medication use.

Results. Each model was significantly valid, predicting a host of important clinical outcomes. Lower-order elements of the …

Interpersonal Pathoplasticity In The Course Of Major Depression, Nicole M. Cain, Emily B. Ansell, Aidan G. C. Wright, Christopher J. Hopwood, Katherine M. Thomas, Anthony Pinto, John C. Markowitz, Charles A. Sanislow, Mary C. Zanarini, M. Tracie Shea, Leslie C. Morey, Thomas H. Mcglashan, Andrew E. Skodol, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Objective: The identification of reliable predictors of course in major depressive disorder (MDD) has been difficult. Evidence suggests that the co-occurrence of personality pathology is associated with longer time to MDD remission. Interpersonal pathoplasticity, the mutually influencing nonetiological relationship between psychopathology and interpersonal traits, offers an avenue for examining specific personality vulnerabilities that may be associated with depressive course. Method: This study examined 312 participants with and without a cooccurring personality disorder diagnosis who met criteria for a current MDD episode at baseline and who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study. Results: Latent profile …

Comparing The Temporal Stability Of Self-Report And Interview Assessed Personality Disorder, Douglas B. Samuel, Christopher J. Hopwood, Emily B. Ansell, Leslie C. Morey, Charles A. Sanislow, John C. Markowitz, Shirley Yen, M. Tracie Shea, Andrew E. Skodol, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Findings from several large-scale, longitudinal studies over the last decade have challenged the long-held assumption that personality disorders (PDs) are stable and enduring. However, the findings, including those from the Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000), rely primarily on results from semistructured interviews. As a result, less is known about the stability of PD scores from self-report questionnaires, which differ from interviews in important ways (e.g., source of the ratings, item development, and instrument length) that might increase temporal stability. The current study directly compared the stability of the Diagnostic and Statistical Manual of Mental Disorders …

The Association Of Personality Disorders With The Prospective 7-Year Course Of Anxiety Disorders, Emily B. Ansell, Anthony Pinto, Maria O. Edelen, John C. Markowitz, Charles A. Sanislow, Shirley Yen, Mary C. Zanarini, Andrew E. Skodol, M. Tracie Shea, Leslie C. Morey, John G. Gunderson, Thomas H. Mcglashan, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Background. This study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs.

Method. Participants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive …

Personality Assessment In Dsm--5: Empirical Support For Rating Severity, Style, And Traits, Christopher J. Hopwood, Johanna C. Malone, Emily B. Ansell, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Anthony Pinto, John C. Markowitz, M. Tracie Shea, Andrew E. Skodol, John G. Gunderson, Mary C. Zanarini, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Despite a general consensus that dimensional models are superior to the categorical representations of personality disorders in DSM-IV, proposals for how to depict personality pathology dimensions vary substantially. One important question involves how to separate clinical severity from the style of expression through which personality pathology manifests. This study empirically distinguished stylistic elements of personality pathology symptoms from the overall severity of personality disorder in a large, longitudinally assessed clinical sample (N = 605). Data suggest that generalized severity is the most important single predictor of current and prospective dysfunction, but that stylistic elements also indicate specific areas of difficulty. …

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 …

State Effects Of Major Depression On The Assessment Of Personality And Personality Disorder, Leslie C. Morey, M. Tracie Shea, John C. Markowitz, Robert L. Stout, Christopher J. Hopwood, John G. Gunderson, Carlos M. Grilo, Thomas H. Mcglashan, Shirley Yen, Charles A. Sanislow, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

OBJECTIVE: The authors sought to determine whether personality disorders diagnosed during a depressive episode have long-term outcomes more typical of those of other patients with personality disorders or those of patients with noncomorbid major depression.

METHOD: The authors used 6-year outcome data collected from the multisite Collaborative Longitudinal Personality Disorders Study (CLPS). Diagnoses and personality measures gathered from the study cohort at the index assessment using interview and self-report methods were associated with symptomatic, functional, and personality measures at 6-year follow-up. Of 668 patients initially recruited to the CLPS, 522 were followed for 6 years. All participants had either a …

Trajectories Of Ptsd And Substance Use Disorders In A Longitudinal Study Of Personality Disorders, Meghan E. Mcdevitt-Murphy, Gilbert R. Parra, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, John G. Gunderson, Andrew E. Skodol, John C. Markowitz

Charles A. Sanislow, Ph.D.

The Stability Of Personality Traits In Individuals With Borderline Personality Disorder, Christopher J. Hopwood, Daniel A. Newman, M. Brent Donnellan, John C. Markowitz, Carlos M. Grilo, Charles A. Sanislow, Emily B. Ansell, M. Tracie Shea, Andrew E. Skodol, Thomas H. Mcglashan, John G. Gunderson, Mary C. Zanarini, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Although stability and pervasive inflexibility are general criteria for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (American Psychiatric Association, 1994) personality disorders (PDs), borderline PD (BPD) is characterized by instability in several domains, including interpersonal behavior, affect, and identity. The authors hypothesized that such inconsistencies notable in BPD may relate to instability at the level of the basic personality traits that are associated with this disorder. Five types of personality trait stability across 4 assessments over 6 years were compared for BPD patients (N = 130 at first interval) and patients with other PDs (N = 302). Structural …

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 …

The Construct Validity Of Rule-Breaking And Aggression In An Adult Clinical Sample, Christopher J. Hopwood, S. Alexandra Burt, John C. Markowitz, Shirley Yen, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Emily B. Ansell, Thomas H. Mcglashan, John G. Gunderson, Mary C. Zanarini, Andrew E. Skodol, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Previous research has demonstrated that aggression (AGG) and non-aggressive rule-breaking (RB) represent elements of antisocial behavior with different etiological mechanisms and associations to personality and psychopathology. However, these constructs have not been investigated in an adult clinical sample. In the current study, interview and self-report derived AGG and RB were associated with personality traits and disorders as well as functioning across several domains, family history, concurrent psychopathology, and prospective behaviors. Both AGG and RB were similarly related to disagreeableness. RB was uniquely related to low conscientiousness, cluster B personality disorders, functioning, problems in childhood, suicide risk, arrests, and substance use …

Improvement In Borderline Personality Disorder In Relationship To Age, M. Tracie Shea, Maria O. Edelen, Shirley Yen, John G. Gunderson, Andrew E. Skodol, Charles A. Sanislow, Carlos M. Grilo, Emily B. Ansell, Maria T. Daversa, Mary C. Zanarini, Thomas H. Mcglashan, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Objective: It is commonly believed that some features of borderline personality disorder (BPD) improve as individuals reach their late 30s and 40s. This study examined age-related change in borderline criteria and functional impairment, testing the hypothesis that older age would be associated with relatively more improvement than younger age.

Method: A total of 216 male and female participants with BPD were followed prospectively with yearly assessments over 6 years.

Results: Participants showed similar rates of improvement in borderline features regardless of age. A significant age by study year interaction showed functioning in older subjects to reverse direction and begin to …

The Construct Validity Of Passive-Aggressive Personality Disorder, Christopher J. Hopwood, Leslie C. Morey, John C. Markowitz, Anthony Pinto, Andrew E. Skodol, John G. Gunderson, Mary C. Zanarini, M. Tracie Shea, Shirley Yen, Thomas H. Mcglashan, Emily B. Ansell, Carlos M. Grilo, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Although Passive Aggressive personality disorder (PAPD) plays an important role in many theories of personality pathology, it was consigned to the appendix of the fourth edition of the DSM. The scientific basis of this decision has been questioned, but several controversies persist regarding PAPD, including its structure, content validity, overlap with other PDs, and relations to validating variables such as personality traits, childhood experiences, and clinically relevant correlates. This study examined these facets of PAPD's construct validity in a large clinical sample. Results suggest that the construct is unidimensional, internally consistent, and reasonably stable. Furthermore, PAPD appears systematically related to …

New Onsets Of Substance Use Disorders In Borderline Personality Disorder Over 7 Years Of Follow-Ups: Findings From The Collaborative Longitudinal Personality Disorders Study, Marc Walter, John G. Gunderson, Mary C. Zanarini, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Leslie C. Morey, Shirley Yen, Robert L. Stout, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Aims: The purpose of this study was to examine whether patients with borderline personality disorder (BPD) have a higher rate of new onsets of substance use disorders (SUD) than do patients with other personality disorders (OPD).

Design: This study uses data from the Collaborative Longitudinal Personality Disorder Study (CLPS), a prospective naturalistic study with reliable repeated measures over 7 years of follow-up.

Setting: Multiple clinical sites in four northeastern US cities.

Participants: A total of 175 patients with BPD and 396 patients with OPD (mean age 32.5 years) were assessed at baseline and at 6, 12, 24, 36, 48, 60, …

Personality Traits And Mental Health Treatment Utilization, Christopher J. Hopwood, Brian D. Quigley, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, Shirley Yen, M. Tracie Shea, Mary C. Zanarini, John G. Gunderson, Andrew E. Skodol, John C. Markowitz, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Recent theory and research suggest a relation between five-factor model personality traits and mental health treatment utilization, even after controlling for psychiatric disorders and global functioning. The current report further tests this hypothesis in a large clinical sample, using a wider array of treatment modalities than has been previously studied. Overall, results were limited and inconsistent. Although neuroticism was related to utilization across treatment modalities, many of these relationships resulted from its association with psychiatric diagnoses. Other traits showed limited and inconsistent relations to the use of psychosocial and psychiatric treatments.

A Comparison Of Interview And Self-Report Methods For The Assessment Of Borderline Personality Disorder Criteria, Christopher J. Hopwood, Leslie C. Morey, Maria Orlando Edelen, M. Tracie Shea, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan, Maria T. Daversa, John G. Gunderson, Mary C. Zanarini, John C. Markowitz, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Interview methods are widely regarded as the standard for the diagnosis of borderline personality disorder (BPD), whereas self-report methods are considered a time-efficient alternative. However, the relative validity of these methods has not been sufficiently tested. The current study used data from the Collaborative Longitudinal Personality disorder Study to compare diagnostic base rates and the relative validity of interview and self-report methods for assessing functional outcome in BPD. Although self-report yielded higher base rates of criteria endorsement, results did not support the common assumption that diagnostic interviews are more valid than self-reports, but instead indicated the combined use of these …

Ethnicity And Mental Health Treatment Utilization By Patients With Personality Disorders, Donna S. Bender, Andrew E. Skodol, Ingrid R. Dyck, John C. Markowitz, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Anthony Pinto, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson, Maria T. Daversa, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic …

Comparison Of Alternative Models For Personality Disorders, Leslie C. Morey, Christopher J. Hopwood, John G. Gunderson, Andrew E. Skodol, M. Tracie Shea, Shirley Yen, Robert L. Stout, Mary C. Zanarini, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: The categorical classification system for personality disorder (PD) has been frequently criticized and several alternative dimensional models have been proposed.

METHOD: Antecedent, concurrent and predictive markers of construct validity were examined for three models of PDs: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP) model and the DSM-IV in the Collaborative Study of Personality Disorders (CLPS) sample.

RESULTS: All models showed substantial validity across a variety of marker variables over time. Dimensional models (including dimensionalized DSM-IV) consistently outperformed the conventional categorical diagnosis in predicting external variables, such as subsequent suicidal gestures and hospitalizations. FFM facets …

Positive Childhood Experiences: Resilience And Recovery From Personality Disorder In Early Adulthood, Andrew E. Skodol, Donna S. Bender, Maria E. Pagano, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Carlos M. Grilo, Maria T. Daversa, Robert L. Stout, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder.

METHOD: Five hundred twenty patients with DSM-IV-based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from …

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

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for borderline personality disorder (BPD). METHODS: At baseline, we used semistructured diagnostic interviews to determine criteria and diagnoses; blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (specifically, conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, with the independent BPD diagnosis at follow-up used as the standard. RESULTS: Longitudinal diagnostic efficiencies for the BPD criteria varied, with the criteria of suicidality or self-injury and unstable relationships demonstrating the most predictive utility. CONCLUSIONS: BPD criteria differ in their predictive …

Natural Course Of Bulimia Nervosa And Of Eating Disorder Not Otherwise Specified: 5-Year Prospective Study Of Remissions, Relapses, And The Effects Of Personality Disorder Psychopathology, Carlos M. Grilo, Maria E. Pagano, Andrew E. Skodol, Charles A. Sanislow, Thomas H. Mcglashan, John G. Gunderson, Robert L. Stout

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine prospectively the natural course of bulimia nervosa and eating disorder not otherwise specified (EDNOS) and to test for the effects of personality disorder psychopathology on remission and relapse.

METHOD: Subjects were 92 female patients with current bulimia nervosa (N = 23) or EDNOS (N = 69) at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study. Axis I psychiatric disorders (including eating disorders) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Version, and personality disorders were assessed with the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). The course of eating disorders was assessed …

Personality Traits Predict Current And Future Functioning Comparably For Individuals With Major Depressive And Personality Disorders, Christopher J. Hopwood, Leslie C. Morey, M. Tracie Shea, Thomas H. Mcglashan, Charles A. Sanislow, Carlos M. Grilo, John G. Gunderson, Mary C. Zanarini, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Axes I and II were separated in DSM-III to encourage the consideration of the influence of both personality and psychopathology on patient behavior, on the assumption that an understanding of personality would increment syndromal diagnosis in treatment decisions. However, in practice the distinction between Axis I and Axis II is less clear. The current report investigates one aspect on which Axis I and Axis II might be expected to differ, that being the the significance of normative personality traits as an influence on functional status. In this study, the contribution of normative personality traits to functioning is presented for 2 …

Longitudinal Effects Of Personality Disorders On Psychosocial Functioning Of Patients With Major Depressive Disorder, John C. Markowitz, Andrew E. Skodol, Eva Petkova, Jianfeng Cheng, Charles A. Sanislow, Carlos M. Grilo, John G. Gunderson, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: No previous research has focused on psychosocial functioning in understanding how personality disorders compound the impairment caused by major depressive disorder over time. This report describes the effects of persistent and remitting comorbid personality disorders on the depressive status and functioning of patients with major depressive disorder over the course of 2 years.

METHOD: Longitudinal data on functioning from the first 2 years of the Collaborative Longitudinal Personality Disorders Study were evaluated for 3 groups of subjects with major depressive disorder: subjects with major depressive disorder alone (N = 103), those with persistent comorbid personality disorders (N = 164), …

Descriptive And Longitudinal Observations On The Relationship Of Borderline Personality Disorder And Bipolar Disorder, John G. Gunderson, Igor Weinberg, Maria T. Daversa, Karsten D. Kueppenbender, Mary C. Zanarini, M. Tracie Shea, Andrew E. Skodol, Charles A. Sanislow, Shirley Yen, Leslie C. Morey, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Ingrid R. Dyck

Charles A. Sanislow, Ph.D.

OBJECTIVE: The purpose of this study was to test whether borderline personality disorder is a variant of bipolar disorder by examining the rates of co-occurrence in both disorders, the effects of co-occurrence on a longitudinal course, and whether the presence of either disorder confers the risk for new onsets of the other.

METHOD: A prospective repeated-measures design with reliable independent diagnostic measures and 4 years of follow-up was used to assess 196 patients with borderline personality disorder and 433 patients with other personality disorders.

RESULTS: Patients with borderline personality disorder had a significantly higher co-occurrence of bipolar disorder (19.4%) than …