Behavior and Behavior Mechanisms Commons^™

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 …

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 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, …

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 …

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 …

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 …

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), …

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, …