Social and Behavioral Sciences Commons^™

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 …

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 …

Psychosocial Impairment And Treatment Utilization By Patients With Borderline Personality Disorder, Other Personality Disorders, Mood And Anxiety Disorders, And A Healthy Comparison Group, Emily B. Ansell, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

This study compared psychosocial functioning and treatment utilization in 130 participants who were diagnosed with a borderline personality disorder (BPD), a non-BPD personality disorder (OPD), a mood and/or anxiety disorder (MAD), or had no current psychiatric diagnosis and served as a healthy comparison group. Diagnostic and Statistical Manual of Mental Disorders (4th Edition) diagnoses, psychosocial functioning, and treatment utilization were determined by using well-established semistructured research interviews conducted by trained doctoral-level clinicians. Analysis of variance revealed the most severe deficits in functioning characterized the BPD group across areas of global functioning with more moderate impairments in functioning occurring in OPD …

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), …

Beliefs About Essences And The Reality Of Mental Disorders, Woo-Kyoung Ahn, Elizabeth H. Flanagan, Jessecae K. Marsh, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Do people believe mental disorders are real and possess underlying essences? The current study found that both novices and practicing clinicians held weaker essentialist beliefs about mental disorders than about medical disorders. They were also unwilling to endorse the idea that mental disorders are real and natural. Furthermore, compared with novices, mental health clinicians were less likely to endorse the view that there is a shared cause underlying a mental disorder and that one needs to remove the cause to get rid of the mental disorder. Clinicians were polarized on their views about whether mental disorders are categorical or dimensional. …

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 …

Prospective Assessment Of Treatment Use By Patients With Personality Disorders, Donna S. Bender, Andrew E. Skodol, Maria E. Pagano, Ingrid R. Dyck, Carlos M. Grilo, M. Tracie Shea, Charles A. Sanislow, Mary C. Zanarini, Shirley Yen, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: This study examined the utilization of mental health treatments over a three-year period among patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders compared with patients with major depressive disorder and no personality disorder.

METHODS: A prospective, longitudinal study design was used to measure treatment use for 633 individuals aged 18 to 45 years during a three-year period.

RESULTS: Patients with borderline personality disorder were significantly more likely than those with major depressive disorder to use most types of treatment. Furthermore, all patients continued using high-intensity, low-duration treatments throughout the study period, whereas individual psychotherapy attendance declined significantly after …

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, …

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 …

Associations In The Course Of Personality Disorders And Axis I Disorders Over Time, M. Tracie Shea, Robert L. Stout, Shirley Yen, Maria E. Pagano, Andrew E. Skodol, Leslie C. Morey, John G. Gunderson, Thomas H. Mcglashan, Carlos M. Grilo, Charles A. Sanislow, Donna S. Bender, Mary C. Zanarini

Charles A. Sanislow, Ph.D.

In this study, the authors examined time-varying associations between schizotypal (STPD), borderline (BPD), avoidant (AVPD), or obsessive-compulsive (OCPD) personality disorders and co-occurring Axis I disorders in 544 adult participants from the Collaborative Longitudinal Personality Disorders Study. The authors tested predictions of specific longitudinal associations derived from a model of crosscutting psychobiological dimensions (L. J. Siever & K. L. Davis, 1991) with participants with the relevant Axis I disorders. The authors assessed participants at baseline and at 6-, 12-, and 24-month follow-up evaluations. BPD showed significant longitudinal associations with major depressive disorder and posttraumatic stress disorder. AVPD was significantly associated with …

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 …

Temporal Coherence Of Criteria For Four Personality Disorders, Leslie C. Morey, Andrew E. Skodol, Carlos M. Grilo, Charles A. Sanislow, Mary C. Zanarini, M. Tracie Shea, John G. Gunderson, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

This study sought to investigate the coherence of changes observed in diagnostic criteria for borderline, schizotypal, obsessive-compulsive, and avoidant personality disorders. Five hundred, forty-nine patients were independently evaluated 2 years apart, and correlations of observed changes in each diagnostic criterion with changes in other criteria were examined to determine if there was within-syndrome consistency in these changes. The observed changes in criteria were consistent within syndrome (median alpha = 0.72 across 4 disorders), and reasonably specific to that syndrome relative to the other disorders. The results support the validity of these criterion sets as representing coherent syndromes.

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 …

The Longitudinal Relationship Of Personality Traits And Disorders, Megan B. Warner, Leslie C. Morey, John F. Finch, John G. Gunderson, Andrew E. Skodol, Charles A. Sanislow, M. Tracie Shea, Thomas H. Mcglashan, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Personality disorders are presumed to be stable because of underlying stable and maladaptive personality traits, but while previous research has demonstrated a link between personality traits and personality disorders cross-sectionally, personality disorders and personality traits have not been linked longitudinally. This study explores the extent to which relevant personality traits are stable in individuals diagnosed with 4 personality disorders (schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders) and examines the assumption that these personality disorders are stable by virtue of stable personality traits. This assumption was tested via the estimation of a series of latent longitudinal models that evaluated whether changes …

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.

Borderline Personality Disorder Criteria Associated With Prospectively Observed Suicidal Behavior, Shirley Yen, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, John G. Gunderson, Thomas H. Mcglashan, Mary C. Zanarini, Leslie C. Morey

Charles A. Sanislow, Ph.D.

OBJECTIVE: The authors prospectively examined associations between each DSM-IV borderline personality disorder criterion and suicidal behaviors.

METHOD: Borderline personality disorder diagnosis and criteria, major depressive disorder, substance use disorders, and history of childhood sexual abuse were assessed with semistructured interviews. Participants (N=621) were followed for 2 years with repeated structured evaluations that included assessments of suicidality.

RESULTS: With the self-injury criterion excluded, the borderline personality disorder criteria of affective instability, identity disturbance, and impulsivity significantly predicted suicidal behaviors. Only affective instability and childhood sexual abuse were significantly associated with suicide attempts (i.e., behavior with some intent to die).

CONCLUSIONS: Affective …

The Natural Course Of Bulimia Nervosa And Eating Disorder Not Otherwise Specified Is Not Influenced By Personality Disorders, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Andrew E. Skodol, Robert L. Stout, Maria E. Pagano, Shirley Yen, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) and to test the effects of personality disorder (PD) comorbidity on the outcomes.

Method: Ninety-two female patients with current BN (N ¼ 23) or EDNOS (N ¼ 69) were evaluated at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study (CLPS). Eating disorders (EDs) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders. Personality disorders (PDs) were assessed with the Diagnostic Interview for DSM-IV PD (DIPD-IV). The course of BN and EDNOS was assessed with the Longitudinal Interval Follow-up …