Psychology Commons^™

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 …

General Psychological Distress Symptoms And Help-Seeking Intentions In Young Australians, Coralie Wilson

Coralie J Wilson

Epidemiological studies suggest that young people might have a tendency to avoid help when they experience symptoms of psychological distress. There is growing evidence that many young people prefer no help from anyone for their mental health problems. The current study examined the association between symptoms of general psychological distress and intentions to seek help from friends, family and professional mental health sources in a sample of 109 trade (TAFE) students from regional and rural Australia. Participants were 67% male and aged from 15-25 years. Higher levels of general psychological distress symptoms were associated with stronger intentions to not seek …

Adolescents' Suicidal Thinking And Reluctance To Consult General Medical Practitioners, Coralie Wilson

Coralie J Wilson

Appropriate help-seeking is widely recognized as a protective factor, and vital for early treatment and prevention of mental health problems during adolescence. General medical practitioners (GPs), that is, family doctors, provide a vital role in the identification of adolescents with mental health problems and the provision of treatment as well as access to other specialists in mental health care services. The current study is part of a larger multi-cite study developed and led by the first author. It examines the association between suicidal ideation and intentions to seek help from a GP for suicidal thoughts, emotional problems and physical health …

Developing Constructs For Psychopathology Research: Research Domain Criteria, Charles A. Sanislow, Daniel S. Pine, Kevin J. Quinn, Michael J. Kozak, Marjorie A. Garvey, Robert K. Heinssen, Philip S. Wang, Bruce N. Cuthbert

Charles A. Sanislow, Ph.D.

There exists a divide between findings from integrative neuroscience and clinical research focused on mechanisms of psychopathology. Specifically, a clear correspondence does not emerge between clusters of complex clinical symptoms and dysregulated neurobiological systems, with many apparent redundancies. For instance, many mental disorders involve multiple disruptions in putative mechanistic factors (e.g., excessive fear, deficient impulse control), and different disrupted mechanisms appear to play major roles in many disorders. The Research Domain Criteria (RDoC) framework is a heuristic to facilitate the incorporation of behavioral neuroscience in the study of psychopathology. Such integration might be achieved by shifting the central research focus …

Help-Negation And Suicidal Ideation: The Role Of Depression, Anxiety And Hopelessness., Coralie J. Wilson

Frank Deane

Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study is part of a larger multi-cite research program developed and led by the first author. It examines the association between suicidal ideation and intentions to seek help from friends, family and professional mental health sources in a sample of 302 Australian university students. Participants were 77.5% female and aged from 18-25 years old, with 85.4% aged 21 years or younger. Higher levels of suicidal ideation were related to lower help-seeking …

Help-Negation And Suicidal Ideation: The Role Of Depression, Anxiety And Hopelessness., Coralie J. Wilson

Coralie J Wilson

Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study is part of a larger multi-cite research program developed and led by the first author. It examines the association between suicidal ideation and intentions to seek help from friends, family and professional mental health sources in a sample of 302 Australian university students. Participants were 77.5% female and aged from 18-25 years old, with 85.4% aged 21 years or younger. Higher levels of suicidal ideation were related to lower help-seeking …

Research Domain Criteria (Rdoc): Toward A New Classification Framework For Research On Mental Disorders, Thomas R. Insel, Bruce N. Cuthbert, Marjorie A. Garvey, Robert K. Heinssen, Daniel S. Pine, Kevin J. Quinn, Charles A. Sanislow, Philip S. Wang

Charles A. Sanislow, Ph.D.

Current versions of the DSM and ICD have facilitated reliable clinical diagnosis and research. However, problems have increasingly been documented over the past several years, both in clinical and research arenas (e.g., 1, 2). Diagnostic categories based on clinical consensus fail to align with findings emerging from clinical neuroscience and genetics. The boundaries of these categories have not been predictive of treatment response. And, perhaps most important, these categories, based upon presenting signs and symptoms, may not capture fundamental underlying mechanisms of dysfunction. One consequence has been to slow the development of new treatments targeted to underlying pathophysiological mechanisms.

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 …

Self-Criticism Versus Neuroticism In Predicting Depression And Psychosocial Impairment For 4 Years In A Clinical Sample, David M. Dunkley, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

The present study extended previous findings demonstrating self-criticism, assessed by the Dysfunctional Attitude Scale (DAS) (Weissman AN, Beck AT. Development and validation of the Dysfunctional Attitude Scale: a preliminary investigation. Paper presented at the 86th Annual Convention of the American Psychological Association, Toronto, Ontario, Canada, 1978), as a potentially important prospective predictor of depressive symptoms and psychosocial functional impairment over time. Using data from a prospective, 4-year study of a clinical sample, DAS self-criticism and neuroticism were associated with self-report depressive symptoms, interviewer-rated major depression, and global domains of psychosocial functional impairment 4 years later. Hierarchical multiple regression results indicated …

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 …

Can Clinicians Recognize Dsm-Iv Personality Disorders From Five-Factor Model Descriptions Of Patient Cases?, Benjamin M. Rottman, Woo-Kyoung Ahn, Charles A. Sanislow, Nancy S. Kim

Charles A. Sanislow, Ph.D.

Objective: This article examined, using theories from cognitive science, the clinical utility of the Five-Factor Model (FFM) of Personality, an assessment and classification system under consideration for integration into the forthcoming fifth edition of the Diagnostic and Statistical Manual (DSM) of Mental Disorders. Specifically, the authors sought to test whether FFM descriptors are specific enough to allow practicing clinicians to capture core features of personality disorders.

Method: In two studies, a large nationwide sample of clinical psychologists, psychiatrists, and clinical social workers (N = 187 and N = 191) were presented case profiles based on symptom formats from either the …

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 …

Correspondence: Help-Negation, Coralie Wilson

Coralie J Wilson

It is positive that preliminary findings from the 2007 National Survey of Mental Health and Wellbeing suggest that more Australians than in 1997 are seeking help for common mental disorders. However, the 2007 Survey also suggests that two in three Australians who had common forms of mental disorder and 41% of those with serious thoughts of suicide during the last year did not seek or engage in professional help for their condition [1]. Even more concerning are the preliminary results suggesting that 86% of those who didn’t seek help for their common mental disorders thought they didn’t need any type …

Gatekeeper Training For Youth Workers: Impact On Mental Health Help-Seeking And Referral Skill, Coralie J. Wilson

Coralie J Wilson

The Youth Empowerment Series (YES!) Workshops (Wilson et al, 2000) were developed to improve gatekeepers' mental health literacy and skills for promoting effective help-seeking and social problem-solving among adolescents and young people. The curent study the skills of those attending the YES! Workshops 9 months after training.

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, …

New Episodes And New Onsets Of Major Depression In Borderline And Other Personality Disorders, John G. Gunderson, Robert L. Stout, Charles A. Sanislow, M. Tracie Shea, Thomas H. Mcglashan, Mary C. Zanarini, Maria T. Daversa, Carlos M. Grilo, Shirley Yen, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Background: In the context of much literature and conjecture about the relationship of personality disorders (PD) and major depressive disorder (MDD), this paper uses longitudinal data to assess the frequency with which PD patients, and especially those with borderline personality disorder (BPD), have recurrences (for patients with lifetime histories), or new onsets (for patients without lifetime histories) of MDD. Methods: A sample of 478 PD patients received reliable repeated follow-up assessments over a period of 6 years. The rates of new onsets and recurrences of MDD in all PD patients, and in BPD patients compared to OPD patients were analyzed. …

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 …

Robert Charles Carson (1930-2006): Obituary, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

No abstract provided.

Reducing Adolescents' Perceived Barriers To Treatment And Increasing Help-Seeking Intentions: Effects Of Classroom Presentations By General Practitioners., Coralie J. Wilson

Coralie J Wilson

The Building Bridges to General Practice (BBGP) program is an outreach initiative (written by the first author). It aims to reduce young peoples’ perceived knowledge- and belief-based barriers to engaging in treatment and to increase their behavioral intentions to consult a general medical practitioner (GP) for physical and psychological problems. By increasing intentions, the BBGP program aims to increase actual consultations with a GP for both types of problem. The current paper is the first of a series that report results from a larger multi-cite research project, developed and led by the first author, which examines the impact of BBGP …

Reducing Adolescents' Perceived Barriers To Treatment And Increasing Help-Seeking Intentions: Effects Of Classroom Presentations By General Practitioners., Coralie J. Wilson

Frank Deane

The Building Bridges to General Practice (BBGP) program is an outreach initiative (written by the first author). It aims to reduce young peoples’ perceived knowledge- and belief-based barriers to engaging in treatment and to increase their behavioral intentions to consult a general medical practitioner (GP) for physical and psychological problems. By increasing intentions, the BBGP program aims to increase actual consultations with a GP for both types of problem. The current paper is the first of a series that report results from a larger multi-cite research project, developed and led by the first author, which examines the impact of BBGP …

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 …