Psychiatry Commons^™

A Scoping Review Of The Associations Between Mental Health And Factors Related To Hiv Acquisition And Disease Progression In Conflict-Affected Populations, Erica Koegler, Erica Koegler, Caitlin E. Kennedy

Erica Koegler

The Promise Of Healthcare Reform In Transforming Services For Jail Detainees, Maureen Mcdonnell, Laura Brookes, Arthur J. Lurigio

Arthur J. Lurigio

Chronic behavioral health conditions, such as psychiatric and substance use disorders, affect at least half of all arrestees, with two-thirds suffering from at least one chronic medical disorder. These conditions contribute to their criminal behaviors and propensities to recycle through the criminal justice system (Binswanger et al. Journal of Urban Health 89:183-190, 2012). Despite their limited resources, jails have nonetheless become de facto settings for the delivery of healthcare services. With the passage of the Affordable Care Act (ACA) of 2010, jail releasees will become eligible for government-subsidized healthcare coverage in 2014. The widespread availability of integrated healthcare services for …

Use And Perceived Effectiveness Of Coping Skills Among Police Officer Spouses, Andrea L. Dinsmore

Andrea L. Dinsmore

Discusses her research on the types of psychological stressors faced by the spouses of police officers and their methods of coping.

Assessment Of Competence Restoration: Determining The Threshold, Andrea L. Dinsmore

Andrea L. Dinsmore

Discusses the legal precedent and research basis of evaluating a defendant's mental competency to stand trial, the variables that contribute to non-restorable incompetence to stand trial, and the differences between patients who are restorable to competency versus those who are not restorable to competency.

Ptsd/Sud In Individuals With Physical Disabilities: Identifying Problems And Promising Interventions, Melissa L. Anderson, Douglas M. Ziedonis, Lisa M. Najavits

Melissa L. Anderson

Co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is common, affects multiple domains of functioning, and presents complex challenges to recovery. Initial research indicates that individuals with physical disabilities experience higher rates of lifetime trauma and PTSD, and exhibit more severe SUD compared to non-disabled individuals. To expand upon these initial findings, we conducted a series of two studies on PTSD and SUD among individuals with physical disabilities.

Morphological Knowledge And Decoding Skills Of Deaf Readers, M. Diane Clark, Gizelle L. Gilbert, Melissa L. Anderson

Melissa L. Anderson

Many studies have reported the necessity of phonological awareness to become a skilled reader, citing barriers to phonological information as the cause for reading difficulties experienced by deaf individuals. In contrast, other research suggests that phonological awareness is not necessary for reading acquisition, citing the importance of higher levels of syntactic and semantic knowledge. To determine if deaf students with higher language skills have better word decoding strategies, students responded to a morphological test, where monomorphemic words and multimorphemic words were matched to their definitions. Two studies are reported, one focusing on English placement levels and a second with formal …

Implementing The Massachusetts Child Trauma Project (Mctp) To Improve Services For Children With Complex Trauma In Child Welfare: Phase I Needs And Readiness Assessment, Charmaine B. Lo, Melodie Wenz-Gross, Jessica L. Griffin

Melodie Wenz-Gross

MCTP seeks to improve placement stability and outcomes for children with complex trauma in the care of the Massachusetts Department of Children and Families (DCF) by creating a sustainable capacity for providing evidence-based trauma interventions within provider agencies, and trauma-informed practices within DCF.

Personality Heterogeneity In Ptsd: Distinct Temperamental And Interpersonal Typologies, Katherine M. Thomas, Christopher J. Hopwood, M. Brent Donnellan, Aidan G. C. Wright, Charles A. Sanislow, Meghan E. Mcdevitt-Murphy, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, M. Tracie Shea, John C. Markowitz, Andrew E. Skodol, Mary C. Zanarini, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create …

Socioeconomic-Status And Mental Health In A Personality Disorder Sample: The Importance Of Neighborhood Factors, Zach Walsh, M. Tracie Shea, Shirley Yen, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Donna S. Bender, Andrew E. Skodol, Charles A. Sanislow, Leslie C. Morey, John G. Gunderson

Charles A. Sanislow, Ph.D.

This cross-sectional study examined the associations between neighborhood-level socioeconomic-status (NSES), and psychosocial functioning and personality pathology among 335 adults drawn from the Collaborative Longitudinal Personality Disorders Study. Participants belonged to four personality disorder (PD) diagnostic groups: Avoidant, Borderline, Schizotypal, and Obsessive Compulsive. Global functioning, social adjustment, and PD symptoms were assessed following a minimum two-year period of residential stability. Residence in higher-risk neighborhoods was associated with more PD symptoms and lower levels of functioning and social adjustment. These relationships were consistent after controlling for individual-level socioeconomic-status and ethnicity; however, the positive association between neighborhood-level socio-economic risk and PD symptoms was …

Individuals With Single Versus Multiple Suicide Attempts Over 10 Years Of Prospective Follow-Up, Christina L. Boisseaua, Shirley Yen, John C. Markowitz, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Mary C. Zanarini, Andrew E. Skodol, John G. Gunderson, Leslie C. Morey, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Background: The study attempted to identify characteristics that differentiate multiple suicide attempters from single attempters in individuals with personality disorders (PDs) and/or major depression.

Method: Participants were 431 participants enrolled in the Collaborative Longitudinal Study of Personality Disorders from July 1996 to June 2008. Suicide attempts were assessed with the Longitudinal Interval Follow-up Evaluation at 6 and 12months, then yearly through 10years. Logistic regression was used to compare single attempters to multiple attempters on Axis I and II psychiatric disorders and personality trait variables.

Results: Twenty-one percent of participants attempted suicide during the 10years of observation, with 39 (9.0%) reporting …

Prospective Investigation Of A Ptsd Personality Typology Among Individuals With Personality Disorders, Meghan E. Mcdevitt-Murphy, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, John C. Markowitz, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

This study investigated the replicability of a previously proposed personality typology of posttraumatic stress disorder (PTSD, and explored stability of cluster membership over a 6-month period. Participants with current PTSD (n = 156) were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS). The CLPS project tracked a large sample of individuals who met criteria for 1 of 4 target diagnoses (borderline, schizotypal, avoidant, and obsessive-compulsive) and a contrast group of individuals who met criteria for depression but no personality disorder. A cluster analysis using scales from the Schedule of Nonadaptive and Adaptive Personality yielded 3 clusters: “internalizing,” “externalizing,” and …

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 …

Avoidant Personality Disorder, Charles A. Sanislow, Ellen E. Bartolini, Emma C. Zoloth

Charles A. Sanislow, Ph.D.

No abstract provided.

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 …

Pathological Personality Traits Among Patients With Absent, Current, And Remitted Substance Use Disorders, Christopher J. Hopwood, Leslie C. Morey, Andrew E. Skodol, Charles A. Sanislow, Carlos M. Grilo, Emily B. Ansell, Thomas H. Mcglashan, John C. Markowitz, Anthony Pinto, Shirley Yen, M. Tracie Shea, John G. Gunderson, Mary C. Zanarini, Robert L. Stout

Charles A. Sanislow, Ph.D.

Personality traits may provide underlying risk factors for and/or sequelae to substance use disorders (SUDs). In this study Schedule for Nonadaptive and Adaptive Personality (SNAP) traits were compared in a clinical sample (N=704, age 18–45) with current, past, or no historical alcohol or non-alcohol substance use disorders (AUD and NASUD) as assessed by DSM-IV semi-structured interview. Results corroborated previous research in showing associations of negative temperament and disinhibition to SUD, highlighting the importance of these traits for indicating substance use proclivity or the chronic effects of substance use. Certain traits (manipulativeness, self-harm, disinhibition, and impulsivity for AUD, and disinhibition and …

Self-Harm Subscale Of The Schedule Of Nonadaptive And Adaptive Personality (Snap): Predicting Suicide Attempts Over 8 Years Of Follow-Up, Shirley Yen, M. Tracie Shea, Zach Walsh, Maria O. Edelen, Christopher J. Hopwood, John C. Markowitz, Emily B. Ansell, Leslie C. Morey, Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: We examined the predictive power of the self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP) to identify suicide attempters in the Collaborative Longitudinal Study of Personality Disorders (CLPS).

Method: The SNAP, a self-report personality inventory, was administered to 733 CLPS participants at baseline, of whom 701 (96%) had at least 6 months of follow-up data. Cox proportional hazards regression analyses were performed to examine the SNAP–self-harm subscale (SNAP- SH) in predicting the 129 suicide attempters over 8 years of follow-up. Possible moderators of prediction were examined, including borderline personality disorder, major depressive disorder (MDD), and substance …

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 …

Ten-Year Course Of Borderline Personality Disorder: Psychopathology And Function From The Collaborative Longitudinal Personality Study, John G. Gunderson, Robert L. Stout, Thomas H. Mcglashan, M. Tracie Shea, Leslie C. Morey, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, John C. Markowitz, Charles A. Sanislow, Emily B. Ansell, Anthony Pinto, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Context: Borderline personality disorder (BPD) is traditionally considered chronic and intractable.

Objective: To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. Design: A collaborative study of treatment-seeking, 18- to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning.

Setting: Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities.

Participants: Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 …

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

Charles A. Sanislow, Ph.D.

Background: Dimensional models of personality are under consideration for integration into the next Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but the clinical utility of such models is unclear.

Objective: To test the ability of clinical researchers who specialize in personality disorders to diagnose personality disorders using dimensional assessments and to compare those researchers’ ratings of clinical utility for a dimensional system versus for the DSM-IV.

Method: A sample of 73 researchers who had each published at least 3 (median = 15) articles on personal- ity disorders participated between December 2008 and January 2009. The Five-Factor Model (FFM), one …

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. …

Personality Disorders Predict Relapse After Remission From An Episode Of Major Depressive Disorder: A 6-Year Prospective Study, Carlos M. Grilo, Robert L. Stout, John C. Markowitz, Charles A. Sanislow, Emily B. Ansell, Andrew E. Skodol, Donna S. Bender, Anthony Pinto, M. Tracie Shea, Shirley Yen, John G. Gunderson, Leslie C. Morey, Christropher J. Hopwood, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To examine prospectively the course of major depressive disorder (MDD) and to test for the moderating effects of personality disorder (PD) comorbidity on relapse after remission from an episode of MDD.

Method: Participants were 303 patients (196 women and 107 men) with current DSM-IV diagnosed MDD at baseline enrollment in the Col­laborative Longitudinal Personality Disorders Study. Major depressive disorder and Axis I psychiatric disorders were assessed with the Structured Clinical Interview for DSM-IV, and Axis II PDs were assessed with the Diagnostic Interview for DSM-IV Personality Disorders. The course of MDD was assessed with the Longitudinal Interval Follow­up Evaluation …

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 Sung-En 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 …

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 …

Methodological Considerations For Treatment Trials For Persons With Borderline Personality Disorder, Mary C. Zanarini, Barbara Stanley, Donald W. Black, John C. Markowitz, Marianne Goodman, Paul Pilkonis, Thomas R. Lynch, Kenneth Levy, Peter Fonagy, Martin Bohus, Joan Farrell, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

BACKGROUND: The National Institute of Mental Health convened an international group of experts to examine the conduct of treatment trials for persons with borderline personality disorder (BPD). The rapid growth of treatment research had led to the recognition that investigators face unique methodological issues with these challenging patients.

METHODS: Conference members reviewed critical aspects of psychotherapy and pharmacotherapy trial design for patients with BPD.

RESULTS: This article summarizes discussions held on March 17-18, 2005.

CONCLUSION: This paper addresses the most pressing issues in sample selection and trial design pertaining to BPD; issues that have bedeviled both investigators submitting applications and …

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 …

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 …