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Emil F. Coccaro - One of the best experts on this subject based on the ideXlab platform.
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evidence for the taxonic latent structure for dsm 5 intermittent explosive disorder in adults
Psychological Medicine, 2021Co-Authors: Jennifer R Fanning, David K Marcus, Jonathan Preszler, Emil F. CoccaroAbstract:BACKGROUND Identification of individuals with clinically significant aggressive behavior is critical for the prevention and management of human aggressive behavior. A previous population-based taxometric study reported that the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV) intermittent explosive disorder (IED) belongs to its own discrete class (taxon) rather than existing along a continuum. METHODS This study sought to extend previous population-based findings in a clinical research sample of adults with DSM-5 IED (n = 346), adults with non-aggressive DSM-5 disorders (n = 293), and adults without any DSM-5 disorder (n = 174), using standardized assessments of DSM-5 diagnoses, aggression, and other related measures not available in past studies. RESULTS Analyses revealed a taxonic latent structure that overlapped with the DSM-5 diagnosis of IED. Within the sample, taxon group members had higher scores on a variety of measures of psychopathology than did the complement members of the sample. Comorbidity of other diagnoses with IED did not affect these results. CONCLUSION These findings support the proposition that DSM-5 IED represents a distinct behavioral disorder rather than the severe end of an aggressive behavior continuum.
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psychosocial impairment in dsm 5 intermittent explosive disorder
Psychiatry Research-neuroimaging, 2018Co-Authors: Lauren Z Rynar, Emil F. CoccaroAbstract:The purpose of this study was to document the functional severity of DSM-5 IED in a clinical research sample. IED and control groups were compared on psychosocial functioning, life satisfaction, and on a variety of cognitive and behavioral issues. IED study participants reported significantly worse psychosocial function, quality of life, and higher job dysfunction than both psychiatric and healthy control study participants. The presence of DSM-5 IED is associated with significant psychosocial and functional impairment. Early intervention may aid in minimizing the consequences of impulsive aggressive behavior, and improving psychosocial functioning and quality of life.
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development of a screening questionnaire for dsm 5 intermittent explosive disorder ied sq
Comprehensive Psychiatry, 2017Co-Authors: Emil F. Coccaro, Mitchell E Berman, Michael MccloskeyAbstract:Abstract Objective This study was designed to develop and test a screening approach to identify individuals with DSM-5 Intermittent Explosive Disorder (IED), a disorder of recurrent, problematic, impulsive aggression. Methods A screening approach to diagnose DSM-5 IED (IED-SQ) was developed by combining items related to life history of aggression and items related to the DSM-5 diagnostic criteria for IED. In study 1, the IED-SQ was studied in 72 adult participants; 33 that met DSM-5 criteria for lifetime IED and 39 that did not. In study 2, the IED-SQ was given to 740 undergraduates at a US university. Measures of aggression and anger expression and anger control were assessed in both studies. Results In study 1, the IED-SQ demonstrated strong concordance with the best estimate diagnoses (Kappa =.80) for lifetime IED by DSM-5 criteria and good test–retest reliability (kappa =0.71). In study 2, the IED-SQ identified 4.3% of the undergraduate sample as meeting DSM-5 criteria for lifetime IED, a rate comparable to that in recent epidemiological studies. Participants identified as meeting DSM-5 criteria for lifetime IED, in both studies, had higher aggression scores, and higher anger expression, and lower anger control scores, compared to participants that did not meet DSM-5 criteria for lifetime IED. Conclusions These data suggest that the IED-SQ is a useful screening tool that can quickly identify the presence of IED by DSM-5 criteria in adults.
Robert F Krueger - One of the best experts on this subject based on the ideXlab platform.
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personality disorder in dsm 5 an oral history
Psychological Medicine, 2016Co-Authors: Peter Zachar, Robert F KruegerAbstract:As the revision process leading to DSM-5 began, the domain of personality disorder embodied the highest aspirations for major change. After an initial prototype-based proposal failed to gain acceptance, the Personality and Personality Disorders Work Group (P&PDWG) developed a hybrid model containing categorical and dimensional components. A clash of perspectives both within the P&PDWG and between the P&PDWG and DSM-5 oversight committees led to the rejection of this proposal from the main body of DSM-5. Major issues included conflicting ways of conceptualizing validation, differences of opinion from personality disorder experts outside the P&PDWG, divergent concepts of the magnitude of evidence needed to support substantial changes, and the disagreements about clinical utility of the hybrid model. Despite these setbacks, the ‘Alternative DSM-5 Model of Personality Disorder’ is presented in Section III of the DSM-5. Further research should clarify its performance relative to the DSM-IV criteria reprinted in the main DSM-5 text.
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the structure and correlates of self reported dsm 5 maladaptive personality traits findings from two german speaking samples
Journal of Personality Disorders, 2014Co-Authors: Johannes Zimmermann, Robert F Krueger, David Altenstein, Tobias Krieger, Martin Grosse Holtforth, Johanna Pretsch, Johanna Alexopoulos, Cars Ten Spitzer, Cord Benecke, Kristian E MarkonAbstract:The authors investigated the structure and correlates of DSM-5 maladaptive personality traits in two samples of 577 students and 212 inpatients using the German self-report form of the Personality Inventory for DSM-5. They found that (a) the factor structure of DSM-5 trait facets is largely in line with the proposed trait domains of Negative Affectivity, Detachment, Antagonism, Disinhibition, and Psychoticism; (b) all DSM-5 trait domains except Psychoticism are highly related to the respective domains of the Five-Factor Model of personality; (c) the trait facets are positively associated with a self-report measure of general personality dysfunction; and (d) the DSM-5 trait facets show differential associations with a range of self-reported DSM-IV Axis I disorders. These findings give further support to the new DSM-5 trait model and suggest that it may generalize to other languages and cultures.
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the role of the dsm 5 personality trait model in moving toward a quantitative and empirically based approach to classifying personality and psychopathology
Annual Review of Clinical Psychology, 2014Co-Authors: Robert F Krueger, Kristian E MarkonAbstract:The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) represents a watershed moment in the history of official psychopathology classification systems because it is the first DSM to feature an empirically based model of maladaptive personality traits. Attributes of patients with personality disorders were discussed by the DSM-5 Personality and Personality Disorders Work Group and then operationalized and refined in the course of an empirical project that eventuated in the construction of the Personality Inventory for DSM-5 (PID-5). We review research to date on the DSM-5 trait model, with a primary aim of discussing how this kind of research could serve to better tether the DSM to data as it continues to evolve. For example, studies to date suggest that the DSM-5 trait model provides reasonable coverage of personality pathology but also suggest areas for continued refinement. This kind of research provides a way of evolving psychopathology classification on the basis of res...
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characterizing psychopathy using dsm 5 personality traits
Assessment, 2013Co-Authors: Casey M Strickland, Robert F Krueger, Laura E Drislane, Megan Lucy, Christopher J PatrickAbstract:Despite its importance historically and contemporarily, psychopathy is not recognized in the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR). Its closest counterpart, antisocial personality disorder, includes strong representation of behavioral deviance symptoms but weak representation of affective-interpersonal features considered central to psychopathy. The current study evaluated the extent to which psychopathy and its distinctive facets, indexed by the Triarchic Psychopathy Measure, can be assessed effectively using traits from the dimensional model of personality pathology developed for DSM-5, operationalized by the Personality Inventory for DSM-5 (PID-5). Results indicate that (a) facets of psychopathy entailing impulsive externalization and callous aggression are well-represented by traits from the PID-5 considered relevant to antisocial personality disorder, and (b) the boldness facet of psychopathy can be effectively captured using additional PID-5 traits. These findings provide evidence that the dimensional model of personality pathology embodied in the PID-5 provides effective trait-based coverage of psychopathy and its facets.
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personality disorder types proposed for dsm 5
Journal of Personality Disorders, 2011Co-Authors: Donna S Bender, Carl C. Bell, Renato D Alarcon, Roel Verheul, John M. Oldham, Lee Anna Clark, Robert F Krueger, Leslie C. Morey, Larry J SieverAbstract:The Personality and Personality Disorders Work Group has proposed five specific personality disorder (PD) types for DSM-5, to be rated on a dimension of fit: antisocial/psychopathic, avoidant, borderline, obsessive-compulsive, and schizotypal. Each type is identified by core impairments in personality functioning, pathological personality traits, and common symptomatic behaviors. The other DSM-IV-TR PDs and the large residual category of personality disorder not otherwise specified (PDNOS) will be represented solely by the core impairments combined with specification by individuals' unique sets of personality traits. This proposal has three main features: (1) a reduction in the number of specified types from 10 to 5; (2) description of the types in a narrative format that combines typical deficits in self and interpersonal functioning and particular configurations of traits and behaviors; and (3) a dimensional rating of the degree to which a patient matches each type. An explanation of these modifications...
Susan M. Bögels - One of the best experts on this subject based on the ideXlab platform.
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the dsm 5 dimensional anxiety scales in a dutch non clinical sample psychometric properties including the adult separation anxiety disorder scale
International Journal of Methods in Psychiatric Research, 2016Co-Authors: Eline L Moller, Susan M. BögelsAbstract:With DSM-5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM-5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM-5-based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM-5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM-5 chapter on anxiety disorders. Moreover, they completed the Screen for Child Anxiety Related Emotional Disorders Adult version (SCARED-A). The DSM-5 Dimensional Anxiety Scales demonstrated high internal consistency, and the scales correlated significantly and substantially with corresponding SCARED-A subscales, supporting convergent validity. Separation anxiety appeared present among adults, supporting the DSM-5 recognition of separation anxiety as an anxiety disorder across the life span. To conclude, the DSM-5 Dimensional Anxiety Scales are a valuable tool to screen for specific adult anxiety disorders, including separation anxiety. Research in more diverse and clinical samples with anxiety disorders is needed. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.
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Adult separation anxiety disorder in DSM-5.
Clinical Psychology Review, 2013Co-Authors: Susan M. Bögels, Susanne Knappe, Lee Anna ClarkAbstract:Abstract Unlike other DSM-IV anxiety disorders, separation anxiety disorder (SAD) has been considered a disorder that typically begins in childhood, and could be diagnosed only in adults “if onset is before 18.” Moreover, SAD is the only DSM-IV anxiety disorder placed under “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence” whereas most anxiety disorders typically start – and are diagnosed – in childhood. Therefore, adult SAD may have been under-recognized and under-diagnosed. A literature review was carried out on behalf of the Anxiety, Obsessive–Compulsive Spectrum, Posttraumatic, and Dissociative Disorders DSM-5 workgroup to explore the evidence for SAD in adulthood, focusing on potentially relevant clinical characteristics and risk factors. The review revealed that SAD in adulthood is prevalent, often comorbid and debilitating. The DSM-IV age-of-onset criterion was not supported as a substantial portion of adults report first onset in adulthood. Research on putative risk factors is limited to childhood SAD: SAD runs in families, albeit patterns of familial aggregation and heritability estimates indicate low specificity. Tentative evidence for biomarkers and biased cognitive processes exists, again pointing to moderate SAD-specificity only. Further research on the epidemiology, etiology, and treatment of ASAD, using DSM-5 criteria, is needed, and particularly prospective-longitudinal studies to understand the developmental trajectories of separation anxiety disorder from childhood to adulthood.
Lee Anna Clark - One of the best experts on this subject based on the ideXlab platform.
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Adult separation anxiety disorder in DSM-5.
Clinical Psychology Review, 2013Co-Authors: Susan M. Bögels, Susanne Knappe, Lee Anna ClarkAbstract:Abstract Unlike other DSM-IV anxiety disorders, separation anxiety disorder (SAD) has been considered a disorder that typically begins in childhood, and could be diagnosed only in adults “if onset is before 18.” Moreover, SAD is the only DSM-IV anxiety disorder placed under “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence” whereas most anxiety disorders typically start – and are diagnosed – in childhood. Therefore, adult SAD may have been under-recognized and under-diagnosed. A literature review was carried out on behalf of the Anxiety, Obsessive–Compulsive Spectrum, Posttraumatic, and Dissociative Disorders DSM-5 workgroup to explore the evidence for SAD in adulthood, focusing on potentially relevant clinical characteristics and risk factors. The review revealed that SAD in adulthood is prevalent, often comorbid and debilitating. The DSM-IV age-of-onset criterion was not supported as a substantial portion of adults report first onset in adulthood. Research on putative risk factors is limited to childhood SAD: SAD runs in families, albeit patterns of familial aggregation and heritability estimates indicate low specificity. Tentative evidence for biomarkers and biased cognitive processes exists, again pointing to moderate SAD-specificity only. Further research on the epidemiology, etiology, and treatment of ASAD, using DSM-5 criteria, is needed, and particularly prospective-longitudinal studies to understand the developmental trajectories of separation anxiety disorder from childhood to adulthood.
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personality disorder types proposed for dsm 5
Journal of Personality Disorders, 2011Co-Authors: Donna S Bender, Carl C. Bell, Renato D Alarcon, Roel Verheul, John M. Oldham, Lee Anna Clark, Robert F Krueger, Leslie C. Morey, Larry J SieverAbstract:The Personality and Personality Disorders Work Group has proposed five specific personality disorder (PD) types for DSM-5, to be rated on a dimension of fit: antisocial/psychopathic, avoidant, borderline, obsessive-compulsive, and schizotypal. Each type is identified by core impairments in personality functioning, pathological personality traits, and common symptomatic behaviors. The other DSM-IV-TR PDs and the large residual category of personality disorder not otherwise specified (PDNOS) will be represented solely by the core impairments combined with specification by individuals' unique sets of personality traits. This proposal has three main features: (1) a reduction in the number of specified types from 10 to 5; (2) description of the types in a narrative format that combines typical deficits in self and interpersonal functioning and particular configurations of traits and behaviors; and (3) a dimensional rating of the degree to which a patient matches each type. An explanation of these modifications...
Dan J Stein - One of the best experts on this subject based on the ideXlab platform.
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a comparison of dsm 5 and dsm iv agoraphobia in the world mental health surveys
Depression and Anxiety, 2019Co-Authors: Annelieke M Roest, Hans-ulrich Wittchen, Ali Alhamzawi, Ymkje Anna De Vries, Carmen C W Lim, Dan J Stein, Tomasz Adamowski, Evelyn J Bromet, Maria Carmen Viana, Giovanni De GirolamoAbstract:Background The Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM‐5) definition of agoraphobia (AG) as an independent diagnostic entity makes it timely to re‐examine the epidemiology of AG. Study objective was to present representative data on the characteristics of individuals who meet DSM‐IV criteria for AG (AG without a history of panic disorder [PD] and PD with AG) but not DSM‐5 criteria, DSM‐5 but not DSM‐IV criteria, or both sets of criteria.
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examining dsm criteria for trichotillomania in a dimensional framework implications for dsm 5 and diagnostic practice
Comprehensive Psychiatry, 2015Co-Authors: David C Houghton, Dan J Stein, Steve Balsis, Scott N Compton, Michael P Twohig, Stephen M Saunders, Martin E Franklin, Angela Nealbarnett, Douglas W WoodsAbstract:Abstract Background Diagnosis of trichotillomania (TTM) requires meeting several criteria that aim to embody the core pathology of the disorder. These criteria are traditionally interpreted monothetically, in that they are all equally necessary for diagnosis. Alternatively, a dimensional conceptualization of psychopathology allows for examination of the relatedness of each criterion to the TTM latent continuum. Objectives First, to examine the ability of recently removed criteria (B and C) to identify the latent dimensions of TTM psychopathology, such that they discriminate between individuals with low and high degrees of hair pulling severity. Second, to determine the impact of removing criteria B and C on the information content of remaining diagnostic criteria. Third, to determine the psychometric properties of remaining TTM diagnostic criteria that remain largely unchanged in DSM-5 ; that is, whether they measure distinct or overlapping levels of TTM psychopathology. Fourth, to determine whether information content derived from diagnostic criteria aid in the prediction of disease trajectory (i.e., can relapse propensity be predicted from criteria endorsement patterns). Method Statistics derived from item response theory were used to examine diagnostic criteria endorsement in 91 adults with TTM who underwent psychotherapy. Results The removal of two criteria in DSM-5 and psychometric validity of remaining criteria was supported. Additionally, individual trait parameters were used to predict treatment progress, uncovering predictive power where none previously existed. Conclusions Diagnostic criteria for TTM should be examined in dimensional models, which allow for nuanced and sensitive measurement of core symptomology in treatment contexts.
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dsm 5 field survey hair pulling disorder trichotillomania
Depression and Anxiety, 2012Co-Authors: Christine Lochner, Dan J Stein, Jon E Grant, Brian L Odlaug, Douglas W Woods, Nancy J KeuthenAbstract:Background The aim of this multisite field survey was to examine the DSM-IV-TR criteria, proposed DSM-5 diagnostic criteria, as well as a number of possible additional diagnostic criteria, in patients with hair-pulling disorder (HPD, or trichotillomania). Methods Four sites were involved. Participants older than 10 years of age, male or female, with hair-pulling symptoms in the last 4 weeks were included. Participants were assessed with two modules based on the Structured Clinical Interview for DSM (SCID-I/P), which addressed the DSM-IV-TR criteria set as well as proposed DSM-5 diagnostic criteria for HPD, respectively. Additional questions were established to test other possible diagnostic criteria. Results Eighty-four (79 female, 5 male, 83 adult) participants with current hair-pulling symptoms were included. All of these participants had recurrent hair-pulling and most (n = 82 [98%]) reported repeated attempts to decrease or stop hair-pulling, and 70 (n = 70 [83%]) met the clinical significance criterion. Diagnostic criteria focused on “urge,” “tension,” “need,” “drive,” or “impulse” to pull, or pleasure, gratification or relief during or after pulling, were endorsed by many, but not all. Individuals who did endorse such criteria had significantly more severe hair-pulling symptoms. Conclusions These data support the proposed diagnostic criteria for HPD in adults. Although most adult patients have urges to pull or experience a sense of relief on pulling, as in the case of skin-picking disorder, such phenomena are not universal and so should not be included in the diagnostic criteria. An additional criterion focused on repeated attempts to decrease or stop hair-pulling seems warranted.
