The Experts below are selected from a list of 47769 Experts worldwide ranked by ideXlab platform
Andrew E. Skodol - One of the best experts on this subject based on the ideXlab platform.
-
Personality Disorders in dsm 5 emerging research on the alternative model
Current Psychiatry Reports, 2015Co-Authors: Leslie C. Morey, Kathryn T Benson, Alexander J Busch, Andrew E. SkodolAbstract:The current categorical classification of Personality Disorders, originally introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), has been found to suffer from numerous shortcomings that hamper its usefulness for research and for clinical application. The Personality and Personality Disorders Work Group for DSM-5 was charged with developing an alternative model that would address many of these concerns. The developed model involved a hybrid dimensional/categorical model that represented Personality Disorders as combinations of core impairments in Personality functioning with specific configurations of problematic Personality traits. The Board of Trustees of the American Psychiatric Association did not accept the Task Force recommendation to implement this novel approach, and thus this alternative model was included in Sect. III of the DSM-5 among concepts requiring additional study. This review provides an overview of the emerging research on this alternative model, addressing each of the primary components of the model.
-
Personality Disorders in dsm 5
Annual Review of Clinical Psychology, 2012Co-Authors: Andrew E. SkodolAbstract:A substantive revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) last occurred in 1994; therefore, the mental health field should anticipate significant changes to the classification of mental Disorders in the fifth edition. Since DSM-5 Work Groups have recently proposed revisions for the major diagnostic classes of mental Disorders, an article on the current status of the Personality Disorders (PDs) is timely. This article reviews scientific principles that have influenced the development of proposed changes for the assessment and diagnosis of Personality psychopathology in DSM-5, presents the proposed model as of the summer of 2011, summarizes rationales for the changes, and discusses critiques of the model. Scientific principles were articulated for DSM-5 more than a decade ago; their application to the process has not been straightforward, however. Work Group members have labored to improve the DSM-5 approach to Personality and PDs to make the classification more valid and mor...
-
Personality Disorders and the 3 year course of alcohol drug and nicotine use Disorders
Archives of General Psychiatry, 2011Co-Authors: Deborah S Hasin, Andrew E. Skodol, Robert F Krueger, Miriam C Fenton, Katherine M Keyes, Timothy Geier, Eliana Greenstein, Carlos Blanco, Bridget F GrantAbstract:Context Little is known about the role of a broad range of Personality Disorders in the course of substance use disorder (SUD) and whether these differ by substance. The existing literature focuses mostly on antisocial Personality disorder and does not come to clear conclusions. Objective To determine the association between the 10 DSM-IV Personality Disorders and the persistence of common SUDs in a 3-year prospective study of a national sample. Design Data were drawn from participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who had alcohol dependence (n = 1172), cannabis use disorder (n = 454), or nicotine dependence (n = 4017) at baseline and who were reinterviewed 3 years later. Control variables included demographic characteristics, family history of substance Disorders, baseline Axis I Disorders and treatment status, and prior SUD duration. Main Outcome Measure Persistent SUD, defined as meeting full criteria for the relevant SUD throughout the 3-year follow-up period. Results Persistent SUD was found among 30.1% of participants with alcohol dependence, 30.8% with cannabis use disorder, and 56.6% with nicotine dependence at baseline. Axis I Disorders did not have strong or consistent associations with persistent SUD. In contrast, antisocial Personality disorder was significantly associated with persistent alcohol, cannabis, and nicotine use Disorders (adjusted odds ratios, 2.46-3.51), as was borderline Personality disorder (adjusted odds ratios, 2.04-2.78) and schizotypal Personality disorder (adjusted odds ratios, 1.65-5.90). Narcissistic, schizoid, and obsessive-compulsive Personality Disorders were less consistently associated with SUD persistence. Conclusions The consistent findings on the association of antisocial, borderline, and schizotypal Personality Disorders with persistent SUD indicates the importance of these Personality Disorders in understanding the course of SUD. Future studies should examine dimensional representations of Personality Disorders and the role of specific components of these Disorders, biological and environmental contributors to these relationships, and potential applications of these findings to treatment development.
-
dimensional representations of dsm iv Personality Disorders relationships to functional impairment
American Journal of Psychiatry, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Ingrid R Dyck, Tracie M Shea, Mary C Zanarini, Robert L Stout, John M. Oldham, Leslie C. Morey, Charles A. Sanislow, Carlos M. GriloAbstract:Objective: This study compared threedimensional 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 and dimensional representations of DSM-IV Personality Disorders had stronger relationships to impairment in functioning in the domains of employment, social relationships with parents and friends, and global social adjustment and to DSM-IV axis V ratings than the three- and five-factor models. DSM-IV dimensions predicted functional impairment best of the four approaches. Although five-factor Personality traits captured variance in functional impairment not predicted by DSM-IV Personality disorder dimensions, the DSM-IV dimensions accounted for significantly more variance than the measures of Personality. Conclusions: Scores on dimensions of general Personality functioning do not appear to be as strongly associated with functional impairment as the psychopathology of DSM Personality disorder. A compromise in the ongoing debate over categories versus dimensions of Personality disorder might be the dimensional rating of the criteria that comprise traditional categories.
-
the collaborative longitudinal Personality Disorders study clps overview and implications
Journal of Personality Disorders, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Tracie M Shea, Mary C Zanarini, Leslie C. Morey, John G. Gunderson, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, Shirley YenAbstract:Abstract 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, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Furthermore, dimensional Personality traits appear to be the foundation of behaviors described by many PD criteri...
Carlos M. Grilo - One of the best experts on this subject based on the ideXlab platform.
-
ten year course of borderline Personality disorder psychopathology and function from the collaborative longitudinal Personality Disorders study
Archives of General Psychiatry, 2011Co-Authors: John G. Gunderson, Tracie M Shea, Mary C Zanarini, Robert L Stout, Leslie C. Morey, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, John C Markowitz, Emily B AnsellAbstract: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 with MDD but no Personality disorder. Main Outcome Measures The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose Personality Disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Results Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P Conclusions The 10-year course of BPD is characterized by high rates of remission, low rates of relapse, and severe and persistent impairment in social functioning. These results inform expectations of patients, families, and clinicians and document the severe public health burden of this disorder.
-
dimensional representations of dsm iv Personality Disorders relationships to functional impairment
American Journal of Psychiatry, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Ingrid R Dyck, Tracie M Shea, Mary C Zanarini, Robert L Stout, John M. Oldham, Leslie C. Morey, Charles A. Sanislow, Carlos M. GriloAbstract:Objective: This study compared threedimensional 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 and dimensional representations of DSM-IV Personality Disorders had stronger relationships to impairment in functioning in the domains of employment, social relationships with parents and friends, and global social adjustment and to DSM-IV axis V ratings than the three- and five-factor models. DSM-IV dimensions predicted functional impairment best of the four approaches. Although five-factor Personality traits captured variance in functional impairment not predicted by DSM-IV Personality disorder dimensions, the DSM-IV dimensions accounted for significantly more variance than the measures of Personality. Conclusions: Scores on dimensions of general Personality functioning do not appear to be as strongly associated with functional impairment as the psychopathology of DSM Personality disorder. A compromise in the ongoing debate over categories versus dimensions of Personality disorder might be the dimensional rating of the criteria that comprise traditional categories.
-
the collaborative longitudinal Personality Disorders study clps overview and implications
Journal of Personality Disorders, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Tracie M Shea, Mary C Zanarini, Leslie C. Morey, John G. Gunderson, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, Shirley YenAbstract:Abstract 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, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Furthermore, dimensional Personality traits appear to be the foundation of behaviors described by many PD criteri...
-
stressful life events as predictors of functioning findings from the collaborative longitudinal Personality Disorders study
Acta Psychiatrica Scandinavica, 2004Co-Authors: Maria E Pagano, Donna S Bender, Robert L Stout, Andrew E. Skodol, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, M T Shea, Shirley Yen, Mary C ZanariniAbstract: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 Disorders (MDD) without PD. Results: Borderline Personality disorder subjects reported significantly more total negative life events than other PDs or subjects with MDD. Negative events, especially interpersonal events, predicted decreased psychosocial functioning over time. Conclusion: Our findings indicate higher rates of negative events in subjects with more severe PDs and suggest that negative life events adversely impact multiple areas of psychosocial functioning.
-
associations in the course of Personality Disorders and axis i Disorders over time
Journal of Abnormal Psychology, 2004Co-Authors: Tracie M Shea, Robert L Stout, Leslie C. Morey, John G. Gunderson, Andrew E. Skodol, Thomas H. Mcglashan, Carlos M. Grilo, Shirley Yen, Maria E Pagano, Charles A. SanislowAbstract: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 anxiety Disorders (specifically social phobia and obsessive-compulsive disorder). Two of the four Personality Disorders under examination (STPD and OCPD) showed little or no association with Axis I Disorders.
Charles A. Sanislow - One of the best experts on this subject based on the ideXlab platform.
-
ten year course of borderline Personality disorder psychopathology and function from the collaborative longitudinal Personality Disorders study
Archives of General Psychiatry, 2011Co-Authors: John G. Gunderson, Tracie M Shea, Mary C Zanarini, Robert L Stout, Leslie C. Morey, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, John C Markowitz, Emily B AnsellAbstract: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 with MDD but no Personality disorder. Main Outcome Measures The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose Personality Disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Results Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P Conclusions The 10-year course of BPD is characterized by high rates of remission, low rates of relapse, and severe and persistent impairment in social functioning. These results inform expectations of patients, families, and clinicians and document the severe public health burden of this disorder.
-
dimensional representations of dsm iv Personality Disorders relationships to functional impairment
American Journal of Psychiatry, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Ingrid R Dyck, Tracie M Shea, Mary C Zanarini, Robert L Stout, John M. Oldham, Leslie C. Morey, Charles A. Sanislow, Carlos M. GriloAbstract:Objective: This study compared threedimensional 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 and dimensional representations of DSM-IV Personality Disorders had stronger relationships to impairment in functioning in the domains of employment, social relationships with parents and friends, and global social adjustment and to DSM-IV axis V ratings than the three- and five-factor models. DSM-IV dimensions predicted functional impairment best of the four approaches. Although five-factor Personality traits captured variance in functional impairment not predicted by DSM-IV Personality disorder dimensions, the DSM-IV dimensions accounted for significantly more variance than the measures of Personality. Conclusions: Scores on dimensions of general Personality functioning do not appear to be as strongly associated with functional impairment as the psychopathology of DSM Personality disorder. A compromise in the ongoing debate over categories versus dimensions of Personality disorder might be the dimensional rating of the criteria that comprise traditional categories.
-
the collaborative longitudinal Personality Disorders study clps overview and implications
Journal of Personality Disorders, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Tracie M Shea, Mary C Zanarini, Leslie C. Morey, John G. Gunderson, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, Shirley YenAbstract:Abstract 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, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Furthermore, dimensional Personality traits appear to be the foundation of behaviors described by many PD criteri...
-
stressful life events as predictors of functioning findings from the collaborative longitudinal Personality Disorders study
Acta Psychiatrica Scandinavica, 2004Co-Authors: Maria E Pagano, Donna S Bender, Robert L Stout, Andrew E. Skodol, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, M T Shea, Shirley Yen, Mary C ZanariniAbstract: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 Disorders (MDD) without PD. Results: Borderline Personality disorder subjects reported significantly more total negative life events than other PDs or subjects with MDD. Negative events, especially interpersonal events, predicted decreased psychosocial functioning over time. Conclusion: Our findings indicate higher rates of negative events in subjects with more severe PDs and suggest that negative life events adversely impact multiple areas of psychosocial functioning.
-
associations in the course of Personality Disorders and axis i Disorders over time
Journal of Abnormal Psychology, 2004Co-Authors: Tracie M Shea, Robert L Stout, Leslie C. Morey, John G. Gunderson, Andrew E. Skodol, Thomas H. Mcglashan, Carlos M. Grilo, Shirley Yen, Maria E Pagano, Charles A. SanislowAbstract: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 anxiety Disorders (specifically social phobia and obsessive-compulsive disorder). Two of the four Personality Disorders under examination (STPD and OCPD) showed little or no association with Axis I Disorders.
Tracie M Shea - One of the best experts on this subject based on the ideXlab platform.
-
ten year course of borderline Personality disorder psychopathology and function from the collaborative longitudinal Personality Disorders study
Archives of General Psychiatry, 2011Co-Authors: John G. Gunderson, Tracie M Shea, Mary C Zanarini, Robert L Stout, Leslie C. Morey, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, John C Markowitz, Emily B AnsellAbstract: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 with MDD but no Personality disorder. Main Outcome Measures The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose Personality Disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Results Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P Conclusions The 10-year course of BPD is characterized by high rates of remission, low rates of relapse, and severe and persistent impairment in social functioning. These results inform expectations of patients, families, and clinicians and document the severe public health burden of this disorder.
-
dimensional representations of dsm iv Personality Disorders relationships to functional impairment
American Journal of Psychiatry, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Ingrid R Dyck, Tracie M Shea, Mary C Zanarini, Robert L Stout, John M. Oldham, Leslie C. Morey, Charles A. Sanislow, Carlos M. GriloAbstract:Objective: This study compared threedimensional 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 and dimensional representations of DSM-IV Personality Disorders had stronger relationships to impairment in functioning in the domains of employment, social relationships with parents and friends, and global social adjustment and to DSM-IV axis V ratings than the three- and five-factor models. DSM-IV dimensions predicted functional impairment best of the four approaches. Although five-factor Personality traits captured variance in functional impairment not predicted by DSM-IV Personality disorder dimensions, the DSM-IV dimensions accounted for significantly more variance than the measures of Personality. Conclusions: Scores on dimensions of general Personality functioning do not appear to be as strongly associated with functional impairment as the psychopathology of DSM Personality disorder. A compromise in the ongoing debate over categories versus dimensions of Personality disorder might be the dimensional rating of the criteria that comprise traditional categories.
-
the collaborative longitudinal Personality Disorders study clps overview and implications
Journal of Personality Disorders, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Tracie M Shea, Mary C Zanarini, Leslie C. Morey, John G. Gunderson, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, Shirley YenAbstract:Abstract 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, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Furthermore, dimensional Personality traits appear to be the foundation of behaviors described by many PD criteri...
-
associations in the course of Personality Disorders and axis i Disorders over time
Journal of Abnormal Psychology, 2004Co-Authors: Tracie M Shea, Robert L Stout, Leslie C. Morey, John G. Gunderson, Andrew E. Skodol, Thomas H. Mcglashan, Carlos M. Grilo, Shirley Yen, Maria E Pagano, Charles A. SanislowAbstract: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 anxiety Disorders (specifically social phobia and obsessive-compulsive disorder). Two of the four Personality Disorders under examination (STPD and OCPD) showed little or no association with Axis I Disorders.
-
childhood maltreatment associated with adult Personality Disorders findings from the collaborative longitudinal Personality Disorders study
Journal of Personality Disorders, 2004Co-Authors: Cynthia L Battle, Tracie M Shea, Mary C Zanarini, John G. Gunderson, Andrew E. Skodol, Charles A. Sanislow, Shirley Yen, Dawn M Johnson, Caron Zlotnick, Carlos M. GriloAbstract:Adverse childhood experiences such as abuse and neglect are frequently implicated in the development of Personality Disorders (PDs); however, research on the childhood histories of most PD groups remains limited. In this multisite investigation, we assessed self-reported history of abuse and neglect experiences among 600 patients diagnosed with either a PD (borderline, schizotypal, avoidant, or obsessive-compulsive) or major depressive disorder without PD. Results indicate that rates of childhood maltreatment among individuals with PDs are generally high (73% reporting abuse; 82% reporting neglect). As expected, borderline PD was more consistently associated with childhood abuse and neglect than other PD diagnoses. However, even when controlling for the effect of borderline PD, other PD diagnoses were associated with specific types of maltreatment.
Mary C Zanarini - One of the best experts on this subject based on the ideXlab platform.
-
ten year course of borderline Personality disorder psychopathology and function from the collaborative longitudinal Personality Disorders study
Archives of General Psychiatry, 2011Co-Authors: John G. Gunderson, Tracie M Shea, Mary C Zanarini, Robert L Stout, Leslie C. Morey, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, John C Markowitz, Emily B AnsellAbstract: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 with MDD but no Personality disorder. Main Outcome Measures The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose Personality Disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Results Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P Conclusions The 10-year course of BPD is characterized by high rates of remission, low rates of relapse, and severe and persistent impairment in social functioning. These results inform expectations of patients, families, and clinicians and document the severe public health burden of this disorder.
-
dimensional representations of dsm iv Personality Disorders relationships to functional impairment
American Journal of Psychiatry, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Ingrid R Dyck, Tracie M Shea, Mary C Zanarini, Robert L Stout, John M. Oldham, Leslie C. Morey, Charles A. Sanislow, Carlos M. GriloAbstract:Objective: This study compared threedimensional 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 and dimensional representations of DSM-IV Personality Disorders had stronger relationships to impairment in functioning in the domains of employment, social relationships with parents and friends, and global social adjustment and to DSM-IV axis V ratings than the three- and five-factor models. DSM-IV dimensions predicted functional impairment best of the four approaches. Although five-factor Personality traits captured variance in functional impairment not predicted by DSM-IV Personality disorder dimensions, the DSM-IV dimensions accounted for significantly more variance than the measures of Personality. Conclusions: Scores on dimensions of general Personality functioning do not appear to be as strongly associated with functional impairment as the psychopathology of DSM Personality disorder. A compromise in the ongoing debate over categories versus dimensions of Personality disorder might be the dimensional rating of the criteria that comprise traditional categories.
-
the collaborative longitudinal Personality Disorders study clps overview and implications
Journal of Personality Disorders, 2005Co-Authors: Andrew E. Skodol, Donna S Bender, Tracie M Shea, Mary C Zanarini, Leslie C. Morey, John G. Gunderson, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, Shirley YenAbstract:Abstract 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, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Furthermore, dimensional Personality traits appear to be the foundation of behaviors described by many PD criteri...
-
stressful life events as predictors of functioning findings from the collaborative longitudinal Personality Disorders study
Acta Psychiatrica Scandinavica, 2004Co-Authors: Maria E Pagano, Donna S Bender, Robert L Stout, Andrew E. Skodol, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo, M T Shea, Shirley Yen, Mary C ZanariniAbstract: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 Disorders (MDD) without PD. Results: Borderline Personality disorder subjects reported significantly more total negative life events than other PDs or subjects with MDD. Negative events, especially interpersonal events, predicted decreased psychosocial functioning over time. Conclusion: Our findings indicate higher rates of negative events in subjects with more severe PDs and suggest that negative life events adversely impact multiple areas of psychosocial functioning.
-
childhood maltreatment associated with adult Personality Disorders findings from the collaborative longitudinal Personality Disorders study
Journal of Personality Disorders, 2004Co-Authors: Cynthia L Battle, Tracie M Shea, Mary C Zanarini, John G. Gunderson, Andrew E. Skodol, Charles A. Sanislow, Shirley Yen, Dawn M Johnson, Caron Zlotnick, Carlos M. GriloAbstract:Adverse childhood experiences such as abuse and neglect are frequently implicated in the development of Personality Disorders (PDs); however, research on the childhood histories of most PD groups remains limited. In this multisite investigation, we assessed self-reported history of abuse and neglect experiences among 600 patients diagnosed with either a PD (borderline, schizotypal, avoidant, or obsessive-compulsive) or major depressive disorder without PD. Results indicate that rates of childhood maltreatment among individuals with PDs are generally high (73% reporting abuse; 82% reporting neglect). As expected, borderline PD was more consistently associated with childhood abuse and neglect than other PD diagnoses. However, even when controlling for the effect of borderline PD, other PD diagnoses were associated with specific types of maltreatment.
