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Sigmund Karterud - One of the best experts on this subject based on the ideXlab platform.
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validity aspects of the diagnostic and Statistical Manual of mental disorders fourth edition narcissistic personality disorder construct
Comprehensive Psychiatry, 2011Co-Authors: Sigmund Karterud, Maria Oien, Geir PedersenAbstract:Abstract Background The Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition , narcissistic personality disorder (NPD) construct has been criticized for being too narrowly defined, for example, by focusing on overt grandiosity at the expense of exhibitionism and narcissistic vulnerability and thus covering only parts of the domain of narcissism. The purpose of this study was to elucidate several validity aspects of the NPD construct. Methods The material consisted of data from 2277 patients (80% of whom had a personality disorder [PD]) who were admitted to units connected to The Norwegian Network of Psychotherapeutic Day Hospitals. The Axis II diagnoses were assessed by Structured Clinical Interview for DSM, Fourth Edition, Axis II Personality Disorders. Results The frequency of NPD was very low (0.8%). Male patients were overrepresented both on a diagnostic level and on criteria levels. The NPD category was positively associated with other cluster B disorders and negatively associated with avoidant PD. The criteria "demands excessive admiration" and "fantasies of unlimited success" correlated almost as highly with the histrionic PD category and loaded primarily on a histrionic factor. The dominant NPD factor also included the antisocial criterion of "showing no regret having injured others." The major part of the patients' personality pathology could be attributed to other PD criteria. Conclusions The results challenge the notion of NPD as a distinct diagnostic category. Rather, narcissism should be conceived as personality dimensions pertinent to the whole range of PDs. The results support the views put forward by Russ et al (Refining the construct of narcissistic personality disorder: diagnostic criteria and subtypes. Am J Psychiatry 2008;11:1473-1481) that what clinicians conceive as narcissism consists of several subtypes (dimensions). Our data support the existence of a grandiose/malignant type and an exhibitionistic type. Unfortunately, there was no measure of hypersensitivity. The proposal to delete NPD as a prototype category in the DSM, Fifth Edition, seems well justified. However, the proposed trait domain of antagonism in the DSM, Fifth Edition, seems to account better for the grandiose/malignant dimension than the exhibitionistic/histrionic dimension.
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Is the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, histrionic personality disorder category a valid construct?
Comprehensive Psychiatry, 2010Co-Authors: Jonas F. Bakkevig, Sigmund KarterudAbstract:Abstract Purpose The study investigated crucial aspects of the construct validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) histrionic personality disorder (HPD) category. Material and methods The study included 2289 patients from the Norwegian Network of Psychotherapeutic Day Hospitals. Construct validity was assessed by means of prevalence, comorbidity with other personality disorders, internal consistency among HPD criteria, severity indices, as well as factor analyses. Results The prevalence of HPD was very low (0.4 %). The comorbidity was high, especially with borderline, narcissistic, and dependent personality disorders. The internal consistency was low. The criteria seemed to form 2 separate clusters: the first contained exhibitionistic and attention-seeking traits and the other contained impressionistic traits. Conclusion The results indicated poor construct validity of the HPD category. Different options for the future of the category are discussed. The authors suggest the HPD category to be deleted from the DSM system. However, the clinical phenomena of exhibitionism and attention-seeking, which are the dominant personality features of HPD, should be preserved in an exhibitionistic subtype of narcissism.
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Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, paranoid personality disorder diagnosis: a unitary or a two-dimensional construct?
Comprehensive Psychiatry, 2009Co-Authors: Erik Falkum, Geir Pedersen, Sigmund KarterudAbstract:Abstract Objective This article examines reliability and validity aspects of the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition (DSM-IV) paranoid personality disorder (PPD) diagnosis. Method Patients with personality disorders (n = 930) from the Norwegian network of psychotherapeutic day hospitals, of which 114 had PPD, were included in the study. Frequency distribution, χ 2 , correlations, reliability statistics, exploratory, and confirmatory factor analyses were performed. Results The distribution of PPD criteria revealed no distinct boundary between patients with and without PPD. Diagnostic category membership was obtained in 37 of 64 theoretically possible ways. The PPD criteria formed a separate factor in a principal component analysis, whereas a confirmatory factor analysis indicated that the DSM-IV PPD construct consists of 2 separate dimensions as follows: suspiciousness and hostility. The reliability of the unitary PPD scale was only 0.70, probably partly due to the apparent 2-dimensionality of the construct. Persistent unwarranted doubts about the loyalty of friends had the highest diagnostic efficiency, whereas unwarranted accusations of infidelity of partner had particularly poor indicator properties. Conclusions The reliability and validity of the unitary PPD construct may be questioned. The 2-dimensional PPD model should be further explored.
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An investigation of the validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition avoidant personality disorder construct as a prototype category and the psychometric properties of the diagnostic criteria
Comprehensive psychiatry, 2006Co-Authors: Benjamin Hummelen, Geir Pedersen, Theresa Wilberg, Sigmund KarterudAbstract:Abstract This study investigated several aspects of the validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition avoidant personality disorder (APD) construct, with emphasis on the psychometric properties of the diagnostic criteria and the prototype nature of the construct. A sample of 1058 patients from the Norwegian Network of Psychotherapeutic Day Hospitals was examined by means of exploratory factor analysis, correlation, and diagnostic efficiency statistics, χ2 analysis, and frequency distribution. The results indicated that APD is a 1-dimensional construct with good internal consistency. The criteria had acceptable diagnostic efficiency; criterion 3 performed poorest. Number of APD criteria showed no distinct threshold between No-APD and patients with APD. Sixty-two different combinations of any 4 APD criteria occurred. It can be concluded that the prototype model fitted the data well and that the APD diagnostic criteria perform well in the current classification system. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition hierarchy of criteria was not supported.
Geir Pedersen - One of the best experts on this subject based on the ideXlab platform.
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validity aspects of the diagnostic and Statistical Manual of mental disorders fourth edition narcissistic personality disorder construct
Comprehensive Psychiatry, 2011Co-Authors: Sigmund Karterud, Maria Oien, Geir PedersenAbstract:Abstract Background The Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition , narcissistic personality disorder (NPD) construct has been criticized for being too narrowly defined, for example, by focusing on overt grandiosity at the expense of exhibitionism and narcissistic vulnerability and thus covering only parts of the domain of narcissism. The purpose of this study was to elucidate several validity aspects of the NPD construct. Methods The material consisted of data from 2277 patients (80% of whom had a personality disorder [PD]) who were admitted to units connected to The Norwegian Network of Psychotherapeutic Day Hospitals. The Axis II diagnoses were assessed by Structured Clinical Interview for DSM, Fourth Edition, Axis II Personality Disorders. Results The frequency of NPD was very low (0.8%). Male patients were overrepresented both on a diagnostic level and on criteria levels. The NPD category was positively associated with other cluster B disorders and negatively associated with avoidant PD. The criteria "demands excessive admiration" and "fantasies of unlimited success" correlated almost as highly with the histrionic PD category and loaded primarily on a histrionic factor. The dominant NPD factor also included the antisocial criterion of "showing no regret having injured others." The major part of the patients' personality pathology could be attributed to other PD criteria. Conclusions The results challenge the notion of NPD as a distinct diagnostic category. Rather, narcissism should be conceived as personality dimensions pertinent to the whole range of PDs. The results support the views put forward by Russ et al (Refining the construct of narcissistic personality disorder: diagnostic criteria and subtypes. Am J Psychiatry 2008;11:1473-1481) that what clinicians conceive as narcissism consists of several subtypes (dimensions). Our data support the existence of a grandiose/malignant type and an exhibitionistic type. Unfortunately, there was no measure of hypersensitivity. The proposal to delete NPD as a prototype category in the DSM, Fifth Edition, seems well justified. However, the proposed trait domain of antagonism in the DSM, Fifth Edition, seems to account better for the grandiose/malignant dimension than the exhibitionistic/histrionic dimension.
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Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, paranoid personality disorder diagnosis: a unitary or a two-dimensional construct?
Comprehensive Psychiatry, 2009Co-Authors: Erik Falkum, Geir Pedersen, Sigmund KarterudAbstract:Abstract Objective This article examines reliability and validity aspects of the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition (DSM-IV) paranoid personality disorder (PPD) diagnosis. Method Patients with personality disorders (n = 930) from the Norwegian network of psychotherapeutic day hospitals, of which 114 had PPD, were included in the study. Frequency distribution, χ 2 , correlations, reliability statistics, exploratory, and confirmatory factor analyses were performed. Results The distribution of PPD criteria revealed no distinct boundary between patients with and without PPD. Diagnostic category membership was obtained in 37 of 64 theoretically possible ways. The PPD criteria formed a separate factor in a principal component analysis, whereas a confirmatory factor analysis indicated that the DSM-IV PPD construct consists of 2 separate dimensions as follows: suspiciousness and hostility. The reliability of the unitary PPD scale was only 0.70, probably partly due to the apparent 2-dimensionality of the construct. Persistent unwarranted doubts about the loyalty of friends had the highest diagnostic efficiency, whereas unwarranted accusations of infidelity of partner had particularly poor indicator properties. Conclusions The reliability and validity of the unitary PPD construct may be questioned. The 2-dimensional PPD model should be further explored.
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An investigation of the validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition avoidant personality disorder construct as a prototype category and the psychometric properties of the diagnostic criteria
Comprehensive psychiatry, 2006Co-Authors: Benjamin Hummelen, Geir Pedersen, Theresa Wilberg, Sigmund KarterudAbstract:Abstract This study investigated several aspects of the validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition avoidant personality disorder (APD) construct, with emphasis on the psychometric properties of the diagnostic criteria and the prototype nature of the construct. A sample of 1058 patients from the Norwegian Network of Psychotherapeutic Day Hospitals was examined by means of exploratory factor analysis, correlation, and diagnostic efficiency statistics, χ2 analysis, and frequency distribution. The results indicated that APD is a 1-dimensional construct with good internal consistency. The criteria had acceptable diagnostic efficiency; criterion 3 performed poorest. Number of APD criteria showed no distinct threshold between No-APD and patients with APD. Sixty-two different combinations of any 4 APD criteria occurred. It can be concluded that the prototype model fitted the data well and that the APD diagnostic criteria perform well in the current classification system. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition hierarchy of criteria was not supported.
Linda M Brzustowicz - One of the best experts on this subject based on the ideXlab platform.
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social pragmatic communication disorder another name for the broad autism phenotype
Autism, 2019Co-Authors: Judy F Flax, Christine Gwin, Sherri Wilson, Yuli Fradkin, Steve Buyske, Linda M BrzustowiczAbstract:The Diagnostic and Statistical Manual of Mental Disorders’ (5th ed.) Social (Pragmatic) Communication Disorder is meant to capture the social elements of communication dysfunction in children who d...
Benjamin Chavez - One of the best experts on this subject based on the ideXlab platform.
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impact of central nervous system stimulant medication use on growth in pediatric populations with attention deficit hyperactivity disorder a review
Pharmacotherapy, 2018Co-Authors: Kyle Troksa, Nikolas Kovacich, Michael Moro, Benjamin ChavezAbstract:Central nervous system stimulants are a commonly used first-line treatment option for attention-deficit/hyperactivity disorder (ADHD). Stimulants are generally well tolerated, with anorexia and insomnia the most common adverse effects. However, there are some concerns with long-term use of stimulants, such as potential growth delay. Historically, data regarding this long-term adverse effect have been conflicting. In this article, we review the newer data surrounding the effects of central nervous system stimulants on growth parameters in children with ADHD. We conducted a literature search of the PubMed database; only articles using ADHD criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, were included to ensure the most up-to-date review of literature. Nine articles were identified for relevance and quality and are discussed in this review, describing clinical observations of height and weight of adolescent or pediatric patients receiving stimulant medications for ADHD therapy. In summary, this review points toward potential associations between duration of treatment and higher doses of stimulants with decreased weight and body mass index. Furthermore, this review demonstrates that evidence is still conflicting regarding the relationship between stimulant use and significant height decreases. Future studies with higher quality of evidence are needed to observe this potential adverse effect of stimulants in children and adolescents.
Susan Shurfen Gau - One of the best experts on this subject based on the ideXlab platform.
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psychiatric comorbidities of adults with early and late onset attention deficit hyperactivity disorder
Australian and New Zealand Journal of Psychiatry, 2016Co-Authors: Yuju Lin, Likuang Yang, Susan Shurfen GauAbstract:Objective:We evaluated the psychiatric comorbidities in adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder as a function of recalled symptom onset before and after the age of 7 years and whether the childhood attention-deficit/hyperactivity disorder symptoms were associated with psychiatric comorbidities.Method:In all, 214 adults who were diagnosed with Diagnostic and Statistical Manual of Mental disorders, 5th edition attention-deficit/hyperactivity disorder and 174 non-attention-deficit/hyperactivity disorder controls (aged 17–40 years) received psychiatric interviews to confirm their previous and current attention-deficit/hyperactivity disorder status and other psychiatric diagnoses. Demographics and risks of lifetime psychiatric disorders were compared among three groups: (1) attention-deficit/hyperactivity disorder, onset <7 years (early-onset); (2) attention-deficit/hyperactivity disorder, onset between 7 and 12 ...
