scholarly journals Personality disorder and impaired functioning from adolescence to adulthood

2007 ◽  
Vol 190 (5) ◽  
pp. 415-420 ◽  
Author(s):  
Andrew E. Skodol ◽  
Jeffrey G. Johnson ◽  
Patricia Cohen ◽  
Joel R. Sneed ◽  
Thomas N. Crawford
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Epidemiological Data ◽  
Adult Onset ◽  
Global Functioning ◽  
Community Based ◽  
Axis I Disorders ◽  
Significant Impairment ◽  
Axis I

BackgroundLittle is currently known about functioning and impairment during adulthood associated with the course of personality disorders.AimsTo investigate the association of personality disorder stability from adolescence through middle adulthood with measures of global functioning and impairment, using prospective epidemiological data.MethodA community-based sample of 658 individuals was interviewed at mean ages 14, 16, 22 and 33 years.ResultsIndividuals with persistent personality disorder had markedly poorer functioning and greater impairment at mean age 33 years than did those who had never been identified as having such disorder or who had a personality disorder that was in remission, after co-occurring Axis I disorders at age 33 years were taken into account. Remitted disorder was associated with mild long-term impairment. Adult-onset personality disorders, however, were also associated with significant impairment.ConclusionsPersistent and adult-onset personality disorders are associated with functional impairment among adults in the community. These effects are independent of co-occurring Axis 1 disorders.

The longitudinal relationship between personality disorder dimensions and global functioning in a community-residing population

2004 ◽  
Vol 35 (6) ◽  
pp. 891-895 ◽  
Author(s):  
JIN PYO HONG ◽  
JACK SAMUELS ◽  
O. JOSEPH BIENVENU ◽  
FANG-CHI HSU ◽  
WILLIAM W. EATON ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Future Research ◽  
Global Functioning ◽  
Long Term Outcome ◽  
Avoidant Personality Disorder ◽  
Axis I Disorders ◽  
Axis I ◽  
Gaf Scores

Background. Little is known about the long-term outcome of personality disorder traits. The purpose of this study was to investigate, in a community-residing population, the longitudinal relationship between psychiatrist-assessed personality disorder scores and global functioning 13–18 years later.Method. A stratified random sample of residents of east Baltimore were examined by psychiatrists in 1981 and asssessed for DSM-III personality disorders using a semi-structured instrument, the Standardized Psychiatric Examination. A total of 292 persons were re-examined by different psychiatrists during 1994–1999 using the Schedules for the Assessment of Neuropsychiatry (SCAN). After completion of the SCAN, the subjects' functional status was evaluated using the Global Assessment of Functioning (GAF). The relationships between personality dimensions and follow-up GAF scores were evaluated using linear regression models.Results. All of the personality disorder scales measured in 1981 were inversely related to functioning 13–18 years later, with the exception of narcissistic and compulsive scales. After controlling for Axis I disorders diagnosed contemporaneously with GAF assessment, schizoid, antisocial, borderline, histrionic, and avoidant personality disorder scores significantly predicted GAF scores.Conclusions. Most dimensions of DSM-III personality disorder traits were significantly associated with global functioning after an interval of 15 years. However, only schizoid, antisocial, borderline, histrionic, and avoidant personality disorder traits had long-term effects on functioning when Axis I disorders at follow-up were controlled. This suggests that the functional effect of the other personality disorder traits may be mediated through their relationship with Axis I disorders. Future research is needed using more specific and sensitive outcome measures.

Treatment Outlines for Borderline, Narcissistic and Histrionic Personality Disorders

1991 ◽  
Vol 25 (3) ◽  
pp. 392-403 ◽  
Keyword(s):  
Personality Disorders ◽  
Expert Committee ◽  
Hypothetical Model ◽  
Special Training ◽  
Axis I Disorders ◽  
Axis I

Treatment outlines for Axis I disorders were published during 1982–1985. Treatment outlines for the DSM-Ill personality disorders are being published. This guide to the treatment of borderline, histrionic and narcissistic disorders was developed from the literature, from the opinions of practising psychiatrists and from the experience of nominated experts. Even though the treatment of patients who suffer from these disorders is very difficult, the surveys of outcome in the literature suggest that a majority of patients improve significantly with long term psychotherapy. In the present outline the expert committee describe a hypothetical model for the genesis of these disorders and outline the steps to be followed if therapy is to be optimal. The experts stress that therapy is often prolonged and difficult but can be rewarding. They caution that therapists are likely to require considerable special training and it is recommended that they seek supervision throughout the process of therapy.

scholarly journals DSM-IV personality disorders in Mexico: results from a general population survey

2008 ◽  
Vol 30 (3) ◽  
pp. 227-234 ◽  
Author(s):  
Corina Benjet ◽  
Guilherme Borges ◽  
Maria Elena Medina-Mora
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Multiple Imputation ◽  
Adult Population ◽  
The United States ◽  
Imputation Method ◽  
Axis I Disorders ◽  
Axis I ◽  
Dsm Iv ◽  
Multiple Imputation Method

OBJECTIVE: This paper reports the first population estimates of prevalence and correlates of personality disorders in the Mexican population. METHOD: Personality disorders screening questions from the International Personality Disorder Examination were administered to a representative sample of the Mexican urban adult population (n = 2,362) as part of the Mexican National Comorbidity Survey, validated with clinical evaluations conducted in the United States. A multiple imputation method was then implemented to estimate prevalence and correlates of personality disorder in the Mexican sample. RESULTS: Multiple imputation method prevalence estimates were 4.6% Cluster A, 1.6% Cluster B, 2.4% Cluster C, and 6.1% any personality disorder. All personality disorders clusters were significantly comorbid with DSM-IV Axis I disorders. One in every five persons with an Axis I disorder in Mexico is likely to have a comorbid personality disorder, and almost half of those with a personality disorder are likely to have an Axis I disorder. CONCLUSIONS: Modest associations of personality disorders with impairment and strong associations with treatment utilization were largely accounted for by Axis I comorbidity suggesting that the public health significance of personality disorders lies in their comorbidity with, and perhaps effects upon, Axis I disorders rather than their direct effects on functioning and help seeking.

scholarly journals DSM–IV personality disorders in the WHO World Mental Health Surveys

2009 ◽  
Vol 195 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Yueqin Huang ◽  
Roman Kotov ◽  
Giovanni de Girolamo ◽  
Antonio Preti ◽  
Matthias Angermeyer ◽  
...  
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Personality Disorders ◽  
World Health ◽  
World Mental Health ◽  
Axis I Disorders ◽  
Clinical Diagnoses ◽  
Axis I ◽  
Dsm Iv ◽  
Health Organization

BackgroundLittle is known about the cross-national population prevalence or correlates of personality disorders.AimsTo estimate prevalence and correlates of DSM–IV personality disorder clusters in the World Health Organization World Mental Health (WMH) Surveys.MethodInternational Personality Disorder Examination (IPDE) screening questions in 13 countries (n = 21 162) were calibrated to masked IPDE clinical diagnoses. Prevalence and correlates were estimated using multiple imputation.ResultsPrevalence estimates are 6.1% (s.e. = 0.3) for any personality disorder and 3.6% (s.e. = 0.3), 1.5% (s.e. = 0.1) and 2.7% (s.e. = 0.2) for Clusters A, B and C respectively. Personality disorders are significantly elevated among males, the previously married (Cluster C), unemployed (Cluster C), the young (Clusters A and B) and the poorly educated. Personality disorders are highly comorbid with Axis I disorders. Impairments associated with personality disorders are only partially explained by comorbidity.ConclusionsPersonality disorders are relatively common disorders that often co-occur with Axis I disorders and are associated with significant role impairments beyond those due to comorbidity.

Test-Retest Reliability of a Self-Report Questionnaire for DSM-IV and ICD-10 Personality Disorders

2000 ◽  
Vol 16 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Hans Ottosson ◽  
Martin Grann ◽  
Gunnar Kullgren
Keyword(s):  
Personality Disorder ◽  
Anxiety Disorders ◽  
Personality Disorders ◽  
Clinical Sample ◽  
Self Report ◽  
Anxiety State ◽  
Short Term ◽  
Retest Reliability ◽  
Axis I ◽  
Test Retest Reliability

Summary: Short-term stability or test-retest reliability of self-reported personality traits is likely to be biased if the respondent is affected by a depressive or anxiety state. However, in some studies, DSM-oriented self-reported instruments have proved to be reasonably stable in the short term, regardless of co-occurring depressive or anxiety disorders. In the present study, we examined the short-term test-retest reliability of a new self-report questionnaire for personality disorder diagnosis (DIP-Q) on a clinical sample of 30 individuals, having either a depressive, an anxiety, or no axis-I disorder. Test-retest scorings from subjects with depressive disorders were mostly unstable, with a significant change in fulfilled criteria between entry and retest for three out of ten personality disorders: borderline, avoidant and obsessive-compulsive personality disorder. Scorings from subjects with anxiety disorders were unstable only for cluster C and dependent personality disorder items. In the absence of co-morbid depressive or anxiety disorders, mean dimensional scores of DIP-Q showed no significant differences between entry and retest. Overall, the effect from state on trait scorings was moderate, and it is concluded that test-retest reliability for DIP-Q is acceptable.

COGNITIVE BEHAVIOUR THERAPY AND ASSERTION TRAINING GROUPS FOR PATIENTS WITH DEPRESSION AND COMORBID PERSONALITY DISORDERS

2000 ◽  
Vol 28 (1) ◽  
pp. 71-85 ◽  
Author(s):  
Jillian Ball ◽  
Brian Kearney ◽  
Kay Wilhelm ◽  
Jodie Dewhurst-Savellis ◽  
Belinda Barton
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Depressive Symptomatology ◽  
Therapy Group ◽  
Self Report ◽  
Cognitive Behaviour ◽  
Long Term Follow Up ◽  
Assertion Training

Longitudinal evaluations were conducted on 61 adults who were referred to a Mood Disorders Unit with a history of depression (all index episodes reached criteria for DSM-III-R major depression or dysthymia) and who had completed a cognitive behavioural therapy group either on its own or in combination with an assertion training group. Assessment of personality was made using DSM-III-R Axis II personality disorder categories. These categories were aggregated to form three groups: (i) no personality disorder; (ii) Cluster B (dramatic-erratic); and (iii) Cluster C (anxious-fearful), and were used to identify responsiveness to treatment and outcome at long-term follow-up. A battery of self-report measures were administered pretreatment, posttreatment and at long-term follow-up (1–3 years later). Both groups showed significant improvements in mean scores during treatment and these gains were maintained over the follow-up period. However, improvement in those patients without personality disorders was greater at posttreatment and at long-term follow-up, both in level of depressive symptomatology and proportion of cases meeting criteria for recovery. The treatment implications of these results are discussed.

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