Self-Report Methodology is Insufficient for Improving the Assessment and Classification of Axis II Personality Disorders

A modified version of the revised Personality Diagnostic Questionnaire (PDQ–R), based on DSM–III–R personality disorders (PDs), was completed by 60 psychiatric patients. An informant's version was also completed by 60 relatives or friends nominated by each subject. Discrete DSM–III–R PDs were rare; the mean number of PDs per subject was 4.5. Cluster analysis showed that only antisocial PD was a basis for classification of patients, while most patients formed two groups which were mainly distinguished by quantitative differences related to the total scores of positive PD criteria. A shorter version of the questionnaire can be used as a screening test for co-morbid PDs (STCPD) which can predict the number of co-morbid DSM–III–R PDs. The total scores of positive PD criteria from the STCPD were usually (and significantly) higher than the corresponding scores from informants' questionnaires but when an informant's total score exceeded that of the patient, this indicated a subject's under-reporting.

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Dimensional models and neurobiology of personality disorders

Acta Neuropsychiatrica ◽

10.1017/s0924270800036279 ◽

1999 ◽

Vol 11 (1) ◽

pp. 1-4

Author(s):

W. van den Brink

Keyword(s):

Personality Disorders ◽

Personality Pathology ◽

Diagnostic Model ◽

Axis Ii ◽

Statistical Procedures ◽

Statistical Studies ◽

Chronic Disorders ◽

Theoretical Considerations ◽

Exclusive Choice

SUMMARYSince the introduction of a separate axis in DSM-III (1980), the validity of the categorical nature of the classification of personality disorders has been seriously questioned. Subsequently, a number of multidimensional alternatives have been proposed based on statistical procedures or theoretical considerations. At the same time, the study of the neurobiological underpinnings of personality and personality disorders has created a better understanding of etiological and pathogenetic processes responsible for these chronic disorders. The findings of these studies corroborate some of the major findings of statistical studies regarding the nature of the frequent comorbidity of axis II disorders. In the discussion, a mixed, two-tier diagnostic model is proposed to serve both scientific and clinical aims without the disadvantages of an exclusive choice for either categorical or dimensional approaches to the classification of personality pathology.

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Countertransference feelings and personality disorders: A psychometric evaluation of a brief version of the Feeling Word Checklist (FWC-BV)

10.21203/rs.2.17558/v3 ◽

2020 ◽

Author(s):

Randi Breivik ◽

Theresa Wilberg ◽

Julie Evensen ◽

Jan Ivar Røssberg ◽

Hanne Sofie Dahl ◽

...

Keyword(s):

Factor Analysis ◽

Psychometric Properties ◽

Personality Disorders ◽

Psychometric Evaluation ◽

Self Report ◽

Personality Pathology ◽

Axis Ii ◽

Working Alliance Inventory ◽

Dsm Iv ◽

Coefficient Omega

Abstract Background The Feeling Word Checklist (FWC) is a self-report questionnaire designed to assess therapists’ countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief, 12-item version of the Feeling Word Checklist (FWC-BV). The second aim was to validate the factor structure by examining the associations between the FWC-BV factors, patients’ personality pathology and therapeutic alliance (TA). Methods Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders participated, and the study includes therapies for a large sample of patients ( N =2425) with personality pathology. Over a period of 2.5 years, therapists completed the FWC-BV for each patient in therapy every 6 months. Statistical methods included exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Mc Donald’s coefficient Omega (ω t ). The Structured Clinical Interview for DSM-IV – Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR). Results Factor analyses revealed three clinically meaningful factors: Inadequate , Idealised and Confident . These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised , and negatively with the factor Confident . All the factors correlated significantly with at least one of the WAI-SR subscales Conclusions The FWC-BV measures three clinically meaningful aspects of therapists’ CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts. Keywords: Countertransference, Feeling Word Checklist, factor analysis, personality disorder, psychometrics

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Assessment of Axis Ii Personality Disorders among Female Substance Abusers

Psychological Reports ◽

10.2466/pr0.1991.68.3c.1344 ◽

1991 ◽

Vol 68 (3_suppl) ◽

pp. 1344-1346 ◽

Cited By ~ 4

Author(s):

Stephen F. Butler ◽

Bernard Gaulier ◽

Deborah Haller

Keyword(s):

Personality Disorders ◽

Substance Abusers ◽

Self Report ◽

Structured Interviews ◽

Axis Ii ◽

High Prevalence

16 female substance abusers were assessed for the presence of personality disorders using two structured interviews and two self-report questionnaires. Although high prevalence of personality disorders was detected by each instrument, there was little agreement among the four methods for assessing these disorders.

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A personality disorders prevalence study among inpatients with mood disorders, psychoactive substance use disorders and anxiety disorders

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00007739 ◽

2000 ◽

Vol 9 (1) ◽

pp. 36-44 ◽

Cited By ~ 4

Author(s):

Maria Grazia Marinangeli ◽

Giancarlo Butti ◽

Antonella Scinto ◽

Loredana Di Cicco ◽

Artemis Kalyvoka ◽

...

Keyword(s):

Personality Disorders ◽

Mood Disorders ◽

Clinical Sample ◽

Psychiatric Inpatients ◽

Self Report ◽

Exact Nature ◽

Obsessive Compulsive ◽

Axis Ii ◽

Axis I Disorders ◽

Axis I

SummaryObjective- The aim of this study was to asses type and prevalence of Personality Disorders (PDs) and their patterns of comorbidity with Axis I disorders in a sample of psychiatric inpatients.Setting- The sample consisted of 300 subjects admitted to a psychiatric unit on a voluntary bases for an index episode. The study was conducted over a period of 12 months, from 1.11.1997 to 31.10.1998.Main outcome measures- The Italian version of SCID-II-PQ (Structured Clinical Interview for DSM-III-R personality disorders, with Personality Questionnaire-PQ- a self report questionnaire).Results- More than half the patients had at least one personality disorder. The mean of disorders per patient was 2.83±1.93 (±SD). The most prevalent Axis II disorders were Borderline PD (30.7%), Obsessive-compulsive PD (30.7%) and Avoidant PD (25.3%). Women were significantly more likely than men to meet criteria for Dependent PD and Avoidant PD. Man showed significantly more frequently than women Antisocial PD. Significant associations (p<0.05) were found for comorbidity of Mood Disorders and Avoidant PD, and for Psicoactive Use Disorders and Antisocial PD.Conclusions- Our study confirms the high prevalence of PDs in psychiatric inpatients and showes some interesting associations between Axis I and Axis II disorders. These results can't be generalized to outpatients because our clinical sample involved mainly severely ill inpatients, but they raise questions about the exact nature of PDs and of the relationship with Axis I disorders. Further research involving outpatients and general population is needed to examine factors that could affect development and course of Personality Disorders.

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Countertransference feelings and personality disorders: A psychometric evaluation of a brief version of the Feeling Word Checklist (FWC-12)

10.21203/rs.2.17558/v1 ◽

2019 ◽

Author(s):

Randi Breivik ◽

Theresa Wilberg ◽

Julie Evensen ◽

Jan Ivar Røssberg ◽

Hanne Sofie Dahl ◽

...

Keyword(s):

Factor Analysis ◽

Personality Disorder ◽

Psychometric Properties ◽

Personality Disorders ◽

Psychometric Evaluation ◽

Self Report ◽

Personality Pathology ◽

Axis Ii ◽

Working Alliance Inventory ◽

Dsm Iv

Abstract Background The Feeling Word Checklist (FWC) is a self-report questionnaire designed to measure therapists’ countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief version of the Feeling Word Checklist comprising twelve feeling words (FWC-12). The second aim was to validate the factor structure by examining the associations between the FWC-12 factors, patients’ personality pathology and therapeutic alliance (TA). Methods Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders completed the FWC-12 every 6 months during the course of treating a patient with a personality disorder (PD), over a period of up to 2.5 years. A large sample of patients with personality pathology participated in the study. The data were analysed with exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Cronbach’s alpha. The Structured Clinical Interview for DSM-IV – Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR). Results Factor analyses revealed three clinically meaningful factors: Inadequate, Idealised and Confident. These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised, and negatively with the factor Confident. All the factors correlated significantly with at least one of the WAI-SR subscales. Conclusions The FWC-12 measures three clinically meaningful aspects of therapists’ CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts. Keywords: Countertransference, Feeling Word Checklist, factor analysis, personality disorder, psychometrics

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Defining the Personality Disorders: Description of an Australian Database

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679609065051 ◽

1996 ◽

Vol 30 (6) ◽

pp. 824-833 ◽

Cited By ~ 7

Author(s):

Gordon Parker ◽

Dusan Hadzi-Pavlovic ◽

Kay Wilhelm ◽

Marie-Paule Austin ◽

Catherine Mason ◽

...

Keyword(s):

Personality Disorders ◽

A Priori ◽

Self Report ◽

Large Set ◽

Data Set ◽

Icd 10 ◽

Dsm Iv ◽

Acceptable Reliability ◽

Sample Recruitment

Objective: We seek to improve the definition and classification of the personality disorders (PDs) and derive a large database for addressing this objective. Method: The paper describes the rationale for the development of a large set of descriptors of the PDs (including all DSM-IV and ICD-10 descriptors, but enriched by an additional 109 items), the design of parallel self-report (SR) and corroborative witness (CW) measures, sample recruitment (of 863 patients with a priori evidence of personality disorder or disturbance) and preliminary descriptive data. Results: Analyses (particularly those comparing ratings on molar PD descriptions with putative PD dimensions) argue for acceptable reliability of the data set, while both the size of the sample and the representation of all PD dimensions of interest argue for the adequacy of the database. Conclusions: We consider in some detail current limitations to the definition and classification of the PDs, and foreshadow the analytic techniques that will be used to address the key objectives of allowing the PDs to be modelled more clearly and, ideally, measured with greater precision and validity.

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Personality Traits in the International Classification of Diseases 11th Revision (ICD-11)

10.31234/osf.io/wyu47 ◽

2020 ◽

Author(s):

Joshua R. Oltmanns

Keyword(s):

Personality Traits ◽

Personality Disorders ◽

Discriminant Validity ◽

Factor Model ◽

Five Factor Model ◽

International Classification Of Diseases ◽

Domain Model ◽

Self Report ◽

Dimensional System

Purpose of review: The ICD-11 officially adopted a dimensional system of personality disorder that was a paradigm shift for the classification of personality disorders. The purpose of this article is to review the growing amount of research on one component of that system—the personality trait domain model. Importantly, several self-report measures have been developed to measure the ICD-11 domains and have been subjected to initial validation through examination of their factor structure, multi-method use, convergent and discriminant validity with other prominent dimensional personality models (such as the Five-Factor Model), and criterion validity for important life outcomes. Recent Findings: Studies indicate the ICD-11 domains align with the Five-Factor Model and prior influential models of dimensional personality traits, as expected, and thus rest on an impressive body of empirical research. They also capture large amounts of variance included in the ICD-10/DSM-5 Section II personality disorders. Summary: Together these findings support the construct validity of the ICD-11 trait domains. However, continued validation research is necessary, as well as research on how to implement these domains into clinical practice, and research on the more specific facet-level of the trait domains—although the ICD-11 model is only officially at the domain-level.

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PERSONALITY DISORDERS AND SOCIAL FUNCTIONING IN DEPRESSED PATIENTS

Social Behavior and Personality An International Journal ◽

10.2224/sbp.2000.28.2.163 ◽

2000 ◽

Vol 28 (2) ◽

pp. 163-175 ◽

Cited By ~ 7

Author(s):

S. Kool ◽

J. Dekker ◽

I. Duijsens ◽

F. De Jonghe ◽

P. De Jong ◽

...

Keyword(s):

Major Depression ◽

Personality Disorders ◽

Social Functioning ◽

Rating Scale ◽

Demographic Characteristics ◽

Self Report ◽

Axis Ii ◽

Depressed Patients ◽

The Social ◽

Significant Difference

There is a high level of comorbidity of personality disorders with major depression. Patients who suffer from both depression and an axis II disorder are, in general, more severely ill and ill for longer periods. The presence of personality disorders also has a negative influence on the social functioning of depressed patients, and it has emerged that certain demographic characteristics are present to a significant extent. This article presents the results of a study of 244 out-patients suffering from major depression. The issues addressed were: Firstly, which axis II disorders are found in this group and are there correlations with the demographic characteristics? Secondly, is there a relationship between individual axis II disorders and the severity of the depression and social functioning? It emerges that 60% of the patients with a Hamilton score of at least 14 have one or more axis II disorders according to the VKP self-report, and that 30% have three or more, with more than 50% in cluster C. It was found also that the schizoid and borderline personality disorders in particular are significantly linked to several demographic characteristics. The patients here are more often single and those with a lower level of education. Using the Hamilton Depression Rating Scale, little significant correlation was found between the presence of an axis II disorder and the severity of the depression. A significant difference was found using the Symptom Check List -90. In social functioning, the citizen role, the social role and the family role turn out to be correlated most significantly, as are the total number of impairments. In addition, the highest correlation is found particularly in cluster C, and the number of axis II disorders is almost always significantly related to the individual roles. The discussion turns to the influence of the measuring instruments used and to the composition of the population, as well as the clinical relevance of the diagnosis of axis II disorders and social functioning in patients with a major depression.

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A perspective on the current issues in the DSM-5 classification of personality disorders

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2013.15.2/jguelfi ◽

2013 ◽

Vol 15 (2) ◽

pp. 131-132 ◽

Cited By ~ 2

Keyword(s):

Personality Disorders ◽

Task Force ◽

Diagnostic Procedures ◽

General Definition ◽

Axis Ii ◽

Dsm 5 ◽

Dsm Iv ◽

New Criteria ◽

Better Than

David Kupfer chaired the DSM-5 Task Force, and Andrew Skodol the working group, on personality disorders. Various initial propositions were posted on the Internet in 2010 for comment and discussion: new general definition, new criteria, new diagnostic procedures, reduction in the number of categories, and dimensional representation. Following numerous criticisms, the Task Force's final decisions were made public on December 1, 2012. Personality disorders now figure alongside other mental disorders, because of the deletion of Axis II. The methodology concerning personality traits is in a third section to promote new studies. The new proposed hybrid system has not, to date, proven better than the categories of the DSM-IV. These various decisions are commented upon.

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