scholarly journals Expert Preferences for Categorical, Dimensional, and Mixed/Hybrid Approaches to Personality Disorder Diagnosis

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Leslie C. Morey ◽  
Christopher J. Hopwood
Keyword(s):  
Personality Disorder ◽  
Rank Order ◽  
Hybrid Approach ◽  
Dimensional Approach ◽  
Age And Gender ◽  
Dsm 5 ◽  
Hybrid Approaches ◽  
General Preference ◽  
And Gender ◽  
Training Background

The authors asked 361 personality disorder experts to rank order their preferences for a categorical, dimensional, or mixed/hybrid approach to personality disorder diagnosis in manuals such as the DSM and ICD. Respondents reported a general preference for the mixed/hybrid approach over a purely dimensional approach, and a clear preference against a categorical model. Although there were some statistically significant differences in the rates across training background, age, and gender, this overall pattern of preferences held across these factors. Preferences were notably similar to those reported by Bernstein et al. (2007) prior to the beginnings of deliberations on DSM-5 that ultimately led to a hybrid model. Results are informative for discussions regarding how to classify personality disorders in diagnostic manuals.

Neurological soft signs in homicidal men with antisocial personality disorder

2004 ◽  
Vol 19 (7) ◽  
pp. 433-437 ◽  
Author(s):  
Nina Lindberg ◽  
Pekka Tani ◽  
Jan-Henry Stenberg ◽  
Björn Appelberg ◽  
Tarja Porkka-Heiskanen ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Antisocial Personality Disorder ◽  
Brain Dysfunction ◽  
Antisocial Personality ◽  
Age And Gender ◽  
Neurological Soft Signs ◽  
System Defect ◽  
History Of ◽  
Forensic Psychiatric ◽  
And Gender

AbstractNeurological soft signs (NSS) are characterized by abnormalities in motor, sensory, and integrative functions. NSS have been regarded as a result of neurodevelopmental dysfunction, and as evidence of a central nervous system defect, resulting in considerable sociopsychological dysfunction. During the last decade there has been growing evidence of brain dysfunction in severe aggressive behavior. As a symptom, aggression overlaps a number of psychiatric disorders, but it is commonly associated with antisocial personality disorder. The aim of the present study was to examine NSS in an adult criminal population using the scale by Rossi et al. [29]. Subjects comprised 14 homicidal men with antisocial personality disorder recruited from a forensic psychiatric examination. Ten age- and gender-matched healthy volunteers as well as eight patients with schizophrenia, but no history of physical aggression, served as controls. The NSS scores of antisocial offenders were significantly increased compared with those of the healthy controls, whereas no significant differences were observed between the scores of offenders and those of patients with schizophrenia. It can be speculated that NSS indicate a nonspecific vulnerability factor in several psychiatric syndromes, which are further influenced by a variety of genetic and environmental components. One of these syndromes may be antisocial personality disorder with severe aggression.

Outpatient psychodynamic group psychotherapy - outcomes related to personality disorder, severity, age and gender

2016 ◽  
Vol 11 (1) ◽  
pp. 37-50 ◽  
Author(s):  
Elfrida Hartveit Kvarstein ◽  
Ola Nordviste ◽  
Lone Dragland ◽  
Theresa Wilberg
Keyword(s):  
Personality Disorder ◽  
Group Psychotherapy ◽  
Psychotherapy Outcomes ◽  
Age And Gender ◽  
And Gender

scholarly journals Sociocultural Context and the DSM-5 Alternative Model of Personality Disorder: Comment on Widiger & Hines

2022 ◽  
Author(s):  
Craig Anthony Rodriguez-Seijas
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Alternative Model ◽  
Sociocultural Context ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Psychological Stressors ◽  
And Gender ◽  
Theory Research

Widiger and Hines provide a brief overview of the development of the Alternative Model of Personality Disorder (AMPD) housed within Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). They highlight eight issues and controversies related to the AMPD in need of resolution for improvement of both the AMPD model itself as well as the field of personality disorders more broadly. In this brief commentary, I add a ninth issue in need of attention both with respect to the AMPD but also within the field of personality disorders more broadly: 9) How is sociocultural context to be accommodated in AMPD—and more generally personality disorder—theory, research, and treatment? The historical intra-individual, deficit-based models for conceptualizing personality disorders linger in current personality disorder discourse. However, failure to appropriately consider sociocultural context that systematically predisposes wide swaths of the population to unequal access to resources and exposure to psychological stressors, which can impact the appearance of personality pathology, serves to stigmatize minoritized individuals. The personality disorder field, and the AMPD discourse, must appropriately contend with sociocultural context in its models otherwise it risks developing models with limited generalizability and which hold potential to adversely affect sexual and gender minoritized populations, among others.

Value Systems and Commitment to Goals as a Function of Age, Integration of Personality, and Fear of Death

1987 ◽  
Vol 10 (2) ◽  
pp. 225-239 ◽  
Author(s):  
Israel Orbach ◽  
Ayala Iluz ◽  
Eliyahu Rosenheim
Keyword(s):  
Rank Order ◽  
Interpersonal Relationship ◽  
Fear Of Death ◽  
Value Systems ◽  
Age And Gender ◽  
Late Adulthood ◽  
And Gender ◽  
Cultural Origins ◽  
Age Integration ◽  
The Relationship

The present study examined the relationship between age, integration of personality, and fear of death and two aspects of the meaning of life (content of values and degree of commitment). Three groups (young adulthood; middle adulthood; and late adulthood) of men and women from different cultural origins and various levels of education participated in the study. The subjects were requested to rank order eight types of values (understanding, relationship, service, belief, expression, obtaining, growth, and hedonism). They also responded to a questionnaire on the degree of commitment to the goal actualisation. The findings were analysed by means of analysis of variance, multiple regression, and smallest space analysis (S.S.A.). The results show that the late adulthood group differed from the other two groups in the content of meaning by shifting to a more spiritual set of values. Yet, interpersonal relationship was the most important value for all groups. Content of meaning was also related to one's level of education. The degree of commitment to goals was affected by integration of personality, age, and gender. Fear of death and cultural origin had no impact on content or commitment. The S.S.A. revealed two clear dimensions of the eight value categories: altruistic-egotistic and spiritual-materialistic.

scholarly journals The Agreement between Clients’ and their Therapists’ Ratings of Personality Disorder Traits

2018 ◽  
Author(s):  
Douglas Samuel
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Rank Order ◽  
Outpatient Clinics ◽  
Dsm 5 ◽  
Median Correlation ◽  
Self Reports ◽  
Higher Rank ◽  
Level Method ◽  
Few Data

Objective: Treating clinicians provide the majority of mental health diagnoses, yet little is known about the validity of their routine diagnoses, including the agreement with clients’ self-reports. This is particularly notable for personality disorders (PDs) as the literature suggests weak agreement between therapists and clients. Existing research has been limited by a focus on PD categories and brief therapist-report measures. Furthermore, although self-reports of PD have been criticized for under-reporting, very few data have compared them to therapist-report in terms of mean-level. Method: We addressed these limitations by collecting dimensional trait ratings from 54 therapist-client dyads within outpatient clinics. The clients (52% women, 94% Caucasian, 39.8 years) provided ratings of dimensional PD traits via the Personality Inventory for DSM-5 (PID-5) while therapists (72% female, 89% Caucasian) completed the Informant version of the same measure. Results: Employing systematic measures of traits yielded higher rank-order agreement than observed in prior studies, with a median correlation of .41 across the PID-5 domains. Most interestingly, mean-level comparisons indicated that clients reported significantly higher levels of PD pathology than did their therapists. This effect was most notable for the domain of Psychoticism, which had the lowest rank-order agreement (r = .16) and the largest mean-level discrepancies. Conclusions: When clinicians utilized systematic measures of dimensional traits their agreement with client was higher than reported in past studies. Furthermore, clients reported significantly more PD pathology than was noted by their therapists suggesting concerns about invalid self-reports due to under-reporting have been overstated.

Depressive Personality Disorder

2012 ◽  
pp. 627-647
Author(s):  
R. Michael Bagby ◽  
Chris Watson ◽  
Andrew G. Ryder
Keyword(s):  
Major Depressive Disorder ◽  
Personality Disorder ◽  
Prevalence Rates ◽  
Dimensional Approach ◽  
Major Depressive ◽  
Dsm 5 ◽  
The Status ◽  
Psychological Difficulties ◽  
Depressive Personality ◽  
The Impact

This chapter provides an overview of depressive personality disorder, including its history, conceptualization within the American Psychiatric Association’s diagnostic manual, prevalence rates, etiology, characteristics, course, comorbidity with dysthymia and other disorders, and a review of the various instruments that can be used for its assessment. Also discussed is the dimensional approach to personality and its applicability to this disorder, and the impact of depressive personality disorder on the treatment of other psychological difficulties, such as major depressive disorder. This chapter ends with an update of the status of depressive personality disorder in DSM-5 and our recommendations for ways to maintain depressive personality traits in future editions of the diagnostic manual.

DSM-5 alcohol use disorder features among treatment-seeking older adults

2018 ◽  
Vol 64 (4) ◽  
pp. 185-196 ◽  
Author(s):  
Silke Behrendt ◽  
Barbara Braun ◽  
Randi Bilberg ◽  
Gerhard Bühringer ◽  
Michael Bogenschutz ◽  
...  
Keyword(s):  
Older Adults ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
The Elderly ◽  
Treatment Seeking ◽  
Controlled Clinical Trial ◽  
Dsm 5 ◽  
Wide Range ◽  
And Gender ◽  
International Multicenter

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

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