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Diagnosing Personality Disorders in the Community: A Comparison of Self-report and Interview Measures

Diagnosing Personality Disorders in the Community: A Comparison of Self-report and Interview... Abstract • The rapidly expanding empirical study of personality disorders is the result of the publication of operational diagnostic criteria in DSM-III and the development of instruments to assess these criteria. Few researchers have examined the comparability of measures of personality disorders, and to our knowledge there are no studies of the factors associated with discordance between measures. In the present study, 697 relatives of psychiatric patients and healthy controls were interviewed with the Structured Interview for Personality Disorders (SIDP) and completed the Personality Disorders Questionnaire (PDQ). Significantly more individuals had a personality disorder according to the SIDP; however, multiple personality disorders were more frequently diagnosed on the PDQ. Schizotypal, compulsive, dependent, and borderline personality disorders were significantly more frequently diagnosed by the PDQ, whereas the SIDP more frequently diagnosed antisocial and passive-aggressive personality disorder. The corresponding dimensional scores of the two measures were all significantly correlated; however, the concordance for categorical diagnoses was poor. Discrepancies between the PDQ and the SIPD dimensional scores were significantly associated with current level of depressive symptoms and PDQ lie scale scores. References 1. Hyler SE, Rieder RO, Spitzer RL, Williams JB. The Personality Disorder Questionnaire (PDQ) . New York, NY: New York State Psychiatric Institute; 1983. 2. Reich JH, Noyes R. A comparison of DSM-III personality disorders in acutely ill panic and depressed patients . J Anxiety Dis . 1987;1:123-131.Crossref 3. Levin AP, Hyler SE. DSM-III personality diagnosis in bulimia . Compr Psychiatry . 1986;27:47-53.Crossref 4. Mavissakalian M, Hamman MS. DSM-III personality disorder in agoraphobia . Compr Psychiatry . 1986;27:471-479.Crossref 5. Hurt SW, Hyler SE, Frances A, Clarkin J, Brent R. Assessing borderline personality disorder with self-report, clinical interview, or semistructured interview . Am J Psychiatry . 1984;141:1228-1231. 6. Reich J, Ndvaguba M, Yates W. Age and sex distribution of DSM-III personality cluster traits in a community population . Compr Psychiatry . 1988;29:298-303.Crossref 7. Stangl D, Pfohl B, Zimmerman M, Bowers W, Corenthal C. A structured interview for the DSM-III personality disorders: a preliminary report . Arch Gen Psychiatry . 1985;42:591-596.Crossref 8. Alnaes R, Torgersen S. The relationship between DSM-III symptom disorders (Axis I) and personality disorders (Axis II) in an outpatient population . Acta Psychiatr Scand . 1988;78:485-492.Crossref 9. Pfohl B, Stangl D, Zimmerman M. The implications of DSM-III personality disorders for patients with major depression . J Affective Disord . 1984;7:309-318.Crossref 10. Pfohl B, Barrash J, True B, Alexander B. Failure of two Axis II measures to predict medication noncompliance among hypertensive outpatients . J Pers Disord . 1989;3:45-52.Crossref 11. Zimmerman M, Coryell W. DSM-III personality disorder diagnoses in a nonpatient sample: demographic correlates and comorbidity . Arch Gen Psychiatry . 1989;46:682-689.Crossref 12. Reich J. Sex distribution of DSM-III personality disorders in psychiatric outpatients . Am J Psychiatry . 1987;144:485-488. 13. Robins LN, Helzer JE, Croughan J, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity . Arch Gen Psychiatry . 1981;38:381-389.Crossref 14. Zimmerman M, Coryell W. The reliability of personality disorder diagnoses in a nonpatient sample . J Pers Disord . 1989;3:53-57.Crossref 15. Zimmerman M, Coryell W, Corenthal C, Wilson S. A self-report scale to diagnose major depressive disorder . Arch Gen Psychiatry . 1983;43:1076-1081.Crossref 16. Hirschfeld RMA, Klerman GL, Clayton PJ, Keller MB, McDonald-Scott P, Larkin BH. Assessing personality: Effects of the depressive state on trait measurement . Am J Psychiatry . 1983;140:695-699. 17. Reich J, Noyes R, Hirschfeld R, Coryell W, O'Gorman T. State and personality in depressed and panic patients . Am J Psychiatry . 1988;144:181-187. 18. Liebowitz MR, Stallone F, Dunner DL, Fieve RR. Personality features of patients with primary affective disorder . Acta Psychiatr Scand . 1979;60:214-224.Crossref 19. Spitzer RL. Psychiatric diagnosis: are clinicians still necessary? Compr Psychiatry . 1983;24:399-411.Crossref 20. Skodol AE, Rosnick L, Kellman D, Oldham JM, Hyler SE. The validity of structural assessments of Axis II. Read before the 141st Annual Meeting of the American Psychiatric Association; May 11, 1988; Montreal, Canada. 21. Mellsop G, Varghese F, Joshua S, Hicks A. The reliability of Axis II of DSM-III . Am J Psychiatry . 1982;139:1360-1361. 22. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 23. Spitzer RL, Endicott J. Schedule for Affective Disorders and Schizophrenia . New York, NY: Biometrics Research Division, New York State Psychiatric Institute; 1978. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Diagnosing Personality Disorders in the Community: A Comparison of Self-report and Interview Measures

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References (23)

Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1990.01810180027005
Publisher site
See Article on Publisher Site

Abstract

Abstract • The rapidly expanding empirical study of personality disorders is the result of the publication of operational diagnostic criteria in DSM-III and the development of instruments to assess these criteria. Few researchers have examined the comparability of measures of personality disorders, and to our knowledge there are no studies of the factors associated with discordance between measures. In the present study, 697 relatives of psychiatric patients and healthy controls were interviewed with the Structured Interview for Personality Disorders (SIDP) and completed the Personality Disorders Questionnaire (PDQ). Significantly more individuals had a personality disorder according to the SIDP; however, multiple personality disorders were more frequently diagnosed on the PDQ. Schizotypal, compulsive, dependent, and borderline personality disorders were significantly more frequently diagnosed by the PDQ, whereas the SIDP more frequently diagnosed antisocial and passive-aggressive personality disorder. The corresponding dimensional scores of the two measures were all significantly correlated; however, the concordance for categorical diagnoses was poor. Discrepancies between the PDQ and the SIPD dimensional scores were significantly associated with current level of depressive symptoms and PDQ lie scale scores. References 1. Hyler SE, Rieder RO, Spitzer RL, Williams JB. The Personality Disorder Questionnaire (PDQ) . New York, NY: New York State Psychiatric Institute; 1983. 2. Reich JH, Noyes R. A comparison of DSM-III personality disorders in acutely ill panic and depressed patients . J Anxiety Dis . 1987;1:123-131.Crossref 3. Levin AP, Hyler SE. DSM-III personality diagnosis in bulimia . Compr Psychiatry . 1986;27:47-53.Crossref 4. Mavissakalian M, Hamman MS. DSM-III personality disorder in agoraphobia . Compr Psychiatry . 1986;27:471-479.Crossref 5. Hurt SW, Hyler SE, Frances A, Clarkin J, Brent R. Assessing borderline personality disorder with self-report, clinical interview, or semistructured interview . Am J Psychiatry . 1984;141:1228-1231. 6. Reich J, Ndvaguba M, Yates W. Age and sex distribution of DSM-III personality cluster traits in a community population . Compr Psychiatry . 1988;29:298-303.Crossref 7. Stangl D, Pfohl B, Zimmerman M, Bowers W, Corenthal C. A structured interview for the DSM-III personality disorders: a preliminary report . Arch Gen Psychiatry . 1985;42:591-596.Crossref 8. Alnaes R, Torgersen S. The relationship between DSM-III symptom disorders (Axis I) and personality disorders (Axis II) in an outpatient population . Acta Psychiatr Scand . 1988;78:485-492.Crossref 9. Pfohl B, Stangl D, Zimmerman M. The implications of DSM-III personality disorders for patients with major depression . J Affective Disord . 1984;7:309-318.Crossref 10. Pfohl B, Barrash J, True B, Alexander B. Failure of two Axis II measures to predict medication noncompliance among hypertensive outpatients . J Pers Disord . 1989;3:45-52.Crossref 11. Zimmerman M, Coryell W. DSM-III personality disorder diagnoses in a nonpatient sample: demographic correlates and comorbidity . Arch Gen Psychiatry . 1989;46:682-689.Crossref 12. Reich J. Sex distribution of DSM-III personality disorders in psychiatric outpatients . Am J Psychiatry . 1987;144:485-488. 13. Robins LN, Helzer JE, Croughan J, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity . Arch Gen Psychiatry . 1981;38:381-389.Crossref 14. Zimmerman M, Coryell W. The reliability of personality disorder diagnoses in a nonpatient sample . J Pers Disord . 1989;3:53-57.Crossref 15. Zimmerman M, Coryell W, Corenthal C, Wilson S. A self-report scale to diagnose major depressive disorder . Arch Gen Psychiatry . 1983;43:1076-1081.Crossref 16. Hirschfeld RMA, Klerman GL, Clayton PJ, Keller MB, McDonald-Scott P, Larkin BH. Assessing personality: Effects of the depressive state on trait measurement . Am J Psychiatry . 1983;140:695-699. 17. Reich J, Noyes R, Hirschfeld R, Coryell W, O'Gorman T. State and personality in depressed and panic patients . Am J Psychiatry . 1988;144:181-187. 18. Liebowitz MR, Stallone F, Dunner DL, Fieve RR. Personality features of patients with primary affective disorder . Acta Psychiatr Scand . 1979;60:214-224.Crossref 19. Spitzer RL. Psychiatric diagnosis: are clinicians still necessary? Compr Psychiatry . 1983;24:399-411.Crossref 20. Skodol AE, Rosnick L, Kellman D, Oldham JM, Hyler SE. The validity of structural assessments of Axis II. Read before the 141st Annual Meeting of the American Psychiatric Association; May 11, 1988; Montreal, Canada. 21. Mellsop G, Varghese F, Joshua S, Hicks A. The reliability of Axis II of DSM-III . Am J Psychiatry . 1982;139:1360-1361. 22. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 23. Spitzer RL, Endicott J. Schedule for Affective Disorders and Schizophrenia . New York, NY: Biometrics Research Division, New York State Psychiatric Institute; 1978.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jun 1, 1990

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