The Relationship Between Personality Disorders and Axis I Psychopathology: Deconstructing Comorbidity.
ABSTRACT The purpose of this review is (a) to study and systematically review the recent literature examining the co-occurrence and relationships between Axis I psychiatric disorders and Axis II personality disorders, specifically the six originally proposed for the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, and (b) to consider the clinical utility of the current Axis I and Axis II approach in the DSM-IV-TRand apply findings to state a position on the issue of collapsing together Axis I and Axis II. Community surveys or prospective cohort studies were reviewed as a priority. Our review indicates that the associations between clinical disorders and personality disorders clearly varied within each disorder and across the six personality disorders. Our understanding has advanced, particularly related to the clinical utility of comorbidity, and there may be sufficient evidence to support moving borderline personality disorder to Axis I. However, it seems premature to conclude that comorbidity is best conceptualized by having all disorders in a single category or by deleting disorders so that comorbidity is reduced. Our review suggests some priorities for future research into comorbidity, such as including personality disorders in future multivariate comorbidity models. Expected final online publication date for the Annual Review of Clinical Psychology Volume 9 is March 26, 2013. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
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ABSTRACT: El Personality Diagnostic Questionnaire-4+ (PDQ-4+) es un autoinforme ampliamente utilizado para la evaluación de los rasgos de los trastornos de la personalidad, sin embargo, sus características psicométricas aún no se han examinado en adolescentes. El principal objetivo fue examinar las propiedades métricas del PDQ-4+ en una muestra representativa de adolescentes no clínicos (N = 1.443; M = 15,9 años; DT = 1,2). Los resultados mostraron que el PDQ-4+ presentó adecuadas propiedades psicométricas. La fiabilidad de las subescalas, que incorporó un formato de respuesta tipo Likert de 5 puntos, osciló entre 0,62 y 0,85. El análisis de la estructura dimensional a nivel de los ítems indicó que las subescalas del PDQ-4+ eran esencialmente unidimensionales. El análisis de la estructura interna a nivel de las subescalas, a través de análisis factoriales exploratorios y de modelos de ecuaciones estructurales exploratorios, arrojó una posible solución tridimensional como la más adecuada. Las subescalas del PDQ-4+ correlacionaron de forma moderada con subescalas del Cuestionario de Capacidades y Dificultades. Los resultados tienen claras implicaciones para la comprensión de los rasgos desadaptativos de la personalidad en la adolescencia.International Journal of Clinical and Health Psychology 09/2013; 13(3):207–215. DOI:10.1016/S1697-2600(13)70025-5 · 2.79 Impact Factor
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ABSTRACT: Previous evidence has shown that schizotypal personality disorder (SPD) is part of the schizophrenia spectrum. Few studies have examined latent classes in the developmental trajectories of SPD features over time in individuals with SPD features. We adopted a longitudinal prospective study design to follow up a cohort of 660 college students during a two-year period. Participants' SPD-like symptoms and psychosocial function were measured by a comprehensive set of questionnaires that covered SPD features and cognitive, emotional, and psychosocial functions. Latent class growth analysis was used to examine the trajectory classes. Three trajectory classes were identified: a low, a medium, and a high SPD features group. Participants in the low group reported few SPD features and their symptoms declined over time. The medium group students had more SPD features than the low group and these symptoms stabilized during the follow up period. Participants in the high group reported the most SPD features and their symptoms increased over time. The three groups differed in paranoid thoughts, psychological distress, neurocognition function, and emotional expression over time. Results of multivariate regression analysis suggested that paranoid thoughts, emotional experience and prospective memory were predictors of social functioning in the high SPD feature group. Our findings suggest that individuals with SPD features may be delineated into different developmental subgroups and these subgroups differ significantly in psychosocial function. Delusions, emotion, and prospective memory may be important features to consider in early diagnosis and interventions for individuals predisposed to SPD and schizophrenia.BMC Psychiatry 11/2013; 13(1):323. DOI:10.1186/1471-244X-13-323 · 2.24 Impact Factor
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ABSTRACT: The Personality Diagnostic Questionnaire-4+ (PDQ-4+) is a self-report used for the assessment of personality disorder traits, however, its psychometric characteristics have yet to be tested in community samples of adolescents. The main goal was to analyze the psychometric properties of the PDQ-4+ scores in a large sample of non-clinical adolescents ( N = 1,443; M = 15.9 years; SD = 1.2). The PDQ-4+ scores showed adequate psychometric properties. Reliability of the subscales, incorporating a Likert-type 5-point response format, ranged from .62 to .85. The study of the internal structure at item level revealed that the PDQ-4+ subscales were essentially one-dimensional. Analysis of the internal structure at the subscale level by means of exploratory factor analysis and exploratory structural equation modeling yielded a possible three-dimensional solution. The PDQ-4+ subscales correlated moderately with emotional and behavioural variables measured by the Strengths and Difficulties Questionnaire. The results have clear implications for the understanding of maladaptive personality traits in adolescents.International Journal of Clinical and Health Psychology 08/2013; 13:207. · 2.79 Impact Factor