The joint structure of DSM-IV and Axis I and II disorders

Norwegian Institute of Public Health and University of Oslo, Norway.
Journal of Abnormal Psychology (Impact Factor: 4.86). 02/2011; 120(1):198-209. DOI: 10.1037/a0021660
Source: PubMed


The Diagnostic and Statistical Manual (4th ed. [DSM-IV]; American Psychiatric Association, 1994) distinction between clinical disorders on Axis I and personality disorders on Axis II has become increasingly controversial. Although substantial comorbidity between axes has been demonstrated, the structure of the liability factors underlying these two groups of disorders is poorly understood. The aim of this study was to determine the latent factor structure of a broad set of common Axis I disorders and all Axis II personality disorders and thereby to identify clusters of disorders and account for comorbidity within and between axes. Data were collected in Norway, through a population-based interview study (N = 2,794 young adult twins). Axis I and Axis II disorders were assessed with the Composite International Diagnostic Interview (CIDI) and the Structured Interview for DSM-IV Personality (SIDP-IV), respectively. Exploratory and confirmatory factor analyses were used to investigate the underlying structure of 25 disorders. A four-factor model fit the data well, suggesting a distinction between clinical and personality disorders as well as a distinction between broad groups of internalizing and externalizing disorders. The location of some disorders was not consistent with the DSM-IV classification; antisocial personality disorder belonged primarily to the Axis I externalizing spectrum, dysthymia appeared as a personality disorder, and borderline personality disorder appeared in an interspectral position. The findings have implications for a meta-structure for the DSM.

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Available from: Kristian Tambs, Oct 13, 2015
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    • " biologi - cal predispositions , the CAPS model emphasizes the substantial influence that biogenetic factors can have at all lev - els of analysis . Indeed , there is an empirical basis for evaluat - ing the biogenetic underpinning of personality and related psychopathology , particularly with regard to Axis II disorders ( DeYoung et al . , 2010 ; Røysamb et al . , 2011 ; South & DeYoung , 2013 ) . More specifically , there is growing evidence for the interaction of biological influences on personality with developmental experiences or contexts ( Bornovalova et al . , 2013 ; Cicchetti , Rogosch , Hecht , Crick , & Hetzel , 2014 ; Dis - tel et al . , 2011 ; Krueger et al . , 2002 ) . One such line of re"
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    ABSTRACT: The Cognitive-Affective Processing System (CAPS) is a dynamic and expansive model of personality proposed by Mischel and Shoda (1995) that incorporates dispositional and processing frameworks by considering the interaction of the individual and the situation, and the patterns of variation that result. These patterns of cognition, affect, and behavior are generally defined through the use of if … then statements, and provide a rich understanding of the individual across varying levels of assessment. In this article, we describe the CAPS model and articulate ways in which it can be applied to conceptualizing and assessing personality pathology. We suggest that the CAPS model is an ideal framework that integrates a number of current theories of personality pathology, and simultaneously overcomes a number of limits that have been empirically identified in the past.
    Journal of Personality Assessment 07/2015; 97(5):1-11. DOI:10.1080/00223891.2015.1058806 · 2.01 Impact Factor
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    Personality disorders: Toward theoretical and empirical integration in diagnosis and assessment, Edited by Steven K. Huprich, 01/2015: chapter 5: pages 109-144; American Psychological Association., ISBN: 978-1-4338-1845-5
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