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T A Widiger

Publications and source records attributed to T A Widiger.

At least 37 records · Page 2Linked to original sources
PubMed1997

Relations of five-factor model antagonism facets with personality disorder symptomatology.

The Five-Factor Model of Personality (FFM) has been used to conceptualize personality disorders as maladaptive variants of normal personality traits. This study assessed the convergence of 6 lower order traits, or facets, of FFM agreeableness versus antagonism (trust, straightforwardness, altruism, compliance, modesty, and tender-mindedness) with antisocial, borderline, narcissistic, paranoid, and passive-aggressive personality traits. Interview-based scores for all of the antagonism facets except compliance demonstrated the expected relations with these personality disorder traits. Results for self-reported facet scores were less clearly supportive, only yielding convergence for straightforwardness and altruism with respect to antisocial traits. It is suggested that future investigations of the FFM, or other normal personality trait models, and personality disorder symptomatology include analyses at the lower order trait level.

Altruism↗
PubMed1996

DSM-IV antisocial personality disorder field trial.

The development of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) included 12 field trials to assess proposed revisions. This article provides results from the antisocial personality disorder (APD) field trial that was conducted to obtain data of relevance to the proposals for simplification and for the inclusion of more traditional traits of psychopathy. Provided herein are the results from 4 sites that had sampled from populations of particular relevance to the diagnosis of APD (i.e., prison inmates, psychiatric inpatients, outpatients with substance use disorders, and homeless persons). The results indicated that some items from the 3rd revised Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1987) could be deleted without affecting the diagnosis. The field trial provided mixed support for the proposal to include more traditional traits of psychopathy.

Adolescent↗
PubMed1995

Aspects of depression associated with borderline personality disorder.

OBJECTIVE: Shared symptoms between borderline personality disorder and depression have resulted in inherent difficulties in evaluating the relationship between these disorders. Some theorists have argued that depression in patients with borderline personality disorder is qualitatively distinct from depression in nonborderline patients. The purpose of this study was to empirically identify aspects of depression most associated with borderline personality disorder. METHOD: Through interview and self-report measures, the authors studied depression in 50 inpatients, 21 of whom had borderline personality disorder. RESULTS: The aspects of depression most associated with borderline personality disorder were self-condemnation, emptiness, abandonment fears, self-destructiveness, and hopelessness; boredom and somatic complaints exhibited no association. CONCLUSIONS: Depression associated with borderline pathology appears to be in some respects unique, as well as distinct from nonborderline depression. The study's implications delineate the importance of considering the phenomenological aspects of depression in borderline personality disorder.

Adult↗
PubMed1995

Sex and gender bias in self-report personality disorder inventories: item analysis of the MCMI-II, MMPI, and PDQ-R.

There has been considerable controversy and research regarding sex bias in the diagnosis of personality disorders, but little has involved self-report inventories. Thus this study investigated items from the Millon Clinical Multiaxial Inventory-II (Millon, 1987), the Minnesota Multiphasic Personality Inventory (Morey, Waugh, & Blashfield, 1985), and the Personality Diagnostic Questionnaire-Revised (Hyler & Rieder, 1987). Subjects (N = 189) completed the Histrionic, Dependent, Antisocial, and Narcissistic scales from these inventories, along with the Bem Sex Role Inventory (Bem, 1974) and the Symptom Checklist-90-Revised (Derogatis, 1977). Items were considered to evidence sex or gender bias if they (a) failed to correlate with dysfunction and (b) exhibited sex or gender role differences. At least 13 items evidenced sex bias (76 items using a more liberal threshold). The majority were from Narcissistic scales; few Histrionic items evidenced sex or gender bias. Implications with respect to sex-bias assessment and item construction are discussed.

Journal Article↗
PubMed1994

Personality and personality disorders.

The mental disorders that most clearly relate to personality are the personality disorders. The purpose of this article is to review the support for the hypothesis that the personality disorders of the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) represent variants of normal personality traits. We focus in particular on the efforts to identify the dimensions of personality that may underlie the personality disorders. We then illustrate the relationship of personality to personality disorders using the five-factor model, discuss conceptual issues in relating normal and abnormal personality traits, and consider methodological issues that should be addressed in future research.

Adaptation, Psychological↗
PubMed1994

DMS-IV meets philosophy.

The authors discuss some of the conceptual issues that must be considered in using and understanding psychiatric classification. DMS-IV is a practical and common sense nosology of psychiatric disorders that is intended to improve communication in clinical practice and in research studies. DSM-IV has no philosophic pretensions but does raise many philosophical questions. This paper describes the development of DSM-IV and the way in which it addresses a number of philosophic issues: nominalism vs. realism, epistemology in science, the mind/body dichotomy, the definition of mental disorders, and dimensional vs. categorical classification.

Humans↗
PubMed1994

Substance use disorder: abuse, dependence and dyscontrol.

The purpose of this paper is to review the diagnostic concepts of substance abuse and substance dependence provided in DMS-III, DSM-III-R, and the forthcoming DSM-IV. The review incorporates the principles that there are no infallible criteria for identifying when a person lacks sufficient control over the usage of a drug, that dyscontrol exists on a continuum, that substance use dyscontrol shares many formal properties with behavioral dyscontrol within other domains, and that the diagnosis of a mental disorder should be free of moralistic connotations. We conclude the paper with an alternative proposal, wherein the DSM-IV diagnoses of abuse and dependence are collapsed within one diagnosis of substance dyscontrol disorder and physiological substance dependence is placed with the diagnoses of substance intoxication and substance withdrawal.

Comorbidity↗
PubMed1993

The classification of panic disorders: from Freud to DSM-IV.

The authors trace the history of the classification of anxiety disorders, beginning with a detailed discussion of Freud's work on anxiety-neurosis as a basis for subsequent work. They discuss how anxiety disorders were described in DSM-I and DSM-II where Freud's concept of the anxiety neurosis was used as a major organizing principle. The revolutionary change in DSM-III is described in which the term and organizing principle of neurosis was dropped. The controversies that have arisen as a result of changes in DSM-III-R are discussed, particularly as they relate to compatibility with the International Classification of Diseases-10 (ICD-10) and especially with respect to the relationship and priority of panic and agoraphobia. Finally the authors discuss the process by which decisions will be made in DSM-IV where changes will be based on systematic reviews of empirical evidence whenever possible.

Anxiety Disorders↗
PubMed1993

The convergent and discriminant validity of the Chapman Scales.

Our study investigated the convergent and discriminant validity of five of Chapman's Schizotypia Scales (i.e., Physical Anhedonia, Revised Social Anhedonia, Perceptual Aberration, Magical Ideation, and Impulsive Nonconformity; L.J. Chapman, J.P. Chapman, & Raulin 1976, 1978; Eckblad & L.J. Chapman, 1983) and Meehl's Schizoidia Scale (Meehl, 1964) within a sample of 50 personality disordered subjects, many of whom possessed schizotypic traits. It was hypothesized in part that all five of the Chapman scales and the Schizoidia Scale would correlate with the schizotypal personality disorder; the Physical Anhedonia and Revised Social Anhedonia Scales would correlate with the schizoid personality disorder, whereas the Magical Ideation and Perceptual Aberration Scales would not; the Physical and Revised Social Anhedonia Scales would not correlate with the avoidant personality disorder; and the Impulsive Nonconformity Scale would correlate with the borderline and antisocial personality disorders. Only the hypotheses concerning the avoidant personality disorder and the Schizoidia Scale were not supported. The findings remained even when the effects of state anxiety and state depression were controlled. Implications of the findings with respect to the validity of the Chapman and Schizoidia Scales and the personality disorders are discussed.

Adult↗
PubMed1992

Generalized social phobia versus avoidant personality disorder: a commentary on three studies.

The findings of Herbert, Hope, and Bellack (1992), Holt, Heimberg, and Hope (1992), and Turner, Beidel, and Townsley (1992) are largely consistent. Avoidant personality disorder and generalized social phobia appear to be overlapping constructs that have only minor differences with respect to severity of dysfunction. This commentary addresses the implications of the findings with respect to the validity of the categorical distinction in the Diagnostic and Statistical Manual of Mental Disorders (rev. 3rd ed.; American Psychiatric Association, 1987) between avoidant personality and generalized social phobia, revisions of their respective diagnostic criteria, and their reclassification as either an anxiety or a personality disorder. Methodological and substantive suggestions for future research are also discussed.

Adult↗
PubMed1992

Comorbidity of personality disorders and depression: implications for treatment.

This article reviews naturalistic and controlled studies of the impact of comorbidity of personality disorders and depression on response to various forms of treatment. The findings support the common belief that personality disorders are associated with a poorer response to treatment for depression. In contrast, the limited data available suggest that the presence of depression may be a positive prognostic indicator for patients with borderline and antisocial personality disorder. There are insufficient data to draw conclusions regarding the influence of specific types of personality disorders on outcome with specific forms of treatment for depression. More specific assessment of personality disorders, particularly of possible underlying dimensions, is likely to be a more fruitful approach than the currently used categorical approach in identifying effective treatments for patients with personality disorders and depression.

Antidepressive Agents↗
PubMed1992

Personality and psychopathology: an application of the five-factor model.

Our review is concerned with the relationship of the five-factor model of personality to psychopathology, focusing in particular on Axis II personality disorders and depression. The five factors provide a particularly compelling model for interpreting the Axis II personality disorders as maladaptive variants of normal personality traits. However, we also discuss methodological and conceptual limitations of this application. There has been little research on the relationship of Openness, Agreeableness, and Conscientiousness to Axis I mental disorders, but considerable attention has been given to Neuroticism and Extraversion. We focus in particular on the difficulty in distinguishing between the various ways in which personality can relate to depression, either as a predisposition to, a complication of, a pathoplastic effect upon, or a spectrum variant of the mental disorder. We conclude with recommendations for future research.

Diagnosis, Differential↗
PubMed1992

DSM-IV and new diagnostic categories: holding the line on proliferation.

The authors discuss aspects of the decision-making process for including "new" diagnostic categories in DSM-IV. They detail the different kinds of new categories proposed for inclusion in DSM-IV and discuss the risks and benefits of incorporating them. The authors comment on whether new diagnostic categories should be included in official nosologies as a stimulus for research or as a culmination of research. They also highlight problems with "sunsetting" diagnoses. The criteria for change in DSM-IV--a way to deal with the expanding array of proposals for additional diagnostic entities--are discussed. The authors also offer a series of specific examples of the different kinds of new categories being considered for inclusion in DSM-IV.

Anxiety Disorders↗
PubMed1991

Toward an empirical classification for the DSM-IV.

The provision of explicit and specific diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 1980, 1987) was instrumental in the production of a substantial amount of informative research. The major emphasis in the preparation of the DSM-IV has been to maximize the impact of this accumulating research on the revision and to document the rationale and empirical support for any changes that are made. In this article we discuss the empirical basis for the DSM-IV. The historical context provided by the previous editions is briefly presented and followed by a description of the process by which the DSM-IV is being constructed. The input of empirical data through literature reviews, data reanalyses, and field trials is described, and an illustration with the antisocial personality disorder diagnosis is given.

Antisocial Personality Disorder↗
PubMed1991

Differentiation of Axis I and Axis II disorders.

The revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1987) distinguishes between Axis I and Axis II disorders: Axis II includes personality (and developmental) disorders, and all others are on Axis I. This distinction is often useful, but the reification of Axis I and II constructs through diagnostic criteria sets that demarcate categorically distinct entities is at times problematic. We review the issues of differentiating personality from Axis I disorders, specifically illustrated by schizotypal and schizophrenic disorders, borderline and mood disorders, antisocial and substance use disorders, and avoidant personality from social phobia. The options for addressing their differentiation include adding exclusion criteria, shifting the placement of disorders, deleting overlapping criteria, adding differentiating criteria, and converting to a dimensional format.

Diagnosis, Differential↗
PubMed1991

Conditional probabilities of child interview symptoms in the diagnosis of attention deficit disorder.

Based upon the standardized interviews of 76 clinic-referred boys, children's reports of behaviors suggestive of attention deficit disorder (ADD) were examined to determine which symptoms were most efficient predictors of an ADD diagnosis. Unlike previous research that has focused exclusively upon the use of sensitivity and specificity rates, this investigation also employed the conditional probability rates of positive and negative predictive power to establish the diagnostic utility of symptoms. As such, this study attempted to establish the diagnostic efficiency of some of the child-reported symptoms and describes a new method to examine any criteria set that is to be used for classification purposes. Results indicated that the optimal child-reported predictors of an ADD diagnosis were not those symptoms typically considered hallmark indicators of the disorder. In addition, no symptom was found to be an efficient exclusion criterion for diagnosis. These findings are discussed in terms of the role of the child as informant for the diagnosis of children's behavior disorders and the need for multisource assessment.

Attention↗