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Biomedical subjects

Thomas A Widiger

Publications and source records attributed to Thomas A Widiger.

At least 19 recordsLinked to original sources
PubMed2006

Clinicians' judgments of clinical utility: a comparison of the DSM-IV and five-factor models.

Clinical utility, or the usefulness of a diagnostic system in clinical practice, has been identified as an important construct in proposed revisions to the diagnostic nomenclature and a significant limitation of dimensional models of personality disorder, such as the 5-factor model (FFM). Only 1 study to date has addressed explicitly the clinical utility of the FFM, and the findings suggested significant limitations. In the current study, 245 practicing psychologists described 3 historic cases using both the FFM and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 2000) and then rated each model on 6 aspects of clinical utility. In contrast to prior research, the psychologists in this study considered the FFM to have greater clinical utility than the existing diagnostic categories.

Antisocial Personality Disorder↗
PubMed2006

Psychometric properties of an abbreviated instrument of the five-factor model.

Brief measures of the five-factor model (FFM) have been developed but none include an assessment of facets within each domain. The purpose of this study was to examine the validity of a simple, one-page, facet-level description of the FFM. Five data collections were completed to assess the reliability and the convergent and discriminant validity of the rating form with other measures of the FFM and to replicate correlations with measures of maladaptive personality functioning that have been obtained with more extensive measures. Results appeared to support the validity of the FFM rating form (FFMRF) because it obtained relatively good internal consistency, convergent validity, and discriminant validity. In addition, self-descriptions of persons in terms of the FFMRF related to maladaptive personality traits in a manner that was consistent with theoretical expectations. Negative findings and limitations of the rating form also are discussed.

Adolescent↗
PubMed2005

Diagnostic categories or dimensions? A question for the Diagnostic And Statistical Manual Of Mental Disorders--fifth edition.

The question of whether mental disorders are discrete clinical conditions or arbitrary distinctions along dimensions of functioning is a long-standing issue, but its importance is escalating with the growing recognition of the frustrations and limitations engendered by the categorical model. The authors provide an overview of some of the dilemmas of the categorical model, followed by a discussion of research that addresses whether mental disorders are accurately or optimally classified categorically or dimensionally. The authors' intention is to document the importance of this issue and to suggest that future editions of the Diagnostic and Statistical Manual of Mental Disorders give more recognition to dimensional models of classification. They conclude with a dimensional mental disorder classification that they suggest provides a useful model.

Diagnostic and Statistical Manual of Mental Disord↗
PubMed2005

Evidence-based assessment of personality disorders.

The purpose of this article is to provide a foundation for the development of evidence-based guidelines for the assessment of personality disorders, focusing in particular on integrated assessment strategies. The general strategy recommended herein is to first administer a self-report inventory to alert oneself to the potential presence of particular maladaptive personality traits followed by a semistructured interview to verify their presence. This strategy is guided by the existing research that suggests particular strengths of self-report inventories and semistructured interviews relative to unstructured clinical interviews. However, the authors also consider research that suggests that further improvements to the existing instruments can be made. The authors emphasize, in particular, a consideration of age of onset, distortions in self-perception and presentation, gender bias, culture and ethnicity, and personality change.

Evidence-Based Medicine↗
PubMed2005

Alternative dimensional models of personality disorder: finding a common ground.

The recognition of the many limitations of the categorical model of personality disorder classification has led to the development of quite a number of alternative proposals for a dimensional classification. The purpose of this article is to suggest that future research work toward the integration of these alternative proposals within a common hierarchical structure. An illustration of a potential integration is provided using the constructs assessed within existing dimensional models. Suggestions for future research that will help lead toward a common, integrative dimensional model of personality disorder are provided.

Depressive Disorder↗
PubMed2005

Personality disorder research agenda for the DSM-V.

The American Psychiatric Association is sponsoring a series of international conferences to set a research agenda for the development of the next edition of the diagnostic manual. The first conference in this series, "Dimensional Models of Personality Disorder: Etiology, Pathology, Phenomenology, and Treatment," was devoted to reviewing the existing research and setting a future research agenda that would be most effective in leading the field toward a dimensional classification of personality disorder. The purpose of this article, authored by the Steering Committee of this conference, was to provide a summary of the conference papers and their recommendations for research. Covered herein are the reviews and recommendations concerning alternative dimensional models of personality disorder, behavioral genetics and gene mapping, neurobiological mechanisms, childhood antecedents, cross-cultural issues, Axes I and II continuity, coverage and cutoff points for diagnosis, and clinical utility.

Congresses as Topic↗
PubMed2005

CIC, CLPS, and MSAD.

The purpose of this article is to provide a commentary on the reports of the findings from the longitudinal Children in the Community (CIC) study by Cohen, Crawford, Johnson, and Kasen (this issue), Collaborative Longitudinal Personality Disorders Study (CLPS) by Skodol et al. (this issue), and McLean Study of Adult Development (MSAD) by Zanarini, Frankenburg, Hennen, Reich, and Silk (this issue). This article focuses in particular on the implications of their longitudinal findings with regard to a fundamental component of personality disorder: temporal stability. Also discussed are their findings with regard to an integration of general personality structure with personality disorder.

Adaptation, Psychological↗
PubMed2005

A dimensional model of personality disorder.

PURPOSE OF REVIEW: Research planning work-groups sponsored by the American Psychiatric Association have called for the development of a dimensional model of personality disorder for a future edition of the diagnostic manual. RECENT FINDINGS: This paper provides a brief summary of current research relevant to the proposal to integrate basic science research on the five-factor model of general personality structure with the diagnosis of personality disorders. Recent studies and the particular advantages of a five-factor model of personality disorder are presented. SUMMARY: Future editions of diagnostic manuals will move toward a more dimensional model of personality disorder classification. Clinicians will benefit from a greater familiarity with this approach to diagnosis, as researchers continue to develop their validity and clinical utility.

Journal Article↗
PubMed2004

Clinicians' personality descriptions of prototypic personality disorders.

Many studies have indicated close convergence of the DSM-IV personality disorders and the five-factor model (FFM) of personality functioning. However, questions have been raised concerning the ability of clinicians to describe personality disorders in terms of the FFM. This study developed a FFM description by practicing clinicians of each DSM-IV personality disorder. Clinicians rated a prototypic case of each DSM-IV personality disorder in terms of the FFM. These ratings, which achieved excellent reliability, were then averaged to produce a consensus FFM profile for each personality disorder. The consensus ratings showed good agreement with previous research that examined both researchers' and clinicians' application of the FFM to prototypic cases of personality disorders. These results suggest that clinicians can conceptualize and apply the FFM to personality disorders in a consistent way. The results further suggest that the FFM may provide a richer and more comprehensive description of personality difficulties than the current DSM-IV personality disorder categories.

Adult↗
PubMed2004

A meta-analysis of the prevalence and usage of the personality disorder not otherwise specified (PDNOS) diagnosis.

The primary aim of the current study was to determine the prevalence and usage of the diagnosis of personality disorder not otherwise specified (PDNOS). As a secondary objective, this study explores the impact of assessment method and definition of PDNOS on observed prevalence. A meta-analysis is reported of 51 studies reporting separate rates for the overall prevalence of specific personality disorders and PDNOS. The best estimate of the absolute prevalence of PDNOS in patient samples is in the range of 8 to 13% and the best estimate of the relative prevalence of PDNOS (i.e., prevalence of PDNOS divided over the overall Axis II prevalence excluding PDNOS) is in the range of 21-49%. In structured interview studies PDNOS is the third most frequently used personality disorder diagnosis, whereas in nonstructured interview studies, PDNOS is often the single most frequently used diagnosis. PDE/IPDE yielded higher PDNOS prevalences than either the SCID or SIDP. Only slightly more than half of the studies provided an operational definition of PDNOS, and the most frequently occurring definition is "mixed" personality disorder. PDNOS would perhaps be the most frequently used diagnosis if it was used in a manner consistent with its definition in DSM-IV. The clinical relevance of future classification, assessment, and research could substantially benefit from validated, explicit, and uniform guidelines for the assessment of PDNOS.

Humans↗
PubMed2003

Current issues in the assessment of personality disorders.

Most patients will have clinically significant maladaptive personality traits. These personality traits can substantially complicate the effective treatment of other mental disorders, and they can also be the focus of effective treatment. The assessment of personality disorders is of considerable clinical importance. However, this assessment can also be highly problematic. This article discusses the major issues in the assessment of personality disorders (eg, differentiation from other mental disorders, from normal personality functioning, and gender bias) and summarizes existing research on the convergent and discriminant validity of the semistructured interviews and self-report inventories, which have been developed to improve the reliability and validity of personality disorder assessment.

Female↗
PubMed2003

Personality and depression in women.

Personality disorders and traits should be assessed in studies concerned with the etiology and treatment of depression in women. There has been a considerable amount of research concerned with the effect of personality functioning on the etiology and treatment of depression, and much of this research has concerned personality traits and disorders for which significant gender differences and issues apply. The importance of personality functioning, and the particular relevance to women and gender-related issues, is illustrated in this paper with regard to dependent personality disorder and dependent personality traits. Implications for future research on the etiology and treatment of depression in women are provided.

Adult↗
PubMed2003

Borderline personality disorder from the perspective of general personality functioning.

The authors extended previous work on the hypothesis that borderline personality disorder (BPD) can be understood as a maladaptive variant of personality traits included within the 5-factor model (FFM) of personality. In each of 3 samples, an empirically derived prototypic FFM borderline profile was correlated with individuals' FFM profiles to yield a similarity score, an FFM borderline index. Results across all samples indicated that the FFM borderline index correlated as highly with existing borderline measures as they correlated with one another, and the FFM borderline index correlated as highly with measures of dysfunction, history of childhood abuse, and parental psychopathology as did traditional measures of BPD. Findings support the hypothesis that BPD is a maladaptive variant of FFM personality traits.

Adult↗
PubMed2003

Personality disorder and Axis I psychopathology: the problematic boundary of Axis I and Axis II.

The confusion of personality disorders with Axis I disorders can be traced in part to inadequacies of assessment instruments and diagnostic criterion sets. However, it also reflects the absence of adequate conceptualization. If Axis I continues to include early onset, chronic impairments that characterize everyday functioning, then there is unlikely to be a clear or meaningful distinction. Inherent and unique to personality disorders is that they concern a person's sense of self and identity. They are disorders of everyday functioning. Personality disorders have an early onset, characterize everyday functioning, and relate closely to personality functioning evident within the general population; Axis I disorders, in contrast, have an onset throughout adult life, are episodic, and are readily distinguishable from normal personality functioning.

Diagnostic and Statistical Manual of Mental Disord↗
PubMed2003

Personality disorder diagnosis.

Every person has a characteristic manner of thinking, feeling, and relating to others. Some of these personality traits can be so dysfunctional as to warrant a diagnosis of personality disorder. The World Health Organization's International Classification of Diseases (ICD- 10) includes ten personality disorder diagnoses. Three issues of particular importance for the diagnosis of personality disorders are their differentiation from other mental disorders, from general personality functioning, and from each other. Each of these issues is discussed in turn, and it is suggested that personality disorders are more accurately and effectively diagnosed as maladaptive variants of common personality traits.

Journal Article↗