Research on personality disorders is plagued by methodological difficulties. The development of structured interviews for personality disorders has addressed concerns regarding interrater reliability, but even with structured interviews, there is relatively little evidence of the clinical and predictive validity of the diagnoses made. The most pressing scientific issue at present is documenting the validity of diagnoses derived from such measures, and the primary goal of the present proposal is to collect data necessary to address the validity question. The first specific aim is to conduct a study of the clinical and predictive validity of the Personality Disorder Examination (PDE) and the Structured Interview for the DSM-III Personality Disorders (SIDP) in a sample of 200 patients with nonpsychotic diagnoses on Axis I of DSM-III-R. The method for establishing validity has been pretested in a pilot study and relies heavily on Spitzer's recommendations for the use of the """"""""LEAD standard."""""""" The acronym LEAD refers to three key concepts: the use of Longitudinal information, ratings of Expert clinicians, and the collection of All Data available.
The second aim i s to compare the diagnoses derived from clinical consensus and the structured interviews (PDE and SIDP) with those generated by the Wisconsin Personality Inventory (WISPI), the most promising self-report instrument currently available for Axis II disorders.
The third aim i s to investigate the influence of symptomatic state on what are assumed to be trait assessments done by these different methods (clinical consensus, structured interview, and self-report). The """"""""state vs. trait"""""""" issue (especially as it influences the concordance between informants and among evaluation methods) is a thorny but fundamental problem in the attempt to establish valid assessment procedures. A longitudinal design will allow us to measure the stability of trait assessments (done using different methods and relying on different informants) as the patient's symptomatology varies over a 12-month period.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH044672-03
Application #
3384055
Study Section
Psychopathology and Clinical Biology Research Review Committee (PCB)
Project Start
1990-04-01
Project End
1994-03-31
Budget Start
1992-04-01
Budget End
1993-03-31
Support Year
3
Fiscal Year
1992
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
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Stepp, Stephanie D; Morse, Jennifer Q; Yaggi, Kirsten E et al. (2008) The role of attachment styles and interpersonal problems in suicide-related behaviors. Suicide Life Threat Behav 38:592-607
Miller, Joshua D; Campbell, W Keith; Pilkonis, Paul A (2007) Narcissistic personality disorder: relations with distress and functional impairment. Compr Psychiatry 48:170-7
Clifton, Allan; Pilkonis, Paul A (2007) Evidence for a single latent class of Diagnostic and Statistical Manual of Mental Disorders borderline personality pathology. Compr Psychiatry 48:70-8
Miller, Joshua D; Pilkonis, Paul A; Mulvey, Edward P (2006) Treatment utilization and satisfaction: examining the contributions of Axis II psychopathology and the Five-Factor Model of personality. J Pers Disord 20:369-87
Miller, Joshua D; Pilkonis, Paul A (2006) Neuroticism and affective instability: the same or different? Am J Psychiatry 163:839-45
Miller, Joshua D; Pilkonis, Paul A; Clifton, Allan (2005) Self- and other-reports of traits from the five-factor model: relations to personality disorder. J Pers Disord 19:400-19
Miller, Joshua D; Reynolds, Sarah K; Pilkonis, Paul A (2004) The validity of the five-factor model prototypes for personality disorders in two clinical samples. Psychol Assess 16:310-22
Miller, Joshua D; Pilkonis, Paul A; Morse, Jennifer Q (2004) Five-factor model prototypes for personality disorders: the utility of self-reports and observer ratings. Assessment 11:127-38
Meyer, B; Pilkonis, P A; Proietti, J M et al. (2001) Attachment styles and personality disorders as predictors of symptom course. J Pers Disord 15:371-89

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