Personality disorders are characteristic patterns of perceiving the world, emotional responsiveness, interpersonal functioning, and impulse control that are maladaptive, pervasive, and inflexible. Individuals with these disorders make like difficult for themselves, those close to them, and society at large. Evaluating these disorders is crucial for clinicians in understanding patients, predicting course, and optimizing treatment. However, there is insufficient empirical support for how best to conceptualize and measure these disorders, and the relationship between 'normal' personality, disordered personality, and other pyschopathology is unclear. We have assembled a unique and important dataset for investigating these issues in a well-characterized sample of individuals who were not selected for treatment. In the previous grant period, we used multiple methods of assessment to characterize the personality structure and psychiatric history of 742 subjects. These subjects have had additional assessments over a 17-year period, as part of the Baltimore Epidemiologic Catchment Area (EGA) and Follow-up studies. To our knowledge, the range of psychopathology assessed, and the range of methods of assessment, is broader than in any other sample. The range of psychopathology assessed includes virtually all axis I and axis II signs, symptoms, traits, and disorders, as well as dimensional measures of normal variation in personality. The assessment methods included psychiatrists using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), master's level psychologists using the International Personality Disorder Examination (IPDE), and the report of significant others as well as self report. The overall goal of the study is to enhance knowledge about the structure of different conceptualizations of personality disorder, their relationships to normal personality and to psychopathology, and their association with measures of disability, selected risk factors, including genetic polymorphisms. Building on our previous contributions, this proposal applies innovative constructs of disordered personality and rigorous analytic strategies.
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