Although personality disorders (PDs) and subthreshold personality pathology are increasingly implicated as diatheses and moderators of treatment response for many Axis I disorders, researchers have identified a number of problems that limit their utility, two of which are particularly significant. First, dimensional approaches to personality diagnosis consistently outperform categorical diagnosis, and it appears clear that DSM-V will move toward dimensional diagnosis of PDs. However, no study has yet examined the comparative validity of the major dimensional alternatives. Second, virtually all PD research relies on patient self-reports; however, increasing evidence suggests limitations in the exclusive reliance on self-reports. The primary aim of this proposal is to evaluate the comparative validity of categorical PD diagnosis and four dimensional alternatives: dimensionalized DSM-IV diagnosis (number of symptoms met per disorder); the recently developed consensus four-factor trait model identified factor-analytically from self-report data; dimensional PD syndromes derived empirically; and PD traits derived factor-analytically using a method that does not rely primarily on self-reports. The secondary aim, given the potential retention in DSM-V of a dimensionalized version of the current PDs, is to compare methods of diagnosing patients dimensionally using the current PDs that vary in their reliance on self-reports. Ss will be 240 patients across three sites. For both aims, we will use the following criterion variables to assess validity: (a) aggregated lay informant-report PD and trait data; (b) treating-clinician PD and trait data; (c) adaptive functioning assessed concurrently and longitudinally (18-month follow-up); (d) etiologic data, including developmental history (childhood trauma), family history of psychiatric disorders, and molecular genetics; and (e) laboratory (implicit) measures targeted to assess specific PDs. Our general goal is to assess validity using two sets of criteria that today are largely seen as a single approach: Robins and Guze criteria (i.e., whether diagnoses differ in etiology, prognosis, laboratory tests, etc.) and construct validation (i.e., whether diagnoses differ in their external correlates in predictable ways). ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH078100-01A1
Application #
7265768
Study Section
Adult Psychopathology and Disorders of Aging Study Section (APDA)
Program Officer
Breiling, James P
Project Start
2007-08-22
Project End
2012-07-31
Budget Start
2007-08-22
Budget End
2008-07-31
Support Year
1
Fiscal Year
2007
Total Cost
$720,982
Indirect Cost
Name
Emory University
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
066469933
City
Atlanta
State
GA
Country
United States
Zip Code
30322
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