PubMed Health⌕ Search

Biomedical subjects

S E Hyler

Publications and source records attributed to S E Hyler.

16 recordsLinked to original sources
PubMed1992

Diagnosis of DSM-III-R personality disorders by two structured interviews: patterns of comorbidity.

OBJECTIVE: The purpose of this study was to examine patterns of co-occurrence of axis II disorders in a group of consecutive patients evaluated with two contrasting structured interviews. METHOD: One hundred of 106 consecutive applicants for long-term, inpatient treatment of severe personality psychopathology were assessed, face-to-face, by psychiatrists using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and the Personality Disorder Examination (PDE). The percent of co-occurrence of pairs of disorders diagnosed by each structured interview separately was calculated, and significance levels were determined by using chi-square tests of independence. Finally, odds ratios were computed for the odds of each pair of disorders occurring together compared with the odds for the occurrence of each disorder alone. RESULTS: The two interview methods revealed different comorbidity patterns. Significant covariation was found for 29 pairs of disorders diagnosed with the PDE, compared with 12 pairs diagnosed with the SCID-II. Six pairs of disorders covaried significantly and were associated with odds ratios greater than 4: histrionic with borderline, histrionic with narcissistic, narcissistic with antisocial, narcissistic with passive-aggressive, avoidant with schizotypal, and avoidant with dependent. CONCLUSIONS: Substantial overlap occurred among personality disorders. In this group of patients, consistent patterns of comorbidity involving narcissistic, avoidant, and histrionic personality disorders suggest that categorical distinctions between them and certain other DSM-III-R personality disorders may be illusory. The question of which of two overlapping disorders is more valid, however, is left unanswered. For clinical purposes, a two-level diagnostic convention is proposed.

Comorbidity↗
PubMed1991

Homicidal maniacs and narcissistic parasites: stigmatization of mentally ill persons in the movies.

The portrayal of mentally ill persons in movies and television programs has an important and underestimated influence on public perceptions of their condition and care. Movie stereotypes that contribute to the stigmatization of mentally ill persons include the mental patient as rebellious free spirit, homicidal maniac, seductress, enlightened member of society, narcissistic parasite, and zoo specimen. The authors suggest that mental health professionals can fight this source of stigma by increasing their collaboration with patient advocacy groups in monitoring negative portrayals of mentally ill people, using public information campaigns such as Mental Illness Awareness Week to call attention to the process of stigmatization, and supporting accurate dramatic and documentary depictions of mental illness.

Attitude of Health Personnel↗
PubMed1990

The factor structure of self-report DSM-III axis II symptoms and their relationship to clinicians' ratings.

A factor analysis of the entire item set of the DSM-III criteria was conducted to determine the extent to which the factors that emerged corresponded to the 11 personality disorders and three clusters included in DSM-III. Data were obtained from 552 patients who completed a self-report personality questionnaire and from 287 psychiatrists who rated their patients. Eleven questionnaire factors emerged that had eigenvalues greater than one, and at least three items emerged with factor loadings greater than 0.40. A correlational and multiple regression analysis of the questionnaire factors and clinicians' ratings showed few strong relationships between the factors and the 11 personality disorders but good correspondence with the three clusters.

Adolescent↗
PubMed1990

Validity of the Personality Diagnostic Questionnaire--revised: comparison with two structured interviews.

The authors gave the self-report Personality Diagnostic Questionnaire--Revised (PDQ-R) to 87 applicants for inpatient treatment of severe personality psychopathology and, blind to these results, diagnosed personality disorders in the applicants by using the Personality Disorder Examination and the Structured Clinical Interview for DSM-III-R Personality Disorders. The PDQ-R was not a substitute for a structured interview assessment of axis II disorders because many of its diagnoses were false positives. Its high sensitivity and moderate specificity for most of the axis II disorders suggest, however, that it is an efficient instrument for screening patients with DSM-III-R personality disorders.

Adult↗
PubMed1989

Screening for Axis II personality disorders in women with bulimic eating disorders.

The Personality Diagnostic Questionnaire (PDQ) was completed by 628 eating-disordered women: 300 with normal-weight bulimia, 15 with anorexia nervosa with bulimic features, and 313 with subdiagnostic eating disorders. Three-quarters (75%) of subjects with normal-weight bulimia had personality disorder diagnoses, compared with 50% of those with subdiagnostic eating disorders. The average number of separate PDQ diagnoses was 2.7 for the normal-weight bulimia group, 2.5 for the group with anorexia nervosa with bulimic traits, and 1.5 for the subdiagnostic group. The most common PDQ diagnoses were schizotypal, histrionic, and borderline disorders, but avoidant and dependent personality features also occurred. Personality disturbances may be common in patients with eating disorders.

Anorexia Nervosa↗
PubMed1984

Assessing borderline personality disorder with self-report, clinical interview, or semistructured interview.

The authors compared three methods of assessing borderline personality disorders. Test-retest reliability for the self-report Personality Diagnostic Questionnaire was adequate and compared favorably with the interrater reliability of the DSM-III-oriented clinical interview and the semistructured research interview. The overall prevalence of personality disorders scored on the questionnaire was similar to that generated by the clinical interview. The specificity and sensitivity of the questionnaire for the diagnosis of borderline personality disorder were slightly higher than 60%, which suggests that it may be a useful and economical instrument for identifying patients with borderline personality disorder.

Adolescent↗
PubMed1984

Somatoform disorders: before and after DSM-III.

The somatoform disorders were included as a new category of mental disorders in the third edition of the Diagnostic and Statistical Manual of Mental Disorders. The authors review the major features of somatization disorder, conversion disorder, psychogenic pain disorder, and hypochondriasis and present a survey of the recent literature about each.

Adaptation, Psychological↗
PubMed1982

Reliability in the DSM-III field trials: interview v case summary.

A study compared the reliability of psychiatric diagnoses obtained from the live interviews and from case summaries, on the same patients, by the same clinicians, using the same DSM-III diagnostic criteria. The results showed that the reliability of the major diagnostic classes of DSM-III was higher when diagnoses were made from live interviews than when they were made from case summaries. We conclude that diagnoses based on information contained in traditionally prepared case summaries may lead to an underestimation of the reliability of diagnoses made based on information collected during a "live" interview.

Adolescent↗
PubMed1978

Hysteria split asunder.

The authors present the proposed DSM-III classification of the traditional hysterical disorders, i.e., disorders that suggest physical illness but in which psychological factors are judged to be of importance. The use of the DSM-III inclusion and exclusion criteria--physical mechanism explains the symptoms, symptoms are linked to psychological factors, symptom initiation is under voluntary control, and there is an obvious recognizable environmental goal--are discussed in the differential diagnosis of somatoform disorder, factitious disorder, malingering, psychological factors affecting physical condition, and undiagnosed physical illness.

Conversion Disorder↗
PubMedDate not supplied

Factor analysis of the DSM-III personality disorder clusters: a replication.

The authors describe the replication of Kass et al.'s study where a factor analysis of scaled ratings of DSM-III personality disorders yielded groupings similar to those described in DSM-III. In this replication the authors used scaled ratings from a nationwide sample of psychiatrists on 358 patients. The authors conclude that this replication lends additional support for the DSM-III (now DSM-III-R) approach towards grouping personality disorders into three (or four) clusters.

Adolescent↗
PubMedDate not supplied

A comparison of clinical and self-report diagnoses of DSM-III personality disorders in 552 patients.

This report examines the relationship between clinicians' diagnoses of personality disorder and self-report diagnoses of personality disorder obtained from the Personality Diagnostic Questionnaire (PDQ). The results from 552 patients showed general lack of agreement between clinical and self-report diagnoses of DSM-III personality diagnoses. The best agreement obtained was for Borderline Personality Disorder: k = 0.46, and r = .51 for scaled ratings. Possible sources of disagreement including failings of the self-report questionnaire, difficulties in relying upon patients' self-reports, lack of reliability of clinical diagnoses of personality, and possible inherent lack of reliability of several of the DSM-III personality disorders are discussed.

Adolescent↗
PubMedDate not supplied

Validity of the Personality Diagnostic Questionnaire-Revised: a replication in an outpatient sample.

We report a replication study of the validity of the Personality Diagnostic Questionnaire-Revised (PDQ-R) in an outpatient sample. Fifty-nine applicants for psychoanalysis at a training institute completed the PDQ-R and were diagnosed by clinicians, blind to the PDQ-R results, using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and the Personality Disorder Examination (PDE). The PDQ-R showed high sensitivity and moderate specificity for most axis II disorders. Although not a substitute for a structured interview because it yields many false-positives, the PDQ-R is an efficient instrument for screening outpatients with DSM-III-R personality disorders.

Adult↗