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Biomedical subjects

T A Widiger

Publications and source records attributed to T A Widiger.

At least 19 recordsLinked to original sources
PubMed2001

Using the five-factor model to represent the DSM-IV personality disorders: an expert consensus approach.

This study sought to extend previous work on the five-factor dimensional model (FFM) of personality disorder (PD) by developing more comprehensive FFM descriptions of prototypic cases. Specifically, the authors asked experts in each of the 10 DSM-IV PDs to rate the prototypic case by using all 30 facets of the FFM. Aggregating across raters of the given disorder generated a prototype for each disorder. In general, there was good agreement among experts and with previous theoretical and empirical FFM translations of DSM diagnostic criteria. Furthermore, the ability of the FFM explanation to reproduce the high comorbidity rates among PDs was demonstrated. The authors concluded that, with the possible exception of schizotypal PD, the DSM PDs can be understood from the dimensional perspective of the FFM. Future directions for research, including the use of the present prototypes to "diagnose" personality disorder, are discussed.

Adult↗
PubMed2001

Pathology versus statistical infrequency: potential sources of gender bias in personality disorder criteria.

The antisocial, narcissistic, dependent, histrionic, and borderline personality disorders often obtain differential sex prevalence rates. One explanation has been that the diagnostic criteria for these personality disorders have different gender implications for maladaptivity (e.g., perhaps the dependent personality disorder diagnostic criteria are considered by clinicians to be more pathological for women than for men). This hypothesis was explored in two studies that obtained judgments by professional clinicians of the maladaptivity and statistical infrequency of personality disorder diagnostic criteria. Significant differences across gender were obtained for the frequency of diagnostic criteria but not for their maladaptivity. The personality disorder diagnostic criteria appear to be gender neutral with respect to their implications for maladaptivity.

Bias↗
PubMed2001

A structured interview for the assessment of the Five-Factor Model of personality: facet-level relations to the axis II personality disorders.

The Structured Interview for the Five-Factor Model (SIFFM; Trull & Widiger, 1997) is an 120-item semistructured interview that assesses both adaptive and maladaptive features of the personality traits included in the five-factor model of personality, or "Big Five." In this article, we evaluate the ability of SIFFM scores to predict personality disorder symptomatology in a sample of 232 adults (46 outpatients and 186 nonclinical college students). Personality disorder symptoms were assessed using the Personality Diagnostic Questionnaire-Revised (PDQ-R; Hyler & Rider, 1987). Results indicated that many of the predicted associations between lower-order personality traits and personality disorders were supported. Further, many of these associations held even after controlling for comorbid personality disorder symptoms. These findings may help inform conceptualizations of the personality disorders, as well as etiological theories and treatment.

Adult↗
PubMed2001

Personality disorders as extreme variants of common personality dimensions: can the Five-Factor Model adequately represent psychopathy?

The present study examined Widiger and Lynam's (1998) hypothesis that psychopathy can be represented using the Five-Factor Model (FFM) of personality. Participants in the study consisted of 481 21-22-year-old men and women who are part of an ongoing longitudinal study. Psychopathy was assessed by the degree of similarity between an individual's NEO-PI-R and an expert-generated FFM psychopathy prototype. The expert-based prototype supported the account of Widiger and Lynam (1998), as did the correlations between the NEO-PI-R Psychopathy Resemblance Index (PRI) and the individual personality dimensions. The PRI was also related in predicted ways to measures of antisocial behavior, drug use, and psychopathology. The results support the contention that psychopathy can be understood as an extreme variant of common dimensions of personality, and underscore the utility of a dimensional model of personality disorders.

Adult↗
PubMed2001

Experimental manipulation of NEO-PI-R items.

Research assessing the relationship of the Five-factor model (FFM) of personality to personality disorder symptomatology has generally been consistent with theoretical expectations. Three exceptions, however, have been failures to confirm predicted associations of the NEO-Personality Inventory-Revised (NEO-PI-R) Conscientiousness scale with obsessive-compulsive personality disorder symptomatology, the NEO-PI-R Agreeableness scale with dependent symptomatology, and the NEO-PI-R Openness scale with schizotypal symptomatology. It was the hypothesis of this study that these findings might be due in part to a relative emphasis on adaptive rather than maladaptive variants of these domains of personality functioning within the NEO-PI-R. This hypothesis was tested by experimentally altering NEO-PI-R items to reverse their implications for maladaptiveness. The predicted correlations of the FFM were confirmed with the experimentally altered items in a sample of 86 adult psychiatric outpatients.

Adult↗
PubMed2000

Toward DSM-V and the classification of psychopathology.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) developed by the American Psychiatric Association (1994) is a compelling effort at a best approximation to date of a scientifically based nomenclature, but even its authors have acknowledged that its diagnoses and criterion sets are highly debatable. Well-meaning clinicians, theorists, and researchers could find some basis for fault in virtually every sentence, due in part to the absence of adequate research to guide its construction. Some points of disagreement, however, are more fundamental than others. The authors discuss issues that cut across individual diagnostic categories and that should receive particular attention in DSM-V: (a) the process by which the diagnostic manual is developed, (b) the differentiation from normal psychological functioning, (c) the differentiation among diagnostic categories, (d) cross-sectional vs. longitudinal diagnoses, and (e) the role of laboratory instruments.

Humans↗
PubMed2000

Adult psychopathology: issues and controversies.

This review discusses issues and controversies with respect to the construct of a mental disorder, models of etiology and pathology, and domains of psychopathology. Fundamental to the science of psychopathology is a conceptualization of mental disorder, yet inadequate attention is being given to the differentiation of normal and abnormal psychological functioning in current research. The boundaries between mental and physical disorders are equally problematic. Neurophysiological models are receiving particular emphasis in large part because of the substantial progress being made in documenting and clarifying the important role of neurophysiological structures and mechanisms in etiology and pathology. However, this attention might be at the expense of the recognition of equally valid psychological models. Problematic diagnostic boundaries are also considered, including those within and between different classes of disorder. Dimensional models may offer a more precise and comprehensive classification of psychopathology.

Adult↗
PubMed2000

Convergent validity of alternative MMPI-2 personality disorder scales.

The Morey, Waugh, and Blashfield (1985) MMPI (Hathaway et al., 1989) personality disorder scales provided a significant contribution to personality disorder research and assessment. However, the subsequent revisions to the MMPI and the multiple revisions to the diagnostic criteria sets that have since occurred may have justified comparable revisions to these scales. Somwaru and Ben-Porath (1995) selected a substantially different set of items from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) to assess Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) personality disorder diagnostic criteria. In our study, we compared the convergent validity of these alternative MMPI-2 personality disorder scales with respect to 3 self-report measures of personality disorder symptomatology in a sample of 82 psychiatric outpatients. The results suggested that Somwaru and Ben-Porath's scales are as valid as the original Morey et al. scales and might be even more valid for the assessment of borderline, antisocial, and schizoid personality disorder symptomatology.

Adult↗
PubMed2000

Personality disorders in the 21st century.

The diagnosis and classification of personality disorders have come a long way since the beginning of the 20th century. Perhaps by this time next century, the diagnostic manual of mental disorders will be using a dimensional model of classification that will provide more reliable and meaningful points of demarcation between normal and abnormal personality functioning. This article offers suggestions for the form, content, and placement of such a dimensional model. The particular model emphasized herein is the five-factor model of personality functioning, but the optimal diagnostic system will probably involve an integration of alternative dimensional models.

Diagnostic Techniques and Procedures↗
PubMed2000

Gender bias in self-report personality disorder inventories.

There has been considerable controversy and research regarding gender biases in the diagnosis of personality disorders, but few studies have explored whether personality disorder self-report inventories might contain gender biases. The current study investigated whether items from three commonly used inventories evidence a potential for gender bias. Subjects were from outpatient mental health clinics. Items were considered gender biased if they exhibited gender differences and failed to correlate with or, more importantly, correlated negatively with dysfunction. Thirty-eight items evidenced potential bias, the majority of which were from Narcissistic scales. The implications of the results for the clinical assessment of purportedly maladaptive personality traits and for the construction of personality disorder scales are discussed.

Adult↗
PubMed1999

Sex bias in the diagnosis of personality disorders: an evaluation of the DSM-IV criteria.

This study considered whether the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) is biased against women by requiring less dysfunction for the personality disorders that are more commonly diagnosed in women (e.g., histrionic). Clinicians estimated the extent of social dysfunction, occupational dysfunction, and personal distress suggested by each of the diagnostic criteria for 6 personality disorders. The results failed to suggest a bias against women, as there was no difference in the overall level of dysfunction associated with the female-typed personality disorder diagnostic criteria (fewer criteria are also required for the male-typed diagnoses). However, the considerable variation in dysfunction across disorders and criteria, and the minimal degree of impairment implied by some of the diagnostic criteria, also raise more general issues that should perhaps be addressed in future editions of the diagnostic manual.

Aged↗
PubMed1999

Consensus criteria for traumatic grief. A preliminary empirical test.

BACKGROUND: Studies suggest that symptoms of traumatic grief constitute a distinct syndrome worthy of diagnosis. AIMS: A consensus conference aimed to develop and test a criteria set for traumatic grief. METHOD: The expert panel proposed consensus criteria for traumatic grief. Receiver operator characteristic (ROC) analyses tested the performance of the proposed criteria on 306 widowed respondents at seven months post loss. RESULTS: ROC analyses indicated that three of four separation distress symptoms (e.g. yearning, searching, loneliness) had to be endorsed as at least 'sometimes true' and four of the final eight traumatic distress symptoms (e.g. numbness, disbelief, distrust, anger, sense of futility about the future) had to be endorsed as at least 'mostly true' to yield a sensitivity of 0.93 and a specificity of 0.93 for a diagnosis of traumatic grief. CONCLUSIONS: Preliminary analyses suggest the consensus criteria for traumatic grief have satisfactory operating characteristics, and point to directions for further refinement of the criteria set.

Grief↗
PubMed1998

Gender differences in the diagnosis of mental disorders: conclusions and controversies of the DSM-IV.

One of the more controversial issues in terms of mental disorder diagnoses has been their differential sex prevalence. The conclusions provided in the 4th edition of the American Psychiatric Association's (1994) Diagnostic and Statistical Manual of Mental Disorders were derived from systematic reviews of the research literature. However, this research is perhaps complicated by common sources of error. Two sources, in particular, are emphasized here: biases in sampling and biases within the diagnostic criteria themselves. The potential for such biases is illustrated for a wide variety of mental disorder diagnoses, and suggestions for research to address them are provided.

Age Factors↗
PubMed1998

Invited essay: sex biases in the diagnosis of personality disorders.

One of the more difficult issues in the development of each edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) has been a possible sex bias in the personality disorder diagnoses. A substantial amount of discussion and research on this issue has occurred since the 1980 publication of the third edition of the DSM. It is now apparent that there are a number of different ways in which the differential sex prevalence rates for the DSM-IV personality disorders could reflect a sex bias, including biased diagnostic constructs, biased thresholds for diagnosis, biased population sampling, biased application of diagnostic criteria, biased instruments of assessment, and biased diagnostic criteria. It is important to understand these different forms of sex bias, as each can occur independently of, be confused with, and interact with one another. The purpose of this paper is to differentiate among, and to describe the support for, each of these different forms of sex bias, with the hope of contributing to their recognition and ultimate resolution.

Diagnostic Errors↗
PubMed1997

Relations of five-factor model antagonism facets with personality disorder symptomatology.

The Five-Factor Model of Personality (FFM) has been used to conceptualize personality disorders as maladaptive variants of normal personality traits. This study assessed the convergence of 6 lower order traits, or facets, of FFM agreeableness versus antagonism (trust, straightforwardness, altruism, compliance, modesty, and tender-mindedness) with antisocial, borderline, narcissistic, paranoid, and passive-aggressive personality traits. Interview-based scores for all of the antagonism facets except compliance demonstrated the expected relations with these personality disorder traits. Results for self-reported facet scores were less clearly supportive, only yielding convergence for straightforwardness and altruism with respect to antisocial traits. It is suggested that future investigations of the FFM, or other normal personality trait models, and personality disorder symptomatology include analyses at the lower order trait level.

Altruism↗