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Biomedical subjects

T A Widiger

Publications and source records attributed to T A Widiger.

At least 55 records · Page 3Linked to original sources
PubMed1991

Epidemiology of borderline personality disorder.

The limited epidemiological data available on borderline personality disorder suggest that the prevalence of the disorder is between .2 and 1.8 percent in the general community, 15 percent among psychiatric inpatients, and 50 percent among psychiatric inpatients with a diagnosis of personality disorder. No data on the incidence--the rate of new cases--of the disorder have been reported, and inferences about incidence based on prevalence rates are complicated by differences in the formal designation of personality disorders before and after DSM-III was issued. Current findings suggest that about 76 percent of borderline patients are female. Epidemiological study of borderline personality disorder has been hindered by the lack of a brief semistructured interview that can be used with large population samples and that does not require substantial clinical expertise. The authors discuss alternative research methods, including use of lay interviewers, recoding of existing data, telephone interviews, and self-report inventories.

Borderline Personality Disorder↗
PubMed1991

An A to Z guide to DSM-IV conundrums.

The work on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) poses many puzzling conundrums that touch on complicated and important theoretical and practical issues. None of these can be resolved in the DSM-IV, but we hope that the Task Force's decisions will be informed by thorough reviews of the currently available evidence and extensive input from all sectors of the mental health field. In this article we provide an alphabetical guide to DSM-IV conundrums that we hope will stimulate comments, suggestions, and criticisms about the work of the Task Force.

Diagnosis, Differential↗
PubMed1990

Categorical versus dimensional status of borderline personality disorder.

One of the many controversies concerning the borderline personality disorder (BPD) diagnosis is whether the construct refers to a categorical or dimensional variable. The current study used Meehl's (1973) maximum covariance analysis to investigate this issue. The charts of 409 psychiatric inpatients were systematically reviewed for the presence of BPD and dysthymic symptoms. Charts of 244 inpatients were also reviewed to assess the presence of indicators of male sex, a categorical variable. The results for BPD and dysthymia were consistent with a dimensional model, whereas those for male sex were consistent with a categorical model. A dimensional model of classification of BPD is recommended, and suggestions for future research are provided.

Adult↗
PubMed1990

DSM-IV: work in progress.

The authors present an overview of the work in progress on DSM-IV. After a brief historical review, they discuss the principles and multiple purposes of the DSM-IV effort and outline the three stages of its empirical documentation: systematic literature reviews, analysis of unpublished data, and field trials. Next, they discuss several of the basic conceptual issues that are implicit in revising a nomenclature. These include the definition of mental disorder, the balance between multiple diagnosis and differential diagnosis, the use of categorical and dimensional models of classification, and issues involved in the construction of criteria. Finally, they summarize the most important specific questions being reviewed by each of the DSM-IV work groups.

Humans↗
PubMed1989

Sex bias in the diagnosis of histrionic and antisocial personality disorders.

The differential prevalence of the histrionic and antisocial personality disorders among men and women has been attributed both to sex biases and to actual variation in disorder base rates. The present study assessed the bias and base rate explanations and examined whether sex biases are minimized by the relatively explicit diagnostic criteria in the DSM-III. Psychologists (N = 354) either diagnosed 9 DSM-III disorders from case histories that varied in the ambiguity of the antisocial and histrionic personality disorder diagnoses or rated the degree to which specific features extracted from the case histories met 10 histrionic and antisocial diagnostic criteria. The sex of the patient was either male, female, or unspecified. Sex biases were evident for the diagnoses but not for the diagnostic criteria. The results are discussed with respect to base rate effects, sex biases, and the construction of diagnostic criteria.

Adult↗
PubMed1989

Personality disorders: issues in assessment.

The multiaxial system adopted in DSM-III (American Psychiatric Association 1980) has fostered much research in the area of the assessment of personality disorders. This paper will address issues and controversies that have an impact on the assessment of personality. Topics to be discussed in this paper include (1) a review of and comparison between categorical and dimensional approaches to personality classification; (2) discussion of differing viewpoints regarding the most appropriate way to conceptualize Axis II diagnoses, with emphasis on their relationship with Axis I and II conditions; and (4) a review of between Axis I and II conditions; and (4) a review of different assessment instruments.

Humans↗
PubMed1988

The DSM-III-R personality disorders: an overview.

The revision of DSM-III (DSM-III-R) includes substantial changes in the axis II personality disorders. The authors present and critically review these revisions and suggest directions for further research. The issues discussed include the multiaxial system, the use of a categorical rather than a dimensional format, the change from monothetic to polythetic criteria sets, the reduction in overlap among criteria sets, the decrease in the amount of unnecessary inferential clinical judgment required to make diagnoses, and the addition of two new personality disorders in an appendix. The criteria sets for many of the DSM-III personality disorders were also substantially revised in DSM-III-R. Changes in each of these are discussed in turn.

Humans↗
PubMed1987

A multidimensional scaling of the DSM-III personality disorders.

The DSM-III employs a categorical model for the classification of personality disorders. A dimensional model provides certain advantages, but there has not yet been an empiric attempt to identify an optimal set of dimensions. We systematically assessed the presence of each of the symptoms for the personality disorders in 84 patients. The number of symptoms of each of the personality disorders possessed by each patient was correlated across patients, and the correlations were subjected to a multidimensional scaling program. A three-dimensional solution was compared with the placements of the personality disorders predicted by dimensions published previously.

Adult↗
PubMed1987

A psychometric analysis of the social-interpersonal and cognitive-perceptual items for the schizotypal personality disorder.

Because the social-interpersonal symptoms of schizotypal personality disorder have been more useful than the cognitive-perceptual in identifying the biological relatives of schizophrenics, it has been recommended that the schizotypal DSM-III-R (or DSM-IV) criteria be revised to emphasize the social-interpersonal items. This study determined whether the social-interpersonal items would be more efficient than the cognitive-perceptual in diagnosing schizotypal personality disorder in patients presenting to a clinical setting. In contrast to studies conducted in nonclinical samples, we found that the cognitive-perceptual items were equally and at times more important than the social-interpersonal items to the diagnosis of patients with schizotypal personality disorder. We demonstrate that the value of an item depends in part on the particular differential diagnosis at issue.

Adult↗
PubMed1987

Covariation of criteria sets for avoidant, schizoid, and dependent personality disorders.

Avoidant personality disorder was a new addition to DSM-III. Reaction to its inclusion was mixed. Critics cited the lack of empirical data and the overlap with schizoid disorder. The authors consider the overlap and covariation among avoidant, schizoid, and dependent symptoms and diagnoses in a sample of 84 inpatients diagnosed by using a semistructured interview. Items for avoidant disorder covaried with criteria for dependent disorder but not with criteria for schizoid disorder. The authors point out the implications of these results for the revision of DSM-III (DSM-III-R).

Adult↗
PubMed1987

The convergent and discriminant validity of the MCMI as a measure of the DSM-III personality disorders.

The personality scales of the Millon Clinical Multiaxial Inventory (MCMI) were constructed and validated to measure the typology developed by Millon (1981). The ability of the MCMI to measure the DSM-III personality disorders has not yet been empirically evaluated. The current study found better convergent validity for the DSM-III personality disorders that are consistent with Millon's typology (i.e., the avoidant and the dependent) than for the disorders that are inconsistent (i.e., the antisocial and the passive-aggressive). However, the results may reflect some advantages Millon's typology might have over the DSM-III. The discriminant validity of all four scales was limited, due in part to the overlap among the MCMI scales and the DSM-III personality disorders. We discuss implications of the results for the revision of the MCMI and the DSM-III.

Adult↗