Hierarchical relationships between borderline, schizotypal, avoidant and obsessive-compulsive personality disorders.

Abstract

OBJECTIVE:

Comorbidity among personality disorders is widely considered problematic. The validity of one proposed solution, diagnostic hierarchies, was investigated in the current study with respect to borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders.

METHOD:

One approach used discriminant functions, derived from multiple psycho-social domains, that were used to classify comorbid individuals from the Collaborative Longitudinal Personality Disorder study (CLPS) to explore the possibility of hierarchical precedence of one personality disorder over another. A second approach examined the incremental increase in R(2)-value in predicting functioning and personality provided by each diagnosis over each other diagnosis.

RESULTS:

Obsessive-compulsive personality disorder was consistently subordinate to other diagnoses, whereas other indications of hierarchical relationships were domain-specific.

CONCLUSION:

Results indicate minimal support for an over-arching hierarchical pattern among studied personality disorders, and suggest the inclusion of all relevant diagnoses in clinical practice.

• Authors: C J Hopwood, L C Morey, J G Gunderson, A E Skodol, M Tracie Shea, C M Grilo, T H McGlashan
• Journal: Acta psychiatrica Scandinavica (Acta Psychiatr Scand) Vol. 113 Issue 5 Pg. 430-9 (May 2006) ISSN: 0001-690X [Print] United States
• PMID: 16603034 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Validation Study)

Topics

• Adolescent
• Adult
• Borderline Personality Disorder (diagnosis, epidemiology, psychology)
• Comorbidity
• Compulsive Personality Disorder (diagnosis, epidemiology, psychology)
• Discriminant Analysis
• Female
• Humans
• Interview, Psychological
• Longitudinal Studies
• Male
• Middle Aged
• Personality Disorders (diagnosis, epidemiology, psychology)
• Personality Inventory
• Predictive Value of Tests
• Psychological Tests
• Reproducibility of Results
• Schizotypal Personality Disorder (diagnosis, epidemiology, psychology)
• Self Disclosure
• Severity of Illness Index