Dimensional Models of Personality Disorders: Refining the Research Agenda for DSM-V

316 Pages·2006·3.07 MB·English

by  Thomas A. Widiger

DIMENSIONAL
MODELS OF
PERSONALITY
DISORDERS
Refining the Research Agenda
for DSM-V
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DIMENSIONAL
MODELS OF
PERSONALITY
DISORDERS
Refining the Research Agenda
for DSM-V
Edited by
Thomas A. Widiger, Ph.D.
Erik Simonsen, M.D.
Paul J. Sirovatka, M.S.
Darrel A. Regier, M.D., M.P.H.
Published by the
American Psychiatric Association
Washington, D.C.
Note: The authors have worked to ensure that all information in this book is ac-
curate at the time of publication and consistent with general psychiatric and medical
standards, and that information concerning drug dosages, schedules, and routes of
administration is accurate at the time of publication and consistent with standards
set by the U.S. Food and Drug Administration and the general medical community.
As medical research and practice continue to advance, however, therapeutic stan-
dards may change. Moreover, specific situations may require a specific therapeutic
response not included in this book. For these reasons and because human and me-
chanical errors sometimes occur, we recommend that readers follow the advice of
physicians directly involved in their care or the care of a member of their family.
The findings, opinions, and conclusions of this report do not necessarily represent
the views of the officers, trustees, or all members of the American Psychiatric Asso-
ciation. The views expressed are those of the authors of the individual chapters.
Copyright © 2006 American Psychiatric Association
ALL RIGHTS RESERVED
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Library of Congress Cataloging-in-Publication Data
Dimensional models of personality disorders : refining the research agenda for
DSM-V / edited by Thomas A. Widiger ... [et al.]. — 1st ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-89042-296-6 (pbk. : alk. paper)
1. Personality disorders—Classification. 2. Diagnostic and statistical manual
of mental disorders. I. Widiger, Thomas A.
[DNLM: 1. Personality Disorders—classification. 2. Models, Psychologi-
cal. WM 15 D582 2006]
RC554.D555 2006
616.85'8—dc22
2006014661
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
This text is dedicated to the memory of
Jerry S. Wiggins
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CONTENTS
CONTRIBUTORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
DISCLOSURE STATEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
FOREWORD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii
Darrel A. Regier, M.D., M.P.H.
PREFACE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxi
Thomas A. Widiger, Ph.D.
Erik Simonsen, M.D.
INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxv
Erik Simonsen, M.D.
Thomas A. Widiger, Ph.D.
1
ALTERNATIVE DIMENSIONAL MODELS OF
PERSONALITY DISORDER: Finding a Common Ground. . . . . . . . . . . . .1
Thomas A. Widiger, Ph.D.
Erik Simonsen, M.D.
2
COMMENTARY ON WIDIGER AND SIMONSEN:
Toward a Consensus Personality Trait Structure. . . . . . . . . . . . . . . . . .23
Lee Anna Clark, Ph.D.
3
COMMENTARY ON WIDIGER AND SIMONSEN:
Working Out a Dimensional Framework . . . . . . . . . . . . . . . . . . . . . . .29
John M. Oldham, M.D.
4
COMMENTARY ON WIDIGER AND SIMONSEN:
From ICD-10 and DSM-IV to ICD-11 and DSM-V . . . . . . . . . . . . . . . .33
Charles B. Pull, M.D., Ph.D.
5
BEHAVIORAL AND MOLECULAR GENETIC CONTRIBUTIONS TO
A DIMENSIONAL CLASSIFICATION OF PERSONALITY DISORDER. . . . .39
W. John Livesley, M.D., Ph.D.
6
COMMENTARY ON LIVESLEY: Genetic Contributions to
a Dimensional Classification: Problems and Pitfalls . . . . . . . . . . . . . . 55
Peter McGuffin, M.D., Ph.D.
7
NEUROBIOLOGICAL DIMENSIONAL MODELS
OF PERSONALITY: A Review of Three Models. . . . . . . . . . . . . . . . . . 61
Joel Paris, M.D.
8
COMMENTARY ON PARIS:
Personality as a Dynamic Psychobiological System. . . . . . . . . . . . . . . 73
C. Robert Cloninger, M.D.
9
COMMENTARY ON PARIS:
The Problem of Severity in Personality Disorder Classification. . . . . . . 77
Peter Tyrer, M.D.
10
TEMPERAMENT AND PERSONALITY AS BROAD-SPECTRUM
ANTECEDENTS OF PSYCHOPATHOLOGY
IN CHILDHOOD AND ADOLESCENCE . . . . . . . . . . . . . . . . . . . . . . . . 85
Ivan Mervielde, Ph.D.
Barbara De Clercq, Ph.D.
Filip De Fruyt, Ph.D.
Karla Van Leeuwen, Ph.D.
11
COMMENTARY ON MERVIELDE ET AL.:
Toward a Developmental Perspective on Personality Disorders. . . . . 111
Rebecca L. Shiner, Ph.D.
12
PERSONALITY DIMENSIONS ACROSS CULTURES. . . . . . . . . . . . . . . 117
Jüri Allik, Ph.D.
13
COMMENTARY ON ALLIK:
The Lexical Approach to the Study of Personality Structure. . . . . . . . 133
Michael Ashton, Ph.D.
14
COMMENTARY ON ALLIK:
A Historical Perspective on Personality Disorder. . . . . . . . . . . . . . . . 139
Juan J. López-Ibor, M.D.
15
COMMENTARY ON ALLIK:
Cross-Cultural Diagnosis of Personality Disorders. . . . . . . . . . . . . . . 143
Yueqin Huang, M.D., M.P.H., Ph.D.
Siu Wa Tang, M.B., Ph.D., F.R.C.P.(C.)
16
CONTINUITY OF AXES I AND II: Toward a Unified Model of
Personality, Personality Disorders, and Clinical Disorders. . . . . . . . . .149
Robert F. Krueger, Ph.D.
17
COMMENTARY ON KRUEGER:
What to Do With the Old Distinctions. . . . . . . . . . . . . . . . . . . . . . . .163
M. Tracie Shea, Ph.D.
18
COMMENTARY ON KRUEGER:
Traits Versus Types in the Classification of Personality Pathology. . . .167
David Watson, Ph.D.
19
DIMENSIONAL MODELS OF PERSONALITY DISORDER:
Coverage and Cutoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171
Timothy J. Trull, Ph.D.
20
COMMENTARY ON TRULL: Drizzling on the 5 ± 3 Factor Parade . . .189
Drew Westen, Ph.D.
21
COMMENTARY ON TRULL: Just Do It: Replace Axis II With a
Diagnostic System Based on the Five-Factor Model of Personality . . .195
Paul Costa Jr., Ph.D.
22
COMMENTARY ON TRULL: Reservations and Hopes . . . . . . . . . . . .199
Carl C. Bell, M.D.
23
CLINICAL UTILITY OF DIMENSIONAL MODELS FOR
PERSONALITY PATHOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .203
Roel Verheul, Ph.D.
24
COMMENTARY ON VERHEUL:
Focusing on the Clinician’s Need for a Better Model. . . . . . . . . . . . .219
Erik Simonsen, M.D.
25
COMMENTARY ON VERHEUL:
Clinical Utility of Dimensional Models for Personality Pathology . . . .227
Theresa Wilberg, M.D., Ph.D.
26
PERSONALITY DISORDER RESEARCH AGENDA FOR DSM-V . . . . . . .233
Thomas A. Widiger, Ph.D.
Erik Simonsen, M.D.
Robert F. Krueger, Ph.D.
W. John Livesley, M.D., Ph.D.
Roel Verheul, Ph.D.
INDEX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257