__________________________________________________________________________________________________ VOLUME 8 _________________________ Personality Disorders WPA Series Evidence and Experience in Psychiatry Personality Disorders. Edited by Mario Maj, Hagop S. Akiskal, Juan E. Mezzich and Ahmed Okasha. 2005 John Wiley & Sons Ltd: ISBN 0-470-09036-7 ________________________________________________________________________________________________ ________________________ Other Titles in the WPA Series Evidence and Experience in Psychiatry Volume1—Depressive Disorders1999 Mario Maj and NormanSartorius Depressive Disorders, Second Edition 2003 Mario Maj and NormanSartorius Volume2—Schizophrenia 1999 Mario Maj and NormanSartorius Schizophrenia, Second Edition 2003 Mario Maj and NormanSartorius Volume3—Dementia 1999 Mario Maj and NormanSartorius Dementia, Second Edition 2003 Mario Maj and NormanSartorius Volume4—Obsessive–Compulsive Disorder 1999 Mario Maj,Norman Sartorius, AhmedOkasha and JosephZohar Obsessive–Compulsive Disorder,Second Edition 2003 Mario Maj,Norman Sartorius, AhmedOkasha and JosephZohar Volume5—Bipolar Disorder Mario Maj,Hagop S.Akiskal, Juan Jose´Lo´pez-Ibor and NormanSartorius Volume 6—Eating Disorders MarioMaj, KatherineHalmi,Juan Jose´Lo´pez-Ibor and NormanSartorius Volume 7—Phobias Mario Maj,Hagop S. Akiskal, Juan Jose´Lo´pez-Ibor andAhmedOkasha __________________________________________________________________________________________________ VOLUME 8 _________________________ Personality Disorders Edited by Mario Maj University of Naples, Italy Hagop S. Akiskal University of California, San Diego, USA Juan E. Mezzich Mount Sinai School of Medicine, New York, USA Ahmed Okasha Ain Shams University, Cairo, Egypt WPA Series Evidence and Experience in Psychiatry Copyrightu2005 JohnWiley&SonsLtd,TheAtrium,SouthernGate,Chichester, WestSussexPO198SQ,England Telephone(+44)1243779777 Email(forordersandcustomerserviceenquiries):[email protected] AllRightsReserved.Nopartofthispublicationmaybereproduced,storedinaretrieval systemortransmittedinanyformorbyanymeans,electronic,mechanical,photocopying, recording,scanningorotherwise,exceptunderthetermsoftheCopyright,DesignsandPatents Act1988orunderthetermsofalicenceissuedbytheCopyrightLicensingAgencyLtd,90 TottenhamCourtRoad,LondonW1T4LP,UK,withoutthepermissioninwritingofthe Publisher.RequeststothePublishershouldbeaddressedtothePermissionsDepartment,John Wiley&SonsLtd,TheAtrium,SouthernGate,Chichester,WestSussexPO198SQ,England,or [email protected],orfaxedto(+44)1243770620. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks. Allbrandnamesandproductnamesusedinthisbookaretradenames,servicemarks, trademarksorregisteredtrademarksoftheirrespectiveowners.ThePublisherisnotassociated withanyproductorvendormentionedinthisbook. Thispublicationisdesignedtoprovideaccurateandauthoritativeinformationinregardtothe subjectmattercovered.ItissoldontheunderstandingthatthePublisherisnotengagedin renderingprofessionalservices.Ifprofessionaladviceorotherexpertassistanceisrequired,the servicesofacompetentprofessionalshouldbesought. OtherWileyEditorialOffices JohnWiley&SonsInc.,111RiverStreet,Hoboken,NJ07030,USA Jossey-Bass,989MarketStreet,SanFrancisco,CA94103-1741,USA Wiley-VCHVerlagGmbH,Boschstr.12,D-69469Weinheim,Germany JohnWiley&SonsAustraliaLtd,33ParkRoad,Milton,Queensland4064,Australia JohnWiley&Sons(Asia)PteLtd,2ClementiLoop#02-01,JinXingDistripark,Singapore 129809 JohnWiley&SonsCanadaLtd,22WorcesterRoad,Etobicoke,Ontario,CanadaM9W1L1 Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsin printmaynotbeavailableinelectronicbooks. LibraryofCongressCataloging-in-PublicationData Personalitydisorders/editedbyMarioMaj ...[etal.]. p.;cm.--(WPAseries,evidenceandexperienceinpsychiatry;v.8) Includesbibliographicalreferencesandindex. ISBN0-470-09036-7(alk.paper) 1.Personalitydisorders. I.Maj,Mario,1953– II.Series. [DNLM: 1.PersonalityDisorders. WM190P46672005] RC554.P468 2005 616.85’81--dc22 BritishLibraryCataloguinginPublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary ISBN0-470-09036-7(HB) Typesetin10/12PalatinobyDobbieTypesettingLtd,Tavistock,Devon PrintedandboundinGreatBritainbyT.J.InternationalLtd,Padstow,Cornwall Thisbookisprintedonacid-freepaperresponsiblymanufacturedfromsustainableforestry inwhichatleasttwotreesareplantedforeachoneusedforpaperproduction. In Memory of Paul E. Meehl ________________________________________________________________________________________________________________ ____________________________ Contents List of Review Contributors xv Preface xvii CHAPTER 1 SCHIZOTYPAL, SCHIZOID AND PARANOID DISORDERS 1 Cluster A Personality Disorders: A Review 1 Josef Parnas, Deborah Licht and Pierre Bovet COMMENTARIES 1.1 Paul E. Meehl’s Model of Schizotypy and Schizophrenia 75 Mark F. Lenzenweger 1.2 Whatever Happened to Healthy Schizotypy? 82 Gordon Claridge 1.3 Genetic Enhancements to Schizotypy Theorizing 84 Irving I. Gottesman and L. Erlenmeyer-Kimling 1.4 Cluster A Personality Disorders: Unanswered Questions about Epidemiological, Evolutionary and Genetic Aspects 87 Matti Isohanni and Pekka Tienari 1.5 Schizotypy and Schizophrenia 89 Joachim Klosterko¨tter 1.6 Parsing the Schizophrenia Spectrum 92 Loring J. Ingraham 1.7 The Future of Cluster A Personality Disorders 94 Ming T. Tsuang and William S. Stone 1.8 Schizotypal Personality Disorder and Phenotype Specification for Genetic Studies of Schizophrenia 97 Jeremy M. Silverman 1.9 A Developmental, Behavioural Genetic Look at Schizotypal Disorder 100 Marco Battaglia 1.10 The Premorbid Personality Background of Psychotic Disorders 103 Victor Peralta and Manuel J. Cuesta viii _________________________________________________________________________________________ CONTENTS 1.11 Changing Boundaries at Different Levels of Validity 106 Erik Simonsen 1.12 Finding the Right Level of Analysis 110 Richard P. Bentall 1.13 Search for a Systematic Approach to the Diagnosis of Personality Disorders 114 Jan Libiger 1.14 Schizotypal Personality Disorder—a Minor Variant of Schizophrenia? 116 Ana Cristina Chaves 1.15 Diagnosis Versus Classification in Psychiatry 117 Robert Cancro 1.16 Cluster A Personality Disorders: Conundrums and New Directions 120 David L. Braff 1.17 Have Paranoid and Schizoid Personality Disorders Become Dispensable Diagnoses? 122 David P. Bernstein CHAPTER 2 ANTISOCIAL DISORDER 125 Antisocial Personality Disorder: A Review 125 C. Robert Cloninger COMMENTARIES 2.1 Understanding the Antisocial Personality Disorder and Psychopathy Professional Literature 170 Carl B. Gacono 2.2 Developmental Perspectives on Self-Awareness in Antisocial Personality Disorder 172 Jonathan Hill 2.3 The Complexity of Antisocial Behaviour 176 John M. Oldham 2.4 Assessing Research on Antisocial Personality 178 Lee N. Robins 2.5 Antisocial or Social Adaptation 180 Janine L. Stevenson 2.6 Antisocial Personality Disorder—The Forgotten Patients of Psychiatry 184 Donald W. Black 2.7 A New Conceptualization of Antisocial Personality Disorder 187 Conor Duggan CONTENTS __________________________________________________________________________________________ ix 2.8 Cloninger’s Theory of Antisocial Personality Disorder 190 Thomas A. Widiger 2.9 An Uphill Battle Being Won 192 Renato D. Alarco´n 2.10 Public Health Approaches to Antisocial Personality Disorder 195 Giovanni de Girolamo and Mariano Bassi 2.11 Antisocial Personality Disorder in its Cultural Context 198 Levent Ku¨ey and O¨mer Aydemir CHAPTER 3 BORDERLINE AND HISTRIONIC DISORDERS 201 Borderline and Histrionic Personality Disorders: A Review 201 Michael H. Stone COMMENTARIES 3.1 From Shifting Diagnoses to Empirically-based Diagnostic Constructs 232 W. John Livesley 3.2 What is a Personality Disorder, a Set of Traits or Symptoms? 235 Allan Tasman 3.3 Mentalization and Borderline Personality Disorder 238 Anthony W. Bateman 3.4 Complex and Diverse, Yet Similar? 243 Sigmund Karterud, Theresa Wilberg and Øyvind Urnes 3.5 The Need for New Paradigms in the Research Approaches to Borderline Personality Disorder 245 Larry J. Siever 3.6 Borderline Personality Disorder: From Clinical Heterogeneity to Diagnostic Coherence 248 Cesare Maffei 3.7 Borderline Personality Disorder: Problems of Definition and Complex Aetiology 250 Jiri Modestin 3.8 Some Problems in the Current Conceptualization of Borderline and Histrionic Personality Disorders 253 Enrique Baca Baldomero 3.9 Borderline (and Histrionic) Personality Disorders: Boundaries, Epidemiology, Genetics and Treatment 255 Svenn Torgersen x ___________________________________________________________________________________________ CONTENTS 3.10 Categorical Conundrums 258 John F. Clarkin 3.11 Are Cyclothymic Temperament and Borderline and Histrionic Personality Related Concepts? 260 Giulio Perugi 3.12 Borderline and Histrionic Personality Disorders: Implications for Health Services 263 Brian Martindale 3.13 Psychotherapy for Borderline Personality Disorder: Some Tentative Interpretations of the Available Empirical Findings 266 Roel Verheul 3.14 How to Cope with the Burden of Trying to Help a Borderline Patient? 269 Vera Lemgruber 3.15 Borderline Personality Disorder: A Complex Disorder, but not just Complex Post-traumatic Stress Disorder 270 Christian Schmahl 3.16 Borderline Personality Disorder between Axis I and Axis II Diagnosis 273 Tarek A. Okasha 3.17 Histrionic and Borderline Personality Disorders: A View from Latin America 275 Ne´stor M. S. Koldobsky CHAPTER 4 NARCISSISTIC DISORDER 277 Narcissistic Personality Disorder: A Review 277 Elsa Ronningstam COMMENTARIES 4.1 Personality Pathology as Pathological Narcissism 328 Leslie C. Morey 4.2 Narcissism within Psychiatry: Past and Future Perspectives 332 Eric M. Plakun 4.3 Some Psychodynamics of Narcissistic Pathology 334 Arnold M. Cooper 4.4 Complexity of Narcissism and a Continuum of Self-Esteem Regulation 336 Paul J. Watson CONTENTS __________________________________________________________________________________________ xi 4.5 Narcissism: Psychodynamic Theme and Personality Disorder 339 Robert Michels 4.6 Of Narcissism, Narcissistic Personality Disorder and Normal Personality 341 Mark A. Blais 4.7 Narcissistic Personality Disorder: The Cassel Hospital Experience 343 Kevin Healy 4.8 Narcissistic Personalities: Pathobiographies and Research Findings from Latin America 346 Ramon U. Florenzano CHAPTER 5 THE ANXIOUS CLUSTER 349 The Anxious Cluster of Personality Disorders: A Review 349 Peter Tyrer COMMENTARIES 5.1 Theory, Contexts, Prototypes and Subtypes 376 Theodore Millon 5.2 Anxious Cluster Personality Disorders: Perspectives from the Collaborative Longitudinal Personality Disorders Study 378 Andrew E. Skodol 5.3 Personality in Anxiety Disorders 381 Matig R. Mavissakalian 5.4 ‘‘Minima Moralia’’ on Cluster C Personality Disorders 384 Carlo Faravelli 5.5 Anxious Cluster Personality Disorders and Axis I Anxiety Disorders: Comments on the Comorbidity Issue 386 M. Tracie Shea 5.6 Cluster C Personality Disorders: Utility and Stability 389 Timothy J. Trull and Stephanie D. Stepp 5.7 Anxiety, Avoidance and Personality—A Dynamic Borderland 391 Dusica Lecic-Tosevski and Mirjana Divac-Jovanovic 5.8 A Theoretical Model of Cluster C Personality Disorders 393 Joel Paris
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