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Psychopathology Review
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 Volume 2, Issue 1, 52-82, 2015
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The Brave New World of Personality Disorder-Trait Specified: Effects of Additional Definitions on Coverage, Prevalence, and Comorbidity

Authors
  Lee Anna Clark - University of Notre Dame, U.S.A
  Emily Vanderbleek - University of Notre Dame, U.S.A
  Jaime Shapiro - University of Notre Dame, U.S.A
  Hallie Nuzum - University of Notre Dame, U.S.A
  Xia Allen - University of Notre Dame, U.S.A
  Elizabeth Daly - University of Notre Dame, U.S.A
  Thomas Kingsbury - University of Notre Dame, U.S.A
  Morgan Oiler - University of Notre Dame, U.S.A
  Eunyoe Ro - Southern Illinois University-Edwardsville, IL U.S. A.

Volume 2, Issue 1, 2015, Pages 52-82
DOI: http://dx.doi.org/10.5127/pr.036314

Abstract
The alternative dimensional model for personality disorder (PD) in DSM-5, Section III (DSM-5-III) includes two main criteria: (A) personality-functioning impairment, and (B) personality-trait pathology; provides specific functioningand-trait criteria for six PD-type diagnoses; and introduces PD-trait specified (PD-TS), which requires meeting the general PD criteria and not meeting criteria for any specific PD type. We termed this Simple PD-TS and developed two additional definitions: Mixed PD-TS, meeting criteria for one or two PD types and having five or more additional pathological traits; and Complex PD-TS, meeting criteria for three or more PD types. In a mixed sample of 165 outpatients and 215 community adults screened to be at highrisk for PD, we investigated the effect of these additional definitions on coverage, prevalence, comorbidity, and within-diagnosis heterogeneity, and conclude that eliminating the PD-type diagnoses and thus having PD-TS as the only PD diagnosis would be both more parsimonious and more useful clinically.

Table of Contents
Introduction
Problems with the Current Categorical PD Diagnostic System
 Comorbidity.
 Within-PD heterogeneity.
 Poor coverage and PD-not otherwise specified.
Personality Disorder-Trait Specified
Challenges in Defining PD-TS
Method
 Participants
  Recruitment.
  Demographics.
 Procedure
  Measures.
 Derivation of DSM-5-III Personality Disorder Diagnoses
  Impairment in personality functioning (Criterion A).
  Pathological traits (Criterion B).
 Operational Definitions of PD-TS
  Simple PD-TS.
  Mixed PD-TS.
  Complex PD-TS.
Results
 Preliminary Analyses: Descriptive Statistics
  Personality pathology scales.
  PD-type diagnostic prevalence.
 Primary Analyses
 Personality Disorder-Trait Specified.
  Coverage and prevalence.
  Severity levels of Basic PD and PD-TS.
  Comorbidity.
  Severity.
 Within-PD heterogeneity.
  Standard deviations.
  Extra-diagnostic traits.
Discussion
 Coverage.
 Prevalence.
 Comorbidity.
 Heterogeneity.
  Within-PD heterogeneity.
  Extra-diagnostic traits.
 PD-NOS.
 Summary and Conclusion.
Acknowledgements
References
Appendix

Correspondence to
Lee Anna Clark, Ph.D., Department of Psychology, University of Notre Dame, 118 Haggar Hall, Notre Dame, IN 46556.

Keywords
Personality disorder-trait specified, alternative DSM-5 model for personality disorder, personality disorder diagnosis, dimensional diagnosis of personality disorder, personality traits, personality-functioning impairment, personality pathology, personality dysfunction, DSM

Dates
Received 23 Mar 2014; Revised 3 Jul 2014; Accepted 4 Jul 2014; In Press 14 Feb 2015







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