An Investigation of Adherence to Diagnostic Criteria, Revisited: Clinical Diagnosis of the<i>DSM-IV/DSM-5</i>Section II Personality Disorders

Morey, Leslie C.; Benson, Kathryn T.

doi:10.1521/pedi_2015_29_188

Cited by 28 publications

(19 citation statements)

References 20 publications

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“…The trait assignments specified for these disorders in the DSM-5 alternative model (indicated in Table 1) demonstrated substantial correlations with the corresponding DSM-IV diagnoses, with an average trait–disorder correlation of 0.52. It is interesting to note that such associations of DSM-5 alternative model features with DSM-IV criterion-derived diagnoses are roughly comparable with the κ 's (median κ = 0.50) obtained when comparing DSM-IV criterion-derived diagnoses with the global DSM-IV clinical diagnoses made by these same clinicians (Morey & Benson, 2015). Furthermore, in most instances, the assigned traits demonstrated higher correlations than the traits not assigned to that diagnosis.…”

Section: Discussionsupporting

confidence: 63%

Relating DSM-5 section III personality traits to section II personality disorder diagnoses

2015

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Although the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

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Section: Discussionsupporting

confidence: 63%

Relating DSM-5 section III personality traits to section II personality disorder diagnoses

2015

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“…In fact, clinicians rated 45 (83%) of the clients in our sample as having at least one PID-5 scale that was clinically elevated (e.g., > 2.0 on a 0-3 scale) and the average client elevated three scales according to the therapist. This discrepancy between infrequent chart PD diagnoses of PD despite elevated ratings on forma scales is actually quite typical (e. g., Samuel, Anez, Paris, & Grilo, 2014) and echoes studies whereby clinicians' own diagnoses do not match their ratings of individual diagnostic criteria (Morey & Benson, 2016;Morey & Ochoa, 1989). This may suggest that chart diagnoses are themselves reflective of clinicians' under-recognition of PD pathology.…”

Section: Limitations and Future Directionsmentioning

confidence: 65%

The Agreement between Clients’ and their Therapists’ Ratings of Personality Disorder Traits

Samuel¹

2018

Preprint

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Objective: Treating clinicians provide the majority of mental health diagnoses, yet little is known about the validity of their routine diagnoses, including the agreement with clients’ self-reports. This is particularly notable for personality disorders (PDs) as the literature suggests weak agreement between therapists and clients. Existing research has been limited by a focus on PD categories and brief therapist-report measures. Furthermore, although self-reports of PD have been criticized for under-reporting, very few data have compared them to therapist-report in terms of mean-level. Method: We addressed these limitations by collecting dimensional trait ratings from 54 therapist-client dyads within outpatient clinics. The clients (52% women, 94% Caucasian, 39.8 years) provided ratings of dimensional PD traits via the Personality Inventory for DSM-5 (PID-5) while therapists (72% female, 89% Caucasian) completed the Informant version of the same measure. Results: Employing systematic measures of traits yielded higher rank-order agreement than observed in prior studies, with a median correlation of .41 across the PID-5 domains. Most interestingly, mean-level comparisons indicated that clients reported significantly higher levels of PD pathology than did their therapists. This effect was most notable for the domain of Psychoticism, which had the lowest rank-order agreement (r = .16) and the largest mean-level discrepancies. Conclusions: When clinicians utilized systematic measures of dimensional traits their agreement with client was higher than reported in past studies. Furthermore, clients reported significantly more PD pathology than was noted by their therapists suggesting concerns about invalid self-reports due to under-reporting have been overstated.

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“…Considering that the other studies used databases to identify their population it is worth noting that ICD classification is required for each hospital diagnostic record in the US, the DSM is not used. There are further problems within each classification system that relate to poor inter-diagnostic reliability, whereby clinicians do not consistently apply the prescribed structural system in assigning routine clinical diagnoses [74]. Whether the ICD 11 and will bring further clarity is yet to be established.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Maternal Personality Disorder and Early Birth Outcomes: A Systematic Review and Meta-Analysis

Marshall

Jomeen

Huang

et al. 2020

IJERPH

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(1) Background: Women with personality disorder are at risk of social and emotional problems which impact deleteriously on everyday functioning. Moreover, a personality disorder diagnosis has been established to have an adverse impact upon pregnancy outcomes and child health. Understanding this impact is critical to improving both maternal and child outcomes. This systematic review and meta-analysis will evaluate the contemporary evidence regarding these relationships. (2) Methods: Prospero and Cochrane were searched for any systematic reviews already completed on this topic. Academic Search Premier, CINAHL Complete, MEDLINE, PsycARTICLES, PsycINFO via the EBSCO host, and the Web of Science Core Collection were searched to include research articles published between 1980 and 2019. A total of 158 records were identified; 105 records were screened by reviewing the abstract; 99 records were excluded; 6 full text articles were assessed for eligibility; 5 records were included in the review. (3) Results: All the included studies reported on preterm birth. The meta-analysis indicates significant risk of preterm birth in women with personality disorder (overall odds ratio (OR) 2.62; CI 2.24–3.06; p < 0.01). Three studies reported on low birth weight, with the meta-analysis indicating a raised risk of low birth weight of the babies born to women with personality disorder (overall OR 2.00 CI 1.12–3.57 (p = 0.02)). Three studies reported on appearance, pulse, grimace, activity, and respiration (APGAR) score, with the meta-analysis of OR’s indicating a risk of low APGAR score in women with personality disorder (overall OR 2.31; CI 1.17–4.55; p = 0.02). (4) Conclusions: The infants of women with personality disorder are at elevated risk of preterm birth, low birth weight and low APGAR score.

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An Investigation of Adherence to Diagnostic Criteria, Revisited: Clinical Diagnosis of theDSM-IV/DSM-5Section II Personality Disorders

Cited by 28 publications

References 20 publications

Relating DSM-5 section III personality traits to section II personality disorder diagnoses

Relating DSM-5 section III personality traits to section II personality disorder diagnoses

The Agreement between Clients’ and their Therapists’ Ratings of Personality Disorder Traits

The Relationship between Maternal Personality Disorder and Early Birth Outcomes: A Systematic Review and Meta-Analysis

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