This study examined the relationship between DSM-IH-R personality disorders and the interpersonal circumplex and Big Five models of personality traits. One hundred and two consecutive referrals for group therapy for personality disorders were evaluated using the Personality Disorder Examination (PDE) and the Millon Clinical Multiaxial Inventory II (MCMI-II) personality-disorder scales. Their placement in circumplex space was assessed using the Inventory of Interpersonal Problems Circumplex Scales, whereas their standing on the Big Five traits was measured with the 50-Bipoiar Self-Rating Scales (50-BSRS). We found that many disorders could be meaningfully located in circumplex space, whereas the use of the Big Five model led to even better placement for several disorders. Further examination of the residuals from the PDE, after the 50-BSRS scales were partialed out, indicated that the remaining common variance could also be understood in terms of the Big Five model.The third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-///; American Psychiatric Association, 1980) introduced operational definitions of personality disorders that were later refined in the DSM-IH-R (American Psychiatric Association, 1987). It has been pointed out that personality disorders as defined in DSM-IIIand DSM-HI-R bear an ambiguous relationship to trait theories as developed by personality psychologists working with normal populations (Clark, Vorhies, & McEwen, in press). Personality disorders occur "when personality traits are inflexible and maladaptive and cause either significant impairment in social or occupational functioning or subjective distress" (American Psychiatric Association, 1987, p. 335). This formulation may be interpreted as suggesting that personalitydisordered persons should exhibit extremes of traits possessed to a less extreme degree by normals. To examine this question, researchers in personality disorder have been encouraged to relate personality pathology to theories of personality traits developed with normal populations.Although there has been much controversy over the decades regarding the best set of traits to use in investigating personal-
Cohesiveness has been viewed as the group psychotherapy equivalent of the therapeutic alliance in individual treatment. Although researchers have attempted to study the concept of cohesion in group treatment, understanding of this so-called "curative" group factor remains quite primitive. In this study of 12 time-limited psychotherapy groups, with a total of 90 nonpsychotic outpatients, we explore the relationships between cohesion, alliance and treatment outcome. Our cohesion measure is a new instrument, the Harvard Community Health Plan Group Cohesiveness Scale, developed for use with group therapy videotapes. To measure alliance we have modified the Penn Helping Alliance Scale (Group Alliance Scale) to be scored from videotapes of group sessions. Both of these instruments use trained observers to make ratings for the group-as-a-whole. The outcome battery for patients in these groups included a widely varied set of measures, enabling us to view change from a number of perspectives. Our findings indicate that cohesion and alliance as measured here are related concepts. We also find that both cohesion and alliance appear to have strong relationships with improved self-esteem and reduced symptomatology for patients in these groups. In addition, it appears that outcome is most related to cohesion in the first 30 minutes of a group session. Implications of these and other findings are discussed.
The 127-item Inventory of Interpersonal Problems (IIP) has proven useful in capturing clinically important aspects of client's interpersonal functioning. Alden, Wiggins, and Pincus constructed a 64-item circumplex form of the IIP (IIP-C). We found that an even shorter form was needed for situations involving the screening of patients in a brief time. We, therefore, constructed a 32-item short circumplex form (IIP-SC). This form was found to exhibit excellent internal consistency reliability and strong test-retest correlations in three outpatient samples. It was found to correlate highly with the longer forms of the IIP and to show similar treatment responsiveness to them. The IIP-SC has also been demonstrated to correspond closely to the circumplex model of interpersonal behavior. The IIP-SC is, thus, an adequate substitute for the complete IIP in settings where brevity is important.
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