Associations in the Course of Personality Disorders and Axis I Disorders Over Time.

Shea, M. Tracie; Stout, Robert L.; Yen, Shirley; Pagano, Maria E.; Skodol, Andrew E.; Morey, Leslie C.; Gunderson, John G.; McGlashan, Thomas H.; Grilo, Carlos M.; Sanislow, Charles A.; Bender, Donna S.; Zanarini, Mary C.

doi:10.1037/0021-843x.113.4.499

Cited by 178 publications

(106 citation statements)

References 43 publications

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“…Nonetheless, the evidence in this study for only a small association of borderline personality disorder with bipolar disorder reinforces other results (29,30,35,36) that have documented a noncyclical, good prognosis course for borderline personality disorder, thereby making a strong spectrum relationship with bipolar disorder extremely unlikely.…”

Section: Ajppsychiatryonlineorgsupporting

confidence: 47%

Descriptive and Longitudinal Observations on the Relationship of Borderline Personality Disorder and Bipolar Disorder

Gunderson

Weinberg²,

Daversa³

et al. 2006

Am J Psychiatry

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Section: Ajppsychiatryonlineorgsupporting

confidence: 47%

Descriptive and Longitudinal Observations on the Relationship of Borderline Personality Disorder and Bipolar Disorder

Gunderson

Weinberg²,

Daversa³

et al. 2006

Am J Psychiatry

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“…These findings are inconsistent with a simple severity hypothesis. Data from several recent studies [125][126][127] also challenge the severity hypothesis. In sum, although SAD typically is more comorbid with AVPD than with other PDs and AVPD more comorbid with SAD than with other anxiety disorders, in neither case is the relationship at all exclusive, nor close enough to support a simple severity hypothesis.…”

Section: Social Anxiety Disorder Versus Avoidant Personality Disordermentioning

confidence: 90%

“…Relatively few studies have examined long-term outcomes or diagnostic course for either SAD or AVPD, but the existing data indicate that both disorders (like many others) have relatively early onsets and a persistent course, albeit with variability in severity over time. [155,168] Both the Collaborative Longitudinal Personality Study [127] and Harvard/Brown Anxiety Research Project [125] found significant but not exclusive overlap in the longitudinal courses of SAD and AVPD. Moreover, the longitudinal courses of AVPD and OCD also overlapped, although not as strongly.…”

Section: Social Anxiety Disorder Versus Avoidant Personality Disordermentioning

confidence: 99%

Social anxiety disorder: questions and answers for the DSM-V

et al. 2010

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Background: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. Method: A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V. Results/Conclusions: Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a ''predominantly performance'' variety of SAD. A specifier based on ''fear of showing anxiety symptoms'' (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options. Depression and Anxiety 27:168-189, 2010. Key words: DSM-V; social anxiety disorder; social phobia; subtypes; classification; interpersonal; performance; test anxiety; selective mutism; avoidant personality disorder INTRODUCTIONThis review evaluates several issues pertaining to the diagnostic criteria for social phobia or social anxiety disorder (SAD) (Table 1), in light of empirical evidence gathered since DSM-IV. The review was guided by questions posed in the DSM-IV Sourcebook (Vol. 2), chapters titled ''Social phobia'' [1] and ''Social phobia subtypes,''[2] a review conducted as part of the DSM-V Stress Induced and Fear Circuitry Disorders Workgroup Conference, titled ''Social Phobia: Towards DSM V, '' [3] by questions posed by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group and by issues raised by consulted experts and advisors. The main issues to be addressed are the generalized specifier and its alternatives, the overlap with avoidant personality disorder, and developmental issues including the relationship that SAD shows in childhood with selective mutism (SM) and test anxiety. STATEMENT OF THE ISSUESThis review addresses the following questions, using the validators provided by the DSM-V Task Force: (1) What is the evidence/utility of the DSM-IV generalized specifier? If there is insufficient evidence/utility for a generalized specifier, what is the utility/evidence for alternative sub...

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“…Recently, researchers have begun to analyze comorbidity data in ways that can inform psychopathological theory. For example, regarding the validity of the Axis I-Axis II distinction, CLPS data have revealed both convergences and disjunctions between concurrent and longitudinal co-occurrence (McGlashan et al 2000, Shea et al 2004). Specifically, both at baseline and longitudinally up to two years follow-up, avoidant PD was associated with social phobia, and BPD with PTSD (Axelrod et al 2005 also found bidirectional BPD-PTSD relations in combat veterans).…”

Section: The Meaning Of Comorbidity Patternsmentioning

confidence: 99%

Assessment and Diagnosis of Personality Disorder: Perennial Issues and an Emerging Reconceptualization

Clark

2007

Annu. Rev. Psychol.

702

718

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This chapter reviews recent (2000)(2001)(2002)(2003)(2004)(2005) personality disorder (PD) research, focusing on three major domains: assessment, comorbidity, and stability. (a) Substantial evidence has accrued favoring dimensional over categorical conceptualization of PD, and the five-factor model of personality is prominent as an integrating framework. Future directions include assessing dysfunction separately from traits and learning to utilize collateral information. (b) To address the pervasiveness and extent of comorbidity, researchers have begun to move beyond studying overlapping pairs or small sets of disorders and are developing broader, more integrated common-factor models that cross the Axis I-Axis II boundary. (c) Studies of PD stability have converged on the finding that PD features include both more acute, dysfunctional behaviors that resolve in relatively short periods, and maladaptive temperamental traits that are relatively more stable-similar to normal-range personality traits-with increasing stability until after 50 years of age. A new model for assessing PDand perhaps all psychopathology-emerges from integrating these interrelated reconceptualizations.

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Associations in the Course of Personality Disorders and Axis I Disorders Over Time.

Cited by 178 publications

References 43 publications

Descriptive and Longitudinal Observations on the Relationship of Borderline Personality Disorder and Bipolar Disorder

Descriptive and Longitudinal Observations on the Relationship of Borderline Personality Disorder and Bipolar Disorder

Social anxiety disorder: questions and answers for the DSM-V

Assessment and Diagnosis of Personality Disorder: Perennial Issues and an Emerging Reconceptualization

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