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Internal consistency and intercriterion overlap within and between DSM-IV Axis II Personality Disorders: Findings from the Collaborative Longitudinal Study of Personality Disorders

Carlos M. Grilo, Yale University School of Medicine
Thomas H. McGlashan, Yale University School of Medicine
Leslie C. Morey, Texas A & M University - College Station
John G. Gunderson, Harvard Medical School and McLean Hospital
Andrew E. Skodol, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons
M. Tracie Shea, Brown University School of Medicine
Charles A. Sanislow, Yale University School of Medicine
Mary C. Zanarini, Harvard Medical School and McLean Hospital
Donna S. Bender, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons
John M. Oldham, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons
Ingrid Dyck, Brown University School of Medicine
Robert L. Stout, Brown University School of Medicine

Abstract

Objective: To evaluate performance characteristics of DSM-IV Personality Disorders (PDs) criteria.

Method: Six hundred and sixty-eight adults recruited for the Collaborative Longitudinal Personality Disorders Study (CLPS) were assessed with diagnostic interviews.

Results: Within-category inter-relatedness was evaluated by Cronbach’s alpha and median intercriterion correlations (MIC). Cronbach’s alpha ranged from 0.47 to 0.87 (median=0.71); seven of the 10 PDs had alphas greater than 0.70. Between-category criterion overlap was evaluated by ‘inter-category’ intercriterion correlations between all PD pairs (ICMIC). ICMIC values (median=0.08) were lower than MIC values (median=0.23). Diagnostic efficiency statistics (sensitivity, specificity, positive predictive power and negative predictive power were calculated for schizotypal, borderline, avoidant and obsessive-compulsive PDs.

Conclusion: DSM-IV PD criteria sets have some convergent validity and discriminant validity: criteria for individual PDs correlate better with each other than with criteria for other PDs. Diagnostic efficiency statistics provide guidance regarding usefulness of criteria for inclusion or exclusion.

Suggested Citation

Grilo, C. M., McGlashan, T. H., Morey, L. C., Gunderson, J. G., Skodol, A. E., Shea, M. T., Sanislow, C. A., Zanarini, M. C., Bender, D. S., Oldham, J. M., Dyck, I. R., & Stout, R. L. (2001). Internal consistency and intercriterion overlap and diagnostic efficiency of criteria sets for DSM-IV schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders. Acta Psychiatrica Scandinavica, 104(4), 246-272.