Assessment and diagnosis of personality disorder: perennial issues and an emerging reconceptualization.

@article{Clark2007AssessmentAD,
  title={Assessment and diagnosis of personality disorder: perennial issues and an emerging reconceptualization.},
  author={Lee Anna Clark},
  journal={Annual review of psychology},
  year={2007},
  volume={58},
  pages={
          227-57
        }
}
  • L. Clark
  • Published 21 December 2007
  • Psychology
  • Annual review of psychology
This chapter reviews recent (2000-2005) 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… 
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References

SHOWING 1-10 OF 184 REFERENCES
The Collaborative Longitudinal Personality Disorders Study (CLPS): overview and implications.
TLDR
It is hypothesized that PDs may be reconceptualized as hybrids of stable personality traits and intermittently expressed symptomatic behaviors, as well as more temporal stability.
Ten-year stability of personality disorders among outpatients with mood disorders.
TLDR
Stability of PDs in a sample of depressed outpatients who were assessed for the full range of Axis II conditions across 5 assessments was generally comparable to that of anxiety disorder diagnoses and normal personality traits.
Stability and Course of Personality Disorders: The Need to Consider Comorbidities and Continuities Between Axis I Psychiatric Disorders and Axis II Personality Disorders
TLDR
The pervasiveness of diagnostic co-occurrence and its implications for continued investigation of the question of PD stability are highlighted and longitudinal studies need to consider continuities between diagnoses.
Stability and change in personality pathology: revelations of three longitudinal studies.
  • L. Clark
  • Psychology
    Journal of personality disorders
  • 2005
TLDR
Three major longitudinal studies of personality disorder jointly provide new insights into the nature of stability and change in this important domain of psychopathology, leading to the insight that DSM personality disorders are hybrids of more acute, "Axis I-like" symptoms that resolve more quickly and longer lasting affective, cognitive, and behavioral personality dysfunctions.
Difficulties in the Assessment of Personality Traits and Disorders in Eating-Disordered Individuals
TLDR
Although there is substantial support for the clinical view that personality variables are linked to anorexia nervosa and bulimia nervosa, the identification of stable traits and Axis II disorders in individual patients should be deferred until after the initial phase of treatment.
Temperament as a unifying basis for personality and psychopathology.
  • L. Clark
  • Psychology
    Journal of abnormal psychology
  • 2005
TLDR
Three broad, innate temperament dimensions differentiate through both biologically and environmentally based developmental processes into a hierarchical personality trait structure and, at their extremes, are risk factors for psychopathology, especially given adverse life experiences (stress).
Short-term diagnostic stability of schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders.
TLDR
Individual differences in personality disorder features appear to be highly stable, although the number of criteria present decreases over time.
Personality disorder assessment: the challenge of construct validity.
TLDR
It is concluded that more complex conceptual models that can incorporate both biological and environmental influences on the development of adaptive and maladaptive personality are needed.
Personality disorder symptoms in adolescence: a five-factor model perspective.
The five-factor model has been widely used to describe adaptive and maladaptive functioning in adulthood. However, less is known about the structure and developmental antecedents of personality
Stability as a distinction between Axis I and Axis II disorders.
TLDR
Though remission/recovery rate at the 2-year follow-up was highest for mood disorders, the probability of recurrence was also particularly high for anxiety disorders, and personality disorders appear to be less stable than conceptualized.
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