Assessing DSM-5 level of personality functioning from videotaped clinical interviews: A pilot study with untrained and clinically inexperienced students

Journal of Personality Assessment

Volumn 96, Issue 4, 2014, Pages 397-409

  Zimmermann, Johannes ^a   Benecke, Cord ^a   Bender, Donna S ^b   Skodol, Andrew E ^b   Schauenburg, Henning ^c   Cierpka, Manfred ^c   Leising, Daniel ^d  

^a UNIVERSITY OF KASSEL   (Germany)

^b UNIVERSITY OF ARIZONA   (United States)

^c UNIVERSITY OF HEIDELBERG   (Germany)

^d DRESDEN UNIVERSITY OF TECHNOLOGY   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; FEMALE; HUMAN; MALE; PERSONALITY DISORDERS; PILOT STUDY; PSYCHOLOGIC TEST; PSYCHOLOGICAL RATING SCALE; SEVERITY OF ILLNESS INDEX; STANDARDS; STUDENT; UNIVERSITY; VIDEORECORDING; YOUNG ADULT;

ADULT; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; FEMALE; HUMANS; INTERVIEW, PSYCHOLOGICAL; MALE; PERSONALITY DISORDERS; PILOT PROJECTS; PSYCHIATRIC STATUS RATING SCALES; SEVERITY OF ILLNESS INDEX; STUDENTS; UNIVERSITIES; VIDEO RECORDING; YOUNG ADULT;

EID: 84903301937     PISSN: 00223891     EISSN: None     Source Type: Journal    
DOI: 10.1080/00223891.2013.852563     Document Type: Article

References (85)

1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
3. Back, M.D., & Kenny, D.A. (2010). The social relations model: How to understand dyadic processes. Social and Personality Psychology Compass, 4, 855-870. doi: 10.1111/j.1751-9004.2010.00303.x
4. Bender, D.S. (2012a). Level of Personality Functioning Scale: Training case vignettes. Unpublished manuscript, Department of Psychiatry, University of Arizona College of Medicine.
5. Bender, D.S. (2012b). Mirror, mirror on the wall: Reflecting on narcissism. Journal of Clinical Psychology: In Session, 68, 877-885. doi: 10.1002/jclp.21892
6. Bender, D.S. (2013). An ecumenical approach to conceptualizing and studying the core of personality psychopathology: A commentary on Hopwood et al. Journal of Personality Disorders, 27, 311-319. doi: 10.1521/pedi.2013.27.3.311
7. Bender, D.S., Morey, L.C., & Skodol, A.E. (2011). Toward a model for assessing level of personality functioning in DSM-5, Part I: A review of theory and methods. Journal of Personality Assessment, 93, 332-346. doi: 10.1080/00223891.2011.583808
8. Benecke, C., Koschier, A., Peham, D., Bock, A., Dahlbender, R.W., Biebl, W., & Doering, S. (2009). Erste Ergebnisse zu Reliabilität und Validität der OPD-2 Strukturachse [First results on the reliability and validity of the OPD-2 axis structure]. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 55, 84-96.
9. Benjamin, L.S. (1996). Interpersonal diagnosis and treatment of personality disorders. New York, NY: Guilford.
10. Berghuis, H., Kamphuis, J.H., Verheul, R., Larstone, R., & Livesley, J. (in press). The General Assessment of Personality Disorder (GAPD) as an instrument for assessing the core features of personality disorders. Clinical Psychology & Psychotherapy. doi: 10.1002/cpp.1811
11. Bornstein, R.F. (1998). Reconceptualizing personality disorder diagnosis in the DSM-V: The discriminant validity challenge. Clinical Psychology: Science and Practice, 5, 333-343. doi: 10.1111/j.1468-2850.1998.tb00153.x
12. Bornstein, R.F., & Huprich, S.K. (2011). Beyond dysfunction and threshold-based classification: A multidimensional model of personality disorder diagnosis. Journal of Personality Disorders, 25, 331-337. doi: 10.1521/pedi.2011.25.3.331
13. Campbell, D.T., & Fiske, D.W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81-105. doi: 10.1037/h0046016
14. Cicchetti, D.V. (1994). Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6, 284-290. doi: 10.1037/1040-3590.6.4.284
15. Clark, L. (2007). Assessment and diagnosis of personality disorder: Perennial issues and an emerging reconceptualization. Annual Review of Psychology, 58, 227-257. doi: 10.1146/annurev.psych.57.102904.190200
16. Clarke, D.E., Narrow, W.E., Regier, D.A., Kuramoto, S.J., Kupfer, D.J., Kuhl, E.A.,., & Kraemer, H.C. (2013). DSM-5 field trials in the United States and Canada, Part I: Study design, sampling strategy, implementation, and analytic approaches. American Journal of Psychiatry, 170, 43-58. doi: 10.1176/appi.ajp.2012.12070998
17. Clarkin, J.F., & Huprich, S.K. (2011). Do DSM-5 personality disorder proposals meet criteria for clinical utility? Journal of Personality Disorder, 25, 192-205. doi: 10.1521/pedi.2011.25.2.192
18. Crawford, M.J., Koldobsky, N., Mulder, R., & Tyrer, P. (2011). Classifying personality disorder according to severity. Journal of Personality Disorders, 25, 321-330. doi: 10.1521/pedi.2011.25.3.321
19. Cronbach, L.J., & Meehl, P.E. (1955). Construct validity in psychological tests. Psychological Bulletin,. 52, 281-302. doi: 10.1037/h0040957
20. First, M.B., Gibbon, M., Spitzer, R.L., Williams, J.B. W., & Benjamin, L.S. (1997). Structured Clinical Interview for DSM-IV Axis II personality disorders (SCID-II). Washington, DC: American Psychiatric Press.
21. First, M.B., Spitzer, R.L., Gibbon, M., &Williams, J.B.W. (2002). Structured Clinical Interview for DSM-IV-TR Axis I disorders (SCID-I). New York, NY: Biometrics Research, New York State Psychiatric Institute.
22. Furr, R.M., & Funder, D.C. (2007). Behavioral observation. In R. Robins., C. Fraley., & R. Krueger. (Eds). Handbook of research methods in personality psychology (pp. 273-291). New York, NY: Guilford.
23. Grande, T., Rudolf, G., & Oberbracht, C. (2000). Verä nderungsmessung auf OPD-Basis: Schwierigkeiten und ein neues Konzept [OPD-based assessment of change: Difficulties and a new concept]. In W. Schneider. & H.J. Freyberger. (Eds.), Was leistet die OPD? Empirische Befunde und klinische Erfahrungen mit der Operationalisierten Psychodynamischen Diagnostik (pp. 148-161). Bern, Switzerland: Huber.
24. Gutiérrez, F., Navinés, R., Navarro, P., García-Esteve, L., Subirá, S., Torrens, M., & Martín-Santos, R. (2008). What do all personality disorders have in common? Ineffectiveness and uncooperativeness. Comprehensive Psychiatry, 49, 570-580. doi: 10.1016/j.comppsych.2008.04.007
25. Hopwood, C.J., Malone, J.C., Ansell, E.B., Sanislow, C.A., Grillo, C.M., McGlashan, T.H.,., & Morey, L.C. (2011). Personality assessment in DSM-5: Empirical support for rating severity, style, and traits. Journal of Personality Disorders, 25, 305-320. doi: 10.1521/pedi.2011.25.3.305
26. Hopwood, C.J., Wright, A.G. C., Ansell, E.B., & Pincus, A.L. (2013). The interpersonal core of personality pathology. Journal of Personality Disorders, 27, 270-295. doi: 10.1521/pedi.2013.27.3.270
27. Johnson, J.G., First, M.B., Cohen, P., & Kasen, S. (2008). Development and validation of a new procedure for the diagnostic assessment of personality disorder: The Multidimensional Personality Disorder Rating Scale (MPDRS). Journal of Personality Disorders, 22, 246-258. doi: 10.1521/pedi.2008.22.3.246
28. Kenny, D.A. (1994). Interpersonal perception: A social relations analysis. New York, NY: Guilford.
29. Kenny, D.A., & Kashy, D.A. (2010). Dyadic data analysis using multilevel modeling. In J. Hox. & J.K. Roberts. (Eds.), The handbook of multilevel analysis (pp. 335-370). London, UK: Taylor & Francis.
30. Kenny, D.A., & West, T.A. (2010). Similarity and agreement in self and other perception: A meta-analysis. Personality and Social Psychology Review, 14, 196-213. doi: 10.1177/1088868309353414
31. Kernberg, O.F. (2012). Overview and critique of the classification of personality disorders proposed for DSM-V. Swiss Archives of Neurology and Psychiatry, 163, 234-238.
32. Kernberg, O.F., & Caligor, E. (2005). A psychoanalytic theory of personality disorders. In M.F. Lenzenweger. & J.F. Clarkin. (Eds.), Major theories of personality disorder (2nd ed., pp. 114-156). New York, NY: Guilford.
33. Kraemer, H.C., Kupfer, D.J., Clarke, D.E., Narrow, W.E., & Regier, D.A. (2012). DSM-5: How reliable is reliable enough? American Journal of Psychiatry, 169, 13-15. doi: 10.1176/appi.ajp.2011.11010050
34. Krueger, R.F., Eaton, N.R., Derringer, J., Markon, K.E., Watson, D., & Skodol, A.E. (2011). Personality in DSM-5: Helping delineate personality disorder content and framing the metastructure. Journal of Personality Assessment, 93, 325-331. doi: 10.1080/00223891.2011.577478
35. Krueger, R.F., Skodol, A.E., Livesley, W., Shrout, P.E., & Yueqin, H. (2007). Synthesizing dimensional and categorical approaches to personality disorders: Refining the research agenda for DSM-V Axis II. International Journal of Methods in Psychiatric Research, 16, 65-73. doi: 10.1002/mpr.212
36. Lahey, M.A., Downey, R.G., & Saal, F.E. (1983). Intraclass correlations: There's more there than meets the eye. Psychological Bulletin, 93, 586-595. doi: 10.1037/0033-2909.93.3.586
37. Landau, S., & Stahl, D. (2013). Sample size and power calculations for medical studies by simulation when closed form expressions are not available. Statistical Methods in Medical Research, 22, 324-345. doi: 10.1177/0962280212439578
38. Leising, D., Krause, S., Köhler, D., Hinsen, K., & Clifton, A. (2011). Assessing interpersonal functioning: Views from within and without. Journal of Research in Personality, 45, 631-641. doi: 10.1016/j.jrp.2011.08.011
39. Leising, D., Rogers, K., & Ostner, J. (2009). The undisordered personality: Normative assumptions underlying personality disorder diagnoses. Review of General Psychology, 13, 230-241. doi: 10.1037/a0017139
40. Leising, D., & Zimmermann, J. (2011). An integrative conceptual framework for assessing personality and personality pathology. Review of General Psychology, 15, 317-330. doi: 10.1037/a0025070
41. Livesley, W.J. (1998). Suggestions for a framework for an empirically based classification of personality disorder. The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 43, 137-147.
42. Livesley, W.J. (2012). Tradition versus empiricism in the current DSM-5 proposal for revising the classification of personality disorders. Criminal Behaviour and Mental Health, 22, 81-90. doi: 10.1002/cbm.1826
43. Lobbestael, J., Leurgans, M., & Arntz, A. (2011). Inter-rater reliability of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and Axis II Disorders (SCID II). Clinical Psychology and Psychotherapy, 18, 75-79. doi: 10.1002/cpp.693
44. Lukowitsky, M.R., & Pincus, A.L. (2013). Interpersonal perception of pathological narcissism: A social relations analysis. Journal of Personality Assessment, 95, 261-273. doi: 10.1080/00223891.2013.765881
45. Luyten, P., & Blatt, S.J. (2013). Interpersonal relatedness and self-definition in normal and disrupted personality development: Retrospect and prospect. American Psychologist, 68, 172-183. doi: 10.1037/a0032243
46. Mahaffey, K.J., & Marcus, D.K. (2006). Interpersonal perception of psychopathy: A social relations analysis. Journal of Social and Clinical Psychology, 25, 53-74. doi: 10.1521/jscp.2006.25.1.53
47. Markon, K.E., Chmielewski, M., & Miller, C.J. (2011). The reliability and validity of discrete and continuous measures of psychopathology: A quantitative review. Psychological Bulletin, 137, 856-879. doi: 10.1037/a0023678
48. McGraw, K.O., & Wong, S.P. (1996). Forming inferences about some intraclass correlation coefficients. Psychological Methods, 1, 30-46. doi: 10.1037/1082-989X.1.1.30
49. Meyer, B., & Pilkonis, P.A. (2005). An attachment model of personality disorders. In M.F. Lenzenweger. & J.F. Clarkin. (Eds.), Major theories of personality disorder (2nd ed., pp. 231-281). New York, NY: Guilford.
50. Morey, L.C., Bender, D.S., & Skodol, A.E. (2013). Validating the proposed Diagnostic and Statistical Manual of Mental Disorders, 5th edition, severity indicator for personality disorder. Journal of Nervous and Mental Disease, 201, 729-735. doi: 10.1097/NMD.0b013e3182a20ea8
51. Morey, L.C., Berghuis, H., Bender, D.S., Verheul, R., Krueger, R.F., & Skodol, A.E. (2011). Toward a model for assessing level of personality functioning in DSM-5, Part II: Empirical articulation of a core dimension of personality pathology. Journal of Personality Assessment, 93, 347-353. doi: 10.1080/00223891.2011.577853
52. OPD Task Force. (Eds.). (2008). Operationalized Psychodynamic Diagnosis OPD-2: Manual of diagnosis and treatment planning. Cambridge, MA: Hogrefe & Huber.
53. Parker, G., Both, L., Olley, A., Hadzi-Pavlovic, D., Irvine, P., & Jacobs, G. (2002). Defining disordered personality functioning. Journal of Personality Disorders, 16, 503-522. doi: 10.1521/pedi.16.6.503.22139
54. Parker, G., Hadzi-Pavlovic, D., Both, L., Kumar, S., Wilhelm, K., & Olley, A. (2004). Measuring disordered personality functioning: To love and work reprised. Acta Psychiatrica Scandinavica, 110, 230-239. doi: 10.1111/j.1600-0447.2004.00312.x
55. Pilkonis, P.A., Hallquist, M.N., Morse, J.Q., & Stepp, S.D. (2011). Striking the (im)proper balance between scientific advances and clinical utility: Commentary on the DSM-5 proposal for personality disorders. Personality Disorders: Theory, Research, and Treatment, 2, 68-82. doi: 10.1037/a0022226
56. Pincus, A.L. (2011). Some comments on nomology, diagnostic process, and narcissistic personality disorder in the DSM-5 proposal for personality and personality disorders. Personality Disorders: Theory, Research, and Treatment, 2, 41-53. doi: 10.1037/a0021191
57. R Core Team. (2012). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. Retrieved from http://www.R-project.org
58. Schauenburg, H., & Grande, T. (2011). Interview measures of interpersonal functioning and quality of object relations. In L.M. Horowitz. & S. Strack. (Eds.), Handbook of interpersonal psychology: Theory, research, assessment, therapeutic interventions (pp. 343-358). Hoboken, NJ: Wiley.
59. Shedler, J., Beck, A., Fonagy, P., Gabbard, G.O., Gunderson, J., Kernberg, O.,., & Westen, D. (2010). Personality disorders in DSM-5. The American Journal of Psychiatry, 167, 1026-1028. doi: 10.1176/appi.ajp.2010. 10050746
60. Shrout, P.E., & Fleiss, J.L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86, 420-428. doi: 10.1037/0033-2909.86.2.420
61. Skodol, A.E. (2012). Personality disorders in DSM-5. Annual Review of Clinical Psychology, 8, 317-344. doi: 10.1146/annurev-clinpsy-032511-143131
62. Skodol, A.E., Bender, D.S., Oldham, J.M., Clark, L.A., Morey, L.C., Verheul, R.,., & Siever, L.J. (2011). Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 Part II: Clinical application. Personality Disorders: Theory, Research, and Treatment, 2, 23-40. doi: 10.1037/a0021892
63. Stiles, W.B., Elliott, R., Llewelyn, S.P., Firth-Cozens, J.A., Margison, F.R., Shapiro, D.A., & Hardy, G. (1990). Assimilation of problematic experiences by clients in psychotherapy. Psychotherapy, 27, 411-420. doi: 10.1037/0033-3204.27.3.411
64. Svrakic, D.M., Whitehead, C., Przybeck, T.R., & Cloninger, C.R. (1993). Differential diagnosis of personality disorders by the seven-factor model of temperament and character. Archives of General Psychiatry, 50, 991-999. doi: 10.1001/archpsyc.1993.01820240075009
65. Taubner, S., Hörz, S., Fischer-Kern, M., Doering, S., Buchheim, A., & Zimmermann, J. (2013). Internal structure of the Reflective Functioning Scale. Psychological Assessment, 25, 127-135. doi: 10.1037/a0029138
66. Turkheimer, E., Ford, D.C., & Oltmanns, T.F. (2008). Regional analysis of self-reported personality disorder criteria. Journal of Personality, 76, 1587-1622. doi: 10.1111/j.1467-6494.2008.00532.x
67. Tyrer, P. (2012). Diagnostic and Statistical Manual of Mental Disorders: A classification of personality disorders that has had its day. Clinical Psychology and Psychotherapy, 19, 372-374. doi: 10.1002/cpp.1810
68. Tyrer, P., Crawford, M., Mulder, R., Blashfield, R., Farnam, A., Fossati, A.,., & Reed, G.M. (2011). The rationale for the reclassification of personality disorder in the 11th revision of the International Classification of Diseases (ICD-11). Personality and Mental Health, 5, 246-259. doi: 10.1002/pmh.190
69. Tyrer, P., & Johnson, T. (1996). Establishing the severity of personality disorder. American Journal of Psychiatry, 153, 1593-1597.
70. Ullrich, S., Farrington, D.P., & Coid, J.W. (2007). Dimensions of DSM-IV personality disorders and life-success. Journal of Personality Disorders, 21, 657-663. doi: 10.1521/pedi.2007.21.6.657
71. Verheul, R., & Widiger, T.A. (2004). A meta-analysis of the prevalence and usage of personality disorder not otherwise specified (PDNOS). Journal of Personality Disorders, 18, 309-319. doi: 10.1521/pedi.18.4.309.40350
72. Wakefield, J.C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47, 373-388. doi: 10.1037/0003-066X.47.3.373
73. West, T.V., & Kenny, D.A. (2011). The truth and bias model of judgment. Psychological Review, 118, 357-378. doi: 10.1037/a0022936
74. Westen, D., & Arkowitz-Westen, L. (1998). Limitations of Axis II in diagnosing personality pathology in clinical practice. American Journal of Psychiatry, 155, 1767-1771.
75. Westen, D., Gabbard, G.O., & Blagov, P. (2006). Back to the future. Personality structure as a context for psychopathology. In R.F. Krueger. & J.L. Tackett. (Eds.), Personality and psychopathology (pp. 335-384). New York, NY: Guilford.
76. Westen, D., & Muderrisoglu, S. (2003). Assessing personality disorders using a systematic clinical interview: Evaluation of an alternative to structured interviews. Journal of Personality Disorder, 17, 351-369. doi: 10.1521/pedi.17.4.351.23967
77. Westen, D., & Weinberger, J. (2004). When clinical description becomes statistical prediction. American Psychologist, 59, 595-613. doi: 10.1037/0003-066X.59.7.595
78. Widiger, T.A., & Samuel, D.B. (2005). Evidence-based assessment of personality disorders. Psychological Assessment, 17, 278-287. doi: 10.1037/1040-3590.17.3.278
79. Widiger, T.A., & Trull, T.J. (2007). Plate tectonics in the classification of personality disorder: Shifting to a dimensional model. American Psychologist, 62, 71-83. doi: 10.1037/0003-066X.62.2.71
80. Wright, A.G. C., & Zimmermann, J. (in press). At the nexus of science and practice: Answering basic clinical questions in personality disorder assessment and diagnosis with quantitative modeling techniques. InS. K. Huprich. (Ed.), Personality disorders: Assessment, diagnosis, and research.
81. Zachar, P., & Kendler, K. (2010). Philosophical issues in the classification of psychopathology. In T. Millon., R.F. Krueger., & E. Simonsen. (Eds.), Contemporary directions in psychopathology: Scientific foundations of the DSM-V and ICD-11 (pp. 127-148). New York, NY: Guilford.
82. Zimmerman, M., Rothschild, L., & Chelminski, I. (2005). The prevalence of DSM-IV personality disorders in psychiatric outpatients. The American Journal of Psychiatry, 162, 1911-1918. doi: 10.1176/appi.ajp.162.10. 1911
83. Zimmermann, J., Benecke, C., Bender, D.S., Skodol, A.E., Krueger, R.F., & Leising, D. (2013). Persönlichkeitsdiagnostik im DSM-5 [Personality assessment in DSM-5 ]. Psychotherapeut, 58, 455-465. doi: 10.1007/s00278-013- 1009-1
84. Zimmermann, J., Ehrenthal, J.C., Cierpka, M., Schauenburg, H., Doering, S., & Benecke, C. (2012). Assessing the level of structural integration using Operationalized Psychodynamic Diagnosis (OPD): Implications for DSM-5. Journal of Personality Assessment, 94, 522-532. doi: 10.1080/00223891.2012. 700664
85. Zimmermann, J., Stasch, M., Grande, T., Schauenburg, H., & Cierpka, M. (in press). Der Beziehungsmuster-Q-Sort (OPD-BQS): Ein Selbsteinschä tzungsinstrument zur Erfassung von dysfunktionalen Beziehungsmustern auf Grundlage der Operationalisierten Psychodynamischen Diagnostik [Maladaptive Interpersonal Patterns Q-Sort (MIPQS): A self-report method for assessing maladaptive interpersonal patterns based on Operationalized Psychodynamic Diagnosis]. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie.