A prototype approach to personality disorder diagnosis

The American Journal of Psychiatry
Drew WestenRebekah Bradley

Abstract

Virtually no research has tested alternatives to the diagnostic method used since DSM-III, which requires decisions about the presence/absence of individual diagnostic criteria, followed by counting symptoms and applying cutoffs (the count/cutoff method). This study tested an alternative, prototype matching procedure designed to simplify diagnosis. The procedure was applied to personality disorders. A random national sample of psychiatrists and clinical psychologists (N=291) described a randomly selected patient in their care. Clinician-provided diagnostic data were used to generate categorical and dimensional DSM-IV diagnoses (number of symptoms present per disorder). Clinicians also used one of two prototype matching systems to provide a diagnosis for the selected patient. Prototype diagnosis led to reduced comorbidity relative to DSM-IV diagnosis, yielded similar estimates of validity in predicting criterion variables (adaptive functioning, treatment response, and etiology), and outperformed DSM-IV diagnosis in ratings of clinical utility and ease of use. Adding a personality health prototype further increased prediction. A simple prototype matching procedure provides a viable alternative for improving diagnosis of personali...Continue Reading

Citations

Dec 11, 2013·Psychiatry Research·Kathrin RitterStefan Roepke
Jul 3, 2007·Journal of Personality Assessment·Jonathan Shedler, Drew Westen
Jul 19, 2012·Journal of Personality Assessment·Leonard J SimmsJane H Rotterman
Jan 22, 2009·The Journal of Nervous and Mental Disease·John J DiLalloDrew Westen
Sep 16, 2009·The Journal of Nervous and Mental Disease·Kile M OrtigoBekh Bradley
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