Trajectories of seclusion and restraint use at a state psychiatric hospital.

Objective: This study investigated patterns of seclusion and restraint among patients hospitalized at a psychiatric facility with a large number of forensic psychiatric beds.

Methods: Seclusion and restraint records were examined for 622 patients who were admitted during a five-year period (September 2001 to September 2006) and had a stay of at least 60 days. Seclusion and restraint episodes were recorded as bimonthly counts over the first two years after the initial admission.

Categorical and dimensional models of personality disorder.

We review major categorical and dimensional models of personality pathology, highlighting advantages and disadvantages of these approaches. Several analytic and methodological approaches to the question of the categorical versus dimensional status of constructs are discussed, including taxometric analyses, latent class analyses, and multivariate genetic analyses. Based on our review, we advocate a dimensional approach to classifying personality pathology.

An evaluation of evaluative personality terms: a comparison of the big seven and five-factor model in predicting psychopathology.

Two personality models are compared regarding their relationship with personality disorder (PD) symptom counts and with lifetime Axis I diagnoses. These models share 5 similar domains, and the Big 7 model also includes 2 domains assessing self-evaluation: positive and negative valence. The Big 7 model accounted for more variance in PDs than the 5-factor model, primarily because of the association of negative valence with most PDs.

The structure of axis II disorders in adolescents: a cluster- and factor-analytic investigation of DSM-IV categories and criteria.

The aim of this study was to ascertain whether the structure of personality disorder (PD) symptoms in adolescents assessed using DSM-IV diagnoses and diagnostic criteria resembles the structure intended for the diagnosis of PDs in adults. A national sample of clinicians rated DSM-IV Axis II criteria on 294 adolescent patients in treatment for enduring maladaptive personality patterns. Cluster analysis replicating procedures used in an adult sample by Morey (1988) identified considerable similarity between adult and adolescent PDs, as did exploratory factor analysis of ratings of diagnostic criteria, which yielded ten empirically derived factors that resembled the ten DSM-IV PDs.

Retrospective measures of childhood abuse: concurrent validity and reliability in a nonclinical sample with borderline features.

This study evaluated the psychometric properties of retrospective reports of childhood sexual and physical abuse by comparing two assessment formats, interview and questionnaire, and looking at both the concurrent validity and test-retest reliability over 2 years. Nonclinical participants completed the Family Experiences Interview (FEI; Ogata et al., 1990) and the Family Experiences Questionnaire (FEQ; Wheelock, Lohr, & Silk, 1997) at age 18 and the FEQ again at age 20.

Borderline personality disorder features predict negative outcomes 2 years later.

In a sample of 351 young adults, the authors assessed whether borderline personality disorder (BPD) features prospectively predicted negative outcomes (poorer academic achievement and social maladjustment) over the subsequent 2 years, over and above gender and both Axis I and Axis II psychopathology. Borderline traits were significantly related to these outcomes, with impulsivity and affective instability the most highly associated. The present findings suggest that the impulsivity and affective instability associated with BPD leads to impairment in relating well with others, in meeting social role obligations, and in academic or occupational achievement.

Personality diagnoses in adolescence: DSM-IV axis II diagnoses and an empirically derived alternative.

Objective: The study of personality pathology in adolescence is in its infancy. This article examined the applicability and limits of DSM-IV axis II personality disorder diagnoses in adolescents, assessed the validity of a method for assessing adolescent personality pathology, and began to develop an empirically grounded classification.

Method: A total of 296 randomly selected clinicians described a patient age 14-18 in treatment for maladaptive personality patterns using axis II ratings scales and the Shedler-Westen Assessment Procedure-200 for Adolescents (SWAP-200-A), a Q-sort instrument for assessing adolescent personality pathology.