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5 Problems in the field of PD personalities. However, Schneider's classification of personality disorders influenced the International Classification of Diseases ([CD) of the WH06 and The Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association7 (Table 1). However, the fact that new disorders were added and deleted with each edition, confirms the validity of Le~is'~ 0bSe~ation. 'It is plain that Kraepeli found the classification of PD defeating, as he frankly admits. Successive editions of his textbook show him struggling with Little success, to cope with the task of shaping cate gories out of the rich variety of human character and conduct. His efforts and his failure are characteristic examples of the frustration which besets students of personality when they aim at precision.' Table 1. Classification of personality disorders Schneider (1923) ICDlO(1993) DSM-III-R (1987) Depressive Hyperthymic Fanatical Explosive Labile Affectionless Insecure: sensitive anancastic Asthenic Attention-seeking - - Paranoid Emotionally unstable: Impulsive type Borderline type Dissocial Anxious (avoidant) Anankastic Hypochondriasis* Histrionic Schizoid Dependent - - - Cyclothymia* Paranoid Explosive* Borderline Antisocial Avoidant Obsessive-compulsive Hypochondriasis* Histrionic Schizoid Dependent Schizotypal Narcissistic Passive aggressive *Located elsewhere in the classification The relation to normal personality Abnormal personality traits exist in milder forms in normal individuals. If the traits manifest themselves as inflexible responses to a broad range
6 A. A. Dahl and A. Andreoli of personal and social situations and result in considerable personal distress or social disruption, they are called PD. They represent extreme or significant deviations from the way in which the average individual in a given culture perceives, thinks, feels, and relates to others. They are thus only quantitatively and not qualitatively different from normal personality. However, the border between normal and abnormal personalities is difficult to draw. The relation to culture and sex Cultural diversity is a characteristic of human nature. Behavioural patterns considered normal in one culture are seen as deviant in another. To identify behavioural panerns that are deviant in all cultures is very difficult. The PDs primarily reflect the views of Western European and North American psychiatry and they may not be equally applicable in other cultures. Role expectations and behaviour, also differ considerably between the sexes. Problems may arise if psychiatry defines personality deviance without considering social role expectations. Unknown personality traits and the use of informants Many individuals may be unaware of some of their personality traits and behavioural patterns. Therefore, an individual often can only provide limited information about him or herself. Heishe may also consciously try to deny certain socially undesirable personality traits. These problems can pmially be solved by interviewing an informant who knows the individual well, but this is still not a standard procedure in the evaluation of PD. Sometimes informants describe PD-pathology that patients deny.9 When the accounts of the subject and the informant deviate, which source of information is more valid? A method of integrating information from such discrepant reports is needed. Separate axis and diagnostic criteria The DSM of Mental Disorders, Thiid Edition (DSM-m)' published by the American Psychiahic Association in 1980 made two innovations of major importance for the study of PDs. They were placed on a separate axis (Axis E), and explicit criteria provided guidelines for the diagnosis of each of the 11 PDs. The introduction of diagnostic criteria stimulated empirical research on the reliability of PDs and the optimal diagnostic criteria.
Page 2 and 3: Until recently, the standardization
Page 4 and 5: Assessment and diagnosis of persona
Page 6 and 7: Contents Contributors Preface Annan
Page 8 and 9: Contributors Dr Antonio Andreoli Ho
Page 10 and 11: Preface One of the major goals of t
Page 12 and 13: ... Xlll Acknowledgements The IPDE
Page 14 and 15: Problems in the field of personalit
Page 18 and 19: 7 Problems in the field of PD In DS
Page 20 and 21: 9 Problems in the field of PD cultu
Page 22 and 23: 11 Review of diagnostic instruments
Page 30 and 31: 19 Epidemiology of DSM-Ill PDs in c
Page 32 and 33: Table l. Prevalence rates of specif
Page 35 and 36: 24 1. H. Reich and G. de Girolamo (
Page 37 and 38: 26 .- 5 2 0 W C .- 0 P g F ? g e Q
Page 39 and 40: 28 J. H. Reich and G. de Girolarno
Page 41 and 42: Table 3. Prevalence rates ofpersona
Page 44 and 45: Pfohl etal.. l986 (67) Pilgrim & Ma
Page 46 and 47: 35 Epidemiology of DSM-Ill PDs were
Page 48 and 49: 37 Epidemiology of DSM-Ill PDs migh
Page 50 and 51: 39 Epidemiology of DSM-Ill PDs 23 R
Page 52 and 53: 4 1 Epidemiology of DSM-Ill PDs 55
Page 54 and 55: 43 International personality disord
Page 56 and 57: I 45 IPDE iner what he is actually
Page 58 and 59: 47 IPDE Sample of IPDE item The que
Page 60 and 61: 49 IPDE dimensional scores are not
Page 62 and 63: 1 9 IPDE considerable training and
Page 64 and 65: 53 Experiences with IPDE The invest
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55 Experiences with IPDE passive ag
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57 Field Trial
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59 Sampling, inte~iewers, interview
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Description of centres participatin
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63 Centres participating in IPDE fi
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P- P Table 1. Sample sizes and IPDE
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73 Results Table 3. ICD-I0 Disorder
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75 Results Table 5. Frequency of CO
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77 Results Table 8. Interrater reli
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Discussion and conclusions Armand W
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8 1 Discussion and Conclusions stab
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83 Discussion and Conclusions Repet
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Discussion and Conclusions of princ
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87 Discussion and Conclusions Frequ
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89 Discussion and Conclusions emoti
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9 1 Discussion and Conclusions inte
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93 Appendix Table A2 Persomlity dis
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95 Appendix Table A4 Personality di
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97 Appendix Table A6 Personaliry di
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99 Appendix Table SA Personaliry di
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Table A10 Personality disorder diag
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103 Appendix Table A12 Personality
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Table A13 (con?) Criterion B7 B8 1
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107 Appendix Table A13 (cont) Frequ
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109 Appendix Table A14 (cont.) Freq
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Acknowledgements 113 Manual History
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Manual History of the IPDE One of t
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116 Manual Struchlre of the IPDE Th
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118 Manual that is likely to enhanc
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120 Manual data. If examiners have
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122 Manual Scoring conventions Much
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124 Manual Recording the scores Req
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126 Manual Q. What do you do when s
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128 Manual section, if there are qu
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ICD-10 criteria and corresponding I
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132 ICD-10 criteria and correspondi
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134 IPDE ICD-10 module screening qu
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136 Screening questionnaire 47 1 lo
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I 138 IPDE ICD-10 module* interview
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140 Interview schedule 2. 0 1 2 7 0
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142 Inte~iew schedule 4. O 1 2 I N
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144 Interview schedule 6. O l Z ? 0
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146 Interview schedule 8. 0 1 2 1 0
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148 Interview schedule .10. 0 1 2 ?
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150 Interview schedule 12. 0 1 2 7
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152 lnte~iew schedule 14. 0 1 2 ? 0
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154 Interview schedule 16. 0 1 2 ?
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156 interview schedule 18. 0 1 2 ?
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158 Interview schedule 20. O 1 2 N
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164 Interview schedule *26. 0 1 2 ?
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166 lntewiew schedule 28. 0 1 2 ? 0
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170 lnte~iew schedule 32. O 1 2 7 N
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174 lntewiew schedule 36. 0 1 2 ? 0
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184 lnte~iew schedule 46. 0 1 2 7 0
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~ 186 Interview schedule 48. 0 1 2
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194 Interview schedule 56. 0 1 2 1
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196 Interview schedule VI. IMPULSE
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200 Interview schedule Have you eve
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202 Interview schedule 1 63. 0 1 2
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204 Intewiew schedule Rate the foll
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206 IPDE ICD-10 module handscoring
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+ 39+44=4, 208 Handscoring algorith
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210 Handscoring algorithms and summ
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IPDE ICD-10 module summary scoreshe
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224 Index paranoid 108 schizoid 108
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226 Index Personalily Assessment Sc
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