The Collaborative Longitudinal Personality Disorders Study: reliability of axis I and II diagnoses

Both the interrater and test-retest-retest reliability of axis I and axis II disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). Fair-good median interrater kappa (.40-.75) were found for all axis II disorders diagnosed five times or more, except antisocial personality disorder (1.0). All of the test-retest kappa for axis II disorders, except for narcissistic personality disorder (1.0) and paranoid personality disorder (.39), were also found to be fair-good. Interrater and test-retest dimensional reliability figures for axis II were generally higher than those for their categorical counterparts; most were in the excellent range (> .75). In terms of axis I, excellent median interrater kappa were found for six of the 10 disorders diagnosed five times or more, whereas fair-good median interrater kappa were found for the other four axis I disorders. In general, test-retest reliability figures for axis I disorders were somewhat lower than the interrater reliability figures. Three test-retest kappa were in the excellent range, six were in the fair-good range, and one (for dysthymia) was in the poor range (.35). Taken together, the results of this study suggest that both axis I and axis II disorders can be diagnosed reliably when using appropriate semistructured interviews. They also suggest that the reliability of axis II disorders is roughly equivalent to that reliability found for most axis I disorders.     

The Collaborative Longitudinal Personality Disorders Study: development, aims, design, and sample characteristics

This paper describes the aims, background, design, and methods used in a collaborative longitudinal study of Axis II personality disorders (PDs). This study examines the putative stability of selected PD diagnoses and criteria, what factors affect their course, and whether their stability and course distinguishes them from a representative Axis I disorder. This article also describes the acquisition and demographics of the sample on whom the study is being done. A prospective, repeated measures investigation of the stability of PDs is now underway at multiple clinical settings in four collaborating urban sites in Boston. New Haven, New York, and Providence. Diagnostic assignments are based on semistructured interview assessments (by clinically trained raters) and confirmed by at least one additional contrasting diagnostic method. The sample consists of 668 treatment seeking and reliably diagnosed adults recruited from a broad range of clinical sites. By design, patients in the sample met standards for one of five diagnostic subgroups: (a) schizotypal (N = 86); (b) borderline (N = 175); (c) avoidant (N = 157); (d) obsessive-compulsive (N = 153) personality disorders or a control group having (e) major depressive disorder without personality disorder (N = 97).     

Associations in the course of personality disorders and Axis I disorders over time

In this study, the authors examined time-varying associations between schizotypal (STPD), borderline (BPD), avoidant (AVPD), or obsessive-compulsive (OCPD) personality disorders and co-occurring Axis I disorders in 544 adult participants from the Collaborative Longitudinal Personality Disorders Study. The authors tested predictions of specific longitudinal associations derived from a model of crosscutting psychobiological dimensions (L. J. Siever & K. L. Davis, 1991) with participants with the relevant Axis I disorders. The authors assessed participants at baseline and at 6-, 12-, and 24-month follow-up evaluations. BPD showed significant longitudinal associations with major depressive disorder and posttraumatic stress disorder. AVPD was significantly associated with anxiety disorders (specifically social phobia and obsessive-compulsive disorder). Two of the four personality disorders under examination (STPD and OCPD) showed little or no association with Axis I disorders.     

Part-whole practice of movement sequences

A 16-element movement sequence was taught under part-whole and whole-practice conditions. Participants (N = 18) produced a right-arm lever movement to sequentially presented target locations. The authors constructed part-whole practice by providing practice on only the 1st 8 elements on the 1st day of practice (100 repetitions of the 8-element sequence) and on all 16 elements on the 2nd day of practice (100 repetitions of the 16-element sequence). The whole-practice group practiced all 16 elements on both days (100 repetitions of the 16-element sequence per day). No differences in sequence structure or in movement duration of the 16-element sequence were noted on the retention test (Day 3). On transfer tests in which the 1st and last 8 elements were tested separately, however, the participants in the part-whole practice group performed more quickly than the participants in the whole-practice group, especially on the last 8 elements. Participants in the whole-practice group appeared to code the sequence so that it was relatively difficult to fully partition it into separate movements. Thus, on the transfer tests, there continued to be residual effects of the 8 elements that did not have to be produced but slowed down the rate of responding for the whole-practice group. That finding was not observed for the part-whole practice group.     

Stability as a distinction between Axis I and Axis II disorders

Temporal stability has served as a conceptual basis for the distinction between the clinical syndromes of Axis I disorders and the Axis II personality disorders, the latter being viewed as lifelong enduring patterns. However, comparisons of the stability of Axis I and II disorders have been limited. The present review examines findings from three naturalistic longitudinal studies that utilize similar methodology: the Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000), the Collaborative Depression Study (CDS; Katz & Klerman, 1979), and the Harvard/Brown Anxiety Research Program (HARP; Keller et al., 1994). Using a definition of remission/recovery as having no or minimal symptoms for 8 consecutive weeks, the courses of personality, depressive, and anxiety disorders were compared. Though remission/recovery rate at the 2-year follow-up was highest for mood disorders, the probability of recurrence was also particularly high. Personality disorders, with remission rates higher than the anxiety disorders, appear to be less stable than conceptualized. The anxiety disorders had remarkably low recovery rates even beyond 5 years of prospective follow-up. Factors that may explain these findings, as well as implications for future conceptualization of DSM, are discussed.     

Men and women at promise for scientific excellence: similarity not dissimilarity

U.S. math-science graduate students possessing world-class talent (368 males, 346 females) were assessed on psychological attributes and personal experiences in order to examine how their talents emerged and developed. Comparisons were made, using similar assessments, with mathematically talented students (528 males, 228 females) identified around age 13 and tracked into adulthood by the Study of Mathematically Precocious Youth (SMPY). Well before college, both samples were academically distinguished; however, the graduate students could be identified during adolescence as a subset of mathematically talented youths based on their nonintellectual attributes. Their profiles corresponded to what earlier psychological studies found to characterize distinguished (and exclusively male) scientists: exceptional quantitative reasoning abilities, relatively stronger quantitative than verbal reasoning ability, salient scientific interests and values, and, finally, persistence in seeking out opportunities to study scientific topics and develop scientific skills. On these attributes, sex differences were minimal for the graduate students (but not for the SMPY comparison groups). Developing exceptional scientific expertise apparently requires special educational experiences, but these necessary experiences are similar for the two sexes.     

The ‘theory theory’ of mind and the aims of Sellars’ original myth of Jones

Recent proponents of the ??theory theory?? of mind often trace its roots back to Wilfrid Sellars?? famous ??myth of Jones?? in his 1956 article, ??Empiricism and the Philosophy of Mind??. Sellars developed an account of the intersubjective basis of our knowledge of the inner mental states of both self and others, an account which included the claim that such knowledge is in some sense theoretical knowledge. This paper examines the nature of this claim in Sellars?? original account and its relationship to more recent debates concerning ??theory of mind??, in particular the theory theory. A close look reveals that Sellars?? original view embodied several distinctions that would enable more recent theory theorists to accommodate certain phenomenological objections that have been raised against that outlook. At the heart of the philosophical issue is an overlooked complexity involved in Sellars?? account of the ??theory/observation?? distinction, involving a conception of the distinction that is both independently plausible and a key to the issue in dispute.     

Developmental Systems Theory Formulated as a Claim about Inherited Representations*

Developmental systems theory (DST) is often dismissed on the basis that the causal indispensability of nongenetic factors in evolution and development has long been appreciated. A reformulation makes a more substantive claim: that the special role played by genes is also played by some (but not all) nongenetic resources. That special role can be captured by Shea's 'inherited representation'. Formulating DST as the claim that there are nongenetic inherited representations turns it into a striking, empirically testable hypothesis. DST's characteristic rejection of a gene versus environment dichotomy is preserved but without dissolving into an interactionist casual soup, as some have alleged.     

Using phenomenal concepts to explain away the intuition of contingency

Humans can think about their conscious experiences using a special class of “phenomenal” concepts. Psychophysical identity statements formulated using phenomenal concepts appear to be contingent. Kripke argued that this intuited contingency could not be explained away, in contrast to ordinary theoretical identities where it can. If the contingency is real, property dualism follows. Physicalists have attempted to answer this challenge by pointing to special features of phenomenal concepts that explain the intuition of contingency. However no physicalist account of their distinguishing features has proven to be satisfactory. Leading accounts rely on there being a phenomenological difference between tokening a physical-functional concept and tokening a phenomenal concept. This paper shows that existing psychological data undermine that claim. The paper goes on to suggest that the recalcitrance of the intuition of contingency may instead by explained by the limited means people typically have for applying their phenomenal concepts. Ways of testing that suggestion empirically are proposed.     

Examining Psychosocial Pathways Underlying Gratitude Interventions: A Randomized Controlled Trial

Despite their unprecedented popularity, the psychological mechanisms through which gratitude journals operate are poorly understood. Also the use of gratitude journaling to enhance social relationships has been neglected in past research, despite the importance of healthy relationships for people’s happiness. This randomized controlled study examined the effect of (a) a traditional gratitude journal (fostering gratitude for daily life), and (b) an interpersonal gratitude journal (fostering gratitude for one’s existing social relationships), versus (c) an active control journal, on life satisfaction. Ninety-one participants were randomized to one of three conditions with 2-week and 1-month follow-ups. The traditional gratitude intervention (vs. control) showed improvements in friendship at immediate post-test and 1-month follow-up, and these effects were accounted for by changes in gratitude over time. Additionally, the traditional gratitude intervention (vs. control) predicted enhanced life satisfaction at follow-up, and this was serially mediated by 6 week changes in gratitude and perceived friendship quality. No such differences over time were observed between the interpersonal gratitude intervention and either the control intervention or the traditional gratitude intervention. Actively appreciating things in daily life appears to be effective in enhancing the quality of people’s social relationships, and producing sustained improvements in subjective wellbeing.