TY - JOUR
T1 - The structure of personality disorders within a depressed sample
T2 - Implications for personalizing treatment
AU - Berg, Joanna M.
AU - Kennedy, Jamie C.
AU - Dunlop, Boadie W.
AU - Ramirez, Cynthia L.
AU - Stewart, Lindsay M.
AU - Nemeroff, Charles B.
AU - Mayberg, Helen S.
AU - Craighead, W. Edward
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/3
Y1 - 2017/3
N2 - Background: Personality disorders (PDs) and major depressive disorder (MDD) are both significant public health burdens. They are frequently comorbid, and this comorbidity predicts poorer treatment outcomes and lower maintenance of treatment effects. Although there is growing consensus on the structure of personality pathology in non-depressed individuals, there is limited research on the structure of personality pathology in individuals experiencing MDD. Method: As part of the Predictors of Remission in Depression to Individual and Combined Treatment (PReDICT) randomized controlled trial, 192 treatment-naïve subjects meeting DSM-IV-TR criteria for MDD completed the International Personality Disorder Examination (IPDE). Using this sample, a principal components analysis explored the factor structure of the IPDE. Results: A three-factor model comprised three factors labeled "NADA" (Negative Affectivity, Disinhibition, and Antagonism)," "Social Anxiety," and "Antisociality." Factor intercorrelations were small-to-moderate, and the sum score of the three factors was highly correlated (r = 0.94) with the total IPDE score. Limitations: Personality pathology was assessed with one instrument, and sample size was smaller than ideal for factor analytic research. Conclusions: Consistent with prior factor-analytic findings, a three-factor solution provided the most clinically and theoretically useful model. This finding lends support for the personality disorders retained in DSM-5 and some support for a model of personality pathology aligned with the personality traits found in the leading nonclinical models of personality. The obtained factors are potential moderators of clinical interventions and may serve as an avenue to personalizing treatments.
AB - Background: Personality disorders (PDs) and major depressive disorder (MDD) are both significant public health burdens. They are frequently comorbid, and this comorbidity predicts poorer treatment outcomes and lower maintenance of treatment effects. Although there is growing consensus on the structure of personality pathology in non-depressed individuals, there is limited research on the structure of personality pathology in individuals experiencing MDD. Method: As part of the Predictors of Remission in Depression to Individual and Combined Treatment (PReDICT) randomized controlled trial, 192 treatment-naïve subjects meeting DSM-IV-TR criteria for MDD completed the International Personality Disorder Examination (IPDE). Using this sample, a principal components analysis explored the factor structure of the IPDE. Results: A three-factor model comprised three factors labeled "NADA" (Negative Affectivity, Disinhibition, and Antagonism)," "Social Anxiety," and "Antisociality." Factor intercorrelations were small-to-moderate, and the sum score of the three factors was highly correlated (r = 0.94) with the total IPDE score. Limitations: Personality pathology was assessed with one instrument, and sample size was smaller than ideal for factor analytic research. Conclusions: Consistent with prior factor-analytic findings, a three-factor solution provided the most clinically and theoretically useful model. This finding lends support for the personality disorders retained in DSM-5 and some support for a model of personality pathology aligned with the personality traits found in the leading nonclinical models of personality. The obtained factors are potential moderators of clinical interventions and may serve as an avenue to personalizing treatments.
KW - Clinical research
KW - Depression
KW - Factor analysis
KW - Personality disorders
UR - http://www.scopus.com/inward/record.url?scp=85045785964&partnerID=8YFLogxK
U2 - 10.1016/j.pmip.2016.12.005
DO - 10.1016/j.pmip.2016.12.005
M3 - Article
AN - SCOPUS:85045785964
SN - 2468-1717
VL - 1-2
SP - 59
EP - 64
JO - Personalized Medicine in Psychiatry
JF - Personalized Medicine in Psychiatry
ER -