Hierarchical relationships between borderline, schizotypal, avoidant and obsessive-compulsive personality disorders.
OBJECTIVE
Comorbidity among personality disorders is widely considered problematic. The validity of one proposed solution, diagnostic hierarchies, was investigated in the current study with respect to borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders.


METHODS
One approach used discriminant functions, derived from multiple psycho-social domains, that were used to classify comorbid individuals from the Collaborative Longitudinal Personality Disorder study (CLPS) to explore the possibility of hierarchical precedence of one personality disorder over another. A second approach examined the incremental increase in R(2)-value in predicting functioning and personality provided by each diagnosis over each other diagnosis.


RESULTS
Obsessive-compulsive personality disorder was consistently subordinate to other diagnoses, whereas other indications of hierarchical relationships were domain-specific.


CONCLUSIONS
Results indicate minimal support for an over-arching hierarchical pattern among studied personality disorders, and suggest the inclusion of all relevant diagnoses in clinical practice.
Hopwood
C J
CJ
Department of Psychology, Texas A & M University, College Station, 77843-4235, USA.
Morey
L C
LC
Gunderson
J G
JG
Skodol
A E
AE
Tracie Shea
M
M
Grilo
C M
CM
McGlashan
T H
TH
D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003193:Compulsive Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory; D011237:Predictive Value of Tests; D011581:Psychological Tests; D015203:Reproducibility of Results; D012569:Schizotypal Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012650:Self Disclosure; D012720:Severity of Illness Index