title: Factor structure and diagnostic efficiency of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for avoidant personality disorder in Hispanic men and women with substance use disorders.
abstract: OBJECTIVE
  This study examined the internal consistency, factor structure, and diagnostic efficiency of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for avoidant personality disorder (AVPD) and the extent to which these metrics may be affected by sex.
  
  
  METHODS
  Subjects were 130 monolingual Hispanic adults (90 men, 40 women) who had been admitted to a specialty clinic that provides psychiatric and substance abuse services to Spanish-speaking patients. All were reliably assessed with the Spanish-Language Version of the Diagnostic Interview for DSM-IV Personality Disorders. The AVPD diagnosis was determined by the best-estimate method. After evaluating internal consistency of the AVPD criterion set, an exploratory factor analysis was performed using principal components extraction. Afterward, diagnostic efficiency indices were calculated for all AVPD criteria. Subsequent analyses examined men and women separately.
  
  
  RESULTS
  For the overall group, internal consistency of AVPD criteria was good. Exploratory factor analysis revealed a 1-factor solution (accounting for 70% of the variance), supporting the unidimensionality of the AVPD criterion set. The best inclusion criterion was "reluctance to take risks," whereas "interpersonally inhibited" was the best exclusion criterion and the best predictor overall. When men and women were examined separately, similar results were obtained for both internal consistency and factor structure, with slight variations noted between sexes in the patterning of diagnostic efficiency indices.
  
  
  CONCLUSIONS
  These psychometric findings, which were similar for men and women, support the construct validity of the DSM-IV criteria for AVPD and may also have implications for the treatment of this particular clinical population.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA 94143, USA. beckerd@sutterhealth.org
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Becker
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Añez
authors.forename: Manuel
authors.initials: M
authors.lastname: Paris
authors.forename: Luis
authors.initials: L
authors.lastname: Bedregal
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology / Q000534:rehabilitation; D002140:California; D003156:Community Mental Health Services; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology / Q000534:rehabilitation; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology / Q000534:rehabilitation