title: The central domains of personality pathology in psychiatric patients.
abstract: There is general agreement that the classification of personality disorders in DSM-IV is unsatisfactory. We systematically reviewed all studies that have analyzed patterns of personality disorder symptoms and signs in psychiatric patients; twenty-two papers were included in the final synthesis. There is reasonable consistency over the number and type of personality pathology traits reported despite differing samples, varying assessment methods, and different statistical manipulations. There are three or four high order traits; an externalizing factor incorporating borderline, narcissistic, histrionic, and antisocial traits (the latter is sometimes recorded as a separate trait); an internalizing factor incorporating avoidant and dependent traits; a schizoid factor; and often a compulsive factor. Using these domains of personality pathology would simplify classification, have higher clinical utility, and allow relatively easy translation of current research.
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand. roger.mulder@otago.ac.nz
authors.forename: Roger T
authors.initials: RT
authors.lastname: Mulder
authors.forename: Giles
authors.initials: G
authors.lastname: Newton-Howes
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Crawford
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Tyrer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008875:Middle Aged; D008960:Models, Psychological; D010551:Personality / Q000145:classification; D010552:Personality Assessment; D010554:Personality Disorders / Q000145:classification* / Q000175:diagnosis / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D055815:Young Adult