title: The structure of personality disorders in individuals with posttraumatic stress disorder.
abstract: Research on the structure of personality disorders (PDs) has relied primarily on exploratory analyses to evaluate trait-based models of the factors underlying the covariation of these disorders. This study used confirmatory factor analysis to evaluate whether a model that included both PD traits and a general personality dysfunction factor would account for the comorbidity of the PDs better than a trait-only model. It also examined if the internalizing/externalizing model of psychopathology, developed previously through research on the structure of Axis I disorders, might similarly account for the covariation of the Axis II disorders in a sample of 245 veterans and nonveterans with posttraumatic stress disorder. Results indicated that the best fitting model was a modified bifactor structure composed of nine lower-order common factors. These factors indexed pathology ranging from aggression to dependency, with the correlations among them accounted for by higher-order Internalizing and Externalizing factors. Further, a general factor, reflecting a construct that we termed boundary disturbance, accounted for additional variance and covariance across nearly all the indicators. The Internalizing, Externalizing, and Boundary Disturbance factors evidenced differential associations with trauma-related covariates. These findings suggest continuity in the underlying structure of psychopathology across DSM-IV Axes I and II and provide empirical evidence of a pervasive, core disturbance in the boundary between self and other across the PDs.
authors.affiliation: National Center for PTSD at VA BostonHealthcare System, Boston, Massachusetts 02130, USA. erika.wolf@va.gov
authors.forename: Erika J
authors.initials: EJ
authors.lastname: Wolf
authors.forename: Mark W
authors.initials: MW
authors.lastname: Miller
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000374:Aggression; D015897:Comorbidity; D003858:Dependency, Psychological; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015233:Models, Statistical; D010551:Personality / Q000145:classification; D010554:Personality Disorders / Q000145:classification / Q000453:epidemiology* / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012649:Self Concept; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D014728:Veterans / Q000523:psychology; D055815:Young Adult