FOR RELEASE: April 14, 1997
Contact: Susan Lang
Office: (607) 255-3613
Internet: [email protected]
Compuserve: Larry Bernard 72650,565
http://www.news.cornell.edu
ITHACA, N.Y. -- Although personality disorders can cause long-term
suffering and disability, they are difficult to detect. As a result, many
people go untreated.
A new screening procedure, developed at Cornell University Medical College
and tested at Cornell University in Ithaca, coupled with a follow-up
interview, reliably identified persons with personality pathology with a
self-administered true-false questionnaire. In the second stage, those
identified with possible personality disorders are interviewed by a
professional clinician to confirm or discount an actual personality
diagnosis, reports Mark Lenzenweger, Ph.D., a psychopathologist at Cornell
in Ithaca.
In tests, no cases of definite personality pathology were missed by this
two-stage procedure, and the researchers believe that it may help reduce
the number of professional interviews required for diagnosis by about
one-half in large-scale epidemiological studies.
Based on their second-stage study of 258 individuals, Lenzenweger and his
colleagues estimated that 11 percent of their nonclinical population had a
diagnosable personality disorder, a rate consistent with previous
"best-guess" estimates.
"Whereas researchers have a good grasp of the epidemiology for most other
major mental disorders, we still don't have good estimates for personality
disorders because their diagnosis requires considerable -- and costly --
clinical sophistication," said Lenzenweger, associate professor of human
development and director of the Laboratory of Experimental Psychopathology
at Cornell and an associate professor of psychology in psychiatry at the
Cornell University Medical College in New York City.
"This is the first time we have hard data on just how prevalent personality
disorders are in a nonclinical population," added Lenzenweger, a clinical
psychologist and psychopathology researcher. "By interviewing only
screened positive cases with little or no loss in diagnostic accuracy, it
appears we have a screening tool that could help us to conduct major
epidemiological studies of personality disorders by screening large numbers
of people relatively inexpensively and accurately."
Personality disorders are enduring and impairing behaviors that generally
fall into one of three groups: odd/eccentric, emotional/erratic/dramatic
or anxious/fearful behaviors. Common disorders include conditions such as
the "borderline," "schizotypal" and "antisocial" personality disorders.
Lenzenweger's collaborators included Armand W. Loranger, Ph.D., the
developer of the screening test and a professor at Cornell University
Medical College; Lauren Korfine, A.M., of Harvard University; and Cynthia
Neff, Ph.D., of the University of Illinois at Urbana-Champaign. Their
study is published in the April issue of Archives of General Psychiatry
(Vol. 54, pp 345-351.)
To test the new screening instrument, the researchers used a two-stage
approach in which they administered the instrument to 2,000 individuals and
received 1,646 inventories. From these data, the researchers identified 43
percent with possible personality disorders and 57 percent with no
personality disorders. The researchers then selected subsamples from each
of these two groups for a total of 258 subjects who then were interviewed
in-depth.
Of the 134 identified with possible personality disorders, 21 cases were
confirmed. Of the 124 identified as showing no possible personality
disorders from the initial screening, none were later diagnosed with a
personality disorder.
"These are exactly the kind of findings one would want from a screening,"
Lenzenweger said. "There were no false negatives. In other words, no
genuine cases were missed."
Previously, researchers have generated "best-guess" estimates of the
prevalence of personality disorders in the population, and these "guesses"
have ranged between 5 and 15 percent of the general population.
Personality disorders are inflexible and enduring maladaptive personality
conditions that cause significant distress or impairment in social,
occupational or other areas of functioning. These behaviors or traits
include paranoid, schizoid (excessively detached from others), borderline
(impulsive behavior, self-mutilation and stormy relationships),
narcissistic (grandiose thoughts or behaviors, need for admiration and lack
of empathy), antisocial, histrionic (over-emotional and attention seeking),
dependent, sadistic, passive/aggressive and obsessive-compulsive
personality disorders, among others.
This screening and diagnostic procedure was part of the initial phase of
the Longitudinal Study of Personality Disorders (LSPD), which Lenzenweger
is conducting. The LSPD is a large-scale longitudinal study of normal
personality, temperament, personality disorders and psychopathology now
under way at Cornell. Lenzenweger teaches abnormal psychology and advanced
experimental psychopathology at Cornell.
The research was supported, in part, with a grant from the National
Institute of Mental Health.
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