Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed Oct. 10, 2007). PDF text: viii, 75, p. : ill. UMI publication number: AAT 3259074. Includes bibliographical references. Also available in microfilm and microfiche formats.

Thesis (Ed.D.)--Boston University

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Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 4 uppsatser.

Publication of DSM-III led to increased recognition and diagnosis of personality disorders by assigning them to a separate axis. Self-report inventories have recently been constructed to reflect these changes in psychiatric nosology. This study compared the diagnostic efficiency of three tests: MMPI personality disorder scales (MMPI PD scales), Million Clinical Multiaxial Inventory (MCMI), and the Personality Diagnostic Questionnaire (PDQ). Subjects were nonpsychotic psychiatric patients (n = 37), and medical control patients (n = 20). Subjects were given a clinical interview to diagnose any and all DSM-III personality disorders, and were then administered the three self-report inventories. Results indicate that the tests were extremely accurate at identifying the presence of any personality disorder, clusters of personality disorders, and specific personality disorders. Using the tests in combination further increased their efficiency. Implications for using cost-effective self-report tests in lieu of labor-intensive structured interviews are discussed.

Goal: The aim of the current studies was to evaluate the ability of individual defenses to differentiate Antisocial (APD) and Borderline (BPD) personalities. Because multiple defense measures were utilized, Study 1 was dedicated to evaluating the convergent validity between the measures used: Defense Style Questionnaire (DSQ), Defense-Q, and Defense Mechanism Manual (DMM). Studies 2, 3, and 4, then evaluated the ability of the defenses to differentiate APD and BPD groups. Method: In Study 1, participants completed all defense measures and correlations were conducted between the individual defenses. In Studies 2, 3, and 4, groups of nonclinical participants were divided into APD and BPD groups based on scores from the Personality Assessment Inventory. They also completed the DSQ (Studies 2, 3, & 4), the Defense-Q (Study 3), and/or the DMM (Study 4).The groups were then examined for differences on defenses using MANOVA and DFA analyses. Results: Results from Study 1 revealed no significant correlations between the measures for any of the individual defenses. In Studies 2, 3, and 4, DSQ and Defense-Q results revealed that defenses were able to differentiate the APD and BPD groups, but the DMM results did not replicate these findings. Univariate analyses showed that many defenses differed between the groups (e.g., Acting Out, Denial, and Turning Against Self), while others showed no differences (e.g., Idealization). Conclusion: The results were discussed in relation to previous theory and research. The findings provided support for many theoretical expectations. For example, the results supported: Kernberg (1984) who posited both groups would use primitive defenses (e.g., Splitting, Denial); Perry and Cooper (1986) who posited BPD groups would internalize negative views towards the self; and Gacono and Meloy (1988) who believed Denial was characteristic of APD. Overall, the results suggested that APD and BPD groups demonstrated differences in defense use.

Goal: The aim of the current studies was to evaluate the ability of individual defenses to differentiate Antisocial (APD) and Borderline (BPD) personalities. Because multiple defense measures were utilized, Study 1 was dedicated to evaluating the convergent validity between the measures used: Defense Style Questionnaire (DSQ), Defense-Q, and Defense Mechanism Manual (DMM). Studies 2, 3, and 4, then evaluated the ability of the defenses to differentiate APD and BPD groups. Method: In Study 1, participants completed all defense measures and correlations were conducted between the individual defenses. In Studies 2, 3, and 4, groups of nonclinical participants were divided into APD and BPD groups based on scores from the Personality Assessment Inventory. They also completed the DSQ (Studies 2, 3, & 4), the Defense-Q (Study 3), and/or the DMM (Study 4).The groups were then examined for differences on defenses using MANOVA and DFA analyses. Results: Results from Study 1 revealed no significant correlations between the measures for any of the individual defenses. In Studies 2, 3, and 4, DSQ and Defense-Q results revealed that defenses were able to differentiate the APD and BPD groups, but the DMM results did not replicate these findings. Univariate analyses showed that many defenses differed between the groups (e.g., Acting Out, Denial, and Turning Against Self), while others showed no differences (e.g., Idealization). Conclusion: The results were discussed in relation to previous theory and research. The findings provided support for many theoretical expectations. For example, the results supported: Kernberg (1984) who posited both groups would use primitive defenses (e.g., Splitting, Denial); Perry and Cooper (1986) who posited BPD groups would internalize negative views towards the self; and Gacono and Meloy (1988) who believed Denial was characteristic of APD. Overall, the results suggested that APD and BPD groups demonstrated differences in defense use.

The purpose of the present study was to begin to develop an understanding of how primary care resident physicians work with patients with personality disorder-type characteristics and processes. Participants include fifteen primary care resident physicians from a community health clinic. Participants individually viewed two video vignettes of an actor-patient being interviewed by a physician. Participants were asked how they would respond to statements the actor-patient made during the course of watching the video and then answered general questions about reactions to the actor-patient and working with patients with personality disorders. Using a naturalistic qualitative analysis, data were analyzed for categories and themes. The results of the analyses are presented within a basic framework for understanding how primary care residents work with and approach the doctor-patient relationship, and treat patients with personality disorder characteristics and associated personality processes. Broad themes emerge from the data. Content of residents' responses suggests two response styles: attention to patient's presenting physical concern or identify and potentially address underlying psychological and emotional concerns. Residents characterize the establishment of a relationship with this patient population as either a distancing, paternalistic approach, or an engaging and collegial relationship. Levels of self-awareness of reactions to patients consist of either a willingness to address personal reactions or a tendency to not identify or discuss those reactions. Residents also demonstrate a dichotomous response to willingness to work with this patient population characterized by either hesitancy to do so, or a desire to engage and attempt to work with these patients. A framework for understanding the possible effects and motivating variables behind these styles is presented. The predominant effects of the residents' interactions styles are either a distancing/paternalistic relationship or an engaging/collegial relationship. Two themes appear to characterize residents' motivations: the resident was driven by self-needs or patient-needs. These results may be useful in developing an initial theory of this previously unexamined dynamic. Moreover, these results may be useful in helping physicians better develop relationships with patients, especially through improvement in recognizing and utilizing personal reaction to patients. Future inquiries directed towards understanding what physician variables contribute to these two basic interaction styles identified here may be useful.