Dimensions of personality disorder. The DSM-III-R cluster B diagnoses

Abstract

This study describes a psychometric approach to refining descriptions of antisocial, borderline, histrionic, and narcissistic personality disorders in an attempt to achieve greater distinctiveness. We developed descriptions of each diagnosis from content analysis of the literature. Psychiatrists' ratings were used to organize the features of each diagnosis into a set of carefully defined behavioral dimensions. Self-report scales were developed to assess each dimension. Scales were administered to a general population sample (N = 274) and a sample of patients with a primary diagnosis of personality disorder (N = 133). Scales demonstrated satisfactory levels of internal consistency. Some dimensions showed a low correlation with other dimensions defining the same diagnosis. These dimensions could be eliminated without affecting reliability. The structure underlying the dimensions delineating each diagnosis was evaluated using factor analysis. For each diagnosis, the structure was highly similar in the two samples. Based on these results, specific proposals are made for redefining diagnoses.