Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T23:19:40.988Z Has data issue: false hasContentIssue false

9b - Improved Operationalization and Measurement Are Central to the Future of Cluster A Personality Disorders: Commentary on Cluster A Personality Disorders

from Part III - Individual Disorders and Clusters

Published online by Cambridge University Press:  24 February 2020

By
Thanh Le  and
Alex S. Cohen
Edited by
Carl W. Lejuez  and
Kim L. Gratz
Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
Get access

Summary

The Diagnostic and Statistical Manual – 5th edition (DSM-5) definitions for Cluster A personality disorders have been valuable to the clinical, scientific, and consumer communities. However, they suffer from serious issues as scientific constructs and are difficult to precisely measure. These issues have constrained our ability to meaningfully comprehend their underlying biopsychosocial mechanisms and to develop cures and treatments. The authors consider three potential ways to improve the operationalization and measurement of Cluster A disorders. First, they discuss the viability of existing alternative diagnostic systems such as the DSM-5 alternative personality disorder model, the five-factor personality model, the Research Domain Criteria (RDoC), and the Hierarchical Taxonomy of Psychopathology (HiTop) systems. Second, they explore the utility of operationalizing Cluster A disorders within a broader spectrum of schizophrenia-related disorders. Lastly, they consider the viability of objectifying cluster A disorders symptoms and behaviors using various genotyping and phenotyping technologies (e.g., mobile devices). While each potential way has its strengths and weaknesses, collectively they may help account for the complex phenotypic heterogeneity associated with Cluster A disorders, provide objective markers of their severity, and facilitate individualized assessment, prevention, and treatment.

Keywords

nosologyschizotypydigital phenotypingobjective assessmentprecision medicine
Type
Chapter
Information
The Cambridge Handbook of Personality Disorders , pp. 217 - 220
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
Barbato, A. (1998). Schizophrenia and Public Health. World Health Organization: Division of Mental Health and Prevention of Substance Abuse.Google Scholar
Ben-Zeev, D., Ellington, K., Swendsen, J., & Granholm, E. (2011). Examining a cognitive model of persecutory ideation in the daily life of people with schizophrenia: A computerized experience sampling study. Schizophrenia Bulletin, 37(6), 1248–1256.Google Scholar
Bollini, A. M., & Walker, E. F. (2007). Schizotypal personality disorder. In O’Donohue, W., Fowler, K. A., & Lilienfeld, S. O. (Eds.), Personality Disorders: Toward the DSM-V (pp. 81–108). Thousand Oaks, CA: Sage Publications.CrossRefGoogle Scholar
Chmielewski, M., Bagby, R. M., Markon, K., Ring, A. J., & Ryder, A.G. (2014). Openness to experience, intellect, schizotypal personality disorder, and psychoticism: Resolving the controversy. Journal of Personality Disorders, 28, 483–489.Google Scholar
Chmielewski, M., Clark, L. A., Bagby, R. M., & Watson, D. (2015). Method matters: Understanding diagnostic reliability in DSM-IV and DSM-5. Journal of Abnormal Psychology, 124(3), 764–769.CrossRefGoogle ScholarPubMed
Chun, C. A., Barrantes-Vidal, N., Sheinbaum, T., & Kwapil, T. R. (2017). Expression of schizophrenia-spectrum personality traits in daily life. Personality Disorders: Theory, Research, and Treatment, 8(1), 64–74.CrossRefGoogle ScholarPubMed
Cohen, A. S. (2019). Advancing ambulatory biobehavioral technologies beyond “proof of concept”: Introduction to the special section. Psychological Assessment, 31(3), 277–284.Google Scholar
Cohen, A. S., Chan, R. C., & Debbané, M. (2018). Crossing boundaries in schizotypy research: An introduction to the special supplement. Schizophrenia Bulletin, 44(Suppl. 2), S457–S459.CrossRefGoogle Scholar
Cuthbert, B. N., & Insel, T. R. (2013). Toward the future of psychiatric diagnosis: The seven pillars of RDoC. BMC Medicine, 11, 126.CrossRefGoogle ScholarPubMed
Docherty, A. R., Fonseca-Pedrero, E., Debbané, M., Chan, R. C. K., Linscott, R. J., Jonas, K. G., … Cohen, A. S. (2018). Enhancing psychosis-spectrum nosology through an international data sharing initiative. Schizophrenia Bulletin, 44(Suppl. 2), S460–S467.Google Scholar
Fonseca-Pedrero, E., Chan, R. C. K., Debbané, M., Cicero, D., Zhang, L. C., Brenner, C., … Ortuño-Sierra, J. (2018). Comparisons of schizotypal traits across 12 countries: Results from the International Consortium for Schizotypy Research. Schizophrenia Research, 199, 128–134.CrossRefGoogle Scholar
Ford, J. M., Morris, S. E., Hoffman, R. E., Sommer, I., Waters, F., McCarthy-Jones, S., … Cuthbert, B. N. (2014). Studying hallucinations within the NIMH RDoC framework. Schizophrenia Bulletin, 40(Suppl. 4), S295–S304.Google Scholar
Harrow, M., Jobe, T. H., & Faull, R. N. (2012). Do all schizophrenia patients need antipsychotic treatment continuously throughout their lifetime? A 20-year longitudinal study. Psychological Medicine, 42(10), 2145–2155.CrossRefGoogle Scholar
Insel, T. R. (2010). Rethinking schizophrenia. Nature, 468(7321), 187–193.Google Scholar
Insel, T. R. (2017). Digital phenotyping: Technology for a new science of behavior. JAMA: Journal of the American Medical Association, 318(13), 1215–1216.Google Scholar
Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., … Wang, P. (2010). Research Domain Criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167(7), 748–751.CrossRefGoogle Scholar
Kendler, K. S., McGuire, M., Gruenberg, A. M., & Walsh, D. (1995) Schizotypal symptoms and signs in the Roscommon Family Study: Their factor structure and familial relationship with psychotic and affective disorders. Archives of General Psychiatry, 52, 296–303.Google Scholar
Kendler, K. S., Neale, M. C., & Walsh, D. (1995). Evaluating the spectrum concept of schizophrenia in the Roscommon Family Study. American Journal of Psychiatry, 152(5), 749–754.Google ScholarPubMed
Kirchner, S. K., Roeh, A., Nolden, J., & Hasan, A. (2018). Diagnosis and treatment of schizotypal personality disorder: Evidence from a systematic review. NPJ Schizophrenia, 4(1), 20.Google Scholar
Krueger, R. F., Kotov, R., Watson, D., Forbes, M. K., Eaton, N. R., Ruggero, C. J., … Zimmermann, J. (2018). Progress in achieving quantitative classification of psychopathology. World Psychiatry, 17, 282–293.Google Scholar
Lenzenweger, M. F. (2006). Schizotaxia, schizotypy, and schizophrenia: Paul E. Meehl’s blueprint for the experimental psychopathology and genetics of schizophrenia. Journal of Abnormal Psychology, 115(2), 195–200.CrossRefGoogle Scholar
McCrae, R. R., & John, O. P. (1992). An introduction to the five-factor model and its applications. Journal of Personality, 60(2), 175–215.CrossRefGoogle Scholar
Strauss, G. P., & Cohen, A. S. (2017). A transdiagnostic review of negative symptom phenomenology and etiology. Schizophrenia Bulletin, 43, 712–719.CrossRefGoogle ScholarPubMed
Swendsen, J., Ben-Zeev, D., & Granholm, E. (2011). Real-time electronic ambulatory monitoring of substance use and symptom expression in schizophrenia. American Journal of Psychiatry, 168(2), 202–209.CrossRefGoogle ScholarPubMed
Torous, J., Onnela, J. P., & Keshavan, M. (2017). New dimensions and new tools to realize the potential of RDoC: Digital phenotyping via smartphones and connected devices. Translational Psychiatry, 7, e1053.Google Scholar
Weinberger, D. R., Glick, I. D., & Klein, D. F. (2015). Whither research domain criteria (RDoC)? The good, the bad, and the ugly. JAMA Psychiatry, 72(12), 1161–1162.CrossRefGoogle ScholarPubMed
Wittchen, H.-U., & Beesdo-Baum, K. (2018). “Throwing out the baby with the bathwater”? Conceptual and methodological limitations of the HiTOP approach. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 17(3), 298–299.Google Scholar
Wright, A. G. C., & Simms, L. J. (2016). Stability and fluctuation of personality disorder features in daily life. Journal of Abnormal Psychology, 125(5), 641–656.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×