Trait-State Artifacts and the Diagnosis of Personality Disorders

doi:10.1001/archpsyc.1991.01810320044007

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Vol. 48 No. 8, August 1991

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Trait-State Artifacts and the Diagnosis of Personality Disorders

Armand W. Loranger, PhD; Mark F. Lenzenweger, PhD; Alison F. Gartner, PhD; Virginia Lehmann Susman, MD; Judith Herzig, MD; Gary K. Zammit, PhD; John D. Gartner, PhD; Robert C. Abrams, MD; Robert C. Young, MD

Arch Gen Psychiatry. 1991;48(8):720-728.

Abstract

• The multiaxial nature of DSM-III has stimulated interestin the personality disorders. There are also indications thatit has produced an increase in their diagnosis. However, thereis clinical and psychometric evidence that a personality evaluationundertaken while a patient is in a dysphoric mental state maydistort or misrepresent traits, the so-called trait-state problemin personality assessment. The present study appears to be thefirst to investigate this phenomenon with a clinical interviewrather than with personality tests. It examined the effect ofanxiety, depression, and level of global impairment on the diagnosisof personality disorder and the assessment of the criteria forthe individual Axis II disorders. Eighty-four patients, mostof whom had current Axis I diagnoses, were evaluated by sevenexperienced clinicians with a new semistructured interview,the Personality Disorder Examination. The sample evidenced atrend toward acknowledging fewer maladaptive personality traitsat follow-up than at entry. There was no evidence, however,that anxiety or depression had affected either the diagnosisof a personality disorder or the criteria associated with mostof the individual personality disorders.

Author Affiliations

From the Department of Psychiatry, Cornell University Medical College, New York, NY, and The New York Hospital-Cornell Medical Center, Westchester Division, White Plains, NY.

Footnotes

Accepted for publication June 5, 1990.

Reprint requests to Westchester Division, New York HospitalCornell Medical Center, 21 Bloomingdale Rd, White Plains, NY10605 (Dr Loranger).

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