Content area
Full Text
Self-defeating personality disorder (SDPD) was proposed for consideration in the DSM-III-R, but was eventually removed from the manual because of the lack of evidence to support its validity. Yet, after DSM-IV was published, some studies suggested that SDPD may be a viable diagnosis. The purpose of this study was to evaluate SDPD's viability as a diagnostic category. Consequently, SDPD's Internal consistency, comorbidity with other Axis I and II disorders, association with psychosocial impairment, and its ability to predict overall impairment in past, current, and global levels of functioning beyond other personality disorder symptomatology was assessed in 1,200 psychiatric evaluated with the Structured Clinical Interview for DSM-IV Personality (Pfohl, Blum, & Zimmerman, 1997). Cronbach's alpha for SDPD criteria was 0.61, and item-total correlations ranged between 0.22-0.38. There was substantial comorbidity of SDPD with depressive, avoidant, and borderline personality disorders, as well as major depression and anxiety disorders. The SDPD group did not significantly differ from psychiatric controls on multiple measures of psychosocial impairment, global functioning, and suicidality. SDPD did not meaningfully add to the prediction of impairment above and beyond other measures of Axis II pathology. It is concluded that the data do not support the reliability, validity, and utility of the SDPD diagnosis.
Self-defeating personality disorder (SDPD) was in Appendix A in the Diagnostic and Statistical Manual of Mental Disorders (DSM), 3rd edition-Revised (American Psychiatric Association [APA], 1987) as a diagnostic category warranting further study. However, in DSM-IV (APA, 1994), it was removed for two reasons: 1) It was asserted that the diagnosis could be misassigned to women in abusive relationships (Caplan & Cans, 1991; Rosewater, 1987; Walker, 1987); and 2) The DSM Personality Disorders Workgroup decided that, after reviewing studies of SDPD, there was not enough evidence to support its validity and utility. Despite this, interest has remained in the validity and clinical utility of the diagnosis, and the disorder continues to be studied.
Pre-DSM-FV research on SDPD found evidence to support its distinctiveness from other personality disorders in clinical populations. Studies of SDPD's precursor-masochistic personality disorder-indicated that the disorder could be distinctively identified among psychiatrists' patients and written case studies (Fuller, 1986; Fuller & Blashfield, 1989; Kass, 1987; Kass, McKinnon, & Spitzer, 1986). After MPD was slightly modified and changed to SDPD,...