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Journal of Personality Disorders. 1(2), 168-173, 1987
1987 The Guilford Press
SELF-DEFEATING PERSONALITY DISORDER:
An Empirical Study
Frederic Kass, MD
Columbia- Presbyterian Medical Center
Recently there has been considerable debate with regard to the addition of
masochistic (self-defeating) personality disorder to DSM-III. Proponents of
the diagnosis have stated that masochistic personality is a common dis order, particularly in outpatient practice, with important prognostic and
treatment considerations (Asch, 1985; Gunderson, 1983; Simons, in press).
Opponents of the diagnosis have argued that the criteria describe adaptive
behaviors to situations of abuse, as well as normative responses of women
and other disadvantaged individuals in our society (Caplan, 1985; Kaplan,
1983; Walker, 1984). Furthermore, opponents have stated that the diag
nosis is based totally on anecdotal and metapsychological formulations.In order to develop an empirical base for the diagnosis, an initial list of
10 masochistic personality disorder criteria was developed. Recently the results of a pilot study utilizing these criteria were published (Kass,
MacKinnon, St Spitzer, 1986). The criteria were found to be common and to have good internal consistency and moderate intercorrelations. Because
of the small sample size and other methodological limitations, however, there was a possible "halo" effect on the data. The purpose of the current
study was to examine the psychometric properties of masochistic person
ality traits in a larger and more diverse sample.
METHOD
Patients were chosen from the private practices of 16 attending psychiatrists, and from the clinic practices of 17 PGY-III and PGY-PV psychiatric residents, three psy
chologists, three social workers, one nurse, and five psychology interns. Twenty-
four clinicians were male and 21 were female. Each clinician was asked to rate all
of his or her psychotherapy patients who "are seen one or more times per week, and in treatment for at least one month." The sample consisted of 367 patients, whose
demographic characteristics are shown in Table 1. For this study the nine criteria for masochistic personality from the DSM-III-R in Development were utilized (Work
Group to Revise DSM-III, 1985) and were interspersed randomly among 13 other
personality criteria randomly chosen from existing Axis II disorders. Clinicians were
Requests for reprints should be sent to Frederic Kass, Presbyterian Hospital, 622 West 168th
Street VC-503. New York. New York 10032-3784.
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AN EMPIRICAL...