VALIDITY OF SELF-DEFEATING PERSONALITY-DISORDER

Objective: The purpose of this study was to assess the validity of DSM -III-R self-defeating personality disorder. Method: Applicants for inp atient treatment of Personality disorders (N=100) or psychoanalysis (N =100) were independently evaluated face to face by experienced clinici ans using the Structured Clinical Interview for DSM-III-R and the Pers onality Disorder Examination. Internal consistency; agreement between assessments, diagnostic efficiency of criteria; prevalence, sex ratio; comorbidity with axis I and II disorders; and relationship to educati on, current employment, and selection for psychoanalytically oriented treatment were examined. Results: The internal consistency of the crit eria set and the agreement between psychiatric assessments of self-def eating personality disorder were fair. The most discriminating criteri a were those referring to a) choices leading to disappointment, failur e, or mistreatment and b) rejection of opportunities for pleasure. A c onsensus diagnosis of self-defeating personality disorder was more com mon than all but three other axis II disorders. The sex ratio of the s ubjects with this diagnosis was not significantly different from the s ex ratio of the entire subject group or of patients with other persona lity disorders. Significant comorbidity with borderline and dependent personality disorders and with current mood disorders was found. Patie nts with self-defeating personality disorder resembled patients with o ther personality disorders in educational attainment and treatment ass ignment. They were more likely to be employed. Conclusions: These data lend little support to the validity of self-defeating personality dis order as a separate personality disorder category.