Interpersonal functioning deficits in association with DSM-IV personality disorder dimensions
According to DSM, interpersonal functioning deficits are a main criterion for the general definition of personality disorders (PDs), but some PD diagnoses do not appear to be related to impaired interpersonal functioning. Social deficits have rarely been studied in all PD dimensions to date.
We analyzed 511 adults aged 20–41 years from the general population of the canton of Zurich, Switzerland, using data from the Epidemiology Survey of the Zurich Programme for Sustainable Development of Mental Health Services (ZInEP). PD dimensions were measured with a questionnaire and indicators of interpersonal functioning with a semi-structured interview. Associations were analyzed with generalized linear models.
All PD dimensions were significantly associated with various indicators of interpersonal functioning deficits, such as distress and conflicts in friendships and partnership, feeling lonely, few close friends, and reduced social support. Schizotypal and borderline PD were relatively strongly associated with distress in friendships when compared with other PD dimensions. Furthermore, both dimensions were significantly related to all indicators of interpersonal functioning deficits.
Subjects scoring high on any PD dimension reported considerable deficits in interpersonal functioning as characterized by a solitary lifestyle, conflictual and distressful social relations, and lack of social support. All DSM-IV PDs are associated with poor interpersonal functioning, but there is some evidence that schizotypal and borderline symptomatology affects deficits in social interactions even more profoundly and pervasively than other PD dimensions.
KeywordsInterpersonal functioning Functional impairment Quality of life Distress Personality disorders Social support DSM-5 Epidemiology
ZInEP was supported by a private donation. The donor had no further role in the experimental design, the collection, analysis, and interpretation of data, the writing of this report, or the decision to submit this paper for publication.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 1.American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR, 4th text revision edn. American Psychiatric Association, Washington, DCGoogle Scholar
- 2.American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders DSM-5. American Psychiatric Association, Washington, DCGoogle Scholar
- 6.Grant BF, Hasin DS, Stinson FS, Dawson DA, Chou SP, Ruan WJ, Pickering RP (2004) Prevalence, correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 65:948–958PubMedCrossRefGoogle Scholar
- 18.Schotte CKW, de Doncker D (1994) ADP-IV questionnaire. University Hospital Antwerp, AntwerpGoogle Scholar
- 23.Gunderson JG, Stout RL, McGlashan TH, Shea MT, Morey LC, Grilo CM, Zanarini MC et al (2011) Ten-year course of borderline personality disorder: psychopathology and function from the collaborative longitudinal personality disorders study. Arch Gen Psychiatry 68:827–837PubMedCentralPubMedCrossRefGoogle Scholar
- 25.Hengartner MP, Ajdacic-Gross V, Rodgers S, Müller M, Rössler W (2013) Childhood adversity in association with personality disorder dimensions: new findings in an old debate. Eur Psychiatry (in press)Google Scholar