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The Relationship between Anxiety Disorders and Personality Disorders

Prevalence Rates and Comorbidity Models
  • Carol J. M. Van Velzen
  • Paul M. G. Emmelkamp
Chapter

Abstract

The relationship between anxiety disorders and personality disorders (PDs) has received a great deal of attention by researchers. This chapter describes the comorbidity of PDs and anxiety disorders. The data, reviewed in this chapter, were provided by prevalence and treatment outcome studies and the review will be limited to a descriptive level of personality pathology (based on self-report and semi-structured interview). This review includes the following anxiety disorders: panic disorder, social phobia, generalized anxiety disorder, and obsessive-compulsive disorder. Further, additional Axis I disorders and symptoms will be summarized in order to provide an overall view on a descriptive level of the co-occurrence of Axis II disorders, anxiety disorders and related symptomatology. Finally, hypotheses concerning associations between anxiety disorders and PDs will be discussed and areas for future research will be outlined. In this chapter, the term “features” will be used when we refer to the criteria of the PDs. The term “traits” will be used when dimensional personality traits are considered.

Keywords

Anxiety Disorder Obsessive Compulsive Disorder Personality Disorder Personality Disorder Social Phobia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Alnaes, R. and Torgersen, S. (1988). The relationship between DSM-III symptom disorders (axis I) and personality disorders (axis II) in an outpatient population. Acta Psychiatrica Scandinavia, 78, 485–492.CrossRefGoogle Scholar
  2. Alnaes, R. and Torgersen, S. (1990). DSM-III personality disorders among patients with major depression, anxiety disorders, and mixed conditions. The Journal of Nervous and Mental Disease, 178, 693–698.CrossRefPubMedGoogle Scholar
  3. American Psychological Association. (1994). Diagnostic and Statistical Manual of Mental Disorders ( fourth ed. ). Washington, DC: Author.Google Scholar
  4. Ameringen, M., Van, Mancini, C., Styan, G., and Donison, D. (1991). Relationship of social phobia with other psychiatric illness. Journal of Affective Disorders, 21, 93–99.CrossRefPubMedGoogle Scholar
  5. Arrindell, W.A. and Emmelkamp, P.M.G. (1987). Psychological states and traits in female agoraphobics: a controlled study. Journal of Psychopathology and Behavioral Assessment, 9, 237–253.CrossRefGoogle Scholar
  6. Baer, L., Jenike, M.A., Ricciardi II, J.N., Holland, A.D., Seymour, R.J., Minichiello, W.E., and Buttolphi, M.L. (1990) Standardized assessment of personality disorders in obsessive-compulsive disorder. Archives of General Psychiatry,47, 826–830.Google Scholar
  7. Baer, L., Jenike, M.A., Black, D.W., Treece, C., Rosenfeld, R., and Greist, J. (1992). Effect of Axis II diagnoses on treatment outcome with clomipramine in 55 patients with obsessive-compulsive disorder. Archives of General Psychiatry, 49, 862–866.CrossRefPubMedGoogle Scholar
  8. Beck, A.T. and Freeman, A. (1990). Cognitive Therapy of Personality Disorders. New York: Guilford Press.Google Scholar
  9. Black, D.W., Yates, W.R., Noyes, R., Pfohl, B., and Kelley, M. (1989). DSM-III personality disorders in obsessive-compulsive study volunteers: a controlled study. Journal of Personality Disorders, 3, 58–62.CrossRefGoogle Scholar
  10. Black, D.W., Noyes, R., Pfohl, B., Goldstein, R.B., and Blum, N. (1993). Personality Disorder in Obsessivecompulsive volunteers, well comparison subjects, and their first-degree relatives. American Journal of Psychiatry, 150, 1226–1232.PubMedGoogle Scholar
  11. Blashfield, R., Noyes, R., Reich, J., Woodman, C., Cook, B.L., and Garvey, M.J. (1994). Personality disorder traits in generalized anxiety and panic disorder patients. Comprehensive Psychiatry, 35, 329–334.CrossRefPubMedGoogle Scholar
  12. Brooks, R.B., Baltazar, PL., and Munjack, D.J. (1989). Co-occurrence of personality disorders with panic disorder, social phobia, and generalized anxiety disorder: a review of the literature. Journal o fAnxiety Disorders, 3, 259–285.CrossRefGoogle Scholar
  13. Brooks, R.B., Baltazar, P.L., Mcdowell, D.E., Munjack, D.J., and Bruns, J.R. (1991). Personality disorders co-occurring with panic disorder with agoraphobia. Journal of Personality Disorders, 5, 328–336.CrossRefGoogle Scholar
  14. Brown, T.A. and Barlow, D.H. (1992). Comorbidity among anxiety disorders: implications for treatment and DSM-IV. Journal of Consulting and Clinical Psychology, 60, 835–844.CrossRefPubMedGoogle Scholar
  15. Brown, E.J., Heimberg, R.G., and Juster, H.R. (1995). Social phobia subtype and avoidant personality disorder: Effect on severity of social phobia, impairment, and outcome of cognitive behavioral treatment. Behaviour Therapy, 26, 467–486.CrossRefGoogle Scholar
  16. Chambless, D.L., Renneberg, B., Goldstein, A., and Gracely, E.J. (1992). MCMI-diagnosed personality disorders among agoraphobic outpatients: Prevalence and relationship to severity and treatment outcome. Journal of Anxiety Disorders, 6, 193–211.CrossRefGoogle Scholar
  17. Clark, L.A. and Watson, D. (1991). Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316–336.CrossRefPubMedGoogle Scholar
  18. Clark, L.A., Watson, D., and Mineka, S. (1994). Temperament, personality, and the mood and anxiety disorders. Journal of Abnormal Psychology, 103, 103–116.CrossRefPubMedGoogle Scholar
  19. Cloninger, C.R. (1987). A systematic method for clinical description and classification of personality variants. Archives of General Psychiatry, 44, 573–588.CrossRefPubMedGoogle Scholar
  20. Costa, P.T. and McCrae, R.R. (1990). Personality disorders and the Five-Factor Model of personality. Journal of Personality Disorders, 4, 362–371.CrossRefGoogle Scholar
  21. Costa, P.T. and McCrae, R.R. (1992). The Five-Factor Model of personality and its relevance to personality disorders. Journal of Personality Disorders, 6, 343–359.CrossRefGoogle Scholar
  22. Costa, P.T. and Widiger, T.A. (1994) Summaries and unresolved issues. In P.T. Costa and T.A. Widiger (Eds.), Personality disorders and The Five-Factor Model of Personality. Washington: American Psychological Association.CrossRefGoogle Scholar
  23. Crino, R.D. and Andrews, G. (1996). Personality disorder in obsessive-compulsive disorder: a controlled study. Psychiatric Research, 30, 29–38.CrossRefGoogle Scholar
  24. Diaferia, G., Sciuto, G., Perna, G., Bernardeschi, L., Battaglia, M., Rusmini, S., and Bellodi, L. (1993) DSM-III-R personality disorders in panic disorder. Journal of Anxiety Disorders, 7, 153–161.CrossRefGoogle Scholar
  25. Dobson, K.S. (1985). The relationship between anxiety and depression. Clinical Psychology Review, 5, 307–324.CrossRefGoogle Scholar
  26. Docherty, J.P., Fiester, S.J., and Shea, T. (1986). Syndrome diagnosis and personality disorder. In A.J. Frances and R.E. Hales (Eds.), American Psychiatric Association Annual Review, Vol. 5, 315–355. Washington, DC: American Psychiatric Press.Google Scholar
  27. Dreessen, L., Arntz, A., Luttels, C., and Sallaerts, S. (1994). Personality disorders do not influence the results of cognitive behaviour therapies for anxiety disorders. Comprehensive Psychiatry, 35, 265–274.CrossRefPubMedGoogle Scholar
  28. Farmer, R. and Nelson-Gray, R.O. (1990). Personality and depression: hypothetical relations, empirical findings, and methodological considerations. Clinical Psychology Review, 10, 453–476.CrossRefGoogle Scholar
  29. Farmer, R. and Nelson-Gray, R.O. (1990). Personality and depression: hypothetical relations, empirical findings, and methodological considerations. Clinical Psychology Review, 10, 453–476.CrossRefGoogle Scholar
  30. Feske, U., Perry, K.J., Chambless, D.L., Renneberg, B., and Goldstein, A.J. (1996). Avoidant personality disorder as a predictor for treatment outcome among generalized social phobics. Journal of Personality Disorders, 10, 174–184.CrossRefGoogle Scholar
  31. Flick, S.N., Roy-Byrne, P.P., Cowley, D.S., Shores, M.M., and Dunner, D.L. (1993). DSM-III-R personality disorders in a mood and anxiety disorders clinic: prevalence, comorbidity, and clinical correlates. Journal of Affective Disorders, 27, 71–79.CrossRefPubMedGoogle Scholar
  32. Friedman, C.J., Shear, M.K., and Frances, A. (1987). DSM-III personality disorders in panic patients. Journal of Personality Disorders, 1, 132–135.CrossRefGoogle Scholar
  33. Garyfallos, G., Adamopoulou, A., Voikli, M., Saitis, M., Kirtsos, P., and Moutzoukis, C. (1994). DSM-III-R personality disorders among patients with depressive and/or anxiety disorders. Journal of Personality Disorders, 8, 320–332.CrossRefGoogle Scholar
  34. Gasperini, M., Battaglia, M., Diaferia, G., and Bellodi, L. (1990). Personality features related to generalized anxiety disorder. Comprehensive Psychiatry, 31, 363–368.CrossRefPubMedGoogle Scholar
  35. Green, M.A. and Curtis, G.C. (1988). Personality disorders in panic patients: Response to termination of antipanic medication. Journal of Personality Disorders, 2, 303–314.CrossRefGoogle Scholar
  36. Greenberg, D. and Stravynski, A. (1983). Social phobia. [Letter to the editor]. British Journal of Psychiatry, 143, 526.CrossRefPubMedGoogle Scholar
  37. Heimberg, R.G., Hope, D.A., Dodge, C.S., and Becker, R.E. (1990). DSM-III-R subtypes of social phobia. Comparison of generalized social phobics and public speaking phobics. The Journal of Mental and Nervous Disease, 178, 172–179.CrossRefGoogle Scholar
  38. Herbert, J.D., Hope, D.A., and Bellack, A.S. (1992). Validity of the distinction between generalized social phobia and avoidant personality disorder. Journal of Abnormal Psychology, 101, 332–339.CrossRefPubMedGoogle Scholar
  39. Hirschfeld, R.M.A., Klerman, G.L., Clayton, P.J., Keller, M.B., McDonald-Scott, P., and Larkin, B.H. (1983). Assessing personality: effects of the depressive state on trait measurement. American Journal of Psychiatry, 140, 695–699.PubMedGoogle Scholar
  40. Hoffart, A. and Martinsen, E.W. (1992). Personality disorders in panic with agoraphobia and major depression. British Journal of Clinical Psychology, 31, 213–214.CrossRefPubMedGoogle Scholar
  41. Hoffart, A., Thornes, K., Hedley, L.M., and Strand, J. (1994). DSM-III-R Axis I and II disorders in agoraphobic patients with and without panic disorder. Acta Psychiatrica Scandinavia, 89, 186–191.CrossRefGoogle Scholar
  42. Hofmann, S.G., Newman, M.G., Becker, E., Taylor, C.B., and Roth, W.T. (1995). Social phobia with and without avoidant personality disorder: preliminary behaviour therapy outcome findings. Journal of Anxiety Disorders, 9, 427–438.CrossRefGoogle Scholar
  43. Holt, C.S., Heimberg, R.G., and Hope, D.A. (1992). Avoidant personality disorder and the generalized subtype of social phobia. Journal of Abnormal Psychology, 1, 318–325.CrossRefGoogle Scholar
  44. Hyler, S.E., Skodol, A.E., Kellman, H.D., Oldham, J.M., and Rosnick, L. (1990). Validity of the Personality Diagnostic Questionnaire-revised: Comparison with two structured interviews. American Journal of Psychiatry, 147, 1043–1048.PubMedGoogle Scholar
  45. Jansen, M.A.,Arntz,A., Merckelbach, H., and Mersch, RA. (1994). Personality disorders and features in social phobia and panic disorder. Journal of Abnormal Psychology, 103, 391–395.CrossRefGoogle Scholar
  46. Joffe, R.T., Swinson, R.P., and Regan, J.J. (1988). Personality features of obsessive-compulsive disorder. American Journal of Psychiatry, 145, 1127–1129.PubMedGoogle Scholar
  47. Koenigsberg, H.W., Kaplan, R.D., Gilmore, M.M., and Cooper, A.M. (1985). The relationship between syndrome and personality disorders in DSM-III: Experience with 2462 patients. American Journal of Psychiatry, 142, 207–212.PubMedGoogle Scholar
  48. Liebowitz, M.R., Gorman, J.M., Feyer, A.J., and Klein, D.F. (1985). Social phobia: Review of a neglected anxiety disorder. Archives of General Psychiatry, 42, 729–736.CrossRefPubMedGoogle Scholar
  49. Loranger, A.W., Lenzenweger, M.E, Gartner, A.F., Susman, V.L., Herzig, J., Zammit, G.K., Gartner, J.D., Abrams, R.C., and Young, R.C. (1991). Trait-state artifacts and the diagnosis of personality disorders. Archives of General Psychiatry, 48, 720–728.CrossRefPubMedGoogle Scholar
  50. Loranger, A.W., Susman, U.L., Oldham, J.M., and Russakoff, L.M. (1987). The personality disorders Examination: A preliminary report. Journal of Personality Disorders, 1, 1–13.CrossRefGoogle Scholar
  51. Mancuso, D.M., Townsend, M.H., and Mercante, D.E. (1993). Long-term follow-up of generalized anxiety disorder. Comprehensive Psychiatry, 34, 441–446.CrossRefPubMedGoogle Scholar
  52. Marks, I.M. (1985). Behavioral treatment of social phobia. Psychopharmacology Bulletin, 21, 615–618.PubMedGoogle Scholar
  53. Mauri, M., Sarno, N., Rossi, V.M., Armani, A, Zambotto, S., Cassano, G.B., and Akiskal, H.S. (1992).Google Scholar
  54. Personality disorders associated with generalized anxiety, panic, and occurrent depressive disorders. Journal of Personality Disorders,6, 162–167.Google Scholar
  55. Mavissakalian, M. and Hamann, M.S. (1986). DSM-III Personality disorder in agoraphobia. Comprensive Psychiatry, 27, 471–479.CrossRefGoogle Scholar
  56. Mavissakalian, M., Hamann, M.S., and Jones, B. (1990a). Correlates of DSM-III personality disorder in obsessive-compulsive disorder. Comprehensive Psychiatry, 31, 481–489.CrossRefPubMedGoogle Scholar
  57. Mavissakalian, M., Hamann, M.S., and Jones, B. (1990b). A comparison of DSM-III personality disorders in panic/agoraphobia and obsessive-compulsive disorder. Comprehensive Psychiatry, 31, 238–244.CrossRefPubMedGoogle Scholar
  58. Mavissakalian, M. and Hamann, M.S. (1988). Correlates of DSM-III personality disorder in panic disorder and agoraphobia. Comprehensive Psychiatry, 29, 535–544.CrossRefPubMedGoogle Scholar
  59. Mavissakalian, M.R., Hamann, M.S., Haidar, S.A., and De Groot, C. (1993). DSM-III personality disorders in generalized anxiety, panic/agoraphobia, and obsessive-compulsive disorders. Comprehensive Psychiatry, 34, 243–248.CrossRefPubMedGoogle Scholar
  60. McCrae, R.R. and John, O.P. (1992). An introduction to the Five-Factor Model and its applications. Journal of Personality, 60, 175–215.CrossRefPubMedGoogle Scholar
  61. Mellman, T.A., Leverich, G.S., Hauser, P, Kramlinger, K., Post, R.M., and Uhde, T.W. (1992). Axis II pathology in panic and affective disorders: relationship to diagnosis, course of illness, and treatment response. Journal of Personality Disorders, 6, 53–63.CrossRefGoogle Scholar
  62. Mersch, P.A., Jansen, M.A., and Arntz, A. (1995). Social phobia and personality disorder: Severity of complaint and treatment effectiveness. Journal of Personality Disorders, 9; 143–159.CrossRefGoogle Scholar
  63. Millon, T. (1983). Millon Clinical Multiaxial Inventory Manual ( 3rd ed. ). Minneapolis, MN: National Computer Systems.Google Scholar
  64. Noyes, R., Reich, J., Christiansen, J., Suelzer, M., Pfohl, B., and Coryell, W.A. (1990). Outcome of panic disorder. Relationship to diagnostic subtypes and comorbidity. Archives of General Psychiatry, 47, 809–818.CrossRefPubMedGoogle Scholar
  65. Noyes, R., Reich, J.H., Suelzer, M., and Christiansen, J. (1991). Personality traits associated with panic disorder: Change associated with treatment. Comprehensive Psychiatry, 32, 283–294.CrossRefPubMedGoogle Scholar
  66. Noyes, R., Woodman, C.L., Holt, C.S., Reich, J.H., and Zimmerman, M.B. (1995). Avoidant personality traits distinguish social phobic and panic disorder subjects. The Journal of Nervous and Mental Disease, 183, 145–153.CrossRefPubMedGoogle Scholar
  67. Pollack, M.H., Otto, M.W., Rosenbaum, J.F., and Sachs, G.S. (1992). Personality disorders in patients with panic disorder: association with childhood anxiety disorders, early trauma, comorbidity, and chronicity. Comprehensive Psychiatry, 33, 78–83.CrossRefPubMedGoogle Scholar
  68. Pollak, J. (1987). Relationship of obsessive-compulsive personality to obsessive-compulsive disorder: a review of literature. Journal of Psychology, 121, 137–148.CrossRefPubMedGoogle Scholar
  69. Rapee, R.M., Sanderson, W.C., and Barlow, D.H. (1988). Social phobia features across the DSM-III-R anxiety disorders. Journal of Psychopathology and Behavioral Assessment, 10, 287–299.CrossRefGoogle Scholar
  70. Rasmussen, S.A. and Tsuang, H.T. (1986). Clinical characteristics and family history in DSM-III obsessive-compulsive disorder. American Journal of Psychiatry, 143, 317–322.PubMedGoogle Scholar
  71. Reich, J.H. (1989). Update on instruments to measure DSM-III and DSM-III-R personality disorders. The Journal of Nervous and Mental Disease, 177. 366–370.CrossRefPubMedGoogle Scholar
  72. Reich, J. (1990). Relationship between DSM-III avoidant and dependent personality disorders. Psychiatry Research, 34, 281–292.CrossRefPubMedGoogle Scholar
  73. Reich, J.H. and Braginsky, Y. (1994). Paranoid personality traits in a panic disorder population: a pilot study. Comprehensive Psychiatry, 35, 260–264.CrossRefPubMedGoogle Scholar
  74. Reich, J.H. and Green, A.I. (1991). Effect of personality disorders on outcome of treatment. The Journal of Nervous and Mental Disease, 179, 74–82.CrossRefPubMedGoogle Scholar
  75. Reich, J.H. and Noyes, R. (1987). A comparison of DSM-III personality disorders in acutely ill patients and depressed patients. Journal of Anxiety Disorders, 1, 123–131.CrossRefGoogle Scholar
  76. Reich, J. and Troughton, E. (1988). Frequency of DSM-III personality disorders in patients with panic disorder: comparison with psychiatric and normal control subjects. Psychiatry Research, 26, 89–100.CrossRefPubMedGoogle Scholar
  77. Reich, J.H. and Vasile, R.G. (1993). Effect of personality disorders on the treatment outcome of Axis I conditions: an update. The Journal of Nervous and Mental Disease, 181, 475–484.CrossRefPubMedGoogle Scholar
  78. Reich, J., Noyes, R., Coryell, W., and O’Gorman, T.W. (1986). The effect of state anxiety on personality measurement. American Journal of Psychiatry, 143, 760–763.PubMedGoogle Scholar
  79. Reich, J., Noyes, R., and Troughton, E. (1987). Dependent personality disorder associated with phobic avoidance in patients with panic disorder. American Journal of Psychiatry, 144, 323–326.PubMedGoogle Scholar
  80. Reich, J., Noyes, R., and Yates, W. (1989). Alprazolam treatment of avoidant personality traits in social phobia patients. Journal of Clinical Psychiatry, 50, 91–95.PubMedGoogle Scholar
  81. Reich, J. and Yates, W. (1988). A pilot study of treatment of social phobia with alprazolam. American Journal of Psychiatry, 145, 590–594.PubMedGoogle Scholar
  82. Renneberg, B., Chambless, D.L., and Gracely, E.J. (1992). Prevalence of SCID-diagnosed personality disorders in agoraphobic outpatients. Journal of Anxiety Disorders, 6, 111–118.CrossRefGoogle Scholar
  83. Sanderson, W.C., Beck, A.T., and McGinn, L.K. (1994). Cognitive therapy for generalized anxiety disorder: Significance of comorbid personality disorders. Journal of Cognitive Psychotherapy, 8, 13–18.Google Scholar
  84. Sanderson, W.C., Wetzler, S., Beck, A.T., and Betz, F. (1994). Prevalence of personality disorders among patients with anxiety disorders. Psychiatry Research, 51, 167–174.CrossRefPubMedGoogle Scholar
  85. Schneier, F.R., Spitzer, R.L., Gibbon, M., Fyer, A.J., and Liebowitz, M.R. (1991). The relationship of social phobia subtypes and avoidant personality disorder. Comprehensive Psychiatry, 32, 496–502.CrossRefPubMedGoogle Scholar
  86. Scholing, A. and Emmelkamp, P.M.G. (1993). Cognitive and behavioral treatments of fear of blushing, sweating or trembling. Behaviour Research and Therapy, 31, 155–170.CrossRefPubMedGoogle Scholar
  87. Sciuto, G., Diaferia, G., Battaglia, M., Perna, G., Gabriele, A., and Bellodi, L. (1991). DSM-III-R personality disorders in panic and obsessive-compulsive disorder: A comparison study. Comprehensive Psychiatry, 32, 450–457.CrossRefPubMedGoogle Scholar
  88. Shea, M.T., Klein, M.H., and Widiger, T.A. (1992). Comorbidity of personality disorders and depression: Implications for treatment. Journal of Consulting and Clinical Psychology, 60, 857–868.CrossRefPubMedGoogle Scholar
  89. Siever, L.J. and Davis, K.L. (1991). A psychobiological perspective on the personality disorders. American Journal of Psychiatry, 148, 1647–1658.PubMedGoogle Scholar
  90. Soldz, S., Budman, S., Demby, A., and Merry, J. (1993). Representation of personality disorders in circumplex and Five-Factor space: Explorations with a clinical sample. Psychological Assessment, 5, 41–52.CrossRefGoogle Scholar
  91. Spitzer, R.L., Williams, J.B.W., Gibbon, M., and First, M.B. (1990). Structured Clinical Interview for DSM-III-R-personality disorders (SCID-II, Version 1.0), Washington, DC: American Psychiatric Press. Stangl, D., Pfohl, B., Zimmerman, M., Bowers, W., and Corenthal, C. (1985). A Structured Interview for the DSM-III Personality Disorders. Archives of General Psychiatry, 42, 591–596.Google Scholar
  92. Stanley, M.A., Turner, S.M., and Borden, J.W. (1990). Schizotypal features in obsessive-compulsive disorder. Comprehensive Psychiatry, 31, 511–518.CrossRefPubMedGoogle Scholar
  93. Starcevic, V. (1992). Comorbidity models of panic disorder/agoraphobia and personality disturbance. Journal of Personality Disorders, 6, 213–225.CrossRefGoogle Scholar
  94. Stavrakaki, C. and Vargo, B. (1986). The relationship of anxiety and depression: a review of the literature. British Journal of Psychiatry, 149, 7–16.CrossRefPubMedGoogle Scholar
  95. Stein, D.J., Hollander, E., and Skodol, A.E. (1993). Anxiety disorders and personality disorders: a review. Journal of Personality Disorders, 7, 87–104.CrossRefGoogle Scholar
  96. Steketee, G. (1990). Personality traits and disorders in obsessive-compulsives. Journal of Anxiety Disorders, 4, 351–364.CrossRefGoogle Scholar
  97. Steketee, G., Grayson, J.B., and Foa, E.B. (1987). A comparison of characteristics of obsessive-compulsive disorder and other anxiety disorders. Journal of Anxiety Disorders, 1, 325–335.CrossRefGoogle Scholar
  98. Tran, G.Q. and Chambless, D.L. (1995). Psychopathology of social phobia: effects of subtype and of avoidant personality disorder. Journal of Anxiety Disorders, 9, 489–501.CrossRefGoogle Scholar
  99. Trull, T.J. (1992). DSM-III-R personality disorders and the Five-Factor Model of personality: an empirical comparison. Journal of Abnormal Psychology, 101, 553–560.CrossRefPubMedGoogle Scholar
  100. Turner, S.M., Beidel, D.C, Borden, J.W., Stanley, M.A., and Jacob, R.G. (1991). Social Phobia: Axis I and II correlates. Journal of Abnormal Psychology, 100, 102–106.CrossRefPubMedGoogle Scholar
  101. Turner, S.M., Beidel, D.C., Dancu, C.V., and Keys, D.J. (1986). Psychopathology of social phobia and comparison to avoidant personality disorder. Journal of Abnormal Psychology, 95, 389–394.CrossRefPubMedGoogle Scholar
  102. Turner, S.M., Beidel, D.C., and Townsley, R.M. (1992). Social Phobia: a comparison of specific and generalized subtypes and avoidant personality disorder. Journal of Abnormal Psychology, 101, 326–331.CrossRefPubMedGoogle Scholar
  103. Tyrer, P, Casey, P., and Gall, J. (1983). Relationship between neurosis and personality disorder. British Journal of Psychiatry, 142, 404–408.CrossRefPubMedGoogle Scholar
  104. Wetzler, S.W., Kahn, R.S., Cahn, W., Praag, H.M., and Asnis, G.M. (1990). Psychological test characteristics of depressed and panic patients. Psychiatry Research, 31, 179–192.CrossRefPubMedGoogle Scholar
  105. Widiger, T.A. and Shea, T. (1991). Differentation of Axis I and Axis II disorders. Journal of Abnormal Psychology, 100, 399–406.CrossRefPubMedGoogle Scholar
  106. Widiger, T.A., Trull, T.J., Clarkin, J.F., Sanderson, C., and Costa, P.T. (1994). A description of the DSM-III-R and DSM-IV personality disorders with the Five-Factor Model of personality. In P.T. Costa and T.A. Widiger (Eds.), Personality Disorders and The Five-Factor Model of Personality. Washington: American Psychological Association.Google Scholar
  107. Wiggins, J.S. and Pincus, A.L. (1989). Conceptions of personality disorders and dimensions of personality. Psychological Assessment, 1, 305–316.CrossRefGoogle Scholar
  108. Wittchen, H.-U., Essau, C.A., and Krieg, J.-C. (1991). Anxiety disorders: similarities and differences of comorbidity in treated and untreated groups. British Journal of Psychiatry, 159, 23–33.CrossRefGoogle Scholar
  109. Yeung, A.S., Lyons, M.J., Waternaux, C.H., Faraone, S.V., and Tsuang, M.T. (1993). The relationship between DSM-III personality disorders and the Five-Factor Model of personality. Comprehensive Psychiatry, 34, 227–234.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Carol J. M. Van Velzen
    • 1
  • Paul M. G. Emmelkamp
    • 2
  1. 1.Department of PsychiatryAcademical HospitalGroningenThe Netherlands
  2. 2.Department of Clinical Psychology Academical HospitalUniversity of GroningenGroningenThe Netherlands

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