Comprehensive Psychiatry
Volume 50, Issue 5 , Pages 463-470, September 2009

Factor structure and diagnostic efficiency of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for avoidant personality disorder in Hispanic men and women with substance use disorders

  • Daniel F. Becker

      Affiliations

    • Department of Psychiatry, University of California, San Francisco, CA 94143, USA
    • Corresponding Author InformationCorresponding author. Mills-Peninsula Medical Center, 1501 Trousdale Dr, Burlingame, CA 94010, USA.
    • ,
  • Luis Miguel Añez

      Affiliations

    • Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
    • ,
  • Manuel Paris

      Affiliations

    • Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
    • ,
  • Luis Bedregal

      Affiliations

    • Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
    • ,
  • Carlos M. Grilo

      Affiliations

    • Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA

published online 19 January 2009.

Abstract 

Objective

This study examined the internal consistency, factor structure, and diagnostic efficiency of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for avoidant personality disorder (AVPD) and the extent to which these metrics may be affected by sex.

Method

Subjects were 130 monolingual Hispanic adults (90 men, 40 women) who had been admitted to a specialty clinic that provides psychiatric and substance abuse services to Spanish-speaking patients. All were reliably assessed with the Spanish-Language Version of the Diagnostic Interview for DSM-IV Personality Disorders. The AVPD diagnosis was determined by the best-estimate method. After evaluating internal consistency of the AVPD criterion set, an exploratory factor analysis was performed using principal components extraction. Afterward, diagnostic efficiency indices were calculated for all AVPD criteria. Subsequent analyses examined men and women separately.

Results

For the overall group, internal consistency of AVPD criteria was good. Exploratory factor analysis revealed a 1-factor solution (accounting for 70% of the variance), supporting the unidimensionality of the AVPD criterion set. The best inclusion criterion was “reluctance to take risks,” whereas “interpersonally inhibited” was the best exclusion criterion and the best predictor overall. When men and women were examined separately, similar results were obtained for both internal consistency and factor structure, with slight variations noted between sexes in the patterning of diagnostic efficiency indices.

Conclusions

These psychometric findings, which were similar for men and women, support the construct validity of the DSM-IV criteria for AVPD and may also have implications for the treatment of this particular clinical population.

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 Presented in part at the 161st Annual Meeting of the American Psychiatric Association, Washington, DC, May 3-8, 2008.

PII: S0010-440X(08)00166-1

doi:10.1016/j.comppsych.2008.10.002

Comprehensive Psychiatry
Volume 50, Issue 5 , Pages 463-470, September 2009

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