¿Es un constructo válido la categoría de trastorno histriónico de la personalidad del Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition? / Is the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, histrionic personality disorder category a valid construct?

Objetivo. El estudio investigó aspectos cruciales de la validez del constructo de la categoría trastorno histriónico de la personalidad (THP) del Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Material y métodos. El estudio incluyó a 2.289 pacientes de la Norwegian Network of Psychotherapeutic Day Hospitals. La validez del constructo fue evaluada mediante la prevalencia, la comorbilidad con otros trastornos de la personalidad, la consistencia interna de los criterios del THP, los índices de gravedad y el análisis de factores. Resultados. La prevalencia fue muy escasa (0,4%). La comorbilidad fue elevada, especialmente con los trastornos límite, narcisista y dependiente de la personalidad. La consistencia interna fue baja. Los criterios parecieron formar dos agrupaciones distintas: el primero contenía rasgos exhibicionistas y que intentan llamar la atención, y el otro contenía rasgos impresionables. Conclusión. Los resultados indicaron una escasa validez del constructo de la categoría THP. Analizamos distintas opciones para el futuro de la categoría. Los autores sugieren que la categoría THP sea eliminada del sistema DSM. No obstante, los fenómenos clínicos de exhibicionismo e intento de llamar la atención, que son los rasgos predominantes de la personalidad en el THP, debieran conservarse en un subtipo exhibicionista de narcisismo(AU)

Purpose: The study investigated crucial aspects of the construct validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) histrionic personality disorder (HPD) category. Material and methods: The study included 2289 patients from the Norwegian Network of Psychotherapeutic Day Hospitals. Construct validity was assessed by means of prevalence, comorbidity with other personality disorders, internal consistency among HPD criteria, severity indices, as well as factor analyses. Results: The prevalence of HPD was very low (0.4%). The comorbidity was high, especially with borderline, narcissistic, and dependent personality disorders. The internal consistency was low. The criteria seemed to form two separate clusters: the first contained exhibitionistic and attention-seeking traits and the other contained impressionistic traits. Conclusion: The results indicated poor construct validity of the HPD category. Different options for the future of the category are discussed. The authors suggest the HPD category to be deleted from the DSM system. However, the clinical phenomena of exhibitionism and attention-seeking, which are the dominant personality features of HPD, should be preserved in an exhibitionistic subtype of narcissism (AU)

Is the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, histrionic personality disorder category a valid construct?

PURPOSE: The study investigated crucial aspects of the construct validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) histrionic personality disorder (HPD) category. MATERIAL AND METHODS: The study included 2289 patients from the Norwegian Network of Psychotherapeutic Day Hospitals. Construct validity was assessed by means of prevalence, comorbidity with other personality disorders, internal consistency among HPD criteria, severity indices, as well as factor analyses. RESULTS: The prevalence of HPD was very low (0.4 %). The comorbidity was high, especially with borderline, narcissistic, and dependent personality disorders. The internal consistency was low. The criteria seemed to form 2 separate clusters: the first contained exhibitionistic and attention-seeking traits and the other contained impressionistic traits. CONCLUSION: The results indicated poor construct validity of the HPD category. Different options for the future of the category are discussed. The authors suggest the HPD category to be deleted from the DSM system. However, the clinical phenomena of exhibitionism and attention-seeking, which are the dominant personality features of HPD, should be preserved in an exhibitionistic subtype of narcissism.