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Multicenter Study
Compr Psychiatry. Sep-Oct 2006;47(5):376-83.
doi: 10.1016/j.comppsych.2006.01.006.
Epub 2006 Apr 21.

An investigation of the validity of the

Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition
avoidant personality disorder
construct as a prototype category and
the psychometric properties of the
diagnostic criteria
Benjamin Hummelen  1 , Theresa Wilberg, Geir Pedersen, Sigmund Karterud

Affiliations
PMID:
16905400
DOI:
10.1016/j.comppsych.2006.01.006

Abstract
This study investigated several aspects of the validity of the Diagnostic
and Statistical Manual of Mental Disorders, Fourth Edition avoidant
personality disorder (APD) construct, with emphasis on the
psychometric properties of the diagnostic criteria and the prototype
nature of the construct. A sample of 1,058 patients from the Norwegian
Network of Psychotherapeutic Day Hospitals was examined by means
of exploratory factor analysis, correlation, and diagnostic efficiency
statistics, chi(2) analysis, and frequency distribution. The results
indicated that APD is a 1-dimensional construct with good internal
consistency. The criteria had acceptable diagnostic efficiency; criterion
3 performed poorest. Number of APD criteria showed no distinct
threshold between No-APD and patients with APD. Sixty-two different
combinations of any 4 APD criteria occurred. It can be concluded that
the prototype model fitted the data well and that the APD diagnostic
criteria perform well in the current classification system. The Diagnostic
and Statistical Manual of Mental Disorders, Fourth Edition hierarchy of
criteria was not supported.

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