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Compr Psychiatry. Sep-Oct 2009;50(5):463-70.

doi: 10.1016/j.comppsych.2008.10.002.
Epub 2009 Jan 16.

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  1 , Luis Miguel Añez, Manuel Paris, Luis Bedregal, Carlos M Grilo

Affiliations
PMID:
19683617
DOI:
10.1016/j.comppsych.2008.10.002

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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