The assessment of personality disorders: implications for cognitive and behavior therapy

This article reviews the comorbidity of personality disorders (PDs) and Axis I disorders and discusses implications for assessment and treatment. Pros and cons of various assessment methods are discussed. The co-occurrence of PDs with Axis I disorders is considerable; roughly half of patients with anxiety disorders, depressive disorders or eating disorders received a PD diagnosis. Comorbidity models are discussed and implications for assessment and treatment are provided. Regarding the impact of PDs on cognitive-behavioral treatment outcome for Axis I disorders, conflicting results are found due to differences in assessment methods, treatment strategies, and patient samples. It is argued that additional Axis I pathology should be taken into account when studying the impact of PDs on treatment outcome for the target Axis I disorders. Finally, it is argued that the interpersonal behavior of the PD patient and the therapeutic relationship deserve more attention in the assessment and treatment of patients with PDs.