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“A valuable resource for truly understanding the depths of personality disorders and the recent developments in our understanding of them, along with interventions. The extensive updates make this a worthwhile addition. *****!”

—Doody's Review Service


“A major contribution to the expanding, challenging field of personality disorders. The second edition includes an up-to-date review of significant empirical research and in-depth analysis of controversies regarding etiology and classification, and it critically—yet fairly and objectively—spells out varying theoretical positions and therapeutic approaches. The authors clearly delineate ways we might advance toward an integrated concept of personality and personality disorders, as well as integration of available therapeutic approaches. This volume is a 'must' for all clinicians dealing with the diagnostic and psychotherapeutic challenges of patients with personality disorders, and an essential reference for researchers.”

—Otto F. Kernberg, MD, Department of Psychiatry, Weill Cornell Medical College; Director, Personality Disorders Institute, New York Presbyterian Hospital


“This handbook beautifully demonstrates that a single volume can integrate the needs of clinicians and researchers. The second edition presents the latest scientific research of relevance to the personality disorder community, and documents its crucial translation to clinical practice. The dissemination of the knowledge in this volume ultimately will be of tremendous benefit to persons in recovery and their family members.”

—Perry D. Hoffman, PhD, President, National Education Alliance for Borderline Personality Disorder


“Livesley has done it again! He and Larstone have assembled a master class of contributors for this second edition—almost all you need to know about personality disorders can be found in the pages of this handbook. Building on the acclaimed first edition, this is a mine of information that no serious student of the subject can afford to ignore.”

—Peter Tyrer, MD, Emeritus Professor of Community Psychiatry, Imperial College, London, United Kingdom


“Elucidating the major models of understanding, diagnosing, and treating personality disorders, this handbook opens up dialogue by offering an integrative but critical perspective that takes us beyond current controversies. The volume presents a number of conceptual models—including cognitive-behavioral, attachment, psychodynamic, neurobiological, and sociocultural perspectives—and describes cutting-edge research and clinical advances. It also explores the origins of prevailing conceptualizations of the self, identity, and personality. The result is a comprehensive work that will be of use to clinicians, students, and researchers at all levels in psychology and psychiatry. I could see building a course around this book to introduce the range of perspectives in personality disorder research and treatment.”

—Diana Diamond, PhD, Clinical Psychology Doctoral Program (Emerita), City University of New York; Senior Fellow, Personality Disorders Institute, Weill Cornell Medical College

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Table of Contents

I. Conceptual and Taxonomic Issues

1. Conceptual Issues, W. John Livesley

2. Theoretical versus Inductive Approaches to Contemporary Personality Pathology, Roger D. Davis, Maria Cristina Samaco-Zamora, & Theodore Millon

3. Official Classification Systems, Thomas A. Widiger

4. Dimensional Approaches to Personality Disorder Classification, Shani Ofrat, Robert F. Krueger, & Lee Anna Clark

5. Cultural Aspects of Personality Disorder, Roger T. Mulder

II. Psychopathology

- Introduction, W. John Livesley & Roseann Larstone

6. Identity, Carsten René Jørgensen

7. Attachment, Mentalizing, and the Self, Peter Fonagy & Patrick Luyten

8. Cognitive Structures and Processes in Personality Disorders, Arnoud Arntz & Jill Lobbestael

9. Taking Stock of Relationships among Personality Disorders and Other Forms of Psychopathology, Merav Silverman & Robert F. Krueger

III. Epidemiology, Course, and Onset

- Introduction, W. John Livesley & Roseann Larstone

10. Epidemiology of Personality Disorders, Theresa A. Morgan & Mark Zimmerman

11. Understanding Stability and Change in the Personality Disorders: Methodological and Substantive Issues Underpinning Interpretive Challenges and the Road Ahead, Mark F. Lenzenweger, Michael N. Hallquist, & Aidan G. C. Wright

12. Personality Pathology and Disorder in Children and Youth, Andrew M. Chanen, Jennifer L. Tackett, & Katherine N. Thompson

IV. Etiology and Development

- Introduction, W. John Livesley & Roseann Larstone

13. Genetics, Kerry L. Jang & Philip A. Vernon

14. Neurotransmitter Function in Personality Disorder, Jennifer R. Fanning & Emil F. Coccaro

15. Emotional Regulation and Emotional Processing, Paul H. Soloff

16. Neuropsychological Perspectives, Marianne Skovgaard Thomsen, Anthony C. Ruocco, Birgit Bork Mathiesen, & Erik Simonsen

17. Childhood Adversities and Personality Disorders, Joel Paris

18. Developmental Psychopathology, Rebecca L. Shiner & Timothy A. Allen

19. An Attachment Perspective on Callous and Unemotional Characteristics across Development, Roseann M. Larstone, Stephanie G. Craig, & Marlene M. Moretti

V. Diagnosis and Assessment

- Introduction, W. John Livesley & Roseann Larstone

20. Empirically Validated Diagnostic and Assessment Methods, Lee Anna Clark, Jaime L. Shapiro, Elizabeth Daly, Emily N. Vanderbleek, Morgan R. Negrón, & Julie Harrison

21. Clinical Assessment, John F. Clarkin, W. John Livesley, & Kevin B. Meehan

22. Using Interpersonal Reconstructive Therapy to Select Effective Interventions for Comorbid Treatment-Resistant, Personality-Disordered Individuals, Lorna Smith Benjamin, Kenneth L. Critchfield, Christie Pugh Karpiak, Tracey Leone Smith, & Robert Mestel

VI. Specific Patterns

- Introduction, W. John Livesley & Roseann Larstone

23. Clinical Features of Borderline Personality Disorder, Joel Paris

24. Theoretical Perspectives on Psychopathy and Antisocial Personality Disorder, Christopher J. Patrick & Sarah J. Brislin

25. Clinical Aspects of Antisocial Personality Disorder and Psychopathy, Lacy A. Olson-Ayala & Christopher J. Patrick

26. Obsessive–Compulsive Personality Disorder and Component Personality Traits, Anthony Pinto, Emily Ansell, Michael G. Wheaton, Robert F. Krueger, Leslie Morey, Andrew E. Skodol, & Lee Anna Clark

VII. Empirically Based Treatments

- Introduction, W. John Livesley & Roseann Larstone

27. Cognitive Analytic Therapy, Anthony Ryle & Stephen Kellett

28. Cognitive-Behavioral Therapy, Kate M. Davidson

29. Dialectical Behavior Therapy, Clive J. Robins, Noga Zerubavel, André M. Ivanoff, & Marsha M. Linehan

30. Mentalization-Based Treatment, Anthony W. Bateman, Peter Fonagy, & Chloe Campbell

31. Schema Therapy, David P. Bernstein & Maartje Clercx

32. Transference-Focused Psychotherapy, John F. Clarkin, Nicole Cain, Mark F. Lenzenweger, & Kenneth N. Levy

33. Systems Training for Emotional Predictability and Problem Solving, Nancee Blum, Donald W. Black, & Don St. John

34. Psychoeducation for Patients with Borderline Personality Disorder, Maria Elena Ridolfi & John G. Gunderson

35. Pharmacotherapy, Paul Markovitz

36. A Treatment Framework for Violent Offenders with Psychopathic Traits, Stephen C. P. Wong

37. Integrated Modular Treatment, W. John Livesley

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About the Editors

W. John Livesley, MD, PhD, is Professor Emeritus in the Department of Psychiatry at the University of British Columbia, Canada. His research focuses on the structure, classification, and origins of personality disorder, and on constructing an integrated framework for describing and conceptualizing personality pathology. His clinical interests are directed toward developing a unified approach to treatment. Dr. Livesley is a Fellow of the Royal Society of Canada. He is a past editor of the Journal of Personality Disorders.

• All titles by W. John Livesley

Roseann Larstone, PhD, is Research Associate in the Northern Medical Program at the University of Northern British Columbia, Canada. She holds an adjunct appointment in the Faculty of Medicine at the University of British Columbia. Her research has focused on personality and psychopathology, adolescent social–emotional development, and adolescent mental health. Dr. Larstone is currently involved in community-based research and program evaluation in the area of health promotion for mental health service recipients. She is a past assistant editor and current editorial board member of the Journal of Personality Disorders.

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Contributors

Timothy A. Allen, MA, Institute of Child Development, University of Minnesota, Minneapolis, Minnesota

Emily Ansell, PhD, Department of Psychology, Syracuse University, Syracuse, New York

Arnoud Arntz, PhD, Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands

Anthony W. Bateman, MD, Anna Freud National Centre for Children and Families, London, United Kingdom

Lorna Smith Benjamin, PhD, ABPP, Department of Psychology, University of Utah, Salt Lake City, Utah

David P. Bernstein, PhD, Department of Clinical Psychological Science, Maastrict University, Maastricht, The Netherlands

Donald W. Black, MD, Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa

Nancee Blum, MSW, Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa

Sarah J. Brislin, MS, Department of Psychology, Florida State University, Tallahassee, Florida

Nicole Cain, PhD, Department of Psychology, Long Island University, Brooklyn, New York

Chloe Campbell, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom

Andrew M. Chanen, PhD, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia

Lee Anna Clark, PhD, Department of Psychology, University of Notre Dame, Notre Dame, Indiana

John F. Clarkin, PhD, Department of Psychiatry, Weill Cornell Medical College, New York, New York

Maartje Clercx, MSc, Faculty of Psychology and Neurosciences, Maastricht University, Maastricht, The Netherlands

Emil F. Coccaro, MD, Department of Psychiatry and Behavioral Science, Pritzker School of Medicine, University of Chicago, Chicago, Illinois

Stephanie G. Craig, PhD, Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada

Kenneth L. Critchfield, PhD, Department of Psychology, James Madison University, Harrisonburg, Virginia

Elizabeth Daly, PhD, Department of Psychology, University of Notre Dame, Notre Dame, Indiana

Kate M. Davidson, PhD, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom

Roger D. Davis, PhD, Department of Psychology, Ateneo de Manila University, Port Charlotte, Florida

Jennifer R. Fanning, PhD, Department of Psychiatry and Behavioral Science, Pritzker School of Medicine, University of Chicago, Chicago, Illinois

Peter Fonagy, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom

John G. Gunderson, MD, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts

Michael N. Hallquist, PhD, Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania

Julie Harrison, PhD, Harrison Psychological Consultations, Indianapolis, Indiana

André M. Ivanoff, PhD, School of Social Work, Columbia University, New York, New York

Kerry L. Jang, PhD, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada

Carsten René Jørgensen, PhD, Department of Psychology, Aarhus University, Aarhus, Denmark

Christie Pugh Karpiak, PhD, Department of Psychology, University of Scranton, Scranton, Pennsylvania

Stephen Kellett, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield, United Kingdom

Robert F. Krueger, PhD, Department of Psychology, University of Minnesota, Minneapolis, Minnesota

Roseann M. Larstone, PhD, Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada

Mark F. Lenzenweger, PhD, Department of Psychology, State University of New York at Binghamton, Binghamton, New York; Department of Psychiatry, Weill Cornell Medical College, New York, New York

Kenneth N. Levy, PhD, Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania

Marsha M. Linehan, PhD, ABPP, Department of Psychology, University of Washington, Seattle, Washington

W. John Livesley, MD, PhD, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada

Jill Lobbestael, PhD, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands

Patrick Luyten, PhD, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium; Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom

Paul Markovitz, MD, PhD, Interventional Psychiatric Associates, Santa Barbara, California

Birgit Bork Mathiesen, PhD, Department of Psychology, University of Copenhagen, Copenhagen, Denmark

Kevin B. Meehan, PhD, Department of Psychology, Long Island University, Brooklyn, New York

Robert Mestel, PhD, Helios Clinics, Berlin, Germany

Theodore Millon, PhD (deceased), Institute for Advanced Studies in Personology

and Psychopathology, Port Jervis, New York

Marlene M. Moretti, PhD, Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada

Leslie Morey, PhD, Department of Psychology, Texas A&M University, College Station, Texas

Theresa A. Morgan, PhD, Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island

Roger T. Mulder, MD, PhD, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand

Morgan R. Negrón, MA, Department of Psychology, University of Notre Dame, Notre Dame, Indiana

Shani Ofrat, PhD, Department of Psychology, University of Minnesota, Minneapolis, Minnesota

Lacy A. Olson-Ayala, PhD, VA Greater Los Angeles Healthcare System, Los Angeles, California

Joel Paris, MD, Department of Psychiatry, McGill University and Jewish General Hospital, Montreal, Quebec, Canada

Christopher J. Patrick, PhD, Department of Psychology, Florida State University, Tallahassee, Florida

Anthony Pinto, PhD, Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and Zucker Hillside Hospital, Glen Oaks, New York

Maria Elena Ridolfi, MD, Fano Department of Mental Health, Fano, Italy

Clive J. Robins, PhD, ABPP, ACT, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina

Anthony C. Ruocco, PhD, Department of Psychology, University of Toronto, Toronto, Ontario, Canada

Anthony Ryle, DM, FRCPsych (deceased), St. Thomas’ Hospital, London, United Kingdom

Maria Cristina Samaco-Zamora, PhD, Department of Psychology, University of San Francisco, San Francisco, California

Jaime L. Shapiro, MA, Department of Psychology, University of Notre Dame, Notre Dame, Indiana

Rebecca L. Shiner, PhD, Department of Psychology, Colgate University, Hamilton, New York

Merav H. Silverman, MA, Department of Psychology, University of Minnesota, Minneapolis, Minnesota

Erik Simonsen, MD, Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

Andrew E. Skodol, MD, Department of Psychiatry, College of Medicine, University of Arizona, Tucson, Arizona

Tracey Leone Smith, PhD, Center for Innovations in Quality and Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas

Paul H. Soloff, MD, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

Don St. John, MA, PA-C, Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa

Jennifer L. Tackett, PhD, Department of Psychology, Northwestern University, Evanston, Illinois

Katherine N. Thompson, PhD, Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia

Marianne Skovgaard Thomsen, PhD, Department of Psychology, University of Copenhagen, Copenhagen, Denmark

Emily N. Vanderbleek, MA, Department of Psychology, University of Notre Dame, Notre Dame, Indiana

Philip A. Vernon, PhD, Department of Psychology, Western University, London, Ontario, Canada

Michael G. Wheaton, PhD, Department of Psychology, Barnard College, New York, New York

Thomas A. Widiger, PhD, Department of Psychology, University of Kentucky, Lexington, Kentucky

Stephen C. P. Wong, PhD, Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

Aidan G. C. Wright, PhD, Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania

Noga Zerubavel, PhD, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina

Mark Zimmerman, MD, Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island

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Audience

Clinical psychologists, psychiatrists, clinical social workers, counselors, and psychiatric nurses.

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Course Use

May serve as a text in graduate-level courses in personality disorders.

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New to this edition:

• Incorporates more than 15 years of major research advances; includes 21 chapters on new topics.
• Critically examines DSM-5 diagnostic criteria.
• Chapters on additional treatments—mentalization-basedtreatment, schema-focused therapy, transference-based psychotherapy, and systems training for emotional predictability and problem solving.
• Chapters on dimensional models, longitudinal studies, and personality pathology in children and adolescents.
• Chapters on specific diagnoses: antisocial/psychopathic, borderline, and obsessive–compulsive personality disorder.
• Integrative section introductions by the editors.