Personality Disorder
Personality disorder remains a research subject in relative infancy, and we need to know more about its classification, underlying biological and psychological substrates, relationship to other mental disorders and its impact upon them, and its treatment. Each of these is being addressed in our research strategy. The classification of personality disorder and its validity is moving into a critical phase, with new evidence from clinical and neurocognitive studies that borderline personality disorder is a separate entity with more of the characteristics of a clinical syndrome. The long-term impact of personality on outcome of common mental disorders is continuing in a project that will be completed in 2012 (Nottingham Study of Neurotic Disorder) and a recent systematic review has confirmed the main findings. The assessment and treatment of personality disorder is a major area of research, and evaluations are being carried out of psychological treatment in borderline personality disorder and of a new treatment, nidotherapy (the systematic manipulation of the physical and social environment to help achieve a better fit for a person with a persistent or permanent mental disorder). Other work is being planned on the epidemiology of personality disorder and two national surveys have recently been completed.
In the last five years, personality disorder has achieved greater prominence in the research literature and policy development, partly reflecting Government concern over public protection. Given our long-standing interest in personality disorder, we have taken this opportunity to expand our research base. For example, we have taken advantage of the investment in services for Dangerous and Severe Personality Disorder (DSPD). A member of our department is the clinical leader of one high secure service and leads the ongoing national cohort study, involving all four UK high DSPD services treating and outcome in patients with high and low psychopathy scores. Other members of the department led an early evaluation of standardised assessment in DSPD, and we are leading on a national evaluation of general adult community services for people with personality disorder, and a multi-method evaluation of services for people with DPSD.
We are also developing, in conjunction with the Universities of Iowa (USA) and Otago (New Zealand), a new method of assessing personality from documentary evidence, as there is increasing awareness that interview information alone is not adequate.
