Inconsistencies in Paranoid Functioning, Premorbid Adjustment, and Chronicity: Question of Diagnostic Criteria

Despite the widely held belief that paranoid behavior is associated with good premorbid adjustment, low chronicity, and high current functioning in psychiatric inpatients, inconsistencies in the literature suggest that supportive evidence may be an artifact of the measurement model commonly used to...

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Bibliographic Details
Published in:Schizophrenia bulletin 1988, Vol.14 (2), p.323-336
Main Authors: Sorensen, Donna J., Paul, Gordon L., Mariotto, Marco J.
Format: Article
Language:English
Subjects:
Adjustment
Adolescent
Adult
Aged
Chronic Disease
Chronicity (Disorders)
Diagnosis
Diagnostic Criteria
Female
Hospitals, Psychiatric
Human
Humans
Male
Middle Aged
Paranoid Psychosis
Premorbidity
Prognosis
Psychiatric Status Rating Scales
Schizophrenia, Paranoid - diagnosis
Schizophrenia, Paranoid - psychology
Social Adjustment
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Summary:Despite the widely held belief that paranoid behavior is associated with good premorbid adjustment, low chronicity, and high current functioning in psychiatric inpatients, inconsistencies in the literature suggest that supportive evidence may be an artifact of the measurement model commonly used to index paranoid status. In a sample of 497 nonorganic inpatients selected from 19 treatment units, paranoid behavior, when measured by a dimensional/cumulative model, was not found to indicate higher functioning and associated relationships, but simply to reflect a narrower class of problem behavior. Only when paranoid status was defined using a traditional model based on the predominance of the defining class of behavior did paranoid subjects demonstrate better premorbid adjustment, lower chronicity, and higher levels of functioning than nonparanoid subjects. Serious problems exist in the use of information obtained from traditional predominance/class models for either theoretical or practical purposes.
ISSN:0586-7614
1745-1701
DOI:10.1093/schbul/14.2.323