generalized subtypes and avoidant personality disorder. Journal of Abnormal Psychology, 102, 326-331. Widiger, T. A. (1989). The categorical distinction between personality and affective disorders. Journal of Personality Disorders, 3, 77-91. Widiger, T. A. (in press). Categorical versus dimensional classification: Implications from and for research.(Journal of Personality Disorders) Page 7 of 710/8/2000http://spider.apa.org/ftdocs/abn/1992/may/abn1012340.htmldiagnostic criteria, or some combination of these. It may be the case, for example, that the APD and GSP symptomatology assessed in the three studies was not in fact characteristic of long-term functioning. Both could have been sequelae of an earlier, more specific social phobia. It may still be meaningful to diagnose the person at the current time with a late-onset APD or GSP, but until subjects are followed across time, the interaction and course of Axis I GSP and Axis II APD will remain ambiguous. Cross-sectional research that may be informative will be epidemiologic studies that sample a sufficiently large number of subjects across a fully representative and comprehensive domain of interpersonal functioning to allow for the use of various taxometric techniques that assess whether there are in fact distinct breaks in the distribution of scores ( Widiger, in press ). There may be a qualitative distinction between APD and GSP that is difficult to identify with a limited number of subjects obtained from only a narrowly confined range of dysfunction. Differences between APD and GSP may become more apparent when the full range of functioning is represented. It is likely, however, that this research will only confirm the findings of Herbert et al., Holt et al., and Turner et al. that GSP and APD are overlapping constructs that have only minor differences with respect to the severity of dysfunction. References Alden, L. (1989). Short-term structured treatment for avoidant personality disorder. Journal of Consulting and Clinical Psychology, 57, 756-764. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed).(Washington, DC: Author) American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (Rev. 3rd ed.).(Washington, DC: Author) Carson, R. C. (1991). Dilemmas in the pathway of the DSM-IV . Journal of Abnormal Psychology, 100, 302-307. Frances, A. J., Pincus, H. A., Widiger, T. A., Davis, W. W. & First, M. B. (1990). DSM-IV : Work in progress. American Journal of Psychiatry, 147, 1439-1448. Gorton, G. & Akhtar, S. (1990). The literature on personality disorders, 1985—1988: Trends, issues, and controversies. Hospital and Community Psychiatry, 41, 39-51. Gunderson, J. G. & Phillips, K. A. (1991). A current view of the interface between borderline personality disorder and depression. American Journal of Psychiatry, 148, 967-975. Heimberg, R. G., Holt, C. S., Schneier, F. R., Spitzer, R. L. & Liebowitz, M. R. (1991). The issue of subtypes in the diagnosis of social phobia .(Manuscript submitted for publication) Herbert, J. D., Hope, D. A. & Bellack, A. S. (1992). Validity of the distinction between generalized social phobia and avoidant personality disorder. Journal of Abnormal Psychology, 102, 332-339. Holt, C. S., Heimberg, R. G. & Hope, D. A. (1992). Avoidant personality disorder and the generalized subtype in social phobia. Journal of Abnormal Psychology, 102, 318-325. Loranger, A. W. (1988). Personality Disorder Examination (PDE) manual .(Yonkers, NY: D. V. Communications) McCrae, R. R. & Costa, P. T. (1990). Personality in adulthood .(New York: Guilford Press) Perry, J. C. (1990). Challenges in validating personality disorders: Beyond description. Journal of Personality Disorders, 4, 273-289. Pilkonis, P. A. (1984). Avoidant and schizoid personality disorders.(In H. E. Adams & P. B. Sutker (Eds.), Comprehensive handbook of psychopathology (pp. 479—494). New York: Plenum Press.) Turner, S. M., Beidel, D. C., Dancu, C. V. & Keys, D. J. (1986). Psychopathology of social phobia and comparison to avoidant personality disorder. Journal of Abnormal Psychology, 95, 389-394. Turner, S. M., Beidel, D. C. & Townsley, R. M. (1992). Social phobia: A comparison of specific and Page 6 of 710/8/2000http://spider.apa.org/ftdocs/abn/1992/may/abn1012340.htmlthree studies as indicating that GSP is a less severe variant of APD. This perspective would have been more apparent if the studies had been conducted by personality disorder researchers in a general outpatient clinic with the schizoid and dependent personality disorders, rather than a discrete social phobia, for comparison groups. To the extent that GSP involves a chronic and pervasive fear of most social situations (such as dating, parties, and talking to co-workers; Holt et al., 1992 ) that has been evident since late childhood or early adolescence ( American Psychiatric Association, 1987 , pp. 242), it is by definition a personality disorder ( American Psychiatric Association, 1987 , pp. 16, 335). The fundamental personality trait of neuroticism includes a facet of trait anxiety, and persons who have always been excessively aloof, reserved, inhibited, shy, and avoidant across most social situations are said to be introverted by personality researchers ( McCrae & Costa, 1990 ). These persons do have clinically significant avoidant behavior that is responsive to cognitive, behavioral, and pharmacologic treatment, but that is not inconsistent with most theories of personality functioning (e.g., Alden, 1989 ; Pilkonis, 1984 ). However, subsuming GSP within Axis II APD may be equally as misleading as subsuming APD within GSP. GSP and APD are disorders in which anxious and avoidant behaviors predominate. Anxiety and personality are not mutually exclusive constructs, and the need to differentiate them is to some extent a procrustean artifact of the DSM—III—R categorical nosology. It may then be preferable to classify GSP-APD on both Axis I and Axis II to emphasize that in these cases the distinction between an anxiety disorder and a personality disorder is less meaningful and clinically useful than recognizing that one is dealing with a boundary condition that includes features of both an anxiety and a personality disorder. An even more radical proposal is to abandon the anxiety and personality categorical distinctions altogether and simply rate a patient on the degree to which
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