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Running Head: CLINICIANS’ JUDGMENTS OF CLINICAL UTILITY - page 29 / 41

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fantasies. He is said to have struggled during this time with constraining these impulses, trying to control and suppress them, but at other times using alcohol as a means with which to disinhibit his constraint. There are also reports that Ted, as an adult, engaged in necrophilic behavior with some of his victims’ corpses (Rule, 2001). Serial rape and murder are not inherent to an antisocial personality disorder, and perhaps Ted should also be diagnosed with a paraphilia on Axis I. Ted’s final acts of sexual sadism were in fact more extreme and dyscontrolled than the vast majority that had preceded them (e.g., the rape and murder of a 12 year-old girl and the bloody slayings of four female college students within a sorority house).  In that respect, the last few murders could even be said to be “out of character” for Ted, as they were more impulsive and poorly planned.

Limitations and Future Research

The results of the current study support the potential clinical utility of the FFM relative to the existing DSM-IV categories, even when the latter are rated dimensionally. The higher ratings obtained for the FFM by experienced clinicians who were well familiar with the DSM-IV nomenclature were replicated across three different case vignettes that summarized the life histories of actual persons who had clinically significant personality disorder symptomatology.

A potential limitation of the current study was that the assessment of clinical utility relied solely on the opinions of clinicians. The subjective opinions of experienced clinicians who are actively engaged in applied practice do provide relevant information concerning clinical utility, particularly with respect to concerns regarding user acceptability (First et al., 2004; Rounsaville et al., 2002). Nevertheless, it is possible that the FFM would in fact be less useful in

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