Integrating Normal and Abnormal Personality Structure: A Proposal for DSM-V

Department of Psychology, University of Kentucky, USA.
Journal of personality disorders (Impact Factor: 3.08). 06/2011; 25(3):338-63. DOI: 10.1521/pedi.2011.25.3.338
Source: PubMed


The personality disorders section of the American Psychiatric Association's fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is currently being developed. The purpose of the current paper is to encourage the authors of DSM-V to integrate normal and abnormal personality structure within a common, integrative model, and to suggest that the optimal choice for such an integration would be the five-factor model (FFM) of general personality structure. A proposal for the classification of personality disorder from the perspective of the FFM is provided. Discussed as well are implications and issues associated with an FFM of personality disorder, including validity, coverage, feasibility, clinical utility, and treatment implications.

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    • "In addition, faceted personality trait measures have not been examined in patient samples with the IIP, leaving open questions regarding range-restriction and generalizability. Furthermore, normal-range lower-order traits (i.e., facets) relevant to recent PD model proposals (e.g., Widiger, 2011) have not been examined with the IIP in any sample. Thus, an important step forward would be to examine how currently prominent PD models relate to the IIP in a patient sample. "
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    ABSTRACT: Interpersonal dysfunction is a defining feature of personality disorders (PDs) and can serve as a criterion for comparing PD models. In this study, the interpersonal coverage of 4 competing PD models was examined using a sample of 628 current or recent psychiatric patients who completed the NEO Personality Inventory-3 First Half (NEO-PI-3FH; McCrae & Costa, 2007), Personality Inventory for the DSM-5 (PID-5; Krueger et al., 2012), Computerized Adaptive Test of Personality Disorder-Static Form (CAT-PD-SF; Simms et al., 2011), and Structured Clinical Interview for DSM-IV Personality Questionnaire (SCID-II PQ; First, Spitzer, Gibbon, & Williams, 1995). Participants also completed the Inventory of Interpersonal Problems-Short Circumplex (IIP-SC; Soldz, Budman, Demby, & Merry, 1995) to assess interpersonal dysfunction. Analyses compared the severity and style of interpersonal problems that characterize PD models. Previous research with DSM-5 Section II and III models was generally replicated. Extraversion and Agreeableness facets related to the most well defined interpersonal problems across normal-range and pathological traits. Pathological trait models provided more coverage of dominance problems, whereas normal-range traits covered nonassertiveness better. These results suggest that more work may be needed to reconcile descriptions of personality pathology at the level of specific constructs. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Personality Disorders: Theory, Research, and Treatment 07/2015; DOI:10.1037/per0000140 · 3.54 Impact Factor
    • "Although a categorical model for personality disorder diagnoses was retained in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; American Psychiatric Association, 2013), a dimensional trait model was added to Section III for further empirical study, including traits of negative affectivity, antagonism, detachment, compulsivity, and psychoticism. Cate gorical models of personality disorders are problematic in that diagnostic thresholds are relatively arbitrary, and that they result in excessive comorbidity and heterogeneity of symptoms within disorders (Widiger, 2011). Dimensional models of personality pathology do not introduce these problems, and they have the added advantage of allowing for the integration of models of normal and pathological personality (Krueger, 2005). "
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    ABSTRACT: To investigate validity of the dimensions that underlie pathological personality in adolescence, we delineated the hierarchical structure of the Dimensional Assessment of Personality Pathology-Short Form-Adolescent version (DAPP-SF-A; Tromp & Koot, 2008) and examined longitudinal associations with Big Five personality dimensions assessed four times from middle childhood to late adolescence. A total of 426 adolescents provided self-reports on the DAPP-SF-A (age M = 18.6, SD = 1.17; 53% female). Mothers provided information on their child's personality eleven, eight, five, and three years earlier. Previous findings on the hierarchical structure of the DAPP-BQ replicated up to the four-component solution (emotional dysregulation, dissocial behavior, inhibition, and compulsivity). In the solution, a thought disturbance component emerged. Interestingly, the five-component solution already showed most differentiated associations with childhood personality in middle childhood. Childhood personality dimensions predicted four out of five adolescent pathological personality traits, indicating continuity of normal and abnormal personality across childhood and adolescence.
    Journal of personality disorders 04/2015; DOI:10.1521/pedi_2015_29_190 · 3.08 Impact Factor
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    • "Before the description of The Personality Inventory for DSM-5 (PID-5), there were many dimensional models of personality; some focused more on the characterization of normal personalities, whereas others were based on a dimensional reorganization of the diagnostic criteria for personality disorders. However, most of these models could be readily integrated within a common hierarchical structure [7]. The Temperament and Character Inventory (TCI) [8] is based on a psychobiological model with four temperament dimensions, including novelty seeking (NS), harm avoidance (HA), reward dependence (RD), and persistence (P), and three character dimensions, which are self-directedness (SD), cooperativeness (C), and self-transcendence (ST). "
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    ABSTRACT: Background Personality traits and schizophrenia present gender differences; however, gender has not been considered in most studies on personality and schizophrenia. This study aims to identify the different personality dimensions of schizophrenia patients and healthy control subjects by gender and to explore the relationship between personality dimensions and illness severity variables by analyzing data for males and females separately. Methods Temperament and Character Inventory-Revised dimensions were compared by gender between 161 schizophrenia patients and 214 healthy controls from a population-based sample using independent t-tests. We then investigated whether personality dimensions are related to illness severity variables using correlation analyses and bivariate logistic regression, also by gender. Results The patients had significantly higher scores for harm avoidance (HA) and self-transcendence (ST) and lower scores for reward dependence (RD), cooperativeness (C), and self-directedness (SD) than the controls. Similar results were obtained when the sample was stratified by gender, however the differences were higher and more significant for HA among males and for RD among females. The number of admissions to a psychiatric hospital positively correlated with novelty seeking (NS) in males and negatively with SD in females. In males, SD and ST negatively correlated with the number of suicide attempts. Conclusions Male and female patients present difficulties for regulating and adapting behavior to achieve goals (SD) and for identifying and accepting others (C), as well as a great sense of spirituality and universe identification (ST). However, male patients are more characterized by being fearful, doubtful and easily fatigued (HA), while female patients are characterized by presenting difficulties maintaining and pursuing associated reward behaviors (RD). Furthermore, male and female patients who are frequently admitted to psychiatric hospitals and male patients who attempt suicide should be evaluated regarding their personality dimensions. Future studies assessing the relationship between personality dimensions and the clinical features of schizophrenia should consider gender differences.
    BMC Psychiatry 05/2014; 14(1):151. DOI:10.1186/1471-244X-14-151 · 2.21 Impact Factor
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