Initial construction of a maladaptive personality trait model and inventory for DSM-5

Department of Psychology, University of Minnesota, Minneapolis, MN 55455, USA.
Psychological Medicine (Impact Factor: 5.43). 12/2011; 42(9):1879-90. DOI: 10.1017/S0033291711002674
Source: PubMed

ABSTRACT DSM-IV-TR suggests that clinicians should assess clinically relevant personality traits that do not necessarily constitute a formal personality disorder (PD), and should note these traits on Axis II, but DSM-IV-TR does not provide a trait model to guide the clinician. Our goal was to provide a provisional trait model and a preliminary corresponding assessment instrument, in our roles as members of the DSM-5 Personality and Personality Disorders Workgroup and workgroup advisors.
An initial list of specific traits and domains (broader groups of traits) was derived from DSM-5 literature reviews and workgroup deliberations, with a focus on capturing maladaptive personality characteristics deemed clinically salient, including those related to the criteria for DSM-IV-TR PDs. The model and instrument were then developed iteratively using data from community samples of treatment-seeking participants. The analytic approach relied on tools of modern psychometrics (e.g. item response theory models).
A total of 25 reliably measured core elements of personality description emerged that, together, delineate five broad domains of maladaptive personality variation: negative affect, detachment, antagonism, disinhibition, and psychoticism.
We developed a maladaptive personality trait model and corresponding instrument as a step on the path toward helping users of DSM-5 assess traits that may or may not constitute a formal PD. The inventory we developed is reprinted in its entirety in the Supplementary online material, with the goal of encouraging additional refinement and development by other investigators prior to the finalization of DSM-5. Continuing discussion should focus on various options for integrating personality traits into DSM-5.

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    • "were asked to rate how accurately each of the items of the PID-5 described them using scales that ranged from 0 (very false or often false) to 3 (very true or often true). The PID-5 has been found to possess adequate psychometric properties in previous studies (e.g., Krueger et al., 2012). "
    • "Turkheimer, Ford, & Oltmanns, 2008). From our perspective, this work is an excellent example of how an increasingly integrative understanding of the place of the borderline construct in the general structure of personality of the DSM-5 Alternative Model [Krueger et al., 2012]). Despite the value of these lower order elements of personality for descriptive and predictive purposes (Krueger & Eaton, 2010; Leising & Zimmermann, 2011), in this article we focus primarily on broad trait domains as organizing rubrics. "
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