Initial construction of a maladaptive personality trait model and inventory for DSM-5.
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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ABSTRACT: Purpose Classification is the cornerstone of clinical diagnostic practice and research. However, the extant psychiatric classification systems are not well supported by research evidence. In particular, extensive comorbidity among putatively distinct disorders flags an urgent need for fundamental changes in how we conceptualize psychopathology. Over the past decade, research has coalesced on an empirically based model that suggests many common mental disorders are structured according to two correlated latent dimensions: internalizing and externalizing. Methods We review and discuss the development of a dimensional-spectrum model which organizes mental disorders in an empirically based manner. We also touch upon changes in the DSM-5 and put forward recommendations for future research endeavors. Results Our review highlights substantial empirical support for the empirically based internalizing–externalizing model of psychopathology, which provides a parsimonious means of addressing comorbidity. Conclusions As future research goals, we suggest that the field would benefit from: expanding the meta-structure of psychopathology to include additional disorders, development of empirically based thresholds, inclusion of a developmental perspective, and intertwining genomic and neuroscience dimensions with the empirical structure of psychopathology.Social Psychiatry and Psychiatric Epidemiology 01/2015; · 2.58 Impact Factor
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ABSTRACT: Empirical research focusing on personality disorders (PDs) among older adults is mainly limited to studies on psychometric properties of age-specific personality tests, the age neutrality of specific items/scales, and validation of personality inventories for older adults. We identified only two treatment studies-one on dialectical behavior therapy and one on schema therapy-both with promising results among older patients despite small and heterogeneous populations. More rigorous studies incorporating age-specific adaptations are needed. Furthermore, in contrast to increasing numbers of psychometric studies, the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 pays little attention to the characteristics of older adults with PDs. Moreover, the constructs "personality change due to another medical condition" and "late-onset personality disorder" warrant further research among older adults. These needs will become even more pressing given the aging society worldwide.Current Psychiatry Reports 01/2015; 17(1):538. · 3.05 Impact Factor
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ABSTRACT: Psychopathy is conceptualized by the triarchic model as encompassing 3 distinct phenotypic constructs: boldness, meanness, and disinhibition. In the current study, the Multidimensional Personality Questionnaire (MPQ), a normal-range personality measure, was evaluated for representation of these 3 constructs. Consensus ratings were used to identify MPQ items most related to each triarchic (Tri) construct. Scale measures were developed from items indicative of each construct, and scores for these scales were evaluated for convergent and discriminant validity in community (N = 176) and incarcerated samples (N = 240). Across the 2 samples, MPQ-Tri scale scores demonstrated good internal consistencies and relationships with criterion measures of various types consistent with predictions based on the triarchic model. Findings are discussed in terms of their implications for further investigation of the triarchic model constructs in preexisting datasets that include the MPQ, in particular longitudinal and genetically informative datasets. (PsycINFO Database Record (c) 2015 APA, all rights reserved)Psychological Assessment. 02/2015;