Leonard J Simms

• PhD Clinical Psychology
• Professor at University at Buffalo, State University of New York

Psychological functioning is shaped by how people navigate their environment. Accordingly, psychopathology is often caused and maintained by patterns of responding to the environment that do not meet situational demands. In particular, psychopathology is often expressed in an inflexible or intense manner of coping with stressful situations. Prior r...

Traditional personality disorders (PDs; e.g., Diagnostic and Statistical Manual of Mental Disorders, fifth edition [DSM-5] Section II PDs), as well as dimensional traits (e.g., alternative model for PD [AMPD]), offer unique advantages in personality pathology assessment. However, very little is known about how these systems compare in predicting ob...

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a nosology that aims to improve upon traditional diagnostic systems by conceptualizing psychopathology dimensionally and hierarchically. A major unanswered question about HiTOP is whether and how the system can be used effectively in clinical practice. The current study reports the efficacy of...

This Viewpoint paper argues for a peer trade-off model of personality disorder (PD) traits during adolescence that allows for both positive (e.g., popularity, peer acceptance) and negative (e.g., peer rejection, peer victimization, peer exclusion) peer outcomes. The need for new interpersonal (dsy)function models of PD traits during adolescence is...

Aktuelle Klassifikationssysteme für psychische Störungen wie das DSM-5 und ICD-11 stehen zunehmend in der Kritik, die Komplexität psychischer Probleme nicht adäquat abzubilden. Ungünstig sind insbesondere die implizite Orientierung am medizinischen Krankheitsmodell, die mangelnde strukturelle Validität sowie die kategoriale Abgrenzung zu psychische...

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a dimensional framework for psychopathology advanced by a consortium of nosologists. In the HiTOP system, psychopathology is grouped hierarchically from super-spectra, spectra, and subfactors at the upper levels to homogeneous symptom components and maladaptive traits and their constituent sym...

Psychological functioning is shaped by how people navigate their environment. Accordingly, psychopathology is often caused and maintained by patterns of responding to the environment that do not meet situational demands. In particular, psychopathology is often expressed in an inflexible or intense manner of coping with stressful situations. Prior r...

Background/Objective The Alternative Model for Personality Disorders (AMPD) within the DSM‐5 includes separable components representing general personality dysfunction (Criterion A) and maladaptive personality traits (Criterion B). Some critique Criterion A for accounting for little incremental variance in PD beyond Criterion B. However, Morey et a...

This chapter describes the collaborative process that is underway to develop measures for the Hierarchical Taxonomy of Psychopathology (HiTOP). Research utility and clinical translation of the model require measures that are keyed to the model. The Measures Development Workgroup of HiTOP is developing both questionnaire and interview methods that (...

Two primary limitations of research on the association between adverse childhood experiences (ACEs) and personality disorder (PD) are (1) failure to consider mechanisms of association and (2) inconsistent results due, in part, to inconsistent approaches to quantifying ACE exposure. The current study will address these limitations by examining the c...

Age and gender differences in narcissism have been studied often. However, considering the rich history of narcissism research accompanied by its diverging conceptualizations, little is known about age and gender differences across various narcissism measures. The present study investigated age and gender differences and their interactions across e...

Age and gender differences in narcissism have been studied often. However, considering the rich history of narcissism research accompanied by its diverging conceptualizations, little is known about age and gender differences across various narcissism measures. The present study investigated age and gender differences and their interactions across e...

Personality pathology is increasingly conceptualized within hierarchical, dimensional trait models. The Comprehensive Assessment of Traits Relevant to Personality Disorders (CAT-PD) is a pathological-trait measure with potential to improve on currently prevailing instruments because it has wider content coverage; however, its domain-level structure...

We examine fear and anxiety in the context of structural models of personality (the five-factor model, or FFM) and psychopathology (the Hierarchical Taxonomy of Psychopathology, or HiTOP); we also highlight important issues related to their assessment. Anxiety is a sustained, future-oriented response to potential threat. Trait measures of anxiety r...

The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research...

The introduction of the alternative model of personality disorders in the fifth edition of the Diagnostic and Statistical Model of Mental Disorders (American Psychiatric Association, 2013) represented a substantive change in how personality disorders (PDs) are diagnosed. One barrier to its adoption (among several) in clinical practice, however, is...

Facial emotion recognition (FER) tasks are often digitally altered to vary expression intensity; however, such tasks have unknown psychometric properties. In these studies, an FER task was developed and validated—the Graded Emotional Face Task (GEFT)—which provided an opportunity to examine the psychometric properties of such tasks. Facial expressi...

The Hierarchical Taxonomy of Psychopathology (HiTOP) represents a new way of classifying mental illness that is based on quantitative research investigating how signs and symptoms naturally co-occur across individuals. This model is dimensional and hierarchical, giving it an advantage over the limitations of traditional classification systems, such...

College students are at heightened risk of engaging in unhealthy alcohol use that leads to negative consequences (e.g., motor vehicle accidents, poor academic performance). Understanding how individual differences, such as maladaptive personality traits, contribute to that risk could improve intervention efforts. A potential pathway through which p...

Overprotection is a known risk factor in parent-child relationships, but has received little attention in the context of friendships. No studies have examined overprotection in emerging-adult friendships. Yet, overprotection may be especially significant during this developmental period given the prevalence of autonomy-seeking and risk-taking behav...

The introduction of the Alternative Model of Personality Disorders (AMPD) in the fifth edition of the Diagnostic and Statistical Model of Mental Disorders (DSM-5, APA, 2013) represented a substantive change in how personality disorders (PDs) are diagnosed. One barrier to its adoption (among several) in clinical practice, however, is a lack of infor...

This commentary discusses questions and misconceptions about HiTOP raised by Haeffel et al. (2021). We explain what the system classifies and why it is descriptive and atheoretical, highlighting benefits and limitations of this approach. We clarify why the system is organized according to patterns of covariation or comorbidity among signs and sympt...

In this commentary, we discuss questions and misconceptions about the Hierarchical Taxonomy of Psychopathology (HiTOP) raised by Haeffel et al. We explain what the system classifies and why it is descriptive and atheoretical, and we highlight benefits and limitations of this approach. We clarify why the system is organized according to patterns of...

Narrative coherence serves as an index of the unity in an individual's sense of self-integrating their past self with their present self and allowing them to pursue meaningful goals for their future. It has been assessed using the Life Story Interview. Personality functioning is used to describe an individual's ability to develop stable and integra...

Personality pathology is increasingly conceptualized within hierarchical, dimensional trait models. The Comprehensive Assessment of Traits Relevant to Personality Disorders (CAT-PD) is a measure of pathological traits with wider coverage than prevailing instruments—however, its domain-level structure is not established. In this pre-registered study...

College students are at heightened risk of engaging in unhealthy alcohol use that leads to negative consequences (e.g., motor vehicle accidents, poor academic performance). Understanding how individual differences, like maladaptive personality traits, contribute to that risk could improve intervention efforts. A potential pathway through which pers...

In this article, we describe the collaborative process that is underway to develop measures for the Hierarchical Taxonomy of Psychopathology (HiTOP). The HiTOP model has generated much interest in the psychiatric literature in recent years, but research applications and clinical translation of the model require measures that are specifically keyed...

Generations of psychologists have been taught that mental disorder can be carved into discrete categories, each qualitatively different from the others and from normality. This model is now outdated. A preponderance of evidence indicates that (a) individual differences in mental health (health vs. illness) are a matter of degree, not kind, and (b)...

Traditional diagnostic systems went beyond empirical evidence on the structure of mental health. Consequently, these diagnoses do not depict psychopathology accurately, and their validity in research and utility in clinical practice are therefore limited. The Hierarchical Taxonomy of Psychopathology (HiTOP) consortium proposed a model based on stru...

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is ge...

Using multilevel structural equation modeling, the authors examined within- and between-person predictors of daily impulsivity, with a particular focus on testing a cascade model of affect and daily stress in a 100-day daily diary study of 101 psychiatric patients with personality disorder diagnoses. On average (i.e., fixed effect), within-person i...

Structural models of mental illness delineate the major phenotypic dimensions of psychopathology. These evidence‐based models, such as the Hierarchical Taxonomy of Psychopathology, are poised to supplement—and even supplant—categorical diagnostic systems in research, assessment and treatment arenas. This special issue of Personality and Mental Heal...

The purpose of this chapter is to review the current state of the dimensional assessment of personality disorder (PD). The first part of the chapter serves as a review of the most well-established and commonly used measures of maladaptive personality traits. Measures that assess the psychosocial impairment associated with personality pathology also...

Objective: Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alte...

This article introduces the rationale for developing a special issue on methodological and statistical advancements in clinical assessment, which will appear approximately 25 years after a similar 1995 issue that produced many seminal and highly cited articles. We commissioned articles from a range of expert scholars in important areas of psychomet...

Background An ongoing challenge in understanding and treating personality disorders (PDs) is a significant heterogeneity in disorder expression, stemming from variability in underlying dynamic processes. These processes are commonly discussed in clinical settings, but are rarely empirically studied due to their personalized, temporal nature. The go...

Background: An ongoing challenge in understanding and treating personality disorders (PDs) issignificant heterogeneity in disorder expression, stemming from variability in underlying dynamic processes. These processes are commonly discussed in clinical settings, but are rarely empirically studied due to their personalized, temporal nature. The goal...

Using multilevel structural equation modeling, we examined within- and between-person predictors of daily impulsivity, with a particular focus on testing a cascade model of affect and daily stress in a 100-day daily diary study of 101 psychiatric patients with personality disorder diagnoses. On average (i.e., fixed effect), within-person increases...

Pathological narcissism involves maladaptive efforts to regulate the self and is conceptualized by 2 key features: narcissistic grandiosity and narcissistic vulnerability. Prior research has found that narcissism is associated with poorer functioning over the long term, especially interpersonal functioning. Despite this, the specific contributions...

Personality and its assessment are growth areas in the psychological literature and are important in applied practice. In the decades since personality re-emerged as a viable scientific construct following the person-situation debate, we have learned much about the nature and full breadth of personality traits as well as refined methods for the ass...

Psychological tests typically include a response scale whose purpose it is to organize and constrain the options available to respondents and facilitate scoring. One such response scale is the Likert scale, which initially was introduced to have a specific 5-point form. In practice, such scales have varied considerably in the nature and number of r...

In this chapter, we review the current state of personality disorder (PD) assessment practices. The review includes both traditional measures that are rooted in categorical conceptualizations of PD and dimensional measures that have emerged in response to mounting evidence that has called into question the validity of traditional PD classification...

The underlying structure of self-harm behaviors is not well-understood; for example, whether suicidality and nonsuicidal self-injury (NSSI) lie on a single dimension or two separate dimensions is unknown. We used confirmatory factor analyses to examine the factor structure of self-harm items in a clinical/community sample ( N = 641). Of three alter...

Introduction: Assessment of withdrawal symptoms, treatment mechanisms, and side effects is central to understanding and improving smoking cessation interventions. Though each domain is typically assessed separately with widely used questionnaires to separately assess each domain (eg, Minnesota Nicotine Withdrawal Scale = withdrawal; Questionnaire o...

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is ge...

Although adult personality is usually assessed via self-report, knowledgeable informants provide useful information on others’ traits. While self-informant agreement on personality is highest among spouses, agreement varies across couples, potentially moderated by relationship satisfaction. It remains unclear whether relationship satisfaction impac...

We investigated the latent structure of narcissistic personality disorder by comparing dimensional, hybrid, and categorical latent variable models, using confirmatory factor analysis (CFA), nonparametric and semiparametric factor analysis, and latent class analysis, respectively. We first explored these models in a clinical sample and then preregis...

The latent structure of schizotypy and psychosis-spectrum symptoms remains poorly understood. Furthermore, molecular genetic substrates are poorly defined, largely due to the substantial resources required to collect rich phenotypic data across diverse populations. Sample sizes of phenotypic studies are often insufficient for advanced structural eq...

FULL PREPRINT LINK: https://psyarxiv.com/tv7r9/ We investigated the latent structure of narcissistic personality disorder (NPD) by comparing dimensional, hybrid, and categorical latent variable models, using confirmatory factor analysis (CFA), non-parametric (NP-FA) and semi-parametric factor analysis (SP-FA), and latent class analysis, respective...

Most studies on depression and personality have focused on the role of Neuroticism and Extraversion. Openness is a much less studied trait in this literature, as past studies investigating Openness and depression often have found non‐significant correlations between them. However, past studies mostly have investigated Openness and depression at the...

The Pathological Narcissism Inventory (PNI) has enjoyed widespread use in the study of the narcissism. However, questions have been raised about whether the PNI’s grandiosity scale adequately captures narcissistic grandiosity as well as other popular measures do. Specifically, some have noted that PNI grandiosity shows a pattern of external associa...

Very little is known about the daily stability and fluctuation of personality pathology. To address this gap in knowledge, we investigated the naturalistic manifestation of personality pathology over the course of 100 days. A group of individuals (N=101) diagnosed with any personality disorder (PD) completed a daily diary study over 100 consecutive...

Background: Psychiatric comorbidity is extensive in both psychiatric settings and the general population. Such comorbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions—internalizing, externalizing, and...

Objective: Dimensional personality trait models have gained favor as an alternative to categorical personality disorder (PD) diagnosis; however, debate persists regarding whether these traits should be conceptualized as maladaptive at both extremes (i.e., maladaptively bipolar) or just one trait pole (i.e., unipolar). Method: To inform the debat...

Background Modern personality disorder (PD) theory and research attempt to distinguish transdiagnostic impairments common to all PDs from constructs that explain varied PD expression. Bifactor modeling tests such distinctions; however, the only published PD criteria bifactor analysis focused on only 6 PDs and did not examine the model's construct v...

The Pathological Narcissism Inventory (PNI; Pincus et al., 2009) has enjoyed widespread use in the study of the narcissism. However, questions have been raised about whether the PNI’s grandiosity scale adequately captures narcissistic grandiosity as well as other popular measures do. Specifically, some have noted that PNI grandiosity shows a patter...

It is well-established that neuroticism, extraversion, and conscientiousness are individually associated with internalizing disorders, but research suggests that these main effects may be qualified by a three-way interaction when predicting depression. The current study was the first to examine this three-way interaction in a psychiatric sample (N=...

This paper introduces a new classification of mental illness, the Hierarchical Taxonomy Of Psychopathology (HiTOP). It aims to address several major shortcomings of traditional taxonomies and provide a better framework for researchers and clinicians.

The reliability and validity of traditional taxonomies are limited by arbitrary boundaries between psychopathology and normality, often unclear boundaries between disorders, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. These taxonomies went beyond evidence available on the structure of psychopathology...

DSM–5 includes 2 competing models of borderline personality disorder (BPD) in Sections II and III. Empirical comparisons between these models are required to understand and improve intermodel continuity. We compared Section III BPD traits to Section II BPD criteria assessed via semistructured interviews in 455 current/recent psychiatric patients us...

Objective: Although conscientiousness/disinhibition plays a substantial role in internalizing and externalizing psychopathology, the underlying mechanisms are not well-understood. We aim to clarify facet-level associations, and to examine whether (a) impairment mediates the link of conscientiousness with internalizing and externalizing symptoms, a...

Very little is known about the daily stability and fluctuation of personality pathology. To address this gap in knowledge, we investigated the naturalistic manifestation of personality pathology over the course of 100 days. A group of individuals (N = 101) diagnosed with any personality disorder (PD) completed a daily diary study over 100 consecuti...

Research has demonstrated consistently that a broad range of personality traits affect intimate relationship quality; however, most of this research has used only self-ratings of personality. More recently, researchers have acknowledged that how partners perceive one another may also influence intimate relationships. The primary goal of the present...

Psychiatric diagnostic covariation suggests that the underlying structure of psychopathology is not one of circumscribed disorders. Quantitative modeling of individual differences in diagnostic patterns has uncovered several broad domains of mental disorder liability, of which the Internalizing and Externalizing spectra have garnered the greatest s...

In this naturalistic study, the authors adopt the lens of interpersonal theory to examine between- and within-person differences in dynamic processes of daily affect and interpersonal behaviors among individuals (N = 101) previously diagnosed with personality disorders who completed daily diaries over the course of 100 days. Dispositional ratings o...

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...

Traditional personality disorders (PDs) are associated with significant psychosocial impairment. DSM-5 Section III includes an alternative hybrid personality disorder (PD) classification approach, with both type and trait elements, but relatively little is known about the impairments associated with Section III traits. Our objective was to study th...

Psychiatric co-morbidity is extensive in both psychiatric settings and the general population. Such co-morbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions - internalizing, externalizing and psychotic...

This study was conducted to establish (a) the stability of the DSM-5 Section III personality disorder (PD) traits, (b) whether these traits predict future psychosocial functioning, and (c) whether changes in traits track with changes in psychosocial functioning across time. Ninety-three outpatients (61% female) diagnosed with at least 1 PD complete...

In the recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the official personality disorder (PD) classification system remains unchanged. However, DSM-5 also includes an alternative hybrid categorical-dimensional PD system in Section III to spur additional research. One defining feature of the alternative system is the incorporat...

Current categorical and dimensional conceptualizations of personality disorder (PD) typically confound pathological PD traits with distress and impairment (dysfunction). The current study examines whether dimensions of personality pathology and psychosocial dysfunction can be psychometrically distinguished. To that end, we collected self-report rat...

In the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013) personality disorder trait model, maladaptive behavior is located at one end of continuous scales. Widiger and colleagues, however, have argued that maladaptive behavior exists at both ends of trait continua. We propose that the role of ev...

The current study examines the relations among contemporary models of pathological and normal range personality traits. Specifically, we report on (a) conjoint exploratory factor analyses of the Computerized Adaptive Test of Personality Disorder static form (CAT-PD-SF) with the Personality Inventory for the Diagnostic and Statistical Manual of Ment...

This study investigated inconsistent responding to survey items by participants involved in longitudinal, web-based substance use research. We also examined cross-sectional and prospective predictors of inconsistent responding. Middle school (N = 1,023) and college students (N = 995) from multiple sites in the United States responded to online surv...

The Schedule for Nonadaptive and Adaptive Personality–Youth Version (SNAP-Y) is a new, reliable self-report questionnaire that assesses 15 personality traits relevant to both normal-range personality and the alternative DSM-5 model for personality disorder. Community adolescents, 12 to 18 years old (N = 364), completed the SNAP-Y; 347 also complete...

University students' beliefs about tobacco and nicotine were assessed before an educational intervention aimed at correcting tobacco-related misinformation. Beliefs were again measured immediately after the intervention, and then again after a 2-, 4-, 6-, or 8-week retention interval. Initially, participants showed significantly more accurate belie...

Computerized adaptive testing (CAT) is an emerging technology in the personality assessment literature given the greater efficiency it affords compared with traditional methods. However, few studies have directly compared the efficiency and validity of 2 competing methods for personality CAT: (a) methods based on item response theory (IRT-CAT) vers...

Individuals infected with human immunodeficiency virus (HIV) are at elevated risk for depressive conditions, which in turn can negatively impact health-related behaviours and the course of illness. The present study tested the role of autobiographical memory specificity and its interaction with perceived stress in the persistence of depressive symp...

Objective: Hybrid models of psychopathology propose to combine the current categorical diagnostic system with shared symptom dimensions common across various disorders. Recently, the first empirically derived hybrid model of social anxiety was developed, including both a specific factor for the diagnostic category of social anxiety and 5 nonspecif...

Recently, integrative, hierarchical models of personality and personality disorder (PD)-such as the Big Three, Big Four, and Big Five trait models-have gained support as a unifying dimensional framework for describing PD. However, no measures to date can simultaneously represent each of these potentially interesting levels of the personality hierar...

Assessment of personality disorders (PD) has been hindered by reliance on the problematic categorical model embodied in the most recent Diagnostic and Statistical Model of Mental Disorders (DSM), lack of consensus among alternative dimensional models, and inefficient measurement methods. This article describes the rationale for and early results fr...

Observed co-morbidity among the mood and anxiety disorders has led to the development of increasingly sophisticated dimensional models to represent the common and unique features of these disorders. Patients often present to primary care settings with a complex mixture of anxiety, depression and somatic symptoms. However, relatively little is known...

The categorical underpinnings of the current diagnostic nomenclature have been the subject of repeated criticism. Recently, researchers have proposed several alternatives to the current system, including hybrid models of combined diagnostic categories and symptom dimensions. In the present study, we investigated the symptoms associated with a hybri...

In response to high levels of comorbidity and symptom overlap between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and other disorders, much attention has been devoted to the role of specific and nonspecific symptoms among the disorders. The present study investigated the overlapping symptoms of PTSD and MDD in treatment-s...

Converging lines of evidence have called into question the validity of conceptualizations of posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2000) and suggested alternative structural models of PTSD symptomatology. We conducted a meta-analysis of 40 PTSD...

In this commentary, the author evaluates the results and conclusions of Miller et al. (2010) with respect to the debate surrounding the posttraumatic stress disorder (PTSD) structural models of King, Leskin, King, and Weathers (1998) and Simms, Watson, and Doebbeling (2002). Although Miller et al. are to be commended for attempting to move this lit...

BACKGROUND: DSM-5 may mark the shift from a categorical classification of personality pathology to a dimensional system. Although dimensional and categorical conceptualizations of personality pathology are often viewed as competing, it is possible to develop categories (prototypes) from combinations of dimensions. Robust prototypes could bridge dim...

Recently, Gros, Antony, Simms, and McCabe (2007) demonstrated support for the psychometric properties of a new measure of state and trait anxiety, the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA). In the present study, we further investigated the STICSA-Trait Version in 127 friendship dyads with a self-report from one participan...

Reports an error in "An item response theory integration of normal and abnormal personality scales" by Douglas B. Samuel, Leonard J. Simms, Lee Anna Clark, W. John Livesley and Thomas A. Widiger ( Personality Disorders: Theory, Research, and Treatment , 2010[Jan], Vol 1[1], 5-21). In the acknowledgments, Douglas Samuel was incorrectly listed as the...