DSM-III-R personality disorders and the five-factor model of personality: an empirical comparison.

The relationship between the five-factor model (FFM) of personality and the Diagnostic and Statistical Manual of Mental Disorders (rev. 3rd ed.; DSM-III-R) personality disorders was examined in a sample of 54 psychiatric outpatients. Correlations between raw scores on the NEO-Personality Inventory (NEO-PI) and the number of DSM-III-R personality disorder symptoms rated present using a semistructured interview were computed. In addition, correlations between NEO-PI scores and scores on two self-report personality disorder inventories were also examined to determine which results replicated across instruments. Results indicated that the FFM personality dimensions of Neuroticism, Extraversion, and Agreeableness were most apparent in the DSM-III-R conceptualizations of the personality disorders.     

A comparison of interview and self-report methods for the assessment of borderline personality disorder criteria

Interview methods are widely regarded as the standard for the diagnosis of borderline personality disorder (BPD), whereas self-report methods are considered a time-efficient alternative. However, the relative validity of these methods has not been sufficiently tested. The current study used data from the Collaborative Longitudinal Personality disorder Study to compare diagnostic base rates and the relative validity of interview and self-report methods for assessing functional outcome in BPD. Although self-report yielded higher base rates of criteria endorsement, results did not support the common assumption that diagnostic interviews are more valid than self-reports, but instead indicated the combined use of these methods optimally identifies BPD criteria.     

Assessment of DSM-IV personality disorders in obsessive-compulsive disorder: comparison of clinical diagnosis, self-report questionnaire, and semi-structured interview

In patients with obsessive-compulsive disorder, personality disorders are not many times assessed according to DSM-IV criteria. The purpose of the present study is to examine the prevalence of personality disorders diagnosed according to the DSM-IV in a severely disordered OCD population (n=65) with three different methods of assessing personality disorders (structured interview, questionnaire, and clinical diagnoses). Furthermore, correspondence between these different methods was investigated and their construct validity was examined by relating the three methods to external variables. Each method resulted in a predominance of Cluster C personality disorders, and obsessive-compulsive personality disorder had the highest prevalence. However, there was generally low correspondence regarding which patient had which personality disorder. Results concerning the relation of external variables were the most promising for the structured clinical interview.     

Rates of personality disorders in substance abusers: a comparison between DSM-III-R and DSM-IV

The publication of the DSM-IV represents the first revision in 7 years to the DSM-III-R diagnostic criteria. The purpose of the current study is to evaluate the impact of changes to the Axis II criteria on diagnostic rates in a substance abusing population. We interviewed 370 patients entering treatment using a modified version of the SCID-II, which allowed for the diagnosis of both DSM-III-R and DSM-IV Axis II diagnoses. Prevalence rates for each Axis II disorder are given, as well as kappa statistics showing diagnostic agreement between the two systems. The results of this study indicate good rates of diagnostic agreement between the two systems with a few notable exceptions. Poor rates of diagnostic agreement were obtained for the histrionic and dependent diagnostic categories. No single diagnostic change appears to be responsible for the prevalence rate differences between the two systems.     

Comparing the temporal stability of self-report and interview assessed personality disorder

Findings from several large-scale, longitudinal studies over the last decade have challenged the long-held assumption that personality disorders (PDs) are stable and enduring. However, the findings, including those from the Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000), rely primarily on results from semistructured interviews. As a result, less is known about the stability of PD scores from self-report questionnaires, which differ from interviews in important ways (e.g., source of the ratings, item development, and instrument length) that might increase temporal stability. The current study directly compared the stability of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) PD constructs assessed via the Schedule for Nonadaptive and Adaptive Personality (SNAP-2; Clark, Simms, Wu, & Casillas, in press) with those from the Diagnostic Interview for DSM-IV Personality Disorders (Zanarini, Frankenburg, Sickel, & Yong, 1996) over 2 years in a sample of 529 CLPS participants. Specifically, we compared dimensional and categorical representations from both measures in terms of rank-order and mean-level stability. Results indicated that the dimensional scores from the self-report questionnaire had significantly greater rank-order (mean r=.69 vs. .59) and mean-level (mean d=0.21 vs. 0.30) stability. In contrast, categorical diagnoses from the two measures evinced comparable rank-order (mean κ=.38 vs. .37) and mean-level stability (median prevalence rate decrease of 3.5% vs. 5.6%). These findings suggest the stability of PD constructs depends at least partially on the method of assessment and are discussed in the context of previous research and future conceptualizations of personality pathology.     

Borderline and avoidant personality disorders and the five-factor model of personality: a comparison between DSM-IV diagnoses and NEO-PI-R.

A self-report measure of the Five-Factor Model (FFM) of personality, NEO-PI-R, was administered to a sample of patients with borderline (BPD, N = 29) or avoidant PD (AVPD, N = 34), admitted to a day treatment program, to investigate the NEO-PI-R profiles of the disorders, and the ability of NEO-PI-R to discriminate between the two disorders. The diagnoses were assessed according to the LEAD standard. AVPD was associated with high levels of Neuroticism and Agreeableness, and low levels of Extraversion and Conscientiousness. BPD was associated with high levels of Neuroticism and low levels of Agreeableness, Extraversion, and Conscientiousness. Eighty-eight percent of the AVPD group had high scores on Neuroticism and low scores on Extraversion, whereas 65% of the BPD group were high on Neuroticism and low on Agreeableness. The Extraversion and Agreeableness scales of NEO-PI-R discriminated between patients with BPD and those with AVPD. Patients with BPD scored significantly higher on the Angry Hostility and Impulsiveness subscales of Neuroticism and significantly lower on three Extraversion subscales, three Agreeableness subscales, and one Conscientiousness subscale. At the DSM-IV criterion level, there were more significant relationships between the subscales of NEO-PI-R and the AVPD criteria than with the BPD criteria. The findings suggest that the FFM has good discriminating ability regarding BPD and AVPD. However, there may be a closer conceptual relationship between the FFM and AVPD than between the FFM and BPD.     

A comparison of passive-aggressive and negativistic personality disorders

Passive-aggressive personality disorder (PAPD) has historically played an important role in clinical theorizing and was diagnosable prior to the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994), in which the construct was relabeled negativistic (NEGPD), expanded to include negative affective symptoms, and appendicized. In this study we tested the hypothesis that the expansion of PAPD to include content related to negative moods and nonspecific personality pathology compromised its discriminant validity. In an undergraduate sample (N = 1,215), a self-report measure of PAPD was only moderately related to NEGPD and showed less diagnostic overlap with other personality disorders than NEGPD. Furthermore, a conjoint factor analysis yielded a strong first factor (moodiness) that appeared less specific to passive-aggressive behavior than 3 other factors (irresponsibility, inadequacy, and contempt). We conclude that future research on this potentially important clinical construct should focus on core passive-aggressive features and abandon the negativistic content that has been added to it in successive editions of the DSM.     

A comparison of the validity of the five-factor model (FFM) personality disorder prototypes. Using FFM self-report and interview measures

Recent studies have demonstrated that personality disorders (PDs) can be assessed via a prototype-matching technique, which enables researchers and clinicians to match an individual's five-factor model (FFM) personality profile to an expert-generated prototype. The current study examined the relations between these prototype scores, using interview and self-report data, and PD symptoms in an outpatient sample (N = 115). Both sets of PD prototype scores demonstrated significant convergent validity with PD symptom counts, suggesting that the FFM PD prototype scores are appropriate for use with both sources of data.     

Retest stability of DSM-III-R diagnoses among adolescents using the diagnostic interview schedule for children (DISC-2.1C)

Retest stability of DSM-III-R diagnoses was assessed using the DISC-2.1C with a sample of Anglo, African, and Hispanic American adolescent patients 12 to 17 years of age. Based on the kappa statistic, retest stability was fair for any disorder ( =.50), for any anxiety disorder ( =.44), for any affective disorder ( =.53), for any disruptive behavior disorder ( =.58), and for substance use disorders ( =.46). Although there was a trend for reliability to be somewhat higher for African Americans ( =.58) than for Anglos ( =.42) or Hispanics ( =.49), these differences were not statistically significant. In general, 15- to 17-year-olds had somewhat better reliability ( =.58) than did 12- to 14-year-olds ( =.44). Males had somewhat higher reliability ( =.63) than females ( =.43). These findings are congruent with those reported recently using the DISC-R (Schwab-Stone et al., 1993) and suggest that the DISC appears to be at least as reliable as other available child diagnostic instruments. In view of the fair-to-moderate levels of reliability of these instruments in general, future research should focus on the joint effects of instrument, subject, interviewer, and nomenclature on operating characteristics of diagnostic interview schedules, focusing in particular on factors affecting accurate recall and reporting of symptoms and episodes. This research was supported in part by grants MH44214 and MH44773 from the National Institute of Mental Health, and by the Hogg Foundation for Mental Health. The authors wish to acknowledge the participation and collaboration of A. J. Pumariega, J. W. Swanson, and C. E. Holzer III and staff of the Center for Cross-Cultural Research, directed by F. M. Treviño.     

Personality characteristics associated with romantic attachment: a comparison of interview and self-report methodologies

This study compared the personality attributes associated with self-report versus interview assessment of romantic attachment. Twenty-three-year-olds (N = 83) completed the Romantic Attachment Interview, the Experiences in Close Relationship Inventory, and measures of response bias, self-enhancement, and self-insight. Five psychologists evaluated the participants' personality. Although both self-report and interview assessment were related to attachment-relevant personality attributes, interview assessment was slightly more likely to explain unique variance in personality, especially regarding intrapsychic attributes. Self-enhancement was negatively related to secure attachment and positively related to dismissing attachment. The opposite pattern emerged for self-insight. A subgroup of 12 vulnerable individuals who described themselves as securely attached on self-report was judged as dismissing according to interview assessment. These individuals scored low on self-insight and high on self-enhancement and psychological vulnerability. The results are discussed with reference to the relative strengths of different measures of romantic attachment and relations among dismissing attachment, self-enhancement, and narcissism.     

Personality disorders in a Dutch forensic psychiatric sample: convergence of interview and self-report measures

Convergence of PDQ-R- and SIDP-R-derived personality disorder diagnoses was studied in a sample of 85 forensic psychiatric patients. For categorical diagnoses, the mean kappa was .34, but on a dimensional level convergence was somewhat higher. Paranoid, antisocial and borderline personality disorders had prevalence rates around 40%; the other personality disorders occurred with much lower frequency. The PDQ-R yielded more diagnoses, except for antisocial, histrionic, narcissistic, and sadistic personality disorder. Because the latter disorders are among the most prevalent in forensic settings, and because they have important risk and treatment implications, the PDQ-R is not suitable as a screening device in forensic populations. Semistructured interviews that make use of collateral information are recommended for diagnosing personality disorders in forensic subjects.     

Validity of the DSM-III-R personality disorder Clusters

This study assessed the validity of the DSM-III-R personality disorder clusters (i.e., odd-eccentric, dramatic-emotional-erratic, and anxious-fearful) by examining the relationships between self-report measures that tap the core features shared by disorders from each cluster and Cluster scores established via a semistructured interview in a sample of 57 outpatients. Results indicated a high degree of correlation among the DSM-III-R personality disorder Cluster scores. In addition, a series of regression analyses revealed that self-report scores did not account for a significant amount of variance in their respective Cluster scores over and above that accounted for by other self-report measures and other Cluster scores. These results suggest that the current DSM-III-R cluster classification scheme may not be appropriate, and it is recommended that a more empirically justifiable classification of the personality disorders be adopted in DSM-IV.     

Dimensional personality profiles of borderline personality disorder in comparison with other personality disorders and healthy controls

The present study examined the sensitivity and clinical specificity of dimensional personality profiles associated with borderline personality disorder (BPD) by comparing three groups of patients: (a) patients with BPD according to DSM-IV criteria (n = 31); (b) patients with other DSM-IV PD (n = 31); and (c) general population controls (n = 31). All three samples were matched for age and gender and the two patient samples were matched for chronicity and depressive symptoms. All patients were given the Six-Factor Test measuring the five-factor model of personality (FFM), the Temperament and Character Inventory (TCI), and the Dimensional Assessment of Personality Pathology (DAPP). Nonparametric statistics were applied to analyze the data (Mann-Whitney-U-tests for group comparisons; Spearman's coefficients for correlational analyses). Neuroticism (FFM), Self-Directedness (TCI), and Emotional Dysregulation (DAPP) were identified as general markers of personality pathology, which were significantly interrelated in all three samples. BPD patients also showed a specific profile compared with other PD patients with lower scores on Agreeableness (FFM), higher scores on Novelty Seeking and Self-Transcendence (TCI), and higher scores on the DAPP higher-order dimensions of Emotional Dysregulation, Dissocial Behavior, and Inhibitedness. Results support the assumption that BPD can be characterized by dimensional approaches with sufficient sensitivity in comparison with healthy controls and specificity in comparison with other PD patients.     

A structured interview for the assessment of the Five-Factor Model of personality: facet-level relations to the axis II personality disorders

The Structured Interview for the Five-Factor Model (SIFFM; Trull & Widiger, 1997) is an 120-item semistructured interview that assesses both adaptive and maladaptive features of the personality traits included in the five-factor model of personality, or "Big Five." In this article, we evaluate the ability of SIFFM scores to predict personality disorder symptomatology in a sample of 232 adults (46 outpatients and 186 nonclinical college students). Personality disorder symptoms were assessed using the Personality Diagnostic Questionnaire-Revised (PDQ-R; Hyler & Rider, 1987). Results indicated that many of the predicted associations between lower-order personality traits and personality disorders were supported. Further, many of these associations held even after controlling for comorbid personality disorder symptoms. These findings may help inform conceptualizations of the personality disorders, as well as etiological theories and treatment.     

The relationship between self-report mood and personality

Past research pertaining to personality and mood has been concerned with the relationship between specific personality traits and specific mood states. The present examines the relationship between self-report measures of personality and mood. University students (82 males, 118 females), completed a personality questionnaire consisting of 20 personality bipolar adjectives and a mood inventory measuring six mood dimensions. Factor analysis of the personality adjectives revealed four factors, which were then correlated with the mood scales. Results of this analysis revealed significant correlations between the personality factors and mood dimensions suggesting that personality is related to some aspects of mood.     

Impaired social functioning and symptoms of personality disorders assessed by peer and self-report in a nonclinical population

Data regarding the connection between personality disorders (PDs) and impaired social functioning are often difficult to interpret because both sets of variables are influenced by depressed mood and both are usually assessed using self-report instruments. We studied PD symptoms in a nonclinical population and examined whether these symptoms are associated with social dysfunction, after controlling for current mental state. Participants were 577 undergraduate students who completed self-report measures of social functioning, PD symptoms, depression, and anxiety, as well as a peer-report PD inventory. As expected, self-reported PD scores and social dysfunction were both correlated with current levels of anxiety and depression. Both self- and peer-reported PD symptoms contributed to the prediction of level of social functioning above and beyond the influence of depressed mood. Overall, our results complement those from clinical samples and provide further evidence that there is an association between PD traits and impaired social functioning.     

Matching components of self-report and peer-nomination personality measures

Two common methods of measuring personality variables are examined with respect to the ways in which they control respondent biases. A form of the mental-test theory model is developed which makes explicit differences in score components that result from different methodological constraints imposed by the two methods. From the model, it is possible to specify the operations necessary to provide equivalent information from the two sets of data. Performance of these operations in an empirical test supports the model by producing generally higher correlations between the variables having score components which are more closely matched.     

Type A personality and discrepancies between self-report and heart-rate responses to stress

The present study was done to replicate previous findings on the discrepancy between Type A persons' self-reports of stress and their physiological arousal. An attempt was made to clarify whether this discrepancy was due to Type A persons' denial of their arousal or an inability to discriminate physiological change. The students' version of the Jenkins Activity Survey was administered to 30 female students, aged 19 to 43 yr., who then performed a digit recall. A Multiple Affect Adjective Check List and a self-report questionnaire were used to measure affective reactions. Analysis showed that Type A individuals had higher heart-rate responses to stress but did not report greater subjective arousal. These results replicated the previously reported discrepancy. The current findings are somewhat consistent with an explanation based on discrimination.     

The altruistic personality and the self-report altruism scale

This paper is divided into two parts. In the first, the rank order stability of individual differences in altruism across situations is examined and it is found that substantial consistency occurs when due regard is given to the principle of aggregation. In the second, a self-report altruism scale, on which respondents rate the frequency with which they have engaged in some 20 specific behaviors, is found to predict such criteria as peer-ratings of altruism, completing an organ-donor card, and paper-and-pencil measures of prosocial orientation. These data suggest there is a broad-based trait of altruism.