Reconceptualizing personality disorder categories using personality trait dimensions: introduction to special section

The categorical model of personality disorders has been widely criticized, and many argue for it to be reconceptualized or replaced by a dimensional model rooted in personality trait research. Such criticisms have forged a much needed integration between the previously distinct research areas of normal and abnormal personality. The five articles in this special section provide compelling evidence for the usefulness of personality traits for describing and explaining the complexities of personality disorders among widely varying samples using very different assessment strategies.     

Emotional correlates of the different dimensions of schizotypal personality disorder

Two studies explored which different dimensions of schizotypal personality disorder (SPD) were associated with negative affect, attention to emotions, clarity of emotions, and emotional intensity/instability. Study 1 included 247 college students, and questionnaires were used to measure SPD. Study 2 included 225 community residents, oversampling for individuals with elevated levels of SPD, and semistructured diagnostic interviews were used to measure SPD. In both studies (a) higher levels of negative affect were associated with higher levels of both cognitive-perceptual and interpersonal symptoms, (b) cognitive-perceptual disturbances were associated with greater attention to emotion, whereas interpersonal disturbances were associated with less attention to emotion, and (c) lower levels of emotional clarity were associated with higher levels of suspiciousness.     

Commentary on reconceptualizing personality disorder categories using trait dimensions

The ability of trait models of personality to account for categories of personality disorder is examined with particular reference to the five-factor approach. Although dimensional models are consistent with the evidence, and trait models can accommodate personality disorder categories, it is not clear that such models are directly applicable to clinical use. The lower-order or facet structure, in particular, needs further development to capture clinical concepts. It is also suggested that trait models do not account for all aspects of personality disorder-attention also needs to be paid to the organizing and integrative functions of personality.     

Predicting dimensions of personality disorder from domains and facets of the Five-Factor Model

We compared the utility of several trait models for describing personality disorder in a heterogeneous clinical sample (N = 94). Participants completed the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993b), a self-report measure that assesses traits relevant to personality disorder, and two measures of the Five-Factor Model: the Revised NEO Personality Inventory (NEO-PI-R; Costa and McCrae, 1992) and the Big Five Inventory (BFI; John, Donahue, & Kentle, 1991). Regression analyses indicated substantial overlap between the SNAP scales and the NEO-PI-R facets. In addition, use of the NEO-PI-R facets afforded substantial improvement over the Five-Factor Model domains in predicting interview-based ratings of DSM-IV personality disorder (American Psychiatric Association, 1994), such that the NEO facets and the SNAP scales demonstrated roughly equivalent levels of predictive power. Results support assessment of the full range of NEO-PI-R facets over the Five-Factor Model domains for both research and clinical use.     

Predicting individual change in personality disorder features by simultaneous individual change in personality dimensions linked to neurobehavioral systems: the longitudinal study of personality disorders

Personality disorders (PDs), long thought to be immutable over time, show considerable evidence of individual change and malleability in modern prospective longitudinal studies. The factors responsible for the evident individual change in PDs over time, however, remain essentially unknown. A neurobehavioral model that posits negative emotion (NEM), nonaffective constraint (CON), communal positive emotion (PEM-C), and agentic positive emotion (PEM-A) as important systems underlying PD provides a theoretical basis for investigating predictors of change in PD features over time. Thus, in this study, the authors investigated how individual change in NEM, CON, PEM-C, and PEM-A over time predicted individual change in PD features over time, using longitudinal data on PD assessed by the International Personality Disorders Examination (A. W. Loranger, 1999), as well as data on normal personality features gathered within a 4-year prospective multiwave longitudinal study (N = 250). The authors used the method of latent growth modeling to conduct their analyses. Lower initial levels of PEM-C predicted initial levels of the growth trajectories for those with elevated Cluster A PD features. Elevated NEM, lower CON, and elevated PEM-A initial levels were found to characterize the initial levels of growth trajectories for those with increased Cluster B PD features. Interestingly, subjects with higher initial levels of PEM-A revealed a more rapid rate of change (declining) in Cluster B PD features over time. Elevated NEM and decreased PEM-C initial levels were found to characterize the growth trajectories for subjects with increased Cluster C PD features. The substantive meaning of these results is discussed, and the methodological advantages offered by this statistical approach are also highlighted.     

The relationship between five-factor personality measurements and ICD-10 personality disorder dimensions: results from a sample of 229 subjects

This article examines the relationship between the five-factor model (FFM) and dimensional ICD-10 personality disorders. In a follow-up study of a child and adolescent psychiatric cohort, former patients and controls were assessed with NEO-FFI and the IPDE interview (CD-10 personality disorder). Full data were available for 229 subjects (149 former patients, 80 controls). Multiple regression analysis showed that the five factors of the FFM as independent variables explained between 5% (schizoid personality disorder) and 32% (anxious personality disorder) of the variance of ICD-10 dimensional personality disorder scores. For the two types of emotionally unstable personality disorder dimension (impulsive and borderline), for anxious (avoidant) personality disorder dimension and for the total score of any personality disorder dimension, FFM explained between 17% and 32% of the variance with almost identical results for the former patient group and the control group. High neuroticism was a feature of paranoid, emotionally unstable, histrionic, anankastic, anxious (avoidant), and dependent personality disorder dimensions, whereas low agreeableness was found in dissocial, emotionally unstable and histrionic personality disorder dimensions. Low extraversion was found in schizoid, anxious (avoidant) and dependent personality disorder dimensions, whereas histrionic PD dimension correlated with high extraversion. We find that the FFM is valuable for the further understanding not only of DSM-IV but also of ICD-10 personality disorder dimensions. The differences between ICD-10 and DSM-IV in this respect seem to be small.     

A theoretical basis for the major dimensions of personality

We argue that lexical studies of personality structure suggest the existence of six major dimensions of personality: (I) Surgency, (II) Agreeableness, (III) Conscientiousness, (IV) Emotional Stability, (V) Intellect/Imagination, and (VI) Honesty. We then propose a two‐part theoretical basis for these dimensions. First, Honesty and rotated variants of Agreeableness and Emotional Stability are interpreted in terms of three traits—fairness/non‐exploitation, forgiveness/non‐retaliation, and empathy/attachment—that underlie prosocial versus antisocial tendencies. Second, the Surgency, Conscientiousness, and Intellect/Imagination factors are interpreted as traits that involve active engagement within three domains of endeavour—social, task‐related, and idea‐related endeavour. Predictions that follow from these interpretations are tested and found to be supported. Copyright © 2001 John Wiley & Sons, Ltd.     

A comparative study of the dimensions and facets of the five-factor model in the diagnosis of cases of personality disorder

Two national samples of psychologists (n = 92, n = 89) rated personality disorder cases using either the five factors (domains) or the 30 facets of the five-factor model (FFM) to examine reliability and clinical utility of the model when used as a diagnostic tool. The cases were prototypic and nonprototypic cases representing the three clusters of personality disorders in the DSM-IV. Although confidence was higher using the factors rather than the facets to rate the cases, interrater reliability was similar and the facets were rated more useful for professional communication, case conceptualization, and treatment. Mean ratings for the prototypic cases supported the theorized relationships between those personality disorders and the FFM. Principal components factor analysis of the facet ratings largely replicated the structure of the FFM with only a few facets failing to load with their superordinate dimension in the model. Implications for use of the FFM with personality disorder are discussed.     

The nature of borderline personality disorder: multiple dimensions, multiple symptoms, but one category

Borderline personality disorder (BPD) is a multidimensional syndrome that is not rooted in a single diathesis. Each of its features (affective instability, impulsivity, unstable relationships, and cognitive defects) reflects different diatheses. BPD differs from other Axis II disorders in its high level of symptoms, but is not a variant of an Axis I disorder and is difficult to describe through dimensional traits. This review suggests that BPD needs to be diagnosed with a narrower set of criteria that cover all of its domains. In the long run, the disorder will need to be redefined on the basis of its etiology and pathogenesis.     

Changes in personality in pre‐ and post‐dialectical behaviour therapy borderline personality disorder groups: A question of self‐control

Dialectical behaviour therapy (DBT) is an evidence‐based therapy for people with borderline personality disorder (BPD). Past research has identified behavioural changes indicating improved functioning for people who undergo DBT. To date, however, there has been little research investigating the underlying mechanism of change. The present study utilised a between‐subjects design and self‐report questionnaires of Self‐Control and the five factor model of personality and drew participants from a metropolitan DBT program. We found that pre‐treatment participants were significantly lower on Self‐Control, Agreeableness and Conscientiousness when compared to both the post‐treatment assessment and the norms for each questionnaire. Neuroticism was significantly higher both before and after treatment when compared to the norms. These findings suggest that Self‐Control may play a role in both the presentation of this disorder and the effect of DBT. High levels of Neuroticism lend weight to the Linehan biosocial model of BPD development.     

Factors of style and personality

In an attempt to find relationships between psychological and linguistic variables, style samples of short stories, 300 words each, were analyzed according to formal criteria and the results were correlated with scores on personality tests. The number of significant correlations supported the hypothesis that style is related to personality. A factor analysis, using the principal component solution and Varimax rotation (Harman, 1967), of the correlation matrix resulted in six identifiable factors of style, three factors of psychological tests, and a large number of small factors, each represented only by two to five experimental variables with significant loadings. A significant loading for interpretation purposes was defined in agreement with Guilford (1956) as 0.30 or greater, positive or negative. A close examination of style factors led to the tentative differentiation of a basic language factor as resulting from grammatical constraint, and several factors of subjective style of individuals. Some of these later factors had enough loadings on personality variables to permit cautious psychological interpretation.     

A taxometric study of borderline personality disorder

Taxometric methodology was used to determine whether borderline personality disorder (BPD) represents a taxon that is categorically distinct from normal personality or whether it falls on a dimensional continuum with normality. Two taxometric procedures were used with a sample of 1,389 outpatients assessed for BPD symptoms by semistructured interview. The procedures indicated that BPD does not represent a latent category. Implications are drawn for the conceptualization and etiology of BPD, and for the categorical versus dimensional status of personality disorders in general.     

Higher-order dimensions of personality disorder: hierarchical structure and relationships with the five-factor model, the interpersonal circle, and psychopathy

Two studies examined the higher-order factor structure of DSM-IV personality disorders using the International Personality Disorder Examination in male forensic psychiatric patients. In Study 1 (N = 168), exploratory factor analysis at the level of individual personality disorder criteria indicated nine primary factors. Exploratory and confirmatory factor analyses of these first-order factors supported a hierarchical structure in which two of three second-order factors covaried to yield a third-order factor. The two resulting superordinate factors were labelled Anxious-Inhibited and Acting Out. In Study 2 (N = 160), we used exploratory and confirmatory factor analyses to test hypotheses of common dimensions underlying these superordinate factors of personality disorder and superordinate factors of the five-factor model of personality, dimensions of the interpersonal circle, and psychopathy. Of three common factors, one combined Anxious-Inhibited disorders, "neurotic introversion," and hostile-submission. The other two factors of Acting Out/ psychopathy and antagonism/hostile-dominance covaried to yield a superordinate factor. Possible substrates underlying two superordinate dimensions common to normal and abnormal personality were identified in the theoretical literature.     

Borderline personality: traits and disorder

Although the 5-factor model (FFM) has been advocated as an alternative to representing the construct of borderline personality, some argue that this diagnosis carries essential information that is not well captured by the FFM. The present study examined antecedent, concurrent, and predictive markers of construct validity in a sample of 362 patients with personality disorders. The results indicated that neuroticism best distinguished borderline and nonborderline patients, whereas the FFM as a whole captured a sizable proportion of the variance in the borderline diagnosis. However, the residual of the borderline diagnosis that was not explained by the FFM was found to be significantly related to childhood abuse history, family history of mood and substance use disorders, concurrent symptoms, and 2-year and 4-year outcomes. Thus, some elements of the borderline diagnosis may not be fully captured in a 5-factor representation.     

A dimensional model of personality disorder: incorporating DSM Cluster A characteristics

The authors articulate an expanded dimensional model of personality pathology to better account for symptoms of DSM-defined Cluster A personality disorders. Two hundred forty participants (98 first-degree relatives of probands with schizophrenia or schizoaffective disorder, 92 community control participants, and 50 first-degree relatives of probands with bipolar disorder) completed a dimensional personality pathology questionnaire, a measure of schizotypal characteristics, and Chapman measures of psychosis proneness. Scales from all questionnaires were subjected to an exploratory factor analysis with varimax rotation. A 5-factor structure of personality pathology emerged from the analyses, with Peculiarity forming an additional factor to the common 4-factor structure of personality pathology (consisting of Introversion, Emotional Dysregulation, Antagonism, and Compulsivity). These results support a 5-factor dimensional model of personality pathology that better accounts for phenomena encompassed by the Cluster A personality disorders in DSM-IV-TR (4th ed., text revised; American Psychiatric Association, 2000). This study has implications for the consideration of a dimensional model of personality disorder in DSM-V by offering a more comprehensive structural model that builds on previous work in this area.     

Consumers' perceptions of the dimensions of brand personality

Brand personality (human‐like characteristics of a brand) has been a popular topic in the marketing literature for over 50 years. However, there is a lack of consumer‐focused studies investigating what factors shape perceptions of brand personality. To address this gap, the purpose of the current study is to understand how consumers form their perceptions of the different dimensions of brand personality identified in Aaker's scale (sincerity, excitement, competence, sophistication and ruggedness), and what product or brand characteristics influence these perceptions. Sixty‐six interviews were conducted with graduate students, who were asked to discuss which brands reflected the specific dimensions of brand personality in Aaker's scale. As a result, we identify the kinds of brands consumers perceive as typical for each personality dimension, discover their common characteristics and explain the reasons why some brands are strongly associated with a particular dimension and some are not. Our findings indicate that specific brand personality dimensions are associated with particular product categories. However, brands mentioned as strong on respective personality dimensions share commonalities beyond just a product category. For instance, sincere brands share family‐related associations and high morals, exciting brands offer consumers the opportunity to experience exciting feelings and are related to special ‘exciting’ occasions, competent brands are mostly associated with expertise and quality, sophisticated brands are usually of feminine nature, whereas rugged brands are of masculine nature. Moreover, we find that brands which consumers perceive as lacking on a particular personality dimension also share common attributes. Copyright © 2011 John Wiley & Sons, Ltd.     

A practical way to diagnosis personality disorder: a proposal

General criteria for the diagnosis of personality disorder are provided based on rating a few items describing four core features of personality disorder: (a) low Self-directedness, (b) low Cooperativeness, (c) low Affective Stability, and (d) low Self-transcendence. These core features correspond closely with the basic concept of personality disorder in DSM-IV and are based on specific items easy for clinicians to rate in a short time. Criteria are also provided for rating severity of personality disorganization and for subtyping based on a profile of three additional dimensions corresponding to core features of DSM-IV clusters A, B, and C. This approach should facilitate efficient screening in clinical practice, encourage an understanding of the development of comorbidity as a self-organizing process, and provide a theory-driven basis for therapeutic planning with drugs and psychotherapy.