Exploring the Assessment of the DSM–5 Alternative Model for Personality Disorders With the Personality Assessment Inventory

Section III of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013) contains an alternative model for the diagnosis of personality disorder involving the assessment of 25 traits and a global level of overall personality functioning. There is hope that this model will be increasingly used in clinical and research settings, and the ability to apply established instruments to assess these concepts could facilitate this process. This study sought to develop scoring algorithms for these alternative model concepts using scales from the Personality Assessment Inventory (PAI). A multiple regression strategy used to predict scores in 2 undergraduate samples on DSM–5 alternative model instruments: the Personality Inventory for the DSM–5 (PID–5) and the General Personality Pathology scale (GPP; Morey et al., 2011 Morey, L. C., Berghuis, H., Bender, D. S., Verheul, R., Krueger, R. F., &; Skodol, A. E. (2011). Toward a model for assessing level of personality functioning in DSM–5, Part II: Empirical articulation of a core dimension of personality pathology. Journal of Personality Assessment, 93, 347–353.[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]). These regression functions resulted in scores that demonstrated promising convergent and discriminant validity across the alternative model concepts, as well as a factor structure in a cross-validation sample that was congruent with the putative structure of the alternative model traits. Results were linked to the PAI community normative data to provide normative information regarding these alternative model concepts that can be used to identify elevated traits and personality functioning level scores.     

What Does the Narcissistic Personality Inventory Measure Across the Total Score Continuum?

The Narcissistic Personality Inventory (NPI) is the most widely used measure of narcissism in the social-personality psychology literature. It contains 40 items that tap into a variety of traits that theoretically comprise narcissism, such as feelings of superiority and willingness to exploit others. Most researchers focus on the total score produced by the NPI and may logically assume that increments in total NPI score correspond with similar increments in underlying narcissism traits. However, research presented in this article suggests that the traits measured by the NPI do not increment at the same rate. Traits reflecting intrapersonally healthy qualities (e.g., leadership, superiority) increment most rapidly within the lower portions of the NPI total score continuum, whereas traits reflecting interpersonally harmful qualities (e.g., entitlement, exploitativeness) increment most rapidly within the upper portions of the NPI continuum. These differences have implications for the meaning of scores on the NPI and how they correlate with other variables. For example, we demonstrate that lower NPI scores best predict self-esteem and higher NPI scores best predict psychopathy.     

How popular is the Personality Assessment Inventory in practice and training?

A review of recent survey data indicates that the Personality Assessment Inventory ranks among the most frequently used objective personality tests in practice and clinical training.     

Development of a Response Inconsistency Scale for the Personality Inventory for DSM–5

The advent of a dimensional model of personality disorder included in DSM–5 has necessitated the development of a new measurement scheme, specifically a self-report questionnaire termed the Personality Inventory for DSM–5 (PID–5; Krueger, Derringer, Markon, Watson, &; Skodol, 2012 Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., &; Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM–5. Psychological Medicine, 42, 1879–1890. doi:10.1017/S0033291711002674[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). However, there are many threats to the validity of a self-report measure, including response inconsistency. This study outlines the development of an inconsistency scale for the PID–5. Across both college student and clinical samples, the inconsistency scale was able to reliably differentiate real from random responding. Random responses led to increased scores on the PID–5 facets, indicating the importance of detecting inconsistent responding prior to test interpretation. Thus, this inconsistency scale could be of use to researchers and clinicians in detecting inconsistent responses to this new personality disorder measure.     

Interparent agreement on the Personality Inventory for Children: Are substantial correlations sufficient?

Mothers' and fathers' responses on the Personality Inventory for Children (PIC) were compared for 360 clinic-referred children and adolescents. Interparent agreement was measured by several different indices. Correlations between parental pairs of scale T-scores derived from each parent averaged .66 for 13 of the profile scales; 9 of the scales exceeded this value. In contrast, mothers and fathers agreed in the classification of the presence of clinical significance an average of 77% of the time across these 13 scales, and pairs of parental PIC profiles contained an average of 3 scales in disagreement. The type of index used to measure interparent agreement was found to affect the results. The discussion examines the nature of interparent disagreement and addresses the implications regarding the use of fathers as informants on this instrument.This article is based on Thomas A. Hulbert's master's thesis. The authors extend their appreciation to James Orisell and Dena Mussaff for their assistance in data preparation and analysis.     

Hierarchical Structure and Cross-Cultural Measurement Invariance of the Norwegian Version of the Personality Inventory for DSM–5

The Personality Inventory for DSM–5 (PID–5) was created to aid a trait-based diagnostic system for personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013a American Psychiatric Association. (2013a). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.[Crossref] , [Google Scholar]). In this study, we aimed to evaluate the Norwegian version of the PID–5 by examining its score reliability, hierarchical structure, congruency with international findings, and cross-cultural measurement invariance with a matched U.S. sample. For this purpose, 503 university students (76% females) were administered the PID–5. The Norwegian PID–5 showed good score reliability and structural validity from 1 to 5 factors. The 5-factor structure was generally congruent with international findings, and support for measurement invariance across the Norwegian and a matched U.S. sample was found. Conclusively, the results indicate that scores on the Norwegian PID–5 have sound psychometric properties, which are substantially comparable with the original U.S. version, supporting its use in a Norwegian population.     

The Validity and Clinical Utility of the Personality Inventory for DSM–5 Response Inconsistency Scale

The Personality Inventory for DSM–5 (PID–5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) is a self-report instrument designed to assess the personality traits of the alternative model of personality disorders (AMPD) in Section III of the DSM–5. Despite its relatively recent introduction to the field, the instrument is frequently and widely used. One criticism of this instrument is that it does not include validity scales to detect potentially invalidating response style, including noncredible over- and underreporting and inconsistent (random) responding. Keeley, Webb, Peterson, Roussin, and Flanagan (2016) constructed an inconsistency scale (the PID–5–INC) to assess random responding on PID–5 and proposed a number of potential cut scores that could be applied. In this study, we attempted to cross-validate the PID–5–INC, including whether the scale could detect randomly generated protocols and distinguish them from nonrandom protocols produced by two student and two clinical samples. The PID–5–INC successfully distinguished random from nonrandom protocols and the best cut scores were similar to those reported by Keeley et al. (2016). We also found that a relatively low amount of random responding compromised the psychometric validity of the PID–5 trait scales, which extended previous work on this instrument.     

The Effect of Response Bias on the Personality Inventory for DSM–5 (PID–5)

Valid self-report assessment of psychopathology relies on accurate and credible responses to test questions. There are some individuals who, in certain assessment contexts, cannot or choose not to answer in a manner typically representative of their traits or symptoms. This is referred to, most broadly, as test response bias. In this investigation, we explore the effect of response bias on the Personality Inventory for DSM–5 (PID–5; Krueger, Derringer, Markon, Watson, & Skodol, 2013 Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2013). The Personality Inventory for DSM–5 (PID–5)–Adult (Full version). Washington, DC: American Psychiatric Association. [Google Scholar]), a self-report instrument designed to assess the pathological personality traits used to inform diagnosis of the personality disorders in Section III of DSM–5. A set of Minnesota Multiphasic Personality Inventory Restructured Form (MMPI–2–RF; Ben-Porath & Tellegen, 2008 Tellegen, A., & Ben-Porath, Y. S (2008). MMPI–2–RF technical manual. Minneapolis: University of Minnesota Press. [Google Scholar]/2011 Ben-Porath, Y. S., & Tellegen, A. (2011). MMPI–2–RF manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press. (Original work published 2008) [Google Scholar]) validity scales, which are used to assess and identify response bias, were employed to identify individuals who engaged in either noncredible overreporting (OR) or underreporting (UR), or who were deemed to be reporting or responding to the items in a “credible” manner—credible responding (CR). A total of 2,022 research participants (1,587 students, 435 psychiatric patients) completed the MMPI–2–RF and PID–5; following protocol screening, these participants were classified into OR, UR, or CR response groups based on MMPI–2–RF validity scale scores. Groups of students and patients in the OR group scored significantly higher on the PID–5 than those students and patients in the CR group, whereas those in the UR group scored significantly lower than those in the CR group. Although future research is needed to explore the effects of response bias on the PID–5, results from this investigation provide initial evidence suggesting that response bias influences scale elevations on this instrument.     

Is the Narcissistic Personality Inventory still relevant? A test of independent grandiosity and entitlement scales in the assessment of narcissism

Some scholars have called for the replacement of the Narcissistic Personality Inventory (NPI) with more narrow scales measuring grandiosity and entitlement instead. In the current study, the authors examined the relations among the NPI and measures of grandiosity and entitlement, as well as in relation to a measure of the Five-Factor Model (FFM). The NPI manifested significant correlations with the alternative scales of entitlement and grandiosity and relatively similar patterns of correlations with the FFM traits. Of note, the NPI manifested significant incremental validity in the prediction of several FFM traits that are central to the conceptualization of narcissism. These findings suggest that some caution must be used before assuming that these lower-order scales can be used to replace the NPI in the assessment of narcissism.     

Trait Variance and Response Style Variance in the Scales of the Personality Inventory for DSM–5 (PID–5)

Using self- and observer reports on the Personality Inventory for DSM–5 (PID–5) and the HEXACO Personality Inventory–Revised (HEXACO–PI–R), we identified for each inventory several trait dimensions (each defined by both self- and observer reports on the facet-level scales belonging to the same domain) and 2 source dimensions (each defined by self-reports or by observer reports, respectively, on all facet-level scales). Results (N = 217) showed that the source dimensions of the PID–5 were very large (much larger than those of the HEXACO–PI–R), and suggest that self-report (or observer report) response styles substantially inflate the intercorrelations and the alpha reliabilities of the PID–5 scales. We discuss the meaning and the implications of the large PID–5 source components, and we suggest some methods of controlling their influence.     

Contributions to the Dimensional Assessment of Personality Disorders Using Millon's Model and the Millon Clinical Multiaxial Inventory (MCMI–III)

To determine if psychopaths with low anxiety are afflicted with a variety of neurosis, groups of psychopaths reporting low and high anxiety were examined with a variety of projective techniques. The use of repressive defenses, accuracy of cognition, and existence of areas of intrapsychic conflict were compared. Variance analyses indicated that the low anxious psychopaths represented a mixture of psychopathic types with a wide range of use of repressive mechanisms. Analysis of uncommon themes on the TAT produced a list of apparent appropriateness for both types of subjects.     

Validation of the NEO Personality Inventory and the five-factor model. Can findings from exploratory and confirmatory factor analysis be reconciled?

The aims of the study were (i) to analyse a Norwegian version of the NEO Personality Inventory (NEO-PI), using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA); (ii) to compare the results of the two factor analytic strategies, both within the present study and across different studies; and (iii) to discuss possible causes of discrepant findings (across factor-analytic methods and across samples). The sample comprised 961 subjects representative of the non-institutionalized Norwegian adult population. Using an EFA strategy, very high coefficients of factor comparability (r=0.93–0.99) across sexes were found. None of the five main domains turned out to be as homogeneous as suggested by the original five-factor model, but most of the deviations from the assumed simple structure were comparable to results from recent American studies. However, none of the revised EFA-based models were supported using CFA methods. Moreover, a large number of modifications were necessary to obtain a model with acceptable fit. It is argued that these discrepant findings can be accounted for, at least in part, by (i) consequences of different model acceptance criteria in the EFA and CFA tradition, (ii) the inherent logical–semantical structure of the NEO-PI, and (iii) consequences of selection effects (factorial invariance problem). © 1997 by John Wiley & Sons, Ltd.     

Are cross-cultural comparisons of personality profiles meaningful? Differential item and facet functioning in the Revised NEO Personality Inventory

Measurement invariance is a prerequisite for confident cross-cultural comparisons of personality profiles. Multigroup confirmatory factor analysis was used to detect differential item functioning (DIF) in factor loadings and intercepts for the Revised NEO Personality Inventory (P. T. Costa, Jr., & R. R. McCrae, 1992) in comparisons of college students in the United States (N = 261), Philippines (N = 268), and Mexico (N = 775). About 40%-50% of the items exhibited some form of DIF and item-level noninvariance often carried forward to the facet level at which scores are compared. After excluding DIF items, some facet scales were too short or unreliable for cross-cultural comparisons, and for some other facets, cultural mean differences were reduced or eliminated. The results indicate that considerable caution is warranted in cross-cultural comparisons of personality profiles.     

A resolution to the interpretive dilemmas created by the Minnesota Multiphasic Personality Inventory 2 (MMPI-2)? A reply to Ben-Porath and Graham

In my original article (Strassberg, 1991) I described (1)some of the changes introduced by the MMPI-2, (2) possible interpretive dilemmas created by these changes, and (3) strategies for dealing with these dilemmas. In their reply to my paper, Ben-Porath and Graham (preceding paper) suggest that the differences between the MMPI-2 and the MMPI (1) are to be expected, (2) are less important than I imply, and (3) when they do occur, will almost always reveal the superiority of the MMPI-2. In this reply to Ben-Porath and Graham, I explain why, despite their reassurances, I continue to contend that interpretive dilemmas can exist when using the MMPI-2, but these should not deter us from using this instrument.     

Relations Between Minnesota Multiphasic Personality Inventory–A Scales and Rorschach Variables With the Scope and Severity of Maltreatment Among Adolescents

This study examined preexisting Rorschach (Exner, 2001) and Minnesota Multiphasic Personality Inventory–A (MMPI–A; Butcher et al., 1992) profiles to determine if selected MMPI–A scales and Rorschach variables would jointly associate with the number and severity of maltreatment subtypes (physical abuse, sexual abuse, neglect, and emotional maltreatment) of 157 adolescents (ages 14–17) with documented maltreatment histories. The Maltreatment Classification System was used to systematically code the maltreatment attributes. Six Rorschach variables (MOR, PER, Afr, SumY, SumC’, Human Content) were significantly correlated with the number of maltreatment subtypes, but none of the anticipated MMPI–A scales were related. MMPI–A Scale 7 and Rorschach variables Ego, MOR, and PER were jointly associated with physical abuse severity. MMPI–A Scale 0 and Rorschach variables MOR, PER, SumY, SumC’, PTI, Human Content, and Texture jointly associated with sexual abuse severity. This study supports the potential for certain MMPI–A scales and Rorschach variables to reflect the impact of adolescents’ maltreatment experiences in terms of the number and severity of types of maltreatment experienced. Because both instruments captured different aspects of adolescents’ maltreatment experiences, clinicians should consider using both when evaluating the impact of maltreatment on adolescents.     

A Psychometric Review of the Personality Inventory for DSM–5 (PID–5): Current Status and Future Directions

The paradigm of personality psychopathology is shifting from one that is purely categorical in nature to one grounded in dimensional individual differences. Section III (Emerging Measures and Models) of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013), for example, includes a hybrid categorical/dimensional model of personality disorder classification. To inform the hybrid model, the DSM–5 Personality and Personality Disorders Work Group developed a self-report instrument to assess pathological personality traits—the Personality Inventory for the DSM–5 (PID–5). Since its recent introduction, 30 papers (39 samples) have been published examining various aspects of its psychometric properties. In this article, we review the psychometric characteristics of the PID–5 using the Standards for Educational and Psychological Testing as our framework. The PID–5 demonstrates adequate psychometric properties, including a replicable factor structure, convergence with existing personality instruments, and expected associations with broadly conceptualized clinical constructs. More research is needed with specific consideration to clinical utility, additional forms of reliability and validity, relations with psychopathological personality traits using clinical samples, alternative methods of criterion validation, effective employment of cut scores, and the inclusion of validity scales to propel this movement forward.     

Structural Analysis of the Trauma Symptom Inventory–2

The Trauma Symptom Inventory (TSI; Briere, 1995), a measure of the psychological effects of trauma and other adverse events, was recently expanded and updated (TSI–2; Briere, 2011). This study evaluated 4 competing models of TSI–2 dimensionality and determined the predictive validity of the best fitting solution. Data were collected from 679 adults in the general population. Confirmatory factor analysis indicated that a 4-factor solution best fit the data. All 4 factors of the final model were significant predictors of exposure to trauma or some other very upsetting event, especially posttraumatic stress. Additional research is indicated to further probe the characteristics of the TSI–2, including its dimensionality in other groups.     

Construct Validity of the DSM–5 Section III Personality Trait Profile for Borderline Personality Disorder

This study evaluated the nomological network of the borderline personality disorder (BPD) trait profile in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]) Section III. BPD symptoms include a variety of maladaptive thoughts and behaviors, and it is important to determine if the Section III trait operationalization for BPD captures these behavioral symptoms, as well as shows similar associations as the traditional Section II version with external criteria. For this purpose, we used a sample of 285 undergraduate students and conducted correlation and regression analyses to delineate the associations between Section III BPD traits and conceptually relevant external criteria. A Section III Total score was meaningfully associated with all criteria. Moreover, externalizing psychopathology tended to be most highly associated with disinhibitory Section III BPD traits, whereas internalizing psychopathology tended to have its strongest unique associations with traits reflective of negative affectivity. These results provide support for the construct validity of the trait profile for BPD in DSM–5 Section III.     

Coping and Personality: Third Time's the Charm?

ABSTRACT In this special issue, a third generation of research is represented which recognizes and demonstrates that individual differences in personality play an important role in the coping process. Although progress is apparent, there are several unresolved issues, including the best way to measure coping and whether "type of coping" matters in naturalistic settings. Three potentially important parameters of coping—range, patterning, and competence—are described, but only the first has received systematic empirical attention. The study of coping might also be advanced by researchers giving more attention to the differences between problem situations in which traits are more easily expressed ("weak" situations) versus those where normative criteria and constraints are explicit ("strong" situations).