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.     

Maladaptive personality functioning within the big five and the five-factor model

The five-factor model (FFM) of general personality functioning was derived originally from lexical studies of trait terms within the English language. Many studies have been conducted on the relationship of the FFM to personality disorder symptomatology but, as yet, no lexical study of the representation of maladaptive personality functioning within a language has been conducted. The current study identified the distribution of socially undesirable trait terms within each of the poles of the Big Five and compared this distribution to findings obtained with FFM personality disorder measures. The implications of the results for a FFM of personality disorders and for the FFM assessment of maladaptive personality functioning are discussed.     

Dimensional personality traits and the prediction of DSM-IV personality disorder symptom counts in a nonclinical sample

The third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; APA, 1980) set forth a categorical system of personality psychopathology that is composed of discrete personality disorders (PDs), each with a distinct set of diagnostic criteria. Although this system is widely accepted and highly influential, alternative dimensional approaches to capturing personality psychopathology have been proposed. Three dimensional models of personality have garnered particular attention-the Five-Factor Model (FFM; Costa & McCrae, 1992), the Seven-Factor Psychobiological Model of Temperament and Character (Seven-Factor Model; Cloninger, Svrakic, & Przybeck, 1993); and the 18-factor model of personality pathology (18-factor model; Livesley, 1986). Although the personality traits from each of these models has been examined in relation to the ten personality disorders in the DSM-IV, no study has examined the comparative and incremental validity of these models in predicting PD symptoms for these ten disorders. Using self-report instruments that measure these models and the ten DSM-IV PDs, correlation and linear regression analyses indicate that traits from all three models had statistically significant associations with PD symptom counts. Hierarchical regressions revealed that the 18-factor model had incremental predictive validity over the FFM and Seven-Fac-tor Model in predicting symptom counts for all ten DSM-IV PDs. The FFM had incremental predictive validity over the Seven-Factor Model model for all ten disorders and the Seven-Factor was able to add incremental predictive validity over the 18-factor model for five of the ten PDs and for eight of the ten disorders relative to the FFM.     

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.     

Borderline personality disorder from the perspective of general personality functioning

The authors extended previous work on the hypothesis that borderline personality disorder (BPD) can be understood as a maladaptive variant of personality traits included within the 5-factor model (FFM) of personality. In each of 3 samples, an empirically derived prototypic FFM borderline profile was correlated with individuals' FFM profiles to yield a similarity score, an FFM borderline index. Results across all samples indicated that the FFM borderline index correlated as highly with existing borderline measures as they correlated with one another, and the FFM borderline index correlated as highly with measures of dysfunction, history of childhood abuse, and parental psychopathology as did traditional measures of BPD. Findings support the hypothesis that BPD is a maladaptive variant of FFM personality traits.     

Dependent personality disorder: comparing an expert generated and empirically derived five-factor model personality disorder count

Assessment of the Diagnostic and Statistical Manual of Mental Disorders (4th Ed.; DSM-IV ) personality disorders (PDs) using five-factor model (FFM) prototypes and counts has shown substantial promise, with a few exceptions. Miller, Reynolds, and Pilkonis suggested that the expert-generated FFM dependent prototype might be misspecified in relation to the DSM-IV because of the overemphasis of high Agreeableness and underemphasis of low Conscientiousness in the experts' conception. A meta-analytic review of the relations between the FFM facets and Dependent PD (DPD) was conducted and used to create a revised, empirically based FFM DPD profile and count. The revised profile and count were more strongly correlated with DSM and non-DSM conceptualizations of maladaptive dependency. In addition, the revised FFM DPD profile was able to recreate the patterns of comorbidity typically found when using DSM-IV measures of DPD. Possible explanations for the discrepancy between the expert ratings and the meta-analytic results are offered.     

Comparing personality disorder models: cross-method assessment of the FFM and DSM-IV-TR

The current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000) defines personality disorders as categorical entities that are distinct from each other and from normal personality traits. However, many scientists now believe that personality disorders are best conceptualized using a dimensional model of traits that span normal and abnormal personality, such as the Five-Factor Model (FFM). However, if the FFM or any dimensional model is to be considered as a credible alternative to the current model, it must first demonstrate an increment in the validity of the assessment offered within a clinical setting. Thus, the current study extended previous research by comparing the convergent and discriminant validity of the current DSM-IV-TR model to the FFM across four assessment methodologies. Eighty-eight individuals receiving ongoing psychotherapy were assessed for the FFM and the DSM-IV-TR personality disorders using self-report, informant report, structured interview, and therapist ratings. The results indicated that the FFM had an appreciable advantage over the DSM-IV-TR in terms of discriminant validity and, at the domain level, convergent validity. Implications of the findings and directions for future research are discussed.     

Self- and other-reports of traits from the five-factor model: relations to personality disorder

The current study used a psychiatric sample (N = 69) to examine: (1) the correspondence between self- and other-reports of general personality, as measured by the Five-Factor Model (FFM; Costa & McCrae, 1990), and personality disorder (PD) traits, as measured by a structured interview, (2) the relations between these two sets of ratings (FFM and PD traits) and consensus ratings of PD and impairment, and (3) the incremental validity of other-rated personality scores. Agreement between raters for the five domains of the FFM ranged from .23 (agreeableness) to .71 (openness); for the PD traits agreement ranged from .37 (avoidant) to .69 (antisocial). At both the domain and facet level, the personality profiles reflected in the correlations between the FFM scores and PD criteria were consistent across raters with the exception of narcissistic PD. Substantial evidence was found for the incremental validity of other-rated personality scores, with these ratings accounting for an additional 8 to 20% of the overall variance in PD features. The other-rated FFM scores also accounted for more variance in consensus ratings of impairment in the domains of romance, work, and social relations.     

The validity of the five-factor model prototypes for personality disorders in two clinical samples

The authors examined the validity of D. R. Lynam and T. A. Widiger's (2001) prototypes for personality disorders (PDs) derived from the facets of the 5-factor model (FFM) of personality in 2 clinical samples. In the 1st sample (N = 94), there was good agreement between the prototypes generated by experts and the profiles reported by patients. These FFM PD similarity scores also demonstrated good convergent and discriminant validity with results from a semistructured interview and a self-report measure of Axis II pathology. In the 2nd sample (N = 132), the FFM PD similarity scores demonstrated excellent longitudinal stability and good predictive validity with regard to consensus ratings of PD features. The implications of these findings are discussed.     

Heritability of personality disorders in childhood: a preliminary investigation

The heritability of personality disorder features was investigated in 112 child (ages 4-15 years) twin pairs (70 monozygotic and 42 dizygotic pairs). Parents assessed personality disorder features using the Coolidge Personality and Neuropsychological Inventory for Children (CPNI; Coolidge, 1998) that measures 12 personality disorders according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association, 1994). Structural equation model-fitting methods indicated that the median heritability coefficient for the 12 scales was .75 (ranging from .81 for the Dependent and Schizotypal Personality Disorder scales to .50 for the Paranoid and Passive-Aggressive Personality Disorder scales). These results suggest that childhood personality disorders have a substantial genetic component and that they are similar to heritability estimates of personality disorder traits in adults and counter hypotheses that only temperaments and higher-order personality disorder traits have significant genetic components (Paris, 1997).     

Using a general model of personality to understand sex differences in the personality disorders

In the present study, a general model of personality was used to evaluate sex bias in the personality disorders (PD). This present study compared observed sex differences among the personality disorders (PD) with differences expected based on the Five Factor Model of personality functioning (FFM). Observed sex differences were obtained by metaanalyzing over 30 reports. Expected sex differences were computed using what is known about sex differences in the FFM traits and how these traits relate to the PDs. Agreement between observed and expected sex differences was quite good for eight of ten PDs. For histrionic PD, the obtained sex difference was larger than expected; for schizotypal personality disorder, an expected sex difference was not obtained. Implications of understanding sex differences in terms of the FFM are discussed and suggestions for future research are provided.     

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.     

Scoring the DSM-IV personality disorders using the Five-Factor Model: development and validation of normative scores for North American, French, and Dutch-Flemish samples

Five-Factor Model (FFM) personality disorder (PD) counts have demonstrated significant convergent and discriminant validity with DSM-IV PD symptoms. However, these FFM PD counts are of limited clinical use without normative data because it is difficult to determine what a specific score means with regard to the relative level of elevation. The current study presents data from three large normative samples that can be used as norms for the FFM PD counts in the respective countries: United States (N = 1,000), France (N = 801), and Belgium-Netherlands (N = 549). The present study also examines the performance, with regard to diagnostic efficiency, of statistically-defined cut-offs at 1.5 standard deviations above the mean (T > or = 65) versus previously identified cut-offs using receiver-operator characteristics (ROC) analyses. These cut-offs are tested in three clinical samples-one from each of the aforementioned countries. In general, the T > or = 65 cut-offs performed similarly to those identified using ROC analyses and manifested properties relevant to a screening instrument. These normative data allow FFM data to be used in a flexible and comprehensive manner, which may include scoring this type of personality data in order to screen for DSM-IV PD constructs.