Multidimensional perfectionism and the DSM-5 personality traits

Encouraging further research on the dimensional assessment of personality disorders (PDs), Section III of the DSM-5 introduced a hybrid model for the assessment of six PDs employing self-reports on 25 maladaptive personality traits (“DSM-5 personality traits”). Following suggestions that multidimensional perfectionism is an important characteristic across various personality disorders (Ayearst, Flett, & Hewitt, 2012), the present study investigated how personal (self-oriented) and interpersonal (other-oriented and socially prescribed) forms of perfectionism predicted the DSM-5 personality traits in a sample of 311 university students. Multiple regressions (controlling for the overlap between the different forms of perfectionism) showed that socially prescribed perfectionism positively predicted the traits defining schizotypal, borderline, avoidant, and obsessive-compulsive PD; other-oriented perfectionism positively predicted the traits defining narcissistic PD; and both socially prescribed and other-oriented perfectionism positively predicted the traits defining antisocial PD. In contrast, self-oriented perfectionism positively predicted only one of the four traits defining obsessive-compulsive PD (rigid perfectionism). Showing that multidimensional perfectionism predicted all DSM-5 traits defining the personality disorders of Section III, the findings suggest that future DSM-5 updates may profit from including interpersonal aspects of perfectionism as a diagnostic criterion.     

Personality assessment in DSM-5: empirical support for rating severity, style, and traits

Despite a general consensus that dimensional models are superior to the categorical representations of personality disorders in DSM-IV, proposals for how to depict personality pathology dimensions vary substantially. One important question involves how to separate clinical severity from the style of expression through which personality pathology manifests. This study empirically distinguished stylistic elements of personality pathology symptoms from the overall severity of personality disorder in a large, longitudinally assessed clinical sample (N = 605). Data suggest that generalized severity is the most important single predictor of current and prospective dysfunction, but that stylistic elements also indicate specific areas of difficulty. Normative personality traits tend to relate to the general propensity for personality pathology, but not stylistic elements of personality disorders. Overall, findings support a three-stage diagnostic strategy involving a global rating of personality disorder severity, ratings of parsimonious and discriminant valid stylistic elements of personality disorder, and ratings of normative personality traits.     

DSM-5 personality traits and DSM-IV personality disorders

Two issues pertinent to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) proposal for personality pathology, the recovery of DSM-IV personality disorders (PDs) by proposed DSM-5 traits and the validity of the proposed DSM-5 hybrid model, which incorporates both personality pathology symptoms and maladaptive traits, were evaluated in a large undergraduate sample (N = 808). Proposed DSM-5 traits as assessed with the Personality Inventory for DSM-5 explained a substantial proportion of variance in DSM-IV PDs as assessed with the Personality Diagnostic Questionnaire-4+, and trait indicators of the 6 proposed DSM-5 PDs were mostly specific to those disorders with some exceptions. Regression analyses support the DSM-5 hybrid model in that pathological traits, and an indicator of general personality pathology severity provided incremental information about PDs. Findings are discussed in the context of broader issues around the proposed DSM-5 model of personality disorders.     

An interpersonal analysis of pathological personality traits in DSM-5

The proposed changes to the personality disorder section of the Diagnostic and statistical manual of mental disorders (5th ed.) places an increased focus on interpersonal impairment as one of the defining features of personality psychopathology. In addition, a proposed trait model has been offered to provide a means of capturing phenotypic variation on the expression of personality disorder. In this study, the authors subject the proposed DSM-5 traits to interpersonal analysis using the inventory of interpersonal problems-circumplex scales via the structural summary method for circumplex data. DSM-5 traits were consistently associated with generalized interpersonal dysfunction suggesting that they are maladaptive in nature, the majority of traits demonstrated discriminant validity with prototypical and differentiated interpersonal problem profiles, and conformed well to a priori hypothesized associations. These results are discussed in the context of the DSM-5 proposal and contemporary interpersonal theory, with a particular focus on potential areas for expansion of the DSM-5 trait model.     

Personality in DSM-5: helping delineate personality disorder content and framing the metastructure

The transition from the Diagnostic and Statistical Model of Mental Disorders (4th ed., text revision [DSM-IV-TR]; American Psychiatric Association, 2000 ) to the fifth edition (DSM-5) represents an unprecedented opportunity to integrate dimensional personality trait models into the official nosology. Not surprisingly, a variety of issues have arisen in contemplating this challenging integration. In this article, we address how a dimensional personality trait model could be a helpful component of DSM-5, from the perspective of our roles as work group members and advisors involved in the creation of a trait model and corresponding assessment instrument. We focus in particular on two potential roles for a trait model in DSM-5 that are under official consideration. First, a dimensional personality trait model might be helpful in delineating the content of personality disorders. Second, a trait model might assist in organizing the "metastructure" of DSM-5 (i.e., the arrangement of chapters and other broader classificatory rubrics).     

Connecting DSM-5 Personality Traits and Pathological Beliefs: Toward a Unifying Model

Dissatisfaction with the DSM-IV model of personality disorders has led to the development of alternative conceptualizations, including pathological trait models and models linked to particular theoretical approaches, such as Beck and Freeman’s (1990) cognitive framework. An important issue involves the potential to interweave such models into a single, parsimonious system that combines their distinct advantages. In this study, pathological trait and dysfunctional belief data from 616 individuals in a non-clinical sample were evaluated for commensurability using structural equation modeling. These models can be integrated via five higher-order factors, and that specific dimensions of dysfunctional beliefs can be differentiated based on features of the DSM-5 trait model. Overall, these results suggest that traits provide scaffolding for individual differences in pathological personality, within which dysfunctional beliefs offer specific vectors for clinical intervention in a cognitive framework. Implications of the empirical commensurability of trait and cognitive models are discussed.     

Proposals for DSM-5: introduction to special section of Journal of Personality Disorders

On February 10, 2010, the official proposals for the personality disorders section of the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) were posted (see www.dsm5.org ). The posting by the DSM-5 Personality and Personality Disorders Work Group has been helpful in informing the field of the possible changes that may occur with DSM-5. Their presence allows for and encourages persons to provide their suggestions and concerns. The extent of the proposals is considerable. As expressed on the website, "the work group recommends a major reconceptualization of personality psychopathology" (Skodol, 2010, "Reformulation of personality disorders in DSM-5," para. 1). The proposals have generated some controversy. The Journal of Personality Disorders has always sought to be a participant in the crucial debates in our field. The purpose of this special issue is to provide members of the Work Group the opportunity to further articulate the rationale for the proposals, and to provide others an opportunity to articulate their concerns. Copies of this special issue were distributed to interested persons when the complete set of final papers were received (October of 2010).     

Personality, interpersonal circumplex, and DSM-5: A commentary on five studies

Much of personality is interpersonal, and what is interpersonal can be elegantly organized through the crossing of 2 fundamental dimensions of personality: agency and communion. The interpersonal circumplex has enriched substantially what is known about personality and in particular personality disorder, emphasizing to clinicians the importance of considering maladaptive interpersonal functioning when conducting clinical assessments. The purpose of this article is to provide a commentary on 5 articles concerning the interpersonal perspective on personality assessment. The contributions of these 5 studies are also understood relative to the proposed revisions to the American Psychiatric Association's personality disorder nomenclature, as the proposed revisions will be cutting out half of the interpersonal circumplex from further recognition.     

Personality traits in leadership tasks

A common factor analysis was performed on the four personality dimensions measured by the Myers-Briggs Type Indicator (MBTI) and questionnaire measures of preferences for the four leadership tasks, Production, Administration, Enterprising, and Integration, described by Adizes. The sample was 1040 Norwegian adults. Three factors showed distinct common variances among the task preferences and the personality traits in a way that supported the construct validity of the traits. The implication of logical consistency among constructs based on self-report data is discussed, and it is argued that such concepts are valid and necessary at both personal and organisational levels although they may not predict performance as exactly as one might want for example in personnel selection.     

Personality traits in leadership behavior

Correlational analyses of the personality traits measured by the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992) and three leadership styles, that is, Change, Production, and Employee (CPE) measured by Ekvall and Arvonen's (1991) CPE questionnaire, were performed. The sample was 106 Norwegian leaders. Three common factors comprising leadership styles and personality domains were interpreted as "looking for new possibilities,"hard working," and "dealing with people." Considering personality traits as behavior tendencies in unspecified situational contexts and leadership styles as behavioral tendencies in the leadership context, and due to the self-report nature of the data, it is argued that the factors show consistency in self-perceptions independent of context. The strongest predictors of the CPE total score were Conscientiousness and Extraversion; Openness and Agreeableness were specific predictors of Change and Employee, respectively.     

Personality traits in patients with narcolepsy

Narcolepsy is a lifelong disorder with the main symptoms of sleep attacks and cataplexy. In this study 49 narcoleptic patients were investigated with a battery of personality inventories, covering the following personality dimensions: anxiety-neuroticism, extraversion and socialization. The results were compared with three groups: normal subject, psychiatric inpatients with anxiety and outpatients with psychosomatic complaints. The main aim was to evaluate a clinical impression of a high degree of extraversion in narcoleptic patients, which according to Eysenck's model could be related to a disturbance in the arousal regulation. Narcoleptic patients had higher anxiety-neuroticism scores than normal individuals, particularly in terms of Somatic Anxiety. They had unexpectedly low scores in some socialization scales, and were contrary to our hypothesis slightly lower in the extraversion variables, than the comparison groups. The high scores in anxiety-neuroticism personality scales may depend on an anxiety-provoking effect of central stimulant drugs and/or a lability of the autonomic regulation associated with the disorder. Further, the strain caused by the narcoleptic symptoms may result in high scores in anxiety-neuroticism scales and low scores in socialization scales, via social-learning mechanisms. However, there may also be a coupling between the genetics of narcolepsy and biologically based personality traits.     

Personality traits and university program

Participants were 147 undergraduates majoring in programs classified as more professional (education, n = 28; business, n = 33) or less professional (natural sciences, n = 36; social science, n = 50) and more people-oriented (education, social sciences) or less people-oriented (business, natural sciences). They completed self-report tests for 13 personality constructs (five from Goldberg's version of the Five Factor Model, three from Eysenck and Eysenck's theory, and five others). Students in less professional disciplines scored higher on openness to experience (intellect/imagination) than those in more professional disciplines. Students in more people-oriented disciplines scored higher on empathy than those in less people-oriented disciplines. Women scored higher than men on conscientiousness, industriousness, and empathy, but lower than men on independence. Critical comments are offered and suggestions for research are made.     

Health anxiety and hypochondriasis in the light of DSM-5

Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD. Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals. Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired, had more often comorbid panic and generalized anxiety disorders, and had more medical consultations as those with IAD. Yet, no significant differences were found between SSD and IAD with regard to levels of health anxiety, other hypochondriacial characteristics, illness behavior, somatic symptom attributions, and physical concerns, whereas both groups differed significantly from clinical and healthy controls in all of these variables. Conclusion: These results do not support the proposed splitting of health anxiety/hypochondriasis into two diagnoses. Further validation studies with larger samples and additional control groups are warranted to prove the validity of the new diagnoses.     

Personality traits in women with Turner syndrome

Turner syndrome is caused by the total or partial absence of, or structural abnormalities in, one sex chromosome. A personality style characterized by traits related to low neuroticism and high extroversion has been reported for females with Turner syndrome, indicating possible genetic factors related to personality development. This study examines personality traits in 37 Swedish women with Turner syndrome using the Karolinska Scales of Personality Inventory. Compared to reference data, the subjects rated themselves as more sensation seeking, less detached, less verbally aggressive and less irritated. These results partially support previous findings. The subjects were divided into three karyotype groups: 45,X (n = 13), 45,X/46,XX or 45,X/45,XY (n = 13), and structural abnormalities (n = 11). Contrary to some previous findings, no differences in personality were found between the karyotype groups.     

Personality types and traits in the Vocational Preference Inventory

The relationships between the six scales on which Holland's (1973) theory is based (viz., Realistic, Investigative, Social, Conventional, Enterprising, Artistic) and the five other scales (viz., Self-control, Masculinity, Status, Infrequency, Acquiescence) of the Vocational Preference Inventory (VPI) (Holland, 1970) were investigated using canonical analysis. Considering the six personality type scales as one set of variables and the five trait scales of the VPI as the second set of variables, five significant canonical correlations were obtained for a sample of 373 mostly white undergraduate students. In a second study, three significant canonical correlations were found for a sample of 115 black college students at another school. The weights of the VPI scales suggested that three patterns of relationships among the scales are shared by the black sample and the mostly white sample.