The representation of borderline,avoidant, obsessive-compulsive,and schizotypal personality disorders by the five-factor model

This study evaluated the accuracy of hypothesized relationships of the five-factor model of personality to four targeted personality disorders in a large multisite sample of patients. Data were gathered from 668 patients, who were assigned to one of five study cells: Borderline, Schizotypal, Avoidant, and Obsessive-Compulsive Personality Disorder, and a Major Depression without personality disorder comparison group. Patients were administered a questionnaire designed to assess the domains and facets of the five-factor model and results were compared among diagnostic groups and between patients and community norms. Although many relationships between personality traits and disorders were obtained, the magnitude of the relationships varied greatly as a function of the comparison group involved. In general, the differences between the personality disorder patients and community norms were far larger than the differences between the specific personality disorder groups. Also, for avoidant personality, it appeared that statistical interactions between personality factors are needed to better differentiate it from other personality disorder groups. The four personality disorder groups studied could each be distinguished from community norms on the personality dimensions of the five-factor model. However, differentiating among the four groups proved more difficult, as each shared the configuration of high Neuroticism, low Agreeableness, and low Conscientiousness. It does not appear that these disorders represent extremes of different personality dimensions, but rather each appears to be a variant of the same extreme configuration. Differences between personality disorders may reflect diverse interactions among the dimensions, rather than differences on single dimensions.     

Millon's dimensional model of personality disorders: a comparative study

Millon has proposed six fundamental dimensions of general personality functioning as providing the underlying structure of personality disorders. However, this widely-cited theoretical model has been the subject of few empirical studies. The purpose of the current study was to directly compare the validity of this model to the five-factor model with respect to their hypothesized relationships with personality disorder symptomatology. Participants were administered the predominant measures of general personality functioning for each theoretical model, along with an assessment of personality disorder symptomatology. The results found only weak support for the theoretical model of Millon. Limitations and suggestions for future research are discussed.     

Temporal coherence of criteria for four personality disorders

This study sought to investigate the coherence of changes observed in diagnostic criteria for borderline, schizotypal, obsessive-compulsive, and avoidant personality disorders. Five hundred, forty-nine patients were independently evaluated 2 years apart, and correlations of observed changes in each diagnostic criterion with changes in other criteria were examined to determine if there was within-syndrome consistency in these changes. The observed changes in criteria were consistent within syndrome (median alpha = 0.72 across 4 disorders), and reasonably specific to that syndrome relative to the other disorders. The results support the validity of these criterion sets as representing coherent syndromes.     

Judgment research and the dimensional model of personality

Comments on the original article "Plate tectonics in the classification of personality disorder: Shifting to a dimensional model," by T. A. Widiger and T. J. Trull. The purpose of this comment is to address (a) whether psychologists know how personality traits are currently assessed by clinicians and (b) the reliability and validity of those evaluations. Although Widiger and Trull argued that the shift to a dimensional model will improve the diagnosis of personality disorders, we can also expect that it will lead to improvements in evaluating personality traits.     

Rigid and extreme: a geometric representation of personality disorders in five-factor model space.

Personality disorder rigidity and extremity can be geometrically defined and operationalized within the 5-factor model (FFM) of personality. A series of geometric and substantive assumptions were derived and then tested in samples of college students (N = 1,323) and psychiatric patients (N = 86). Normal and disordered personalities were found to coexist in a variety of regions of the FFM multivariate space. Within regions, the profiles of normal and disordered personalities were very similar in characteristic configuration but notably different in profile variability. Personality-disordered individuals tended to be located in the perimeters or outer regions of the FFM space, as indicated by their longer vector lengths. These findings generalized across 2 measures of personality disorders and across 2 measures of normal personality traits.     

Longitudinal studies of personality disorders: four lessons from personality psychology

The three longitudinal projects described in this special section of the Journal of Personality Disorders raise a number of intriguing questions concerning the natural history of personality disorders and offer more than their share of surprises. In addition, they underscore several valuable lessons derived from the literature on normal-range personality traits. Drawing in part from the writings of the American trait psychologist Gordon Allport, I describe four such lessons: (1) change and continuity of personality traits and disorders can and do coexist, (2) the covariation among personality traits helps to account for the "comorbidity" among personality disorders, (3) personality traits and disorders influence how individuals interpret life events, and (4) personality traits must be distinguished from behavioral adaptations to these traits. These lessons remind us that the science of personality disorders must be informed by the basic science of personality.     

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.     

The DSM-5 dimensional model of personality disorder: rationale and empirical support

Ideally, a dimensional model of normal and abnormal personality functioning within the forthcoming DSM-5 would represent a common ground among the existing alternative models and would be consistent with the substantial body of empirical research that has accumulated on such models. The DSM-5 Work Group had the opportunity to make an historic step toward the integration of the normal personality traits researched within psychology with the personality disorders of psychiatry. They chose instead to construct a cumbersome six-dimensional model of personality disorder that excludes normal personality traits, is inconsistent with the preponderance of the research, and is distinguished explicitly from the predominant dimensional model of general personality structure.     

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.     

Depressive personality disorder: rates of comorbidity with personality disorders and relations to the five-factor model of personality

Depressive personality disorder (DPD) is listed in the DSM-IV as one of the "Disorders for Further Study." In this investigation we examined (1) the rates of comorbidity of DPD with the 10 personality disorders (PDs) in the main text of DSM-IV, and (2) the convergent and discriminant validity of DPD in its relation to the 30 facet traits of the Five-Factor Model of personality (FFM). One hundred and sixty-nine participants with psychiatric diagnoses were interviewed with the Structured Clinical Interview for DSM-IV Personality Disorders Questionnaire (SCID-II) and completed the Revised NEO Personality Inventory (NEO PI-R). A total of 26 (15%) of the participants met diagnostic criteria for at least one of the 10 main text PDs, and 15 (9%) met criteria for DPD. Of those who met criteria for DPD, 10 (59%) of the participants also met criteria for one or more of the 10 main text PDs. Regression analyses indicated a four-facet trait set derived from the NEO PI-R thought to be uniquely associated with DPD accounted for a significant amount of variance in DPD SCID-II PD scores and was significantly larger for DPD than it was for the 9 of the 10 main text PDs; the sole exception was for avoidant PD. Diagnostically, DPD overlaps significantly with other PDs but is distinguishable in its unique relation with traits from the FFM.     

Relating the Spherical representation of vocational interests to the HEXACO personality model

The present study extends previous research on interests–personality relations by comparing recent models of vocational interests (using the Personal Globe Inventory; PGI, Tracey, 2002) and personality (using the HEXACO-PI-R; Ashton, Lee, & de Vries, 2014) with each other. First, the structure of the Spherical representation was adequately replicated in a Dutch sample (N = 656). Second, in so far as comparisons were possible, the relations between interests and personality were found to be congruent with previous findings. Third, Prestige interests, the defining feature of the Spherical representation, were related, albeit weakly, to Openness to Experience and to Extraversion. Last of all, Honesty–Humility and Openness to Experience were related to profile elevation in interest scores. All results were obtained for normative and ipsatized scales, revealing several meaningful differences in interests–personality relations depending on the type of interest scoring procedure.     

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.     

Five-factor model prototypes for personality disorders: the utility of self-reports and observer ratings

The current study examined the prototype-matching technique for using the five-factor model (FFM) of personality to assess personality disorders (PDs) and their correlates. The sample was composed of 69 psychiatric patients, most of whom suffered from affective or anxiety disorders. The participants were predominantly outpatients (78%), Caucasian (94%), and women (58%). NEO Personality Inventory (NEO-PI) data from these patients and informants were available for deriving PD prototype scores. The results supported four conclusions. First, the FFM prototype-matching method is useful for clinical samples. Second, agreement between self-reports and information from significant others (SOs) using this method is good compared to previous results. Third, this agreement varies systematically with the observability of the PD criteria. Fourth, the value of self- and other-reported personality information depends on the rating source of the outcome variables. Other-reported information provides incremental utility in predicting impairment and interpersonal distress rated by clinicians and significant others.     

Continuity of axes I and II: toward a unified model of personality, personality disorders, and clinical disorders

In the current standard psychiatric nomenclature, the DSM-IV-TR (APA, 2000), mental disorders are divided into two groups: Clinical Disorders (CDs) and Personality Disorders (PDs), and CD and PD diagnoses are recorded on two separate axes (Axes I and II, respectively). This article considers evidence regarding putative bases for distinguishing between CDs and PDs, and finds that these constructs are more similar than distinct. Links between the domains may be better understood by focusing on how personality connects CDs and PDs. This perspective underlines the need to work toward a more unified model of personality, PDs, and CDs in research and in future editions of the DSM.     

Differential impairment as an indicator of sex bias in DSM-IV criteria for four personality disorders

The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and women in the relationship between each diagnostic criterion and level of impairment. The results suggest that most of the diagnostic criteria examined do not seem to display sex bias. However, those criteria that displayed evidence of bias came largely from the borderline diagnosis.     

A four dimensional,integrative, categorial model of psychotherapy

Integration of psychotherapeutic approaches has been notoriously difficult because of incompatibility of technical procedures and theoretical concepts. A categorial analysis from a higher level of abstraction might be able to overcome these difficulties. A model is proposed with four dimensions: personal regard, a relationship component; structure, a planning component; consciousness, a cognitive component; and process, an individual component. It is maintained that these four dimensions span out the space within which psychotherapy of any lineage moves along. Problems with incompatibility of systems and techniques might stem from the fact that different schools of psychotherapy emphasize different aspects of this framework, while using the other aspects only implicitly. It might also be that clients with different problems and pathologies, and at different stages in therapy, need different approaches reflected in different weights of the four dimensions. The model could be used to arrive at a broader understanding of what psychotherapy does. Should it prove helpful, it could also be used as a means of understanding successful and unsuccessful therapies and as a prognostic tool.     

The association of affiliation and achievement personality styles with DSM-IV personality disorders

Investigators from theoretically diverse backgrounds have long described two personality styles associated with depression. The affiliation style describes individuals with interpersonal concerns; the achievement style describes individuals who have concerns with personal failure. Although primarily related to risk for depression, there has also been recognition that extreme forms of these styles are related to personality disorders (PDs). The current study examines the relation between the DSM-IV PDs and the two personality styles, assessing the latter using two approaches: (a) dependency/self-criticism (Blatt, 1974) and (b) sociotropy/autonomy (Beck, 1983). Results show that whereas the achievement style is associated with most PDs (except for the histrionic and dependent PDs), the affiliation style is associated only with histrionic, dependent, and depressive PDs. Controlling for shared PD variance leaves only two associations, affiliation with dependent PD and achievement with narcissistic PD. Results are discussed in the context of current efforts to capture personality psychopathology within a comprehensive dimensional framework.     

Clinical utility of dimensional models for personality pathology

Clinical utility is defined as the extent to which the DSM assists clinical decision makers in fulfilling the various clinical functions of a psychiatric classification system. Distinction is made between elements of diagnostic validity that are more or less conditional to utility (i.e., coverage, and consistency with etiology and prognosis) and components of clinical utility in the narrow sense of the term (i.e., user acceptability and accuracy, communication, reliability, subtlety, and clinical decision making). Clinical utility is often considered the driving force behind the respective revisions of the DSM system, yet it has been difficult if not impossible to obtain reasonable levels of clinical utility within categorical classifications of personality disorders. This paper presents evidence that a dimensional diagnostic system will substantially improve clinical utility, especially with respect to coverage, reliability, subtlety, and clinical decision making. In addition, some evidence suggests that the purely dimensional models outperform the so-called hybrid models (i.e., dimensional profiling of categories) with respect to coverage, consistency with etiology, subtlety, and clinical decision making. Several research options that might inform future revisions, including the choice or development of a dimensional classification, are suggested.     

The longitudinal relationship of personality traits and disorders

Personality disorders are presumed to be stable because of underlying stable and maladaptive personality traits, but while previous research has demonstrated a link between personality traits and personality disorders cross-sectionally, personality disorders and personality traits have not been linked longitudinally. This study explores the extent to which relevant personality traits are stable in individuals diagnosed with 4 personality disorders (schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders) and examines the assumption that these personality disorders are stable by virtue of stable personality traits. This assumption was tested via the estimation of a series of latent longitudinal models that evaluated whether changes in relevant personality traits lead to subsequent changes in personality disorders. In addition to offering large consistency estimates for personality traits and personality disorders, the results demonstrate significant cross-lagged relationships between trait change and later disorder change for 3 of the 4 personality disorders studied.