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.     

Preferential selection and stereotypes: Effects on evaluation of female leader performance,subordinate goal commitment,and task performance

In a laboratory setting, 135 undergraduate students (69 male, 66 female; approximately 98% white) completed a mock class scheduling task led by a female confederate who was chosen either preferentially or by merit. Results indicated that (1) subordinate evaluations of female leader performance were not affected by preferential selection, but were significantly related to degree of non-traditional views held toward female managers; (2) commitment to the goal assigned by the female leader was not lessened by preferential selection, but also was significantly related to degree of non-traditional views toward female managers; and (3) subordinate performance on the scheduling task was significantly related to commitment to the leader-assigned goal.     

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.     

Schizotypal Personality Questionnaire-Brief: factor structure and convergent validity in inpatient adolescents

We examined the internal consistency, factor structure, and validity of the Schizotypal Personality Questionnaire-Brief (SPQ-B). Two hundred thirty-seven psychiatrically hospitalized adolescents were administered the SPQ-B and a battery of well-established self-report instruments. The SPQ-B demonstrated adequate internal consistency. Exploratory factor analysis provided mixed support for the SPQ-B 3-factor structure of interpersonal deficits, cognitive-perceptual deficits, and disorganization. The Interpersonal and Cognitive-Perceptual subscales demonstrated convergent and discriminant relationships with other measures of interpersonal impairment and cognitive abnormalities. We concluded that the SPQ-B is a promising measure for evaluating schizotypal personality disorder features, specifically interpersonal and cognitive-perceptual deficits, with adolescent psychiatric inpatients.     

Applicability of personality disorder criteria in late adolescence: internal consistency and criterion overlap 2 years after psychiatric hospitalization.

We examined internal consistency and criterion overlap of DSM-III-R personality disorder criteria in late adolescence, 2 years after psychiatric hospitalization. A total of 60 adolescents were assessed with the Personality Disorder Examination. Within-category cohesiveness (internal consistency) was evaluated by coefficient alpha and mean intercriterion correlation (MIC). Between-category criterion overlap was evaluated by examining intercategory mean intercriterion correlations (ICMIC) between all pairs of disorders. Internal consistency was low, with alpha less than .70 for all except borderline and dependent personality disorders. For most disorders, MIC values were higher than ICMIC values. Our findings suggest that personality disorder criteria sets have limited internal consistency in older adolescents. Although the criteria for most personality disorders correlate better with each other than with the criteria for other personality disorders, suggesting some degree of discriminant validity, comparison of these results with a similar analysis performed shortly after hospital admission raises questions about personality disorder construct validity during adolescence.     

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.     

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.     

The representation of four personality disorders by the schedule for nonadaptive and adaptive personality dimensional model of personality

This study examined the relationships of the Schedule for Nonadaptive and Adaptive Personality (SNAP) model of personality to 4 targeted personality disorders (PDs) in a large multisite sample of patients. Data were examined from 529 patients, who were assigned 1 of 5 primary diagnoses: borderline, schizotypal, avoidant, and obsessive-compulsive PDs and major depression without PD. Patients were administered the SNAP questionnaire and results were compared among diagnostic groups and between patient groups and nonclinical norms. Results indicated that the dimensions of the model appear to have considerable promise in differentiating normal from abnormal personality, particularly in the propensity of individuals with PDs to manifest negative affects and interpersonal detachment. Furthermore, the model appeared to successfully distinguish specific PDs, a property that represents a particular challenge for dimensional models of personality.