Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-24T20:09:59.941Z Has data issue: false hasContentIssue false
  • English
  • Français

Initial construction of a maladaptive personality trait model and inventory for DSM-5

Published online by Cambridge University Press:  08 December 2011

R. F. Krueger ,
J. Derringer ,
K. E. Markon ,
D. Watson  and
A. E. Skodol
R. F. Krueger*
Affiliation:
Department of Psychology, University of Minnesota, Minneapolis, MN, USA
J. Derringer
Affiliation:
Department of Psychology, University of Minnesota, Minneapolis, MN, USA
K. E. Markon
Affiliation:
Department of Psychology, University of Iowa, Iowa City, IA, USA
D. Watson
Affiliation:
Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
A. E. Skodol
Affiliation:
Department of Psychiatry, University of Arizona School of Medicine, Phoenix, AZ, USA
*
*Address for correspondence: R. F. Krueger, Ph.D., Department of Psychology, University of Minnesota, N414 Elliott Hall, Minneapolis, MN 55455, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

DSM-IV-TR suggests that clinicians should assess clinically relevant personality traits that do not necessarily constitute a formal personality disorder (PD), and should note these traits on Axis II, but DSM-IV-TR does not provide a trait model to guide the clinician. Our goal was to provide a provisional trait model and a preliminary corresponding assessment instrument, in our roles as members of the DSM-5 Personality and Personality Disorders Workgroup and workgroup advisors.

Method

An initial list of specific traits and domains (broader groups of traits) was derived from DSM-5 literature reviews and workgroup deliberations, with a focus on capturing maladaptive personality characteristics deemed clinically salient, including those related to the criteria for DSM-IV-TR PDs. The model and instrument were then developed iteratively using data from community samples of treatment-seeking participants. The analytic approach relied on tools of modern psychometrics (e.g. item response theory models).

Results

A total of 25 reliably measured core elements of personality description emerged that, together, delineate five broad domains of maladaptive personality variation: negative affect, detachment, antagonism, disinhibition, and psychoticism.

Conclusions

We developed a maladaptive personality trait model and corresponding instrument as a step on the path toward helping users of DSM-5 assess traits that may or may not constitute a formal PD. The inventory we developed is reprinted in its entirety in the Supplementary online material, with the goal of encouraging additional refinement and development by other investigators prior to the finalization of DSM-5. Continuing discussion should focus on various options for integrating personality traits into DSM-5.

Keywords

AssessmentDSMpersonality disorderspersonality traits
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 9 , September 2012 , pp. 1879 - 1890
Copyright
Published by Cambridge University Press 2011 Copyright © 2011 American Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, revised, p. 685. American Psychiatric Association: Washington, DC.Google Scholar
Asparouhov, T (2005). Sampling weights in latent variable modeling. Structural Equation Modeling 12, 411–434.CrossRefGoogle Scholar
Austin, EJ, Deary, IJ (2000). The ‘four As’: a common framework for normal and abnormal personality? Personality and Individual Differences 28, 977–995.CrossRefGoogle Scholar
Browne, MW (2001). An overview of analytic rotation in exploratory factor analysis. Multivariate Behavioral Research 36, 111–150.CrossRefGoogle Scholar
Cai, L (2010). High-dimensional exploratory item factor analysis by a Metropolis–Hastings Robbins–Monro algorithm. Psychometrika 75, 33–57.CrossRefGoogle Scholar
Cella, D, Riley, W, Stone, A, Rothrock, N, Reeve, B, Yount, S, Amtmann, D, Bode, R, Buysse, DJ, Choi, SW, Cook, KF, DeVellis, R, DeWalt, D, Fries, JF, Gershon, R, Hahn, E, Pilkonis, P, Revicki, D, Rose, M, Weinfurt, K, Hays, RD, on behalf of the PROMIS Cooperative Group (2010). The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. Journal of Clinical Epidemiology 63, 1179–1194.CrossRefGoogle ScholarPubMed
Chmielewski, M, Watson, D (2008). The heterogeneous structure of schizotypal personality disorder: item-level factors of the schizotypal personality questionnaire and their associations with obsessive-compulsive disorder symptoms, dissociative tendencies, and normal personality. Journal of Abnormal Psychology 117, 364–376.CrossRefGoogle ScholarPubMed
Clark, LA (2007). Assessment and diagnosis of personality disorder: perennial issues and emerging conceptualization. Annual Review of Psychology 58, 227–258.CrossRefGoogle Scholar
Clark, LA, Simms, LJ, Wu, KD, Casillas, A (in press). Manual for the Schedule for Nonadaptive and Adaptive Personality – Second Edition (SNAP-2). University of Minnesota Press: Minneapolis, MN.Google Scholar
Costa, PT Jr., McCrae, RR (1992). Revised NEO Personality Inventory NEO–PI–R and NEO Five-Factor Inventory NEO–FFI Professional Manual. Psychological Assessment Resources: Odessa, FL.Google Scholar
Costa, PT Jr., Widiger, TA (editors) (2002). Personality Disorders and the Five-Factor Model of Personality, 2nd edn. American Psychological Association: Washington, DC. CrossRefGoogle Scholar
Cuijpers, P, Smit, F, Penninx, BWJH, de Graaf, R, ten Have, M, Beekman, ATF (2010). Economic costs of neuroticism: a population-based study. Archives of General Psychiatry 67, 1086–1093.CrossRefGoogle ScholarPubMed
De Clercq, B, De Fruyt, F, Van Leeuwen, K, Mervielde, I (2006). The structure of maladaptive personality traits in childhood: a step toward an integrative developmental perspective for DSM-5. Journal of Abnormal Psychology 115, 639–657.CrossRefGoogle Scholar
de Moor, MHM, Costa, PT, Terracciano, A, Krueger, RF, de Geus, EJC, Toshiko, T, Penninx, BW, Esko, T, Madden, PA, Derringer, J, Amin, N, Willemsen, G, Hottenga, JJ, Distel, MA, Uda, M, Sanna, S, Spinhoven, P, Hartman, CA, Sullivan, P, Realo, A, Allik, J, Heath, AC, Pergadia, ML, Agrawal, A, Lin, P, Grucza, R, Nutile, T, Ciullo, M, Rujescu, D, Giegling, I, Konte, B, Widen, E, Cousminer, DL, Eriksson, JG, Palotie, A, Peltonen, L, Luciano, M, Tenesa, A, Davies, G, Lopez, LM, Hansell, NK, Medland, SE, Ferrucci, L, Schlessinger, D, Montgomery, GW, Wright, MJ, Aulchenko, YS, Janssens, AC, Oostra, BA, Metspalu, A, Abecasis, GR, Deary, IJ, Räikkönen, K, Bierut, LJ, Martin, NG, van Duijn, CM, Boomsma, DI (2010). Meta-analysis of genome-wide association studies for personality. Molecular Psychiatry. Published online: 21 December 2010. doi:10.1038/mp.2010.128.Google ScholarPubMed
Dennis, JM (2010). Summary of Knowledge Panel Design (http://www.knowledgenetworks.com/knpanel/docs/KnowledgePanel%28R%29-Design-Summary-Description.pdf). Accessed 11 November 2011.Google Scholar
Embretson, SE, Reise, SP (2000). Item Response Theory for Psychologists. Lawrence Erlbaum Associates, Inc.: Mahwah, NJ.Google Scholar
Goldberg, LR (1993). The structure of phenotypic personality traits. American Psychologist 48, 26–34.CrossRefGoogle ScholarPubMed
Harkness, AR, Lilienfeld, SO (1997). Individual differences science for treatment planning: personality traits. Psychological Assessment 9, 349–360.CrossRefGoogle Scholar
Harkness, AR, McNulty, JL, Ben-Porath, YS (1995). The personality psychopathology five (PSY-5): constructs and MMPI-2 scales. Psychological Assessment 7, 104–114.CrossRefGoogle Scholar
Hopwood, CJ, Donnellan, MB (2010). How should the internal structure of personality inventories be evaluated? Personality and Social Psychology Review 14, 332–346.CrossRefGoogle ScholarPubMed
Hopwood, CJ, Quigley, BD, Morey, LC, Bender, DS, Skodol, AE, Stout, RL, McGlashan, TH, Grilo, CM, Gunderson, JG (2008). Personality traits and mental health treatment utilization. Personality and Mental Health 2, 207–217.CrossRefGoogle ScholarPubMed
Kendler, KS, Aggen, SH, Knudsen, GP, Røysamb, E, Neale, MC, Reichborn-Kjennerud, T (2011). The structure of genetic and environmental risk factors for syndromal and subsyndromal common DSM-IV axis I and all axis II disorders. American Journal of Psychiatry 168, 29–39.CrossRefGoogle ScholarPubMed
Kraemer, HC, Kupfer, DJ, Narrow, WE, Clarke, DE, Regier, DA (2010). Moving toward DSM-5: the field trials. American Journal of Psychiatry 167, 1158–1160.CrossRefGoogle ScholarPubMed
Krueger, RF, Eaton, NR (2010). Personality traits and the classification of mental disorders: toward a more complete integration in DSM-5 and an empirical model of psychopathology. Personality Disorders: Theory, Research, and Treatment 1, 97–118.CrossRefGoogle Scholar
Livesley, WJ (2007). A framework for integrating dimensional and categorical classifications of personality disorder. Journal of Personality Disorders 21, 199–224.CrossRefGoogle ScholarPubMed
Livesley, WJ, Jackson, DN (2009). Manual for the Dimensional Assessment of Personality Pathology. Sigma Press: Port Huron, MI.Google Scholar
Markon, KE (2010). Modeling psychopathology structure: a symptom-level analysis of axis I and II disorders. Psychological Medicine 40, 273–288.CrossRefGoogle ScholarPubMed
Markon, KE, Krueger, RF, Watson, D (2005). Delineating the structure of normal and abnormal personality: an integrative hierarchical approach. Journal of Personality and Social Psychology 88, 139–157.CrossRefGoogle ScholarPubMed
Morey, LC (2003). Essentials of PAI Assessment. John Wiley: New York.Google Scholar
Muthén, LK, Muthén, BO (1998–2010). MPlus Users Guide, 6th edn. Muthén & Muthén: Los Angeles, CA.Google Scholar
Nestadt, G, Costa, PT Jr., Hsu, F-C, Samuels, J, Bienvenu, OJ, Eaton, WW (2008). The relationship between the five-factor model and latent Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition personality disorder dimensions. Comprehensive Psychiatry 49, 98–105.CrossRefGoogle ScholarPubMed
Oltmanns, TF, Turkheimer, E (2009). Person perception and personality pathology. Current Directions in Psychological Science 18, 32–36.CrossRefGoogle ScholarPubMed
Piedmont, RL, Sherman, MF, Sherman, NC, Dy-Liacco, GS, Williams, JE (2009). Using the five-factor model to identify a new personality disorder domain: the case for experiential permeability. Journal of Personality and Social Psychology 96, 1245–1258.CrossRefGoogle ScholarPubMed
Pincus, AL, Lukowitsky, MR, Wright, AGC (2010). The interpersonal nexus of personality and psychopathology. In Contemporary Directions in Psychopathology: Scientific Foundations for DSM-V and ICD-11 (ed. Millon, T., Krueger, R. and Simonsen, E.), pp. 523–552. Guilford: New York.Google Scholar
Røysamb, E, Kendler, KS, Tambs, K, Orstavik, RE, Neale, MC, Aggen, SH, Torgersen, S, Reichborn-Kjennerud, T (2011). The joint structure of DSM-IV axis I and axis II disorders. Journal of Abnormal Psychology 120, 198–209.CrossRefGoogle ScholarPubMed
Samuel, DB, Widiger, TA (2008). A meta-analytic review of the relationships between the five-factor model and DSM-IV-TR personality disorders: a facet level analysis. Clinical Psychology Review 28, 1326–1342.CrossRefGoogle ScholarPubMed
Schwarz, GE (1978). Estimating the dimension of a model. Annals of Statistics 6, 461–464.CrossRefGoogle Scholar
Scientific Software International, Inc. (2010). IRTPRO Application, version 1.1.20215.1 BETA (http://www.ssicentral.com). Accessed August 2010.Google Scholar
Simms, L, Goldberg, LR, Roberts, JE, Watson, D, Welte, J, Rotterman, JH (2011). Computerized Adaptive Assessment of Personality Disorder: introducing the CAT-PD project. Journal of Personality Assessment 93, 380–389.CrossRefGoogle ScholarPubMed
Simms, L, Watson, D (2007). The construct validation approach to personality scale construction. In Handbook of Research Methods in Personality Psychology (ed. Robins, R. W., Fraley, R. C. and Krueger, R. F.), pp. 240–258. Guilford: New York.Google Scholar
Smits, N, Vorst, HCM (2007). Reducing the length of questionnaires through structurally incomplete designs: an illustration. Learning and Individual Differences 17, 25–34.CrossRefGoogle Scholar
Tang, TZ, DeRubeis, RJ, Hollon, SD, Amsterdam, J, Shelton, R, Schalet, B (2009). Personality change during depression treatment: a placebo-controlled trial. Archives of General Psychiatry 66, 1322–1330.CrossRefGoogle ScholarPubMed
Team, RDC (2010). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing: Vienna.Google Scholar
Trull, TJ, Durrett, CA (2005). Categorical and dimensional models of personality disorder. Annual Review of Clinical Psychology 1, 355–380.CrossRefGoogle ScholarPubMed
van den Oord, EJCG (2005). Estimating Johnson curve population distributions in MULTILOG. Applied Psychological Measurement 29, 45–64.CrossRefGoogle Scholar
van den Oord, EJCG, Kuo, P-H, Hartmann, AM, Webb, BT, Moller, H-J, Hettema, JM, Giegling, I, Bukszár, J, Rujescu, D (2008). Genomewide association analysis followed by a replication study implicates a novel candidate gene for neuroticism. Archives of General Psychiatry 65, 1062–1071.CrossRefGoogle ScholarPubMed
Watson, D, Clark, LA, Chmielewski, M (2008). Structures of personality and their relevance to psychopathology: II. Further articulation of a comprehensive unified trait structure. Journal of Personality 76, 1545–1586.CrossRefGoogle ScholarPubMed
Widiger, TA, Livesley, WJ, Clark, LA (2009). An integrative dimensional classification of personality disorder. Psychological Assessment 21, 243–255.CrossRefGoogle ScholarPubMed
Widiger, TA, Simonsen, E (2005). Alternative dimensional models of personality disorder: finding a common ground. Journal of Personality Disorders 19, 110–130.CrossRefGoogle ScholarPubMed
Zwick, WF, Velicer, WF (1986). Comparison of five rules for determining the number of components to retain. Psychological Bulletin 99, 432–442.CrossRefGoogle Scholar
Supplementary material: File

Krueger Supplementary Material

Krueger Supplementary Material

Download Krueger Supplementary Material(File)
File 1.6 MB