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Relating DSM-5 section III personality traits to section II personality disorder diagnoses

Published online by Cambridge University Press:  30 October 2015

L. C. Morey ,
K. T. Benson  and
A. E. Skodol
L. C. Morey*
Affiliation:
Department of Psychology, Texas A&M University, College Station, TX, USA
K. T. Benson
Affiliation:
Department of Psychology, Texas A&M University, College Station, TX, USA
A. E. Skodol
Affiliation:
Department of Psychiatry, University of Arizona College of Medicine, Phoenix, AZ, USA
*
* Address for correspondence: L. C. Morey, Ph.D., Department of Psychology, Texas A & M University, College Station, TX 77843-4235, USA. (Email: [email protected])
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Abstract

Background

The DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DSM categorical diagnoses to be retained in this system – antisocial, avoidant, borderline, narcissistic, obsessive–compulsive and schizotypal personality disorders. The goal of the current study was to describe the empirical relationships between the DSM-5 section III pathological traits and DSM-IV/DSM-5 section II personality disorder diagnoses.

Method

Data were obtained from a sample of 337 clinicians, each of whom rated one of his or her patients on all aspects of the DSM-IV and DSM-5 proposed alternative model. Regression models were constructed to examine trait–disorder relationships, and the incremental validity of core personality dysfunctions (i.e. criterion A features for each disorder) was examined in combination with the specified trait clusters.

Results

Findings suggested that the trait assignments specified by the Work Group tended to be substantially associated with corresponding DSM-IV concepts, and the criterion A features provided additional diagnostic information in all but one instance.

Conclusions

Although the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

Keywords

DSM-5personality disorderstaxonomy
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 3 , February 2016 , pp. 647 - 655
Copyright
Copyright © Cambridge University Press 2015 

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Press: Washington, DC.Google Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Press: Washington, DC.Google Scholar
Anderson, J, Snider, S, Sellbom, M, Krueger, R, Hopwood, C (2014). A comparison of the DSM-5 section II and section III personality disorder structures. Psychiatry Research 216, 363–372.Google Scholar
Costa, PT, McCrae, RR (1992). The five-factor model of personality and its relevance to personality disorders. Journal of Personality Disorders 6, 343–359.Google Scholar
Few, LR, Miller, JD, Rothbaum, AO, Meller, S, Maples, J, Terry, DP, Collins, B, MacKillop, J (2013). Examination of the section III DSM-5 diagnostic system for personality disorders in an outpatient clinical sample. Journal of Abnormal Psychology 122, 1057.Google Scholar
Fossati, A, Krueger, RF, Markon, KE, Borroni, S, Maffei, C (2013). Reliability and validity of the Personality Inventory for DSM-5 (PID-5) predicting DSM-IV personality disorders and psychopathy in community-dwelling Italian adults. Assessment 20, 689–708.Google Scholar
Goldberg, LR (1993). The structure of phenotypic personality traits. American Psychologist 48, 26–34.Google Scholar
Hopwood, CJ, Thomas, KM, Markon, KE, Wright, AG, Krueger, RF (2012). DSM-5 personality traits and DSM-IV personality disorders. Journal of Abnormal Psychology 121, 424–432.Google Scholar
Hyler, SE (1994). Personality Diagnostic Questionnaire (PDQ-4). New York State Psychiatric Institute: New York.Google Scholar
Jopp, AM, South, SC (2015). Investigating the personality inventory for DSM-5 using self and spouse reports. Journal of Personality Disorders 29, 193–214.Google Scholar
Krueger, RF, Derringer, J, Markon, KE, Watson, D, Skodol, AE (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine 42, 1879–1890.Google Scholar
Krueger, RF, Eaton, NR, Clark, LA, Watson, D, Markon, KE, Derringer, J, Skodol, AE, Livesley, WJ (2011). Deriving an empirical structure for personality pathology for DSM-5. Journal of Personality Disorders 25, 170–191.CrossRefGoogle ScholarPubMed
Miller, JD, Few, LR, Lynam, DR, MacKillop, J (2015). Pathological personality traits can capture DSM-IV personality disorder types. Personality Disorders Theory Research and Treatment 6, 32–40.Google Scholar
Miller, JD, Gentile, B, Wilson, L, Campbell, WK (2013). Grandiose and vulnerable narcissism and the DSM-5 pathological personality trait model. Journal of Personality Assessment 95, 284–290.Google Scholar
Morey, LC (1988 a). Personality disorders under DSM-III and DSM-III-R: an examination of convergence, coverage, and internal consistency. American Journal of Psychiatry 145, 573–577.Google Scholar
Morey, LC (1988 b). The categorical representation of personality disorder: a cluster analysis of DSM-III-R personality features. Journal of Abnormal Psychology 97, 314–321.Google Scholar
Morey, LC, Benson, KT (2015). An investigation of adherence to diagnostic criteria, revisited: clinical diagnosis of the DSM-IV/DSM-5 section II personality disorders. Journal of Personality Disorders. Published online 23 April 2015. doi:10.1521/pedi_2015_29_188.Google Scholar
Morey, LC, Skodol, AE (2013). Convergence between DSM-IV-TR and DSM-5 diagnostic models for personality disorder: evaluation of strategies for establishing diagnostic thresholds. Journal of Psychiatric Practice 19, 179–193.Google Scholar
Morey, LC, Skodol, AE, Oldham, JM (2014). Clinician judgments of clinical utility: a comparison of DSM-IV-TR personality disorders and the alternative model for DSM-5 personality disorders. Journal of Abnormal Psychology 123, 398–405.Google Scholar
Morey, LC, Stagner, BH (2012). Narcissistic pathology as core personality dysfunction: comparing DSM-IV and the DSM-5 proposal for narcissistic personality disorder. Journal of Clinical Psychology: In Session 68, 908–921.Google Scholar
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.Google Scholar
Saulsman, LM, Page, AC (2004). The five-factor model and personality disorder literature: a meta-analytic review. Clinical Psychology Review 23, 1055–1085.Google Scholar
Sellbom, M, Sansone, RA, Songer, DA, Anderson, JL (2014). Convergence between DSM-5 section II and section III diagnostic criteria for borderline personality disorder. Australian and New Zealand Journal of Psychiatry 48, 325–332.Google Scholar
Skodol, AE, Bender, DS, Morey, LC (2014). Narcissistic personality disorder in DSM-5. Personality Disorders: Theory, Research and Treatment 5, 422–427.Google Scholar
Skodol, AE, Morey, LC, Bender, DS, Oldham, JM (2015). The alternative DSM-5 model for personality disorders: a clinical application. American Journal of Psychiatry 172, 606–613.CrossRefGoogle ScholarPubMed
Zimmermann, J, Altenstein, D, Krieger, T, Holtforth, MG, Pretsch, J, Alexopoulos, J, Spitzer, C, Benecke, C, Krueger, RF, Markon, KE, Leising, D (2014). The structure and correlates of self-reported DSM-5 maladaptive personality traits: findings from two German-speaking samples. Journal of Personality Disorders 28, 518–540.Google Scholar