Jaime L. Anderson

On the Convergence Between PSY-5 Domains and PID-5 Domains and Facets Implications for Assessment of DSM-5 Personality Traits

The DSM-5 Personality and Personality Disorders workgroup and their consultants have developed the 220-item, self-report Personality Inventory for the DSM-5 (PID-5) for direct assessment of the proposed personality trait system for DSM-5; however, most practicing clinical psychologists will likely continue to rely on separate omnibus measures to index symptoms and traits associated with psychopathology. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is one such measure and assesses the Personality Psychopathology Five (PSY-5) domains, which are conceptual cognates of the DSM-5 trait domains. The current study examined the associations between the MMPI-2-RF PSY-5 scales and the DSM-5 trait domains and facets indexed by the PID-5. A clear pattern of convergence was found indicating that each of the PSY-5 scales was most highly correlated with its conceptually expected PID-5 counterpart (rs = .44-.67; Mdn r = .53) and facet correlations generally showed the same pattern. Similarly, when each of the PSY-5 scales was regressed onto the PID-5 domains, the conceptually expected pattern of associations emerged even more clearly. Finally, a joint exploratory factor analysis with the PSY-5 and PID-5 trait facet scales indicated a five-factor solution that clearly resembled both of the PSY-5/DSM-5 trait domains. These results show clear evidence that the MMPI-2-RF has utility in the assessment of dimensional personality traits proposed for the upcoming DSM-5.

Examining the associations between DSM-5 section III antisocial personality disorder traits and psychopathy in community and university samples.

The current investigation examined the associations between personality traits representing DSM-5 Section III Antisocial Personality Disorder (ASPD), its psychopathy specifier, and contemporary models of psychopathic personality disorder. We used two samples consisting of university students (n = 463) and community-dwelling participants (n = 148) recruited for subclinical psychopathic proclivities. Both samples were administered the Personality Inventory for DSM-5 (Krueger et al., 2012), Triarchic Psychopathy Measure (Patrick, 2010), and versions of the Psychopathic Personality Inventory (PPI; Lilienfeld & Widows, 2005). University students also completed the Structured Clinical Interview for DSM-IV Axis II Disorders-Personality Questionnaire (First, Gibbon, Spitzer, Williams, & Benjamin, 1997). Across both samples, the Section III ASPD traits were moderately strongly correlated with psychopathy measures, except the fearless-dominance/boldness domain. However, as would be expected, traits representing the Section III psychopathy specifier accounted for a substantial amount of variance within this domain. Furthermore, additional DSM-5 Section III personality traits augmented the characterization of psychopathy from the PPI and Triarchic perspectives.

A comparison of the DSM-5 Section II and Section III personality disorder structures

The DSM-5 Section III includes a hybrid model for the diagnosis of personality disorders, in which sets of dimensional personality trait facets are configured into personality disorder types. These PD types resemble the Section II categorical counterparts with dimensional traits descriptive of the Section II criteria to maintain continuity across the diagnostic systems. The current study sought to evaluate the continuity across the Section II and III models of personality disorders. This sample consisted of 397 undergraduate students, administered the Personality Inventory for the DSM-5 (Krueger et al., 2012) and the Structured Clinical Interview for the DSM-IV Axis II Disorders-Personality Questionnaire (First et al., 2013). We examined whether the DSM-5 Section III trait facets for the PDs would be associated with their respective Section II counterparts, as well as determining whether additional facets could augment the prediction of the Section II disorders. Results revealed that, generally, the DSM-5 Section II disorders were most strongly associated with their Section III traits. Results also showed evidence to support the addition of facets not included in the Section III diagnostic criteria in the prediction of most disorders. These results show general support for the Section III model of personality disorders, however, results also show that additional research is needed to replicate these findings.

Convergence between DSM-5 Section II and Section III diagnostic criteria for borderline personality disorder

Objective: Borderline personality disorder (BPD) is a common mental health condition in psychiatric settings. The current study examined the overlap between the operationalization of BPD listed in Section II (Diagnostic Criteria and Codes) and the alternative, dimensional personality trait-based operationalization listed in Section III (Emerging Measures and Models) of the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Moreover, the unique contributions of specific personality traits for indexing the traditional BPD operationalization were also evaluated, including conceptually relevant traits not originally proposed for Section III BPD. Method: Participants were 145 consecutive patients from a psychiatric unit in a hospital in the USA. These individuals completed a series of questionnaires that index both traditional (DSM-IV/DSM-5 Section II) and alternative (DSM-5 Section III personality traits) diagnostic criteria for BPD. Results: Structural equation modeling results revealed that latent constructs representing the Section II and Section III operationalizations of BPD, respectively, overlapped substantially (r = 0.86, p < 0.001). Hierarchical latent regression models indicated that at least five of the seven traits proposed to define Section III BPD uniquely accounted for variance (69%) in a latent Section II BPD variable. Finally, at least one other conceptually relevant trait (Perceptual Dysregulation) augmented the prediction of latent BPD scores. Conclusions: The proposed personality traits for Section III BPD are clearly aligned with traditional conceptualizations of this important personality disorder construct. At least five of the seven dimensional traits proposed to define Section III contributed uniquely to the characterization of Section II BPD, and these traits can be augmented by Perceptual Dysregulation. If replicated in other settings, these findings might warrant some modification to the operationalization of DSM-5 Section III BPD.

Associations between DSM-5 section III personality traits and the Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scales in a psychiatric patient sample.

Our aim in the current study was to evaluate the convergence between Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) Section III dimensional personality traits, as operationalized via the Personality Inventory for DSM-5 (PID-5), and Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scale scores in a psychiatric patient sample. We used a sample of 346 (171 men, 175 women) patients who were recruited through a university-affiliated psychiatric facility in Toronto, Canada. We estimated zero-order correlations between the PID-5 and MMPI-2-RF substantive scale scores, as well as a series of exploratory structural equation modeling (ESEM) analyses to examine how these scales converged in multivariate latent space. Results generally showed empirical convergence between the scales of these two measures that were thematically meaningful and in accordance with conceptual expectations. Correlation analyses showed significant associations between conceptually expected scales, and the highest associations tended to be between scales that were theoretically related. ESEM analyses generated evidence for distinct internalizing, externalizing, and psychoticism factors across all analyses. These findings indicate convergence between these two measures and help further elucidate the associations between dysfunctional personality traits and general psychopathology.

Assessing DSM-5 section III personality traits and disorders with the MMPI-2-RF.

An alternative model for diagnosing personality disorders (PDs) appears in DSM-5 Section III. This model includes a set of dimensional personality traits, which along with impairment in personality functioning can be configured to represent one of six PDs. Although specific assessment instruments for these personality traits have already been developed (e.g., the Personality Inventory for DSM-5 [PID-5]), clinicians will likely continue to use omnibus measures of psychopathology that are familiar to them to inform diagnostic decision making. One such measure, the Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF), will likely remain in the test armamentarium of many practitioners and be employed to assess the DSM-5 dimensional traits. In the current investigation, we examined the associations between MMPI-2-RF scale scores and the PID-5 trait scores and DSM-5 Section III PDs in a combined sample of university students (n = 668) from the United States and Canada. Our results indicated that the MMPI-2-RF scale scores mostly converge with PID-5 dimensional traits as well as the Section III PDs in a conceptually expected manner. As such, we conclude that the MMPI-2-RF is a potentially useful instrument in assessing personality psychopathology as conceptualized in DSM-5 Section III.

Exploring the Hierarchical Structure of the MMPI–2–RF Personality Psychopathology Five in Psychiatric Patient and University Student Samples

In this study our goal was to examine the hierarchical structure of personality pathology as conceptualized by Harkness and McNultys (1994) Personality Psychopathology Five (PSY–5) model, as recently operationalized by the MMPI–2–RF (Ben-Porath & Tellegen, 2011) PSY–5r scales. We used Goldbergs (2006) “bass-ackwards” method to obtain factor structure using PSY–5r item data, successively extracting from 1 to 5 factors in a sample of psychiatric patients (n = 1,000) and a sample of university undergraduate students (n = 1,331). Participants from these samples had completed either the MMPI–2 or the MMPI–2–RF. The results were mostly consistent across the 2 samples, with some differences at the 3-factor level. In the patient sample a factor structure representing 3 broad psychopathology domains (internalizing, externalizing, and psychoticism) emerged; in the student sample the 3-factor level represented what is more commonly observed in “normal-range” personality models (negative emotionality, introversion, and disconstraint). At the 5-factor level the basic structure was similar across the 2 samples and represented well the PSY–5r domains.

Utility of the Personality Inventory for DSM-5-Brief Form (PID-5-BF) in the Measurement of Maladaptive Personality and Psychopathology.

The Diagnostic and Statistical Manual of Mental Disorders–Fifth edition (DSM-5) Personality and Personality Disorders workgroup developed the Personality Inventory for the DSM-5 (PID-5) for the assessment of the alternative trait model for DSM-5. Along with this measure, the American Psychiatric Association published an abbreviated version, the PID-5–Brief form (PID-5-BF). Although this measure is available on the DSM-5 website for use, only two studies have evaluated its psychometric properties and validity and no studies have examined the U.S. version of this measure. The current study evaluated the reliability, factor structure, and construct validity of PID-5-BF scale scores. This included an evaluation of the scales’ associations with Section II PDs, a well-validated dimensional measure of personality psychopathology, and broad externalizing and internalizing psychopathology measures. We found support for the reliability of PID-5-BF scales as well as for the factor structure of the measure. Furthermore, a series of correlation and regression analyses showed conceptually expected associations between PID-5-BF and external criterion variables. Finally, we compared the correlations with external criterion measures to those of the full-length PID-5 and PID-5–Short form. Intraclass correlation analyses revealed a comparable pattern of correlations across all three measures, thereby supporting the use of the PID-5-BF as a screening measure of dimensional maladaptive personality traits.

Measurement of DSM-5 section II personality disorder constructs using the MMPI-2-RF in clinical and forensic samples.

In the current study, we evaluated the associations between the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) scale scores and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) Section II personality disorder (PD) criterion counts in inpatient and forensic psychiatric samples from The Netherlands using structured clinical interviews to operationalize PDs. The inpatient psychiatric sample included 190 male and female patients and the forensic sample included 162 male psychiatric patients. We conducted correlation and count regression analyses to evaluate the utility of relevant MMPI-2-RF scales in predicting PD criterion count scores. Generally, results from these analyses emerged as conceptually expected and provided evidence that MMPI-2-RF scales can be useful in assessing PDs. At the zero-order level, most hypothesized associations between Section II disorders and MMPI-2-RF scales were supported. Similarly, in the regression analyses, a unique set of predictors emerged for each PD that was generally in line with conceptual expectations. Additionally, the results provided general evidence that PDs can be captured by dimensional psychopathology constructs, which has implications for both DSM-5 Section III specifically and the personality psychopathology literature more broadly.

Construct Validity of the DSM–5 Section III Personality Trait Profile for Borderline Personality Disorder

This study evaluated the nomological network of the borderline personality disorder (BPD) trait profile in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]) Section III. BPD symptoms include a variety of maladaptive thoughts and behaviors, and it is important to determine if the Section III trait operationalization for BPD captures these behavioral symptoms, as well as shows similar associations as the traditional Section II version with external criteria. For this purpose, we used a sample of 285 undergraduate students and conducted correlation and regression analyses to delineate the associations between Section III BPD traits and conceptually relevant external criteria. A Section III Total score was meaningfully associated with all criteria. Moreover, externalizing psychopathology tended to be most highly associated with disinhibitory Section III BPD traits, whereas internalizing psychopathology tended to have its strongest unique associations with traits reflective of negative affectivity. These results provide support for the construct validity of the trait profile for BPD in DSM–5 Section III.