Mapping personality traits: A network approach to uncovering Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, Brief Form's factorial structure.

Proposed changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) include replacing current personality disorder (PD) categories on Axis II with a taxonomy of dimensional maladaptive personality traits. Most of the work on dimensional models of personality pathology, and on personality disorders per se, has been conducted on young and middle-aged adult populations. Numerous questions remain regarding the applicability and limitations of applying various PD models to early and later life. In the present paper, we provide an overview of such dimensional models and review current proposals for conceptualizing PDs in DSM-V. Next, we extensively review existing evidence on the development, measurement, and manifestation of personality pathology in early and later life focusing on those issues deemed most relevant for informing DSM-V. Finally, we present overall conclusions regarding the need to incorporate developmental issues in conceptualizing PDs in DSM-V and highlight the advantages of a dimensional model in unifying PD perspectives across the life span.

A radical reworking of Axis II has been proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders whereby personality disorder categories will be replaced by a trait dimensional model of personality pathology. Perfectionism is specified as a lower order facet of Compulsivity within this proposed model. This marginalization of the perfectionism construct is inconsistent with the empirical literature that suggests that perfectionism is an important dimension of maladaptive personality in its own right, complete with its own set of more specific lower order facets. Further, perfectionism in the current proposed system is relevant only to the characterization of the obsessive-compulsive personality disorder type, despite compelling empirical research that demonstrates that various dimensions of perfectionism are differentially associated with personality pathology of all kinds. The present article reviews existing research on the role of various dimensions of perfectionism in personality disorder, highlights these seemingly ignored areas of the perfectionism literature, and discusses the problems and consequences that will arise if perfectionism continues to be defined narrowly and is largely excluded from dimensional models of personality pathology.

The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive-compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. These preliminary findings suggest that little information is 'lost' in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain 'cross walk' is provided in the article.

Despite its importance historically and contemporarily, psychopathy is not recognized in the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR). Its closest counterpart, antisocial personality disorder, includes strong representation of behavioral deviance symptoms but weak representation of affective-interpersonal features considered central to psychopathy. The current study evaluated the extent to which psychopathy and its distinctive facets, indexed by the Triarchic Psychopathy Measure, can be assessed effectively using traits from the dimensional model of personality pathology developed for DSM-5, operationalized by the Personality Inventory for DSM-5 (PID-5). Results indicate that (a) facets of psychopathy entailing impulsive externalization and callous aggression are well-represented by traits from the PID-5 considered relevant to antisocial personality disorder, and (b) the boldness facet of psychopathy can be effectively captured using additional PID-5 traits. These findings provide evidence that the dimensional model of personality pathology embodied in the PID-5 provides effective trait-based coverage of psychopathy and its facets.

Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) includes a dimensional model of personality pathology, operationalized in the Personality Inventory for DSM-5 (PID-5), with 25 facets grouped into 5 higher order factors resembling the Big Five personality dimensions. The present study tested how well these 25 facets could be integrated with the 10-factor structure of traits within the Big Five that is operationalized by the Big Five Aspect Scales (BFAS). In 2 healthy adult samples, 10-factor solutions largely confirmed our hypothesis that each of the 10 BFAS would be the highest loading BFAS on 1 and only 1 factor. Varying numbers of PID-5 scales were additional markers of each factor, and the overall factor structure in the first sample was well replicated in the second. Our results allow Cybernetic Big Five Theory (CB5T) to be brought to bear on manifestations of personality disorder, because CB5T offers mechanistic explanations of the 10 factors measured by the BFAS. Future research, therefore, may begin to test hypotheses derived from CB5T regarding the mechanisms that are dysfunctional in specific personality disorders.

A Young Attorney Presents for Outpatient Treatment of Depression Ms.Bisa32-year-oldsingleCaucasianwomanwhowasreferred byafriend’spsychiatristformentalhealthtreatmentforthe first time after a 4-month period of depression. She reported persistent feelings of “emptiness” and “worthlessness,” increased sleeping with difficulty getting out of bed, impaired concentration, decreased energy nearly every day, slight weight gain, and ruminations about her childhood and family life. The depressionstartedaftershewastoldather firmthatshewasnotgoingto be considered for partnership. Her initial reaction was one of anger, bitter disappointment, and shame, but this gave way to feelingsofdepressionandworryaboutherfuture.Sheadmittedto thoughts of death and dying but denied having any suicidal ideation. Ms. B does notdrink alcoholor use any other substances and she denies ever having felt “manic.” Her physical health is good. Ms. B also reported that she did not consider her life, in general, to be satisfactory or fulfilling. Although she had been highly successful in school, earning excellent grades at a firstrate college and law school, she has had difficulty making friends and now sees the few friends who she believes “like her” only occasionally, for “attention” and “support.” She has only“dated”oneman,brieflyincollege,butshefeltinhibitedin the relationship, afraid and ashamed to let the man know that she cared about him. Even though they drifted apart after only afewmonths,sheoftenthinksofhimandwonderswhetherher life would be better if they had gotten together. She is pessimisticaboutherprospectsforanotherrelationshipinthefuture because she believes that it would be very hard for her to find someone who would live up to her expectations. Ms. B has few interests outside of work. With respect to music, art, or sports, she said that whatever she tried, she was “not very good at it,” quickly lost interest, and gave up.

A diagnostic questionnaire for childbirth related posttraumatic stress disorder: a validation study

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The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), includes an empirically supported dimensional model of personality pathology that is assessed via the Personality Inventory for the DSM-5 (PID-5). Here we used magnetoencephalography (MEG; 248 sensors) to evaluate resting-state neural network properties associated with the five primary DSM-5 maladaptive personality domains (negative affect, detachment, antagonism, disinhibition, and psychoticism) in 150 healthy veterans ("control" group) and 179 veterans with various psychiatric disorders ("psychopathology" group). Since a fundamental network property is the strength of functional connectivity among network elements, we used the absolute value of the pairwise correlation coefficient (aCC) between prewhitened MEG sensor time series as a measure of neural functional connectivity and assessed its relations to the quantitative PID-5 scores in a linear regression model, where the log-transformed aCC was the dependent variable and individual PID scores, age, and gender were the independent variables. The partial regression coefficient (pRC) for a specific PID-5 score in that model provided information concerning the direction (positive, negative) and size (absolute value) of the PID effect on the strength of neural correlations. We found that, overall, PID domains had a negative effect (i.e., negative pRC; decorrelation) on aCC in the control group, but a positive one (i.e., positive pRC; hyper-correlation) in the psychopathology group. This dissociation of PID effects on aCC was especially pronounced for disinhibition, psychoticism, and negative affect. These results document for the first time a fundamental difference in neural-PID relations between control and psychopathology groups.

The categorical borderline personality disorder (BPD) diagnosis identifies people who struggle to manage negative emotions. As the field transitions to dimensional personality disorder (PD) models, it is important to know whether alternative diagnostic constructs capture emotion regulation difficulties to the same degree. If not, it may make sense to modify the dimensional models or else retain the BPD syndrome to preserve its incremental utility for clinical description, treatment planning, and prognosis. In three adult samples (total N = 1,197), we modeled self-rated emotion dysregulation as a function of Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) Alternative Model of Personality Disorder dimensions and traditional BPD features. We found that personality dysfunction had bivariate correlations with emotion dysregulation of .70-.80 across samples, almost identical to those observed for BPD. Combined, personality dysfunction and maladaptive personality traits explained 52%-73% of individual differences in emotion dysregulation. Controlling for Alternative Model of Personality Disorder constructs, a standalone measure of BPD features accounted for an additional 7%, 0.6%, and 1% of emotion-dysregulation variation across samples. We conclude that emotion dysregulation is better conceptualized as a general feature of the PD space, rather than a specific deficit in borderline or any other PD. We encourage additional investigation into ways that dimensional models of personality pathology relate to emotion dysregulation. The study's raw data and analysis code are available at https://osf.io/x9jbs/. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

We aimed to determine and compare the longitudinal predictive power of Diagnostic and Statistical Manual of Mental Disorders, fifth edition's (DSM-5) two models of personality disorder (PD) for multiple clinically relevant outcomes. A sample of 600 community-dwelling adults-half recruited by calling randomly selected phone numbers and screening-in for high-risk for personality pathology and half in treatment for mental health problems-completed an extensive battery of self-report and interview measures of personality pathology, clinical symptoms, and psychosocial functioning. Of these, 503 returned for retesting on the same measures an average of 8 months later. We used Time 1 interview data to assess DSM-5 personality pathology, both the Section-II PDs and the alternative (DSM-5) model of personality disorder's (AMPD) Criterion A (impairment) and Criterion B (adaptive-to-maladaptive-range trait domains and facets). We used these measures to predict 20 Time 2 functioning outcomes. Both PD models significantly predicted functioning-outcome variance, albeit modestly-averaging 12.6% and 17.9% (Section-II diagnoses and criterion counts, respectively) and 15.2% and 23.2% (AMPD domains and facets, respectively). Each model significantly augmented the other in hierarchical regressions, but the AMPD domains (6.30%) and facets (8.62%) predicted more incremental variance than the Section-II diagnoses (3.74%) and criterion counts (3.31%), respectively. Borderline PD accounted for just over half of Section II's predictive power, whereas the AMPD's predictive power was more evenly distributed across components. We note the predictive advantages of dimensional models and articulate the theoretical and clinical advantages of the AMPD's separation of personality functioning impairment from how this is manifested in personality traits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Malignant self-regard (MSR) is a self-representation that encompasses the shared features of depressive personality disorder, masochistic/self-defeating personality disorder, depressive-masochistic personality, and vulnerable narcissism. In this review we begin by describing the construct's historical precursors, which begin in early psychoanalytic/dynamic theory, and then trace its development across iterations of the Diagnostic and Statistical Manual of Mental Disorders. Special attention is paid to differentiating MSR from vulnerable narcissism. We then consider MSR's place within transdiagnostic, transtheoretical, and dimensional models of personality pathology. We focus heavily on MSR's impact on various personality systems (e.g., thought and affect systems) and also on overall personality functioning. The empirical research on MSR in relation to these systems is thoroughly reviewed and largely supports its psychometric properties and clinical significance. We suggest that MSR may map onto the distress subfactor in the hierarchical taxonomy of psychopathology (HiTOP) and that MSR seems to occupy the shared internalizing space across the neurotic and borderline level of personality organization in Kernberg's model of personality disorders. We also identify four major directions for future research: the possible benefits of self-defeating tendencies that involve pathological narcissism and self-esteem; MSR's relationship to overall health and well-being; depressive states and MSR severity; and how MSR fits within the Alternative Model for Personality Disorders and the personality disorder framework of the International Classification of Diseases.

With the creation of the Somatic Symptom and Related Disorders category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition in 2013, the functional neurological (symptom) disorder diagnostic criteria underwent transformative changes. These included an emphasis on ‘rule-in’ physical examination signs/semiological features guiding diagnosis and the removal of a required proximal psychological stressor to be linked to symptoms. In addition, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder, somatoform pain disorder and undifferentiated somatoform disorder conditions were eliminated and collapsed into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition somatic symptom disorder diagnosis. With somatic symptom disorder, emphasis was placed on a cognitive-behavioural (psychological) formulation as the basis for diagnosis in individuals reporting distressing bodily symptoms such as pain and/or fatigue; the need for bodily symptoms to be ‘medically unexplained’ was removed, and the overall utility of this diagnostic criteria remains debated. A consequence of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition restructuring is that the diagnosis of somatization disorder that encompassed individuals with functional neurological (sensorimotor) symptoms and prominent other bodily symptoms, including pain, was eliminated. This change negatively impacts clinical and research efforts because many patients with functional neurological disorder experience pain, supporting that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition would benefit from an integrated diagnosis at this intersection. We seek to revisit this with modifications, particularly since pain (and a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder comorbidity, more specifically) is associated with poor clinical prognosis in functional neurological disorder. As a first step, we systematically reviewed the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition somatization disorder literature to detail epidemiologic, healthcare utilization, demographic, diagnostic, medical and psychiatric comorbidity, psychosocial, neurobiological and treatment data. Thereafter, we propose a preliminary revision to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition allowing for the specifier functional neurological disorder ‘with prominent pain’. To meet this criterion, core functional neurological symptoms (e.g. limb weakness, gait difficulties, seizures, non-dermatomal sensory loss and/or blindness) would have ‘rule-in’ signs and pain (>6 months) impairing social and/or occupational functioning would also be present. Two optional secondary specifiers assist in characterizing individuals with cognitive-behavioural (psychological) features recognized to amplify or perpetuate pain and documenting if there is a pain-related comorbidity. The specifier of ‘with prominent pain’ is etiologically neutral, while secondary specifiers provide additional clarification. We advocate for a similar approach to contextualize fatigue and mixed somatic symptoms in functional neurological disorder. While this preliminary proposal requires prospective data and additional discussion, these revisions offer the potential benefit to readily identify important functional neurological disorder subgroups—resulting in diagnostic, treatment and pathophysiology implications.

Alternative DSM-5 Model for Personality Disorders

With normal personality traits well described in the novel – A Dream of Red Mansions (DRM), there might be rich narrations of personality disorders regarding sorts of character in it as well. We have speculated that the special traditional Chinese culture (including paternalism, male dominance and Collectivism) have a great influence on ancients’ personality traits and lead to some kinds of personality disorders. Therefore, in this chapter, we would like to look for descriptions of personality disorders in the text of DRM. Personality-descriptive terms (adjective)/phrases, and sentences/paragraphs of each character were sorted and summarized to compare with the dimensional classification criteria of personality disorders in Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, American Psychiatric Association 2013). Some characters in the novel, Jia Baoyu, Wang Xifeng, Lin Daiyu, Xue Baochai, Xue Pan, Jia Yucun, Concubine Zhao, Jia Rui, Miaoyu, and Jia Jing, with their impairments in personality functioning and pathological traits, might be diagnosed as antisocial, borderline, narcissistic, obsessive-compulsive, or schizotypal personality disorder, or a trait-specified, respectively. Maladaptive traits in antagonism domain might be the most described traits in DRM. The second described domain might be negative affectivity and disinhibition. The psychoticism and detachment domains might be less described. Females in DRM might have the tendency to some level of negative affectivity, while males more Antagonism and disinhibition. On one hand, this study proves the cross-culture and time consistency of personality disorders. On the other hand, owing to the special traditional Chinese culture, self-direction would be difficult in some degree and interpersonal impairments would stand out with the personality disorder. There was a high level of Antagonism in the characters and special submissiveness for most females that time. Daoism or Buddhism would lead to unrealistic goal setting, and avoidance of social contact. The study implicates that Chinese culture has contributed to personality disorders or traits at least from seventeenth to eighteenth century on, and has disclosed the disadvantages of Daoism, Buddhism, and hierarchy, male dominance and Collectivism under the influence of Confucianism in the development of personality disorder. This study also calls for investigations on normal and disordered personality traits in contemporary China (see Chapter “ Cultural Contribution to Personality Disorders in China”).