Dimensional Assessment Of Personality Pathology Research Articles

Convergence of the dimensional assessment of personality pathology (DAPP-BQ) and the five-factor personality inventory for the international classification of diseases 11th edition (FFiCD) in the context of the five-factor model and personality disorders

The current manuscript presents the convergence of the Dimensional Assessment of Personality Pathology (DAPP-BQ), using its short form the DAPP-90, and the Five-Factor Personality Inventory for International Classification of Diseases (ICD-11), the FFiCD, in the context of the five-factor personality model and the categorical approach of personality disorders (PDs). The current manuscript compares the predictive validity of both the FFiCD and the DAPP-90 regarding personality disorder scales and clusters. Results demonstrate a very high and meaningful convergence between the DAPP-90 and the FFiCD personality pathology models and a strong alignment with the FFM. The DAPP-90 and the FFiCD also present an almost identical predictive power of PDs. The DAPP-90 accounts for between 18% and 47%, and the FFiCD between 21% and 47% of PDs adjusted variance. It is concluded that both DAPP-90 and FFiCD questionnaires measure strongly similar pathological personality traits that could be described within the frame of the FFM. Additionally, both questionnaires predict a very similar percentage of the variance of personality disorders.

Differentiating Abnormal, Normal, and Ideal Personality Profiles in Multidimensional Spaces

Abstract: Current dimensional taxonomies of personality disorder (PD) establish that intense traits do not suffice to diagnose a disorder, and additional constructs reflecting dysfunction are required. However, traits appear able to predict maladaptation by themselves, which might avoid duplications and simplify diagnosis. On the other hand, if trait-based diagnoses are feasible, it is the whole personality profile that should be considered, rather than individual traits. This takes us into multidimensional spaces, which have their own particular – but poorly understood – logic. The present study examines how profile-level differences between normal and disordered subjects can be used for diagnosis. The Dimensional Assessment of Personality Pathology – Basic Questionnaire (DAPP-BQ) and the Personality Inventory for DSM-5 (PID-5) were administered to a community and a clinical sample each (total n = 1,925 and 3,543 respectively). Intense traits proved to be common in the general population, so empirically-based thresholds are indispensable not to take as abnormal what is at most unideal. Profile-level parameters such as Euclidean and Mahalanobis distances outperformed individual traits in predicting mental problems and equaled the performance of published measures of dysfunction or severity. Personality profiles can play a more central role in identifying disorders than is currently acknowledged, provided that adequate metrics are used.

A Commentary on “Eating Disorders and the Rorschach” (Guinzbourg de Braude et al., 2021)

A Commentary on “Eating Disorders and the Rorschach” (Guinzbourg de Braude et al., 2021)

Preliminary Scales for ICD-11 Personality Disorder: Self and Interpersonal Dysfunction Plus Five Personality Disorder Trait Domains.

The ICD-11 personality disorder model is the first fully dimensional assessment of personality pathology. It consists of a personality disorder (PD) dysfunction-severity dimension, which encompasses both self- and interpersonal dysfunction, and six optional qualifiers for five prominent personality traits—Negative Affectivity (NA), Detachment (DET), Dissociality (DSL), Disinhibition (DSN), and Anankastia (ANK)—plus a borderline pattern that is defined by the criteria of DSM-IV borderline PD. This article reports on the development of a new self-report measure to assess self- and interpersonal dysfunction and the five trait qualifiers. It is the first comprehensive measure of the ICD-11 PD model in that (a) it is the only one to include both PD dysfunction-severity as well as trait scales and because (b) it is based on the Clinical Description and Diagnostic Guidelines, which are more detailed than the “statistical” model description that is currently on the ICD-11 website. The authors wrote 992 items and then reduced the pool to 300 items by eliminating redundancy and selecting the consensus best few items for each subconstruct. Data were collected using an online sample of 383 Prolific workers. Using exploratory factor analysis, seven domain scales were developed, each of which contained two to four scales assessing components of the domain. These preliminary scales’ psychometrics were excellent, as were the domains’ and their components’ convergent and discriminant validity, with a few generally minor exceptions. Structural analyses at the component level revealed a three-factor structure consisting of two moderately correlated Internalizing factors, one centered on Self Dysfunction with two NA components and a DSN component (Distractibility) and the other on Interpersonal Dysfunction with DET and ANK components; as well as an Externalizing factor with DSL and a DSN component (Reckless Impulsivity) that was uncorrelated with the other two factors. Two aspects of the results in particular are striking: (1) ANK was not the opposite end of a DSN dimension, but rather contributed to an Internalizing Interpersonal Dysfunction dimension and (2) DSN had both an Internalizing and an Externalizing component. Implications of the findings and study limitations are discussed.

Development of a Short and ICD-11 Compatible Measure for DSM-5 Maladaptive Personality Traits Using Ant Colony Optimization Algorithms.

While Diagnostic and Statistical Manual of Mental Disorders–Fifth edition (DSM-5) Section III and ICD-11 (International Classification of Diseases 11th–Revision) both allow for dimensional assessment of personality pathology, the models differ in the definition of maladaptive traits. In this study, we pursued the goal of developing a short and reliable assessment for maladaptive traits, which is compatible with both models, using the item pool of the Personality Inventory for DSM-5 (PID-5). To this aim, we applied ant colony optimization algorithms in English- and German-speaking samples comprising a total N of 2,927. This procedure yielded a 34-item measure with a hierarchical latent structure including six maladaptive trait domains and 17 trait facets, the “Personality Inventory for DSM-5, Brief Form Plus” (PID5BF+). While latent structure, reliability, and criterion validity were ascertained in the original and in two separate validation samples (n = 849, n = 493) and the measure was able to discriminate personality disorders from other diagnoses in a clinical subsample, results suggest further modifications for capturing ICD-11 Anankastia.

Toward an Integrated Model of Pathological Personality Traits: Common Hierarchical Structure of the PID-5 and the DAPP-BQ.

A dimensional classification seems to be the next move in the personality disorders field. However, it is not clear whether there is one dimensional model or many, or whether the currently available dimensional instruments measure the same traits. To help clarify these issues, the authors administered the Personality Inventory for DSM-5 (PID-5) and the Dimensional Assessment of Personality Pathology (DAPP-BQ) to 414 psychiatric outpatients. Factor analyses showed that a common hierarchical structure underlies both instruments, even if each one measures slightly different aspects of it. Disattenuated correlations indicated that, at the lower order level, two thirds of the PID-5 and DAPP-BQ facets measure essentially the same traits, although the pairings were not exactly as predicted. Among higher order domains, only PID Negative Affectivity and Detachment converged unambiguously with DAPP Emotional Dysregulation and Inhibition. Overall, the PID-5 and the DAPP-BQ reflect, with small divergences, one and the same structure of pathological personality traits.

SAT-441 Oxytocin Levels Are Associated with Psychopathology in Restricting but Not Binge-Purge Subtype of Anorexia Nervosa

Objective: Anorexia nervosa (AN), a psychiatric disorder characterized by food restriction and distorted body image, is associated with depression, anxiety, and social-emotional functioning deficits. Basal levels of oxytocin, an anorexigenic hormone with antidepressant, anxiolytic, and prosocial properties, are low in women with AN, and a relationship between low oxytocin levels and psychopathology when examined across AN and healthy control groups has been established. We aimed to determine whether oxytocin levels in AN are related to psychopathology, and whether AN subtype (restrictive food intake alone [AN-R] vs. restriction plus binge and/or purge behaviors [AN-BP]) impacts this relationship. Methods: We performed a cross-sectional study of 39 women with AN (age [mean±SEM]: 28.3±8.3 years; BMI: 18.5±1.7 kg/m2; 23 AN-R, 16 AN-BP). We obtained fasting serum oxytocin levels and self-report measures for psychopathology (Eating Disorder Examination Questionnaire [EDE-Q], Beck Depression Inventory-IA [BDI-IA], State-Trait Anxiety Inventory – Trait scale [STAI-T], Dimensional Assessment of Personality Pathology – Basic Questionnaire [DAPP-BQ], Liebowitz Social Anxiety Scale [LSAS], Toronto Alexithymia Scale [TAS-20], and Interpersonal Support Evaluation List [ISEL]). Results: Oxytocin levels and psychopathology scores did not significantly differ in AN-R vs. AN-BP. In AN-R but not AN-BP, oxytocin levels were negatively associated with disordered eating psychopathology (EDE-Q global score: rs=−0.54, p=0.012), depressive and anxiety symptoms (BDI-IA: rs=-0.63, p=0.003; STAI-T: rs=−0.68, p=0.001), and social-emotional symptoms (DAPP BQ Suspiciousness: rs= -0.48, p=0.03; LSAS social fear: rs= -0.71, p=0.0004; LSAS public fear: rs = -0.40, p=0.046; LSAS social avoidance: rs= -0.66, p=0.0016; LSAS public avoidance: rs = -0.54, p= 0.014; TAS-20 total score: rs= -0.45, p=0.049). In both AN-R and AN-BP, oxytocin levels were positively associated with perceived social support (ISEL total score: rs =0.6, p=0.004 in AN-R; rs =0.52, p=0.046 in AN-BP). Conclusions: Low oxytocin levels are associated with severity of psychopathology in AN-R but not AN-BP, suggesting divergent underlying neurobiology.

Dimensional Pathological Personality Predicting Personality Disorders: Comparison of the DAPP-BQ and PID-5 Shortened Versions in a Spanish Community Sample

This study explored the psychometric properties of the shortened forms of The Dimensional Assessment of Personality Pathology (DAPP-BQ) and The Personality Inventory for DSM-5 (PID-5) in a large cohort from a Spanish community and compared simultaneously the predictive power with regard to personality disorders (PDs) scores in the International Personality Disorder Examination (IPDE). The IPDE is a self-report inventory of 77 items. Each item measures a criterion and a dimensional score can be obtained for each personality disorder. Both shortened forms (named DAPP-90 and PID-5/SF, respectively) obtained a good structural validity and reliability. Linear regression analysis showed that both questionnaires were predictive of the PDs scores. DAPP-90 factors explained about 25% of PDs variance (37% of the PDs clusters). Facets slightly increased the percentages accounting for PDs variance and clusters to 31% and 43%, respectively. PID-5/SF factors, meanwhile, explained 23% of PDs and 33% of PDs clusters, while the facets accounted for 25% of PDs and 37% of clusters. It is concluded that both questionnaires were good instruments for measuring pathological personality, and predicted a similar part of the variance in PDs. However, given that neither the DAPP-90 nor the PID-5/SF accounted for all the variation in PDs, categorical classification of the broader set of PDs may continue to be desired by some researchers and practicing clinicians.

The Dimensional Assessment of Personality Pathology – Short Form for Adolescents (DAPP-SF-A): normative data for Flemish adolescents aged 16 to 21 years

Abstract Background The Dimensional Assessment of Personality Pathology – Short Form for Adolescents (DAPP-SF-A) is an age-adapted version of the DAPP Basic Questionnaire (DAPP-BQ). The psychometric properties of this questionnaire were established by Tromp and Koot. However, norming data are currently available exclusively for Dutch adolescents. Objective The main aim of this study was to provide community-based norming data for the DAPP-SF-A in Flemish adolescents and separately for boys and girls. The second aim was to compare the Flemish norms with the Dutch norms. Method The sample consisted of 425 adolescents (52% girls), aged 16 to 21 years (mean, 18.6; SD, 1.16), from the general Flemish population. In 2012, all respondents completed the DAPP-SF-A and the Youth Self-Report as a part of the longitudinal Flemish Study on Parenting, Personality, and Development. Results: Internal consistency reliabilities of the lower-order dimensions were acceptable to good (a ranged from 0.71 to 0.87, median=0.85, mean item-rest correlations ranged from 0.44 to 0.67). The lower-order dimensions showed distinctive mean patterns for boys and girls, with higher scores for girls on Affective Instability and Insecure Attachment [effect sizes (d) were both −0.35] and higher scores for boys on all lower-order dimensions of Dissocial Behavior, Inhibitedness, and three lower-order dimensions of Emotional Dysregulation (d ranged from 0.21 to 0.79). The comparison of the Flemish scores with the Dutch scores showed substantial inter-cultural differences (d ranged from 0.13 to −1.78). Conclusions The DAPP-SF-A shows satisfactory reliability in a Flemish community-based sample of adolescents. Furthermore, given the differences between boys and girls, the use of gender-based norms seems appropriate. Finally, substantial differences with the Dutch general population norms warrant the use of separate norms in Flemish adolescents.

Association of Adolescent Dimensional Borderline Personality Pathology with Past and Current Nonsuicidal Self-Injury and Lifetime Suicidal Behavior: A Clinical Multicenter Study

Descriptive diagnoses of nonsuicidal self-injury (NSSI) and suicide attempts (SAs) may detract from underlying dimensional borderline personality pathology (D-BPP). This study aimed to investigate D-BPP in adolescent inpatients with NSSI and SAs. A consecutive sample of 359 adolescent inpatients was assessed for current and past NSSI and life-time SAs. D-BPP and current mental health problems were measured using the Dimensional Assessment of Personality Pathology and the Strengths and Difficulties Questionnaire, respectively. D-BPP was significantly associated with both current (p < 0.001) and past NSSI (p = 0.025) and life-time SAs (p < 0.001) compared to their non-self-harming peers. Patients with current and past NSSI did not differ in terms of D-BPP or current mental health problems. A multivariate model did not show any additional influence of current mental health problems over and above D-BPP in predicting NSSI and SAs. It can be hypothesized that D-BPP underlies adolescent self-harm and may persist even after its termination, promoting a higher burden of mental health problems.

The twofold diagnosis of personality disorder: How do personality dysfunction and pathological traits increment each other at successive levels of the trait hierarchy?

Besides the categorical classification of personality disorders (PDs) in Section II of the DSM-5 (American Psychiatric Association, 2013), which has been transferred as such from DSM-IV, Section III provides an alternative model to stimulate further research on the dimensional conceptualization of PDs. In this alternative system, a PD diagnosis is based on 2 essential criteria: impaired personality functioning and the presence of pathological traits. One topic that warrants further research concerns the incremental validity of these 2 components. The current study addresses this issue in a mixed community-patient sample (N = 233). First, Goldberg's (2006) "bass-ackwards" method was used to examine the hierarchical structure of pathological traits as measured by the Dimensional Assessment of Personality Pathology (DAPP-BQ; Livesley & Jackson, 2009). We then extracted a single higher order factor from the Severity Index of Personality Problems (SIPP-118; Verheul et al., 2008) to derive 1 coherent indicator of personality dysfunction. Correlation and hierarchical regression analyses were used to determine the incremental validity of the dysfunction factor versus the trait components at succeeding levels of the DAPP-BQ hierarchy. The results only partially supported the 2-component PD diagnosis, as traits and dysfunction appeared to have only limited incremental validity. Moreover, lower order traits were generally unable to outperform higher order components in predicting specific DSM-IV PDs. Implications for the conceptualization and assessment of personality pathology are discussed. (PsycINFO Database Record

Psychometric Qualities of the Dimensional Assessment of Personality Pathology – Short Form for Adolescents

Abstract Background: A growing body of research recognizes the occurrence and validity of personality pathology during adolescence as well as its relevance as a developmental precursor of adult personality pathology. Objective: The present study recognizes the need for a comprehensive and concise instrument to assess the dimensions of personality pathology in adolescents. Therefore, the psychometric qualities of an abbreviated version of the Dimensional Assessment of Personality Pathology - Basic Questionnaire for Adolescents (DAPP-BQ-A), which has been denoted as the DAPP - Short Form for Adolescents (DAPP-SF-A), were examined. Method: The factorial structure, internal consistency, test-retest reliability, discriminative validity, and classification accuracy of the DAPP-SF-A scales were examined in three samples: 1596 non-referred adolescents; 166 adolescents referred to inpatient and outpatient mental health services; and 58 referred and general population adolescents. Results: Despite a reduction in the number of items by 50% (from 290 to 144 items), the promising psychometric qualities established for the DAPP-BQ-A were replicated for the DAPP-SF-A. Conclusions: The results of this study are promising regarding the qualities of the DAPP-SF-A and its utility in both clinical and research settings. In addition, the equivalence of the instruments for adolescents and (young) adults enables the investigation of developmental trajectories across different life stages.

The DAPP–SF as a Screener for Personality Disorder in a Forensic Setting

Studies on the Dimensional Assessment of Personality Pathology–Short Form (DAPP–SF) have shown its ability to identify treatment-seeking patients with personality disorders. This study focuses on its screening potential for personality disorder in 89 criminal suspects (77 men, 12 women; M age = 37.0 years) undergoing residential pretrial psychological assessments in a high-security setting. It was expected that Structured Interview for DSM–IV Personality (SIDP–IV) criteria met for personality disorder(s) would be associated with higher DAPP–SF scores. A floor effect was found in DAPP–SF scores: The forensic population reported less personality pathology than the general population. Only moderate associations between DAPP–SF and SIDP–IV outcome were found. Receiver operating characteristic analysis showed that some DAPP–SF subscales did not exceed chance level in their ability to screen for personality disorders. It is concluded that the DAPP–SF has limited usefulness as a screener for personality disorders in a forensic pretrial setting. Alternative forensic screening instruments are presented.

The essential features of personality disorder in DSM-5: the relationship between criteria A and B.

The essential features of the general criteria for personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are based on impairments in self and interpersonal functioning (criterion A) and pathological personality traits (criterion B). The current study investigated the relationship between criteria A and B in a German psychiatric sample (N = 149). Criterion A was measured by the General Assessment of Personality Disorder (GAPD); criterion B, by the Dimensional Assessment of Personality Pathology (DAPP) and the Revised NEO Personality Inventory (NEO-PI-R). There was a significant relationship between the GAPD, the DAPP, and the NEO-PI-R. The DAPP and NEO-PI-R domains increased the predictive validity of the GAPD (by 7.5% and 14.6%, respectively). The GAPD increased the variance explained by the DAPP by 1.5% and by the NEO-PI-R by 6.5%. The results suggest a substantial relationship between criteria A and B. Criterion B shows incremental validity over criterion A but criterion A only in part over criterion B. Future research should investigate whether it is possible to assess functional impairment apart from personality traits.

Personality dimensions in persons symptomatically at risk of psychosis: pronounced but lacking a characteristic profile

Personality dimensions are frequently abnormal in psychosis. We examined if these abnormalities form a personality profile that is characteristic for patients symptomatically at risk of psychosis. Four higher order personality dimensions were assessed in 104 at-risk patients, 67 clinical and 97 healthy controls with the 'Dimensional Assessment of Personality Pathology', and analysed by two-step cluster procedure to detect personality profiles. Logistic regression was used to test for predictors of profile assignment. Low and high scorers were distinguished by two profiles. Patients were more likely high scorers. The presence of clinically relevant depression, though equally frequent in clinical groups, best predicted high scorers among patients. Though at-risk patients were significantly more often high scorers, this seemed to be a general reflection of the level of psychopathology rather than a group characteristic. Thus, personality dimensions might be of little value for facilitating early detection but might be important to consider in early intervention approaches.

Stability of narcissistic personality disorder: Tracking categorical and dimensional rating systems over a two-year period.

Personality disorders are characterized as temporally stable patterns of symptoms (APA, 2000). However, evidence on the stability of narcissistic personality disorder (NPD) is generally lacking. This study tracked the prevalence and remission rates of individual criteria for NPD over the course of 2 years. In addition, the stability of dimensional personality pathology in patients with NPD (assessed with the Dimensional Assessment of Personality Pathology, DAPP-BQ) was assessed over time. A sample of 96 patients with a diagnosis of NPD was recruited at baseline. Forty patients participated in the follow-up assessment 2 years later. Our results indicate a moderate remission rate (53%) for NPD as a categorical diagnosis. However, single NPD criteria differed in their prevalence and temporal stability, similar to findings for other personality disorders. Moreover, scores on dimensional subscales of the DAPP-BQ remained stable over time. Theoretical implications are discussed.

Hierarchical Structure of Maladaptive Personality Traits in Older Adults: Joint Factor Analysis of the PID-5 and the DAPP-BQ

In DSM-5, the categorical model and criteria for the 10 personality disorders included in DSM-IV will be reprinted in Section II. Moreover, an alternative dimensional classification model will appear in Section III. This alternative DSM-5 proposal for the diagnosis of a personality disorder is based on two fundamental criteria: impairments in personality functioning (Criterion A) and the presence of pathological personality traits (Criterion B). In the maladaptive trait model that has been developed to operationalize Criterion B, 25 pathological traits are organized according to five higher order dimensions. The current study focuses on the convergence of the proposed DSM-5 trait model (as measured by the Personality Inventory for DSM-5 [PID-5]) with the Dimensional Assessment of Personality Pathology (DAPP) model (as measured by the Dimensional Assessment of Personality Pathology-Basic Questionnaire [DAPP-BQ]) in a sample of older people. A joint hierarchical factor analysis showed clear convergence between four PID-5 dimensions (Negative Affect, Detachment, Antagonism, Disinhibition) and conceptually similar DAPP-BQ components. Moreover, the PID-5 and the DAPP-BQ showed meaningful associations on different levels of their joint hierarchical factor structure. Methodological and theoretical implications of these initial results for the conceptualization of personality pathology are discussed.

Erratum to: An Exploratory Study of Integrative Personality Pathology Systems and the Interpersonal Circumplex

Calculation errors in “An exploratory study of integrative personality pathology systems and the interpersonal circumplex” by Hopwood, Koonce, and Morey (2009) led to systematic over-estimates of amplitude and elevation parameters reported in that paper. In Table 1 of that paper, amplitude parameters were estimated for two interpersonal surfaces, the Interpersonal Adjective Scales (IAS) and Inventory of Interpersonal Problems Circumplex (IIP-C) using trait scales from the Schedule for Nonadaptive and Adaptive Personality (SNAP) and the Dimensional Assessment of Personality Pathology (DAPP-BQ). As the elevation parameter is of limited interpretability on the IAS, elevation parameters were only reported for the IIP-C. Correct and reported values for Table 1 of the original paper are reported in Table 1 below. Calculation errors led to reported values that are uniformly higher than actual values (average over-estimate for amplitude was .13 and the average over-estimate for elevation was .09), however the correlations between the reported and correct values were>.95 for amplitude across all four subsets of analyses (i.e., IAS and IIP-C with SNAP and DAPP) and the correlations between reported and correct elevations were .86 for the DAPP and IIP-C and .99 for the SNAP and IIP-C. Given that calculation errors were uniform (i.e. largely correct in terms of rank order but consistently higher in terms of magnitude), substantive conclusions from the paper generally hold with the application of a more relaxed rubric for interpreting meaningful elevation and amplitude values. Specifically, Hopwood et al. classified elevation values>.30 as indicating meaningful relations to interpersonal problems and amplitude values>.30 as indicating thematic interpretability on the interpersonal circumplex surfaces. As all amplitude and elevation parameters that were reported to be>.30 are nearly all>.20, changing these cutoffs to .20 would lead to the same substantive conclusions. There were two exceptions. First, whereas the DAPP-BQ submissiveness amplitude on the IIP-C was originally reported as .34, which is above the interpretability cutoff of .30, the actual value is .18, which is below the corrected cutoff of .20. Second, the Insecure Attachment amplitude originally reported as .28 was below the cutoff of .30. However, the actual value of .20 would meet the .20 cutoff for the corrected values. Calculation errors also affected the amplitude estimates reported in the final column of Table 3 of the Hopwood et al. paper. The correct and reported values are given in Table 2. Again, these parameters were uniformly overestimated, and the results do not change substantive conclusions in the paper. The online version of the original article can be found at http://dx.doi.org/ 10.1007/s10862-008-9124-y.

Validation of the FFM PD count technique for screening personality pathology in later middle-aged and older adults

Research on the applicability of the five factor model (FFM) to capture personality pathology coincided with the development of a FFM personality disorder (PD) count technique, which has been validated in adolescent, young, and middle-aged samples. This study extends the literature by validating this technique in an older sample. Five alternative FFM PD counts based upon the Revised NEO Personality Inventory (NEO PI-R) are computed and evaluated in terms of both convergent and divergent validity with the Assessment of DSM-IV Personality Disorders Questionnaire (shortly ADP-IV; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders – Fourth edition). For the best working count for each PD normative data are presented, from which cut-off scores are derived. The validity of these cut-offs and their usefulness as a screening tool is tested against both a categorical (i.e., the DSM-IV – Text Revision), and a dimensional (i.e., the Dimensional Assessment of Personality Pathology; DAPP) measure of personality pathology. All but the Antisocial and Obsessive-Compulsive counts exhibited adequate convergent and divergent validity, supporting the use of this method in older adults. Using the ADP-IV and the DAPP – Short Form as validation criteria, results corroborate the use of the FFM PD count technique to screen for PDs in older adults, in particular for the Paranoid, Borderline, Histrionic, Avoidant, and Dependent PDs. Given the age-neutrality of the NEO PI-R and the considerable lack of valid personality assessment tools, current findings appear to be promising for the assessment of pathology in older adults.

Further evidence for the fifth higher trait of personality pathology: A correlation study using normal and disordered personality measures

Studies between disordered personality and the Big-Five or the Alternative Five-Factor model of normal personality have consistently shown four higher traits. The fifth higher trait, relating to Openness to Experience or Impulsive Sensation Seeking was less supported. The culture-free Nonverbal Personality Questionnaire (NPQ) might help us to characterise the fifth higher trait. We therefore tried the Dimensional Assessment of Personality Pathology (DAPP), the NEO-Personality Inventory-Revised (NEO-PI-R), the Zuckerman–Kuhlman Personality Questionnaire (ZKPQ) and the NPQ in 253 healthy participants. Our results yielded five factors, four of which resembled the previous ones. The fifth one, namely Peculiarity Seeking, was defined by NPQ and NEO-PI-R Openness to Experience, ZKPQ Impulsive Sensation Seeking and DAPP Stimulus Seeking. Whether the fifth factor is linked to the schizotypal personality disorder as proposed remains unanswered.