The joint structure of maladaptive personality traits and psychopathology

Deriving the Transdiagnostic Scales From the Personality Assessment Inventory and SPECTRA: Indices of Psychopathology: A Demonstration

Transdiagnostic models of psychopathology address many of the shortcomings common to categorical diagnostic systems. These empirically derived models conceptualize psychopathology as a few broad interrelated and hierarchically arranged dimensions, with an overarching general psychopathology dimension, the p-factor, at the apex. While transdiagnostic models are gaining prominence in mental health research, the lack of available tools has limited their clinical translation. The present study explored the potential of creating transdiagnostic scales from the joint factor structure of the Personality Assessment Inventory, Alternative Model of Personality Disorder trait scales (AMPD), and the clinical scales of the SPECTRA: Indices of Psychopathology (SPECTRA). Exploratory factor analysis in a clinical sample (n = 212) identified five factors corresponding to the Negative Affect/Internalizing, Detachment, Antagonism/Externalizing, Disinhibition/Externalizing, and Thought Disorder transdiagnostic dimensions. Goldberg's "Bass-Ackward" method supported a hierarchical structure. Five composite transdiagnostic scales were created by summing each factor's highest loading PAI and SPECTRA scales. A global psychopathology scale was created by summing the five composite scales. All the composite scales demonstrated adequate internal consistency. Correlations between the composite scales and the NEO Five-Factor Inventory-3 provide initial validity evidence for four composite and global scales. The composite thought disorder scale had no conceptually corresponding NEO domain. Clinical implications and study limitations are discussed.

The joint hierarchical structure of psychopathology and dysfunctional personality domain indicators among community-dwelling adults

To examine the hierarchical structure of psychopathology and dysfunctional personality domains, 2416 Italian community-dwelling adult volunteers were administered a set of psychometrically sound psychopathology measures and the Personality Inventory for DSM-5 Brief Form+ (PID-5-BF+). Parallel analysis, minimum average partial, and very simple structure results suggested that 1-6 principal components (PCs) should be retained. Goldberg's bass-ackwards model of the joint psychopathology measure and PID-5-BF+ ipsatized domain scale correlation matrix evidenced a hierarchical structure that was consistent with the working model proposed by the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium. Hierarchical agglomerative cluster analysis around latent variables of the psychopathology indicators and PID-5-BF+ domain scales recovered four latent dimensions, which were akin to the corresponding bass-ackwards components and nicely reproduced the HiTOP Internalizing, Externalizing, Thought Disorder, and Eating Pathology dimensions.

Situating Psychopathy Within the DSM-5 Alternative Model of Personality Disorders (AMPD) Among Italian Community-Dwelling Adults

Given growing evidence for a joint hierarchical framework of clinical and personality symptomatology, situating triarchic traits within this model would acknowledge transdiagnostic trait-related variance and provide a basis for linking the DSM-5 Alternative Model of Personality Disorders (AMPD) domains to established indicators of these neurobehavioral traits. The current study (N = 2,041 Italian adults) sought to replicate and extend recent evidence regarding the locations of triarchic traits within the AMPD and to examine relations with criterion measures at different levels of the hierarchy. "Bass-ackwards" analyses revealed a hierarchical structure of personality pathology in which triarchic traits aligned with broad dispositional domains of the AMPD. Boldness, meanness, and disinhibition were clearly situated within the Externalizing branch of the hierarchy and helped to differentiate the Negative Affect, Antagonism, Detachment, and Disinhibition domains at lower levels. The current findings support the view of psychopathy as multidimensional and encompassing developmentally meaningful and neurobehaviorally relevant traits.

On top or underneath: where does the general factor of psychopathology fit within a dimensional model of psychopathology?

BACKGROUND

Dimensional models of psychopathology are increasingly common and there is evidence for the existence of a general dimension of psychopathology ('p'). The existing literature presents two ways to model p: as a bifactor or as a higher-order dimension. Bifactor models typically fit sample data better than higher-order models, and are often selected as better fitting alternatives but there are reasons to be cautious of such an approach to model selection. In this study the bifactor and higher-order models of p were compared in relation to associations with established risk variables for mental illness.

METHODS

A trauma exposed community sample from the United Kingdom (N = 1051) completed self-report measures of 49 symptoms of psychopathology.

RESULTS

A higher-order model with four first-order dimensions (Fear, Distress, Externalising and Thought Disorder) and a higher-order p dimension provided satisfactory model fit, and a bifactor representation provided superior model fit. Bifactor p and higher-order p were highly correlated (r = 0.97) indicating that both parametrisations produce near equivalent general dimensions of psychopathology. Latent variable models including predictor variables showed that the risk variables explained more variance in higher-order p than bifactor p. The higher-order model produced more interpretable associations for the first-order/specific dimensions compared to the bifactor model.

CONCLUSIONS

The higher-order representation of p, as described in the Hierarchical Taxonomy of Psychopathology, appears to be a more appropriate way to conceptualise the general dimension of psychopathology than the bifactor approach. The research and clinical implications of these discrepant ways of modelling p are discussed.

The clinical utility of the ICD-11 classification of personality disorders and related traits: A preliminary scoping review

OBJECTIVES

A diagnostic system that fails to deliver clinically useful information will not be utilized and consequently will be unable to provide valuable data for health policy and clinical decision making. Therefore, it is imperative to obtain an accurate depiction of the clinical utility of the eleventh revision of the International Classification of Diseases (ICD-11) Personality Disorder (PD) model. The current mixed-methods systematic review aimed to determine the clinical utility of the ICD-11 PD classification system.

METHOD

An electronic screening of six databases was conducted and resulting studies were subjected to specific exclusion criteria, which elicited eight studies of interest. Study characteristics were tabulated and methodological quality was appraised.

RESULTS

Four studies offered strong support for the model's clinical utility, three offered some support accompanied by notable limitations and one study could only offer criticisms.

CONCLUSION

Future investigation of the ICD-11 PD classification system's (a) communicative value between clinicians and their patients, and between clinicians and their patient's families; (b) ease of use; and (c) feasibility in terms of practical application is required to achieve a complete understanding of its clinical utility and ultimately bring clarity to the current ambiguous findings.