FFMPD scales: Comparisons with the FFM, PID-5, and CAT-PD-SF

The structure of pathological personality traits and temperament in a Persian community sample

The present study examined the extent to which the currently established factor structure of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2013) generalizes to a large Persian community sample, as well as relations between the resulting PID-5 factors and two temperament measures. Cross-sectional data came from 946 adults (65% female) from western Iran. With the use of exploratory structural equation modeling (ESEM) with target rotation, we found factor loadings that showed fairly similar patterns to those found in two previous meta-analytic PID-5 studies with predominantly North American and European samples (Watters & Bagby, 2018; Somma et al., 2019). Despite slight differences in each of the target rotations, there were moderate congruence coefficients (~0.85) between loadings for the five PID-5 domains, with the weakest evidence supporting the Disinhibition factor. The resulting PID-5 factors showed meaningful associations with temperament domains assessed via the Temperament and Character Inventory (TCI; Cloninger, 1994) and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A; Akiskal et al., 2005). Overall, our findings suggest that the documented structure of personality pathology assessed by the PID-5 generalizes somewhat to this sample of Persian participants, and pathological personality traits show important overlap with temperament, although these constructs are meaningfully distinct.

Personality Functioning, Problems in Living, and Personality Traits

The publication of the Alternative Model of Personality Disorder (AMPD) was a signpost achievement in the personality assessment. However, research on the AMPD has generally not led to either a deeper understanding of personality disorder or personality assessment or new ideas about how to provide better care for people with personality disorder diagnoses. A significant portion of research has focused on narrow issues and appears to be driven in part by ideological differences between scholars who prefer Criterion A (personality functioning) or Criterion B (maladaptive traits). I trace these issues to ambiguity about the concept of personality functioning as defined in the AMPD and its conceptual distinction from personality traits and problems in living. In this paper, I reground these concepts in coherent and distinct definitions, elaborate upon the implications of their differences, and show how these differences can help clarify and reorient AMPD research to focus on generating clinically useful models for personality pathology and personality assessment.

Meta-Analytic Review of Temperamental Correlates of the Five-Factor Model and Hierarchical Taxonomy of Psychopathology Domains

Background

There is little and heterogeneous knowledge on the links between the temperamental predispositions of psychopathology and the contemporary dimensional models of psychopathology, such as the Hierarchical Taxonomy of Psychopathology (HiTOP) classification system, which can be aligned with the five-factor model (FFM) of personality. This meta-analysis seeks to expand the temperamental theoretical basis of the HiTOP model by incorporating associations of temperament traits of two temperamental theories measured, respectively, by the Temperament and Character Inventory (TCI) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) with (a) the FFM's personality domains and (b) HiTOP's five psychopathological spectra.

Methods

A systematic search was done on Web of Science, Scopus, PubMed, ProQuest, Cochrane Database, and Google Scholar for all articles published in English from January 1990 to August 2020. Because of heterogeneity in the results of almost 70% of studies, pooled estimates of correlation coefficients were calculated using the random-effects method. Risk of bias (low-quality studies) and publication bias are reported.

Results

The pooled correlations obtained from the analysis of 35 studies showed that the temperamental profile associated with each FFM domain and HiTOP spectra is distinct. Specifically, TCI-harm avoidance (HA) and all TEMPS temperaments were more strongly related to neuroticism/internalizing, extraversion/low detachment, and conscientiousness/disinhibition. In contrast, TCI-novelty seeking was more strongly related to both disinhibited/antagonistic externalizing and thought disorder.

Conclusions

A large body of research supports maladaptive variants of all FFM domains and some psychopathological spectra of HiTOP related to the abnormal-range temperaments.

Measurement invariance of the Personality Inventory for DSM-5 across sex

Introduction

There has been an international movement towards dimensional models of personality disorders (PDs) in the last decades, which culminated in the publication of the Alternative Model of Personality Disorders (AMPD) in the Emerging Measures and Models section of the DSM-5. This model was accompanied by a APA-sanctioned Personality Inventory for DSM-5 (PID-5) for the assessment of the AMPD pathological personality traits. One major issue with the assessment of personality disorders pertains to sex differences, and measurement invariance across sex in assessment instruments for PDs is necessary in order to ensure non-biased evaluations and to make valid comparisons between men and women. This study aimed to provide more information on measurement invariance across sex for the PID-5, using both the original scoring approach provided by the authors of the instrument and the scoring approach suggested by the APA in the published version of the PID-5.

Methods

This study was conducted with a sample of 2273 participants from the general Québec (Canada) adult population aged 18 to 90 years (M = 46.59; SD = 16.32; 51.8% women).

Results

The original scoring approach model showed good fit to data after freeing paths between certain traits and reached strict invariance. The APA scoring approach also showed good fit to data and reached strict invariance, but needed an adjustment (path freed between Emotional lability and Impulsivity in men) to reach scalar invariance.

Discussion

In line with previous research, the PID-5 is invariant across sex and the five-factor structure adjusts well to data. The APA scoring approach appears to attenuate the cross-loading problem observed with the original scoring approach. In light of these results, we recommend using the APA scoring approach to derive domain scores.

Structure of Pathological Personality Traits Through the Lens of the CAT-PD Model

Personality pathology is increasingly conceptualized within hierarchical, dimensional trait models. The Comprehensive Assessment of Traits Relevant to Personality Disorders (CAT-PD) is a pathological-trait measure with potential to improve on currently prevailing instruments because it has wider content coverage; however, its domain-level structure, which is of scientific and clinical interest, is not established. In this study, we investigated the structure and construct validity of the CAT-PD's domain level to facilitate wider use of the measure. We estimated five- and six-factor models with exploratory factor analysis in a pooled sample of eight independent subsamples (N = 3,987) and found that both models fit the data well; each had interpretable factors that were invariant across gender, sample type, and Black/White racial groups; and the factors had good convergent validity with other measures of maladaptive traits, Big Five personality, and interpersonal problems. Our results support the validity of the CAT-PD for assessing multiple levels of the pathological trait hierarchy.

Association of Multidimensional Schizotypy with PID-5 Domains and Facets

The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms referred to as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. The present study examined associations of positive, negative, and disorganized schizotypy with pathological personality traits and facets assessed by the Personality Inventory for DSM-5 (PID-5) in 1,342 young adults. As hypothesized, positive schizotypy was associated with the PID-5 psychoticism domain and facets, negative schizotypy was associated with the detachment domain and facets and the restricted affectivity facet, and disorganized schizotypy's strongest associations were with the distractibility and eccentricity facets and the negative affect domain. The PID-5 facets accounted for upwards of two thirds of the variance in each schizotypy dimension. The authors conclude by providing regression-based algorithms for computing positive, negative, and disorganized schizotypy scores based on the PID-5 facets.

Pathological personality, situations, and their joint influences on daily emotional symptoms

OBJECTIVE

The present research aims to advance current understanding on how individuals with pathological personality traits construe their day-to-day situational experiences.

METHOD

College students (N = 231) completed a measure of personality pathology, followed by six assessments of everyday situations and anxiety/depression symptoms over two weeks.

RESULTS

Multilevel analyses indicated that personality pathology was meaningfully associated with situational experiences. Major findings suggested that situations that entailed aggravations and interpersonal confrontations were associated with negative affectivity, antagonism, and psychoticism. Detached individuals were less likely to experience pleasant and social situations. Exploratory analyses suggested an amplification effect where individuals high on personality pathology were more anxious or depressed when they perceived certain situational features, compared to their low trait counterparts. However, such cross-level interactions constituted a small minority; most personality traits and situations exerted additive effects on symptoms.

CONCLUSION

Situational experiences appear to be driven in part by personality pathology. The exacerbation of daily negative symptoms can be attributed to the joint (largely additive) influence of the trigger situations and pathological personality traits.

Alternative DSM-5 Model for Personality Disorders Through the Lens of an Empirical Network Model

The Alternative Model for Personality Disorders defined in Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) has recently attracted considerable interest in empirical research, with different hypotheses being proposed to explain the discordant results shown in previous research. Empirical network analysis has begun to be applied for complementing the study of psychopathological phenomena according to a new perspective. This article applies this analysis to personality facets measured in a sample of 626 patients with mental disorders and a 1,034 normative sample, using the Personality Inventory for DSM-5. The results reveal five substructures partially equivalent to domains defined in the DSM-5. Discordant facets (suspiciousness, hostility, rigid perfectionism, attention seeking, and restricted affectivity) play the role of connectors between substructures. Invariance between clinical and community networks was found except for the connection between unusual beliefs and perceptual dysregulation (stronger in the clinical sample). Considering the strength centrality index, anxiousness, emotional lability, and depressivity can be highlighted for their relative importance within both clinical and normative networks.

Applying Item Response Theory to the OPD Structure Questionnaire: Identification of a Unidimensional Core Construct and Feasibility of Computer Adaptive Testing

Recent developments in the dimensional assessment of personality functioning have made the implementation of latent measurement models increasingly attractive. In this study, we applied item response theory (IRT) to a well-established personality functioning instrument (the OPD Structure Questionnaire) to identify a unidimensional latent trait and to evaluate the feasibility of computer adaptive testing (CAT). We hypothesized that the use of IRT could reduce the test burden - compared to a fixed short form - while maintaining high precision over a wide range of the latent trait. The OPD-SQ was collected from 1235 patients in a psychosomatic clinic. IRT assumptions were fulfilled. A 9-factor model yielded sufficient fit and unidimensionality in exploratory factor analysis with bifactor rotation. Items were iteratively reduced, and a graded-response IRT model was fitted to the data. Simulations showed that a CAT with approximately 7 items was able to capture an OPD-SQ global severity score with an accuracy similar to that of a fixed 12-item short form. The final item bank and CAT yielded satisfactory content validity. Strong correlations with depression and anxiety replicated previous results on the OPD-SQ. We concluded that IRT applications could be useful to reduce the test burden of personality functioning instruments.

Arabic Version of the Personality Inventory for the DSM-5 (PID-5) in a Community Sample of United Arab Emirates Nationals

Background:

Section III of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) proposes a model for conceptualizing personality disorders in which they are characterized by impairments in personality functioning and maladaptive personality traits. The Personality Inventory for DSM-5 (PID-5) is a self-report measure that assesses the presence and severity of these maladaptive personality traits.

Objective:

The current study examined the reliability and validity of the Arabic version of the Personality Inventory for DSM-5 (PID-5) to measure maladaptive personality traits in the Emirati population of the United Arab Emirates.

Methods:

The Arabic version of the PID-5 was administered to a community sample of 1,090 United Arab Emirates nationals (89.5% female and 10.5% male, mean age = 22.44 years old). The descriptive measures, internal consistency, test-retest reliability, convergent validity with NEO – Five Factor Inventory, as well as PID-5’s factor structure, were all addressed.

Results:

The PID-5facets and domains mean scores were higher in the Emirati sample compared to the original US sample. Internal consistency of the PID-5 scales was acceptable to high and test-retest coefficients ranged from 0.84 (facets) to 0.87 (domains). As expected, the five domains of the Arabic version of the PID-5 correlated significantly with all Five-Factor Model domains of personality. Additionally, the Arabic version of the PID-5 confirmed a five-factor structure that resembles the PID-5 domains.

Conclusion:

The findings of this study provided initial support for the use of the Arabic version of the PID-5 to assess maladaptive personality traits in the Emirati population of the United Arab Emirates.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): I. Psychosis superspectrum

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a scientific effort to address shortcomings of traditional mental disorder diagnoses, which suffer from arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. This paper synthesizes evidence on the validity and utility of the thought disorder and detachment spectra of HiTOP. These spectra are composed of symptoms and maladaptive traits currently subsumed within schizophrenia, other psychotic disorders, and schizotypal, paranoid and schizoid personality disorders. Thought disorder ranges from normal reality testing, to maladaptive trait psychoticism, to hallucinations and delusions. Detachment ranges from introversion, to maladaptive detachment, to blunted affect and avolition. Extensive evidence supports the validity of thought disorder and detachment spectra, as each spectrum reflects common genetics, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, biomarkers, and treatment response. Some of these characteristics are specific to one spectrum and others are shared, suggesting the existence of an overarching psychosis superspectrum. Further research is needed to extend this model, such as clarifying whether mania and dissociation belong to thought disorder, and explicating processes that drive development of the spectra and their subdimensions. Compared to traditional diagnoses, the thought disorder and detachment spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and higher acceptability to clinicians. Validated measures are available to implement the system in practice. The more informative, reliable and valid characterization of psychosis-related psychopathology offered by HiTOP can make diagnosis more useful for research and clinical care.

Global personality dysfunction and the relationship of pathological and normal trait domains in the DSM-5 alternative model for personality disorders

OBJECTIVE

The DSM-5 Alternative Model of Personality Disorders distinguishes core personality dysfunction common to all personality pathology from maladaptive traits that delineate specific variants of disorder. Previous research shows the convergence between maladaptive and normal range trait domains as well as substantial correlations between maladaptive traits and core dysfunctions, leading some to conclude that personality traits and dysfunction are redundant. This study sought to examine the potential utility of the concept of core dysfunctions as a means of clarifying the nature of the relationship between maladaptive and normal-range traits.

METHOD

Three nonclinical samples (n = 178, 307, and 1,008) were evaluated for personality dysfunction, maladaptive traits, and normal-range traits using different measures.

RESULTS

Results indicated that: (1) normal trait domains and core dysfunction contribute independently to understanding maladaptive traits; (2) the correlation of a normal trait domain with its putative maladaptive equivalent is consistently accounted for in part by core dysfunction; and (3) the multitrait multimethod matrices of normal and maladaptive personality trait domains demonstrate appreciable discriminant validity problems that are clarified by a consideration of core dysfunction.

CONCLUSION

These results suggest that maladaptive traits reflect the distinguishable contributions of core personality dysfunction (problems) and normal-range personality traits (person).

The Alternative Model of Personality Disorders (AMPD) from the Perspective of the Five-Factor Model

The fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders(DSM-5; American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington: American Psychiatric Association; 2013) includes an Alternative Model of Personality Disorders (AMPD). The AMPD includes two components: the Criterion A level of personality functioning (i.e., impairments or deficits in the sense of self and interpersonal relatedness) and the Criterion B five-domain maladaptive trait model. The purpose of the current paper is to discuss the AMPD from the perspective of the Five-Factor Model (FFM) of general personality structure. The conclusion of this review is that both the Criterion A self-other deficits and the Criterion B traits can be understood as maladaptive variants of the FFM.

Bruno Klopfer Award Address: Five-Factor Model Personality Disorder Scales

The predominant model of general personality structure is the Five-Factor Model (FFM), consisting of the five broad domains of neuroticism, extraversion, openness, agreeableness, and conscientiousness. A hypothesis of long-standing interest has been that personality disorders can be understood as extreme or maladaptive variants of the domains and facets of the FFM. The purpose of this article was to discuss the development and validation of FFM personality disorder scales. These scales assess the DSM-5 Section II personality disorders from the perspective of the FFM, as well as maladaptive variants of both poles of all five domains of the FFM.

A Brief but Comprehensive Review of Research on the Alternative DSM-5 Model for Personality Disorders

PURPOSE OF REVIEW

Both the Alternative DSM-5 Model for Personality Disorders (AMPD) and the chapter on personality disorders (PD) in the recent version of ICD-11 embody a shift from a categorical to a dimensional paradigm for the classification of PD. We describe these new models, summarize available measures, and provide a comprehensive review of research on the AMPD.

RECENT FINDINGS

A total of 237 publications on severity (criterion A) and maladaptive traits (criterion B) of the AMPD indicate (a) acceptable interrater reliability, (b) largely consistent latent structures, (c) substantial convergence with a range of theoretically and clinically relevant external measures, and (d) some evidence for incremental validity when controlling for categorical PD diagnoses. However, measures of criterion A and B are highly correlated, which poses conceptual challenges. The AMPD has stimulated extensive research with promising findings. We highlight open questions and provide recommendations for future research.

Maladaptive Variants of Adaptive Traits and Bloated Specific Factors

The five-factor model of personality disorder (FFMPD) hypothesizes that the traditionally adaptive five-factor model (FFM) poles (e.g., agreeableness) include maladaptive variants. However, "bloated specific factors" (BSFs), which are artifactual factors that emerge when a specific facet of a broader construct is over-represented, complicate research on the maladaptive variants. Twenty-five sets of factor analyses are completed herein demonstrating that items from maladaptive trait facet scales form BSFs when over-represented in factor analyses with other FFM indicators, separating from the higher-order domains in which they were originally located. These results held in 23 of 25 cases. Ensuring balanced collections of scales representing constructs would help researchers avoid BSFs. The implications of BSFs for future research on personality structure are discussed.