The reliability and validity of traditional taxonomies are limited by arbitrary boundaries between psychopathology and normality, often unclear boundaries between disorders, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. These taxonomies went beyond evidence available on the structure of psychopathology and were shaped by a variety of other considerations, which may explain the aforementioned shortcomings. The Hierarchical Taxonomy Of Psychopathology (HiTOP) model has emerged as a research effort to address these problems. It constructs psychopathological syndromes and their components/subtypes based on the observed covariation of symptoms, grouping related symptoms together and thus reducing heterogeneity. It also combines co-occurring syndromes into spectra, thereby mapping out comorbidity. Moreover, it characterizes these phenomena dimensionally, which addresses boundary problems and diagnostic instability. Here, we review the development of the HiTOP and the relevant evidence. The new classification already covers most forms of psychopathology. Dimensional measures have been developed to assess many of the identified components, syndromes, and spectra. Several domains of this model are ready for clinical and research applications. The HiTOP promises to improve research and clinical practice by addressing the aforementioned shortcomings of traditional nosologies. It also provides an effective way to summarize and convey information on risk factors, etiology, pathophysiology, phenomenology, illness course, and treatment response. This can greatly improve the utility of the diagnosis of mental disorders. The new classification remains a work in progress. However, it is developing rapidly and is poised to advance mental health research and care significantly as the relevant science matures.
Evidence has accrued to suggest that there are 2 distinct dimensions of narcissism, which are often labeled grandiose and vulnerable narcissism. Although individuals high on either of these dimensions interact with others in an antagonistic manner, they differ on other central constructs (e.g., Neuroticism, Extraversion). In the current study, we conducted an exploratory factor analysis of 3 prominent self-report measures of narcissism (N=858) to examine the convergent and discriminant validity of the resultant factors. A 2-factor structure was found, which supported the notion that these scales include content consistent with 2 relatively distinct constructs: grandiose and vulnerable narcissism. We then compared the similarity of the nomological networks of these dimensions in relation to indices of personality, interpersonal behavior, and psychopathology in a sample of undergraduates (n=238). Overall, the nomological networks of vulnerable and grandiose narcissism were unrelated. The current results support the need for a more explicit parsing of the narcissism construct at the level of conceptualization and assessment.
The current study attempts to clarify the multi‐faceted nature of impulsivity through the use of the four‐factor UPPS Impulsive Behaviour scale. In order to build the nomological network surrounding this scale, the UPPS was administered to individuals with borderline personality disorder (BPD), pathological gamblers (PG), alcohol abusers (divided into two groups based on the presence of antisocial features), and a control group. Several of the UPPS scales (e.g. Urgency, lack of Premeditation, and Sensation Seeking) differentiated the BPD, PG, and alcohol abusers with antisocial features from a group of non‐antisocial alcohol abusers and a control group. Overall, the UPPS scales accounted for between 7% (pathological gambling) and 64% (borderline personality disorder features) of the overall variance in the psychopathology measures. Individual UPPS scales also made unique contributions to several of these disorders, which may provide insight into which of these personality traits may predispose individuals to behave in maladaptive or problematic ways. The results provide support for the differentiation of impulsivity‐related constructs into the current four‐factor model. Copyright © 2005 John Wiley & Sons, Ltd.
The present study examined Widiger and Lynam's (1998) hypothesis that psychopathy can be represented using the Five-Factor Model (FFM) of personality. Participants in the study consisted of 481 21-22-year-old men and women who are part of an ongoing longitudinal study. Psychopathy was assessed by the degree of similarity between an individual's NEO-PI-R and an expert-generated FFM psychopathy prototype. The expert-based prototype supported the account of Widiger and Lynam (1998), as did the correlations between the NEO-PI-R Psychopathy Resemblance Index (PRI) and the individual personality dimensions. The PRI was also related in predicted ways to measures of antisocial behavior, drug use, and psychopathology. The results support the contention that psychopathy can be understood as an extreme variant of common dimensions of personality, and underscore the utility of a dimensional model of personality disorders.
Since its publication, the Psychopathic Personality Inventory and its revision (Lilienfeld & Andrews, 1996; Lilienfeld & Widows, 2005) have become increasingly popular such that it is now among the most frequently used self-report inventories for the assessment of psychopathy. The current meta-analysis examined the relations between the two PPI factors (factor 1: Fearless Dominance; factor 2: Self-Centered Impulsivity), as well as their relations with other validated measures of psychopathy, internalizing and externalizing forms of psychopathology, general personality traits, and antisocial personality disorder symptoms. Across 61 samples reported in 49 publications, we found support for the convergent and criterion validity of both PPI factor 2 and the PPI total score. Much weaker validation was found for PPI factor 1, which manifested limited convergent validity and a pattern of correlations with central criterion variables that was inconsistent with many conceptualizations of psychopathy.
There is a lack of consensus surrounding the conceptualization of narcissism. The present study compared two measures of narcissism-one used in clinical settings (Personality Diagnostic Questionnaire, PDQ-4+; Hyler, 1994) and one used in social-personality research (Narcissistic Personality Inventory, NPI; Raskin & Terry, 1988)-across two samples. Sample 1 (N=271) was composed of undergraduates, whereas Sample 2 (N=211) was composed of parents of the Sample 1 participants. The scales were significantly interrelated but manifested divergent relations with general personality traits, personality disorders (including expert prototypal ratings of narcissism), recollections of parenting received, and psychological distress and self-esteem. PDQ-4 narcissism captured an emotionally unstable, negative-affect-laden, and introverted variant of narcissism; NPI narcissism captured an emotionally resilient, extraverted form. The clinical and social-personality conceptualizations of narcissism primarily share a tendency to use an antagonistic interpersonal style. Implications for the DSM-V are discussed.
Paulhus and Williams (2002) identified a "Dark Triad" comprising the following related personality styles: narcissism, psychopathy, and Machiavellianism. The heterogeneity found in narcissism and psychopathy raises the possibility of a second triad made up of emotional vulnerability and dark traits (i.e., the vulnerable dark triad; VDT). Along with vulnerable narcissism and Factor 2 psychopathy, the third member of the hypothesized VDT is borderline personality disorder (BPD). Using a sample of 361 undergraduates, we examine the relations between these constructs and their relations with criterion variables, including personality, environmental etiological factors (e.g., abuse), and current functioning (e.g., psychopathology, affect). The results suggest that the VDT constructs are significantly related to one another and manifest similar nomological networks, particularly vulnerable narcissism and BPD. Although the VDT members are related to negative emotionality and antagonistic interpersonal styles, they are also related to introversion and disinhibition. Ultimately, it seems there is a "dark continuum" of pathological personality traits that differ primarily in relation to negative and positive emotionality and disinhibition.
There has been a surge in interest in and research on narcissism and narcissistic personality disorder (NPD). Despite or because of this increased attention, there are several areas of substantial debate that surround the construct, including descriptions of grandiose and vulnerable dimensions or variants, questions regarding the existence of a consensual description, central versus peripheral features of narcissism, distinctions between normal and pathological narcissism, possible etiological factors, the role of self-esteem in narcissism, where narcissism should be studied, how it can be assessed, and its representation in diagnostic nosologies. We suggest that a failure to distinguish between grandiose (i.e., overtly immodest, self-centered, entitled, domineering) and vulnerable (e.g., self-centered, distrustful, neurotic, introverted) presentations of narcissism has led to a less cohesive and coherent literature and that trait-based models of personality and personality disorder can bring greater clarity to many of these important debates.
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