Background DSM-IV-TR suggests that clinicians should assess clinically relevant personality traits that do not necessarily constitute a formal personality disorder, and should note these traits on Axis II, but DSM-IV-TR does not provide a trait model to guide the clinician. Our goal was to provide a provisional trait model and a preliminary corresponding assessment instrument, in our roles as members of the DSM-5 personality and personality disorders workgroup and workgroup advisors. Methods An initial list of specific traits and domains (broader groups of traits) was derived from DSM-5 literature reviews and workgroup deliberations, with a focus on capturing maladaptive personality characteristics deemed clinically salient, including those related to the criteria for DSM-IV-TR personality disorders (PDs). The model and instrument were then developed iteratively using data from community samples of treatment seeking participants. The analytic approach relied on tools of modern psychometrics (e.g., item response theory models). Results Twenty-five reliably measured core elements of personality description emerged that, together, delineate five broad domains of maladaptive personality variation: negative affect, detachment, antagonism, disinhibition, and psychoticism. Conclusions We developed a maladaptive personality trait model and corresponding instrument as a step on the path toward helping users of DSM-5 assess traits that may or may not constitute a formal PD. The inventory we developed is reprinted in its entirety in the supplementary materials, with the goal of encouraging additional refinement and development by other investigators prior to the finalization of DSM-5. Continuing discussion should focus on various options for integrating personality traits into DSM-5.

The results offer a novel perspective on comorbidity, suggesting that comorbidity results from common, underlying core psychopathological processes. The results thereby argue for focusing research on these core processes themselves, rather than on their varied manifestations as separate disorders.

A hierarchical biometric model is presented of the origins of comorbidity among substance dependence, antisocial behavior, and a disinhibited personality style. The model posits a spectrum of personality and psychopathology, united by an externalizing factor linked to each phenotype within the spectrum, as well as specific factors that account for distinctions among phenotypes within the spectrum. This model fit self-report and mother-report data from 1,048 male and female 17-year-old twins. The variance of the externalizing factor was mostly genetic, but both genetic and environmental factors accounted for distinctions among phenotypes within the spectrum. These results reconcile evidence for general and specific causal factors within the externalizing spectrum and offer the externalizing factor as a novel target for future research.

Increasing evidence indicates that normal and abnormal personality can be treated within a single structural framework. However, identification of a single integrated structure of normal and abnormal personality has remained elusive. Here, a constructive replication approach was used to delineate an integrative hierarchical account of the structure of normal and abnormal personality. This hierarchical structure, which integrates many Big Trait models proposed in the literature, replicated across a metaanalysis as well as an empirical study, and across samples of participants as well as measures. The proposed structure resembles previously suggested accounts of personality hierarchy and provides insight into the nature of personality hierarchy more generally. Potential directions for future research on personality and psychopathology are discussed.In recent years, there has been increasing consensus that normal and abnormal personality variation can be treated within a single, unified structural framework (Eysenck, 1994;O'Connor, 2002;. A variety of studies have indicated, for example, that personality structure is essentially the same in clinical and nonclinical samples (O'Connor, 2002), that normal and abnormal personality are strongly related at the etiologic level (Jang & Livesley, 1999;Markon, Krueger, Bouchard, & Gottesman, 2002), and that abnormal personality can be modeled as extremes of normal personality variation (O'Connor & Dyce, 2001).Despite consensus about the possibility of describing normal and abnormal personality within a single structural framework, however, there is less consensus about what this structural framework might be. Although there is emerging consensus about the superordinate structure of normal personality (Goldberg, 1993), less consensus exists about a similar structure of abnormal personality (Livesley, 2001). Delineating a unified superordinate structure across normal and abnormal domains of personality has been even more challenging. Empirical results have supported a variety of conclusions, and validity has been demonstrated for multiple structural models (e.g., Jang & Livesley, 1999;Markon et al., 2002;O'Connor, 2002).Here, we argue that abnormal and normal personality variation is best described within a single integrative hierarchy. We demonstrate that this hierarchical structure replicates across a metaanalytic dataset and empirical sample, replicates across different sets of measures, and is consistent with previous integrative analyses of superordinate personality structure.Correspondence concerning this article should be addressed to Kristian E. Markon Structural Models of Abnormal PersonalityMany models of personality structure, including those of Eysenck (1947;Eysenck & Eysenck, 1976) and Cloninger (1987;Cloninger, Svrakic, & Przybeck, 1993), were formulated with an explicit goal of describing both normal and abnormal trait variation. Other prominent models, such as the Big Five, were developed without explicit attention to any distinction between normal and...

Antisocial behavior, substance use, and impulsive and aggressive personality traits often co-occur, forming a coherent spectrum of personality and psychopathology. In the current research, the authors developed a novel quantitative model of this spectrum. Over 3 waves of iterative data collection, 1,787 adult participants selected to represent a range across the externalizing spectrum provided extensive data about specific externalizing behaviors. Statistical methods such as item response theory and semiparametric factor analysis were used to model these data. The model and assessment instrument that emerged from the research shows how externalizing phenomena are organized hierarchically and cover a wide range of individual differences. The authors discuss the utility of this model for framing research on the correlates and the etiology of externalizing phenomena. Keywords drug; alcohol; impulsivity; aggression; classificationThe existence of individual differences in the tendency to contain versus express impulses has been recognized in academic psychology since its inception as a discipline (James, 1890(James, /1983. In more recent times, this domain has been instantiated in psychological constructs ranging from disinhibition (Clark & Watson, 1999;Gorenstein & Newman, 1980) to impulsivity (Barratt, 1994;Dickman, 1990;Gray, 1981;Whiteside & Lynam, 2001), ego control (J. Block, 1965; J. H. Block & Block, 1980), constraint (Tellegen, 1985), the problem behavior syndrome (Jessor & Jessor, 1977), sensation seeking (Zuckerman & Kuhlman, 2000), and novelty seeking (Cloninger, Svrakic, & Przybeck, 1993). In addition, a dimension of effortful control is a salient feature of childhood temperament that likely relates to these disinhibitory personality characteristics in adulthood (Rothbart, Ahadi, & Evans, 2000). Robust correlations have also been observed between these disinhibitory personality constructs and mental disorders involving substance problems and antisocial behavior (for a review, see Sher & Trull, 1994).In spite of these rich interrelations, many of these constructs continue to be studied and conceptualized as separate entities, in separate literatures. A major reason for this fragmentation is the lack of an integrative model of this domain (Widiger & Clark, 2000). The purpose of the current research is to further the development of an empirically based model of NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript this broad domain of personality and psychopathology, which we term the externalizing spectrum (Krueger, Markon, Patrick, & Iacono, 2005). Origins of the Externalizing Spectrum ConceptualizationAs applied to adult psychopathology, the externalizing spectrum conceptualization emerged initially from research on mental disorders defined within current nosologies. In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text. rev.; DSM-IV-TR; American Psychiatric Association, 2000), various forms of substance problems are conceptualized as discrete disorder...

The latent structure and stability of 10 common mental disorders were examined in a birth cohort at ages 18 and 21. A 2-factor model, in which some disorders were presumed to reflect internalizing problems and others were presumed to reflect externalizing problems, provided a more optimal fit to the data than either a 1- or a 4-factor model. To a significant extent, persons in the sample retained their relative positions on the latent factors across the 3-year period from age 18 to age 21. Results offer potential clarification of the meaning of comorbidity in psychopathology research by suggesting that comorbidity may results from common mental disorders being reliable, covariant indicators of stable, underlying "core psychopathological processes."

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) represents a watershed moment in the history of official psychopathology classification systems because it is the first DSM to feature an empirically based model of maladaptive personality traits. Attributes of patients with personality disorders were discussed by the DSM-5 Personality and Personality Disorders Work Group and then operationalized and refined in the course of an empirical project that eventuated in the construction of the Personality Inventory for DSM-5 (PID-5). We review research to date on the DSM-5 trait model, with a primary aim of discussing how this kind of research could serve to better tether the DSM to data as it continues to evolve. For example, studies to date suggest that the DSM-5 trait model provides reasonable coverage of personality pathology but also suggest areas for continued refinement. This kind of research provides a way of evolving psychopathology classification on the basis of research evidence as opposed to clinical authority.

The authors used model-based cluster analysis to identify subtypes of criminal psychopaths on the basis of differences in personality structure. Participants included 96 male prisoners diagnosed as psychopathic, using the Psychopathy Checklist Revised (PCL-R; R. D. Hare, 1991). Personality was assessed using the brief form of the Multidimensional Personality Questionnaire (MPQ-BF; C. J. Patrick, J. J. Curtin, and A. Tellegen, 2002). The best-fitting model yielded two clusters. Emotionally stable psychopaths were characterized by low Stress Reaction and high Agency. Aggressive psychopaths were characterized by high Negative Emotionality, low Constraint, and low Communion. These results suggest that psychopaths as defined by the PCL-R includes distinct subtypes, distinguishable in terms of personality structure, that may reflect different etiologies.