Alternative Dimensional Models of Personality Disorder: Finding a Common Ground

Widiger, Thomas A.; Simonsen, Erik

doi:10.1521/pedi.19.2.110.62628

Cited by 572 publications

(641 citation statements)

References 58 publications

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“…92 An example of this appears in section 3 of the DSM-5 (conditions that require further research), 1 but at present there is no consensus among the field as to which dimensional model should be adopted. 93 Potential advantages of a dimensional approach are that (1) adolescents with BPD can be described much more in detail than previously possible, (2) subthreshold conditions can be easily identified and classified, (3) changes in BPD symptomatology over the course of illness can be more sensitively detected, and (4) therapeutic interventions could be more individually targeted. 94 …”

Section: Dimensional Diagnostic Approachmentioning

confidence: 99%

Borderline Personality Disorder in Adolescence

2014

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This is the 4th in our series on Adolescent Health. abstract Borderline personality disorder (BPD) is a common and severe mental disorder that is associated with severe functional impairment and a high suicide rate. BPD is usually associated with other psychiatric and personality disorders, high burden on families and carers, continuing resource utilization, and high treatment costs. BPD has been a controversial diagnosis in adolescents, but this is no longer justified. Recent evidence demonstrates that BPD is as reliable and valid among adolescents as it is in adults and that adolescents with BPD can benefit from early intervention. Consequently, adolescent BPD is now recognized in psychiatric classification systems and in national treatment guidelines. This review aims to inform practitioners in the field of adolescent health about the nature of BPD in adolescence and the benefits of early detection and intervention. BPD diagnosis and treatment should be considered part of routine practice in adolescent mental health to improve these individuals' well-being and long-term prognosis.

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Section: Dimensional Diagnostic Approachmentioning

confidence: 99%

Borderline Personality Disorder in Adolescence

2014

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“…Together, the literature suggests that clinical and more trait-related pathology can be meaningfully captured by means of dimensional models that generalize across the life span. Furthermore, there is a general consensus on the basic dimensional structure of maladaptive personality in adulthood, with emotional dysregulation versus emotional stability, extraversion versus introversion, antagonism versus compliance, and constraint versus impulsivity as the four broad maladaptive trait dimensions (Widiger & Simonsen, 2005). De Clercq, De Fruyt, Van Leeuwen, and Mervielde (2006) reported that the basic dimensional structure of early maladaptive trait characteristics can be conceptualized along four broad trait factors, labeled as emotional instability, introversion, compulsivity, and disagreeableness.…”

Section: Conceptualization Of Personality Dysfunction and Psychopathomentioning

confidence: 99%

Exploring the complexity of the childhood trait–psychopathology association: Continuity, pathoplasty, and complication effects

et al. 2015

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Four different models have been generally proposed as plausible etiological explanations for the relation between personality and psychopathology, namely, the vulnerability, complication, pathoplasty, and spectrum or continuity model. The current study entails a joint investigation of the continuity, pathoplasty, and complication models to explain the nature of the associations between early maladaptive traits and psychopathology over time in 717 referred and community children (54.4% girls), aged from 8 to 14 years. Across a 2-year time span, maladaptive traits and psychopathology were measured at three different time points, thereby relying on comprehensive and age-specific dimensional operationalizations of both personality symptoms and psychopathology. The results demonstrate overall compelling evidence for the continuity model, finding more focused support for pathoplasty and complication effects for particular combinations of personality symptoms and psychopathology dimensions. As expected, the continuity associations were found to be more robust for those personality-psychopathology associations that are conceptually closer, such as the emotional instability/introversion-internalizing problems association and the disagreeableness-externalizing problems association. Continuity associations were also stronger when personality was considered from a maladaptive rather than from a general trait perspective. The implication of the findings for the treatment of psychopathology and personality symptoms are briefly discussed.Although clinical disorders and personality pathology have been traditionally conceived as distinct groups of pathology (Clark, 2005), empirical evidence does generally not support this conceptual bifurcation. More specifically, there has been a historical belief that personality disorders, in contrast to clinical disorders, reflect enduring patterns that are relatively stable over time. Recent longitudinal studies, however, have demonstrated a natural plasticity of personality symptoms both in adulthood (Cohen, Crawford, Johnson, & Kasen, 2005;Lenzenweger, 1999;Livesley, 2005;Skodol et al., 2005;Zanarini, Frankenburg, Hennen, Reich, & Silk, 2005) & Verhulst, 2003). In addition, a mass of literature reports on the substantial overlap between personality and psychopathology in adults (Widiger, 2003) and children (Tackett, 2006), including shared genetic etiological factors (Bienvenu, Hettema, Neale, Prescott, & Kendler, 2007;Krueger, Markon, Patrick, & Iacono, 2005). These research findings all suggest that personality and psychopathology are closely interconnected, given their similar nature and developmental course over time. Much is to be studied, however, to unravel their complex longitudinal interrelations from childhood onward. Delineating these trait-psychopathology connections from the various etiological models makes it possible to map causally oriented pathways of maladjustment toward adulthood . The current study aims to explore the etiology of these associations between earl...

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“…These general traits show strong links to all common forms of psychopathology (Clark, 2005;Kotov et al, 2010, Saulsman & Page, 2004; in addition, specific facets are highly informative for understanding certain mental disorders (Samuel & Widiger, 2008;Watson, Stasik, EllicksonLarew, & Stanton, 2015). Although extensive discussion of connections between personality and psychopathology is beyond the scope of the present paper, we should note that the taxonomy of normal personality has played a major role in shaping dimensional models of personality pathology (Widiger & Mullins-Sweatt, 2009;Widiger & Simonsen, 2005;Widiger & Trull, 2007). Personality models are also important because the scope of a quantitative nosology includes both symptoms, which are relatively transient forms of psychopathology, and maladaptive personality traits that form a more stable core of the clinical picture (Hopwood et al, 2011;Krueger & Markon, 2006).…”

mentioning

confidence: 97%

The Hierarchical Taxonomy of Psychopathology (HiTOP): A Dimensional Alternative to Traditional Nosologies

Kotov¹,

Krueger²,

Watson³

et al. 2017

Preprint

502

932

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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.

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Alternative Dimensional Models of Personality Disorder: Finding a Common Ground

Cited by 572 publications

References 58 publications

Borderline Personality Disorder in Adolescence

Borderline Personality Disorder in Adolescence

Exploring the complexity of the childhood trait–psychopathology association: Continuity, pathoplasty, and complication effects

The Hierarchical Taxonomy of Psychopathology (HiTOP): A Dimensional Alternative to Traditional Nosologies

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