Examination of the Section III DSM-5 diagnostic system for personality disorders in an outpatient clinical sample.

Abstract

The DSM-5 includes a novel approach to the diagnosis of personality disorders (PDs) in Section III, in order to stimulate further research with the possibility that this proposal will be included more formally in future DSM iterations. The current study provides the first test of this proposal in a clinical sample by simultaneously examining its two primary components: a system for rating personality impairment and a newly developed dimensional model of pathological personality traits. Participants were community adults currently receiving outpatient mental health treatment who completed a semi-structured interview for DSM-IV PDs and were then rated in terms of personality impairment and pathological traits. Data on the pathological traits were also collected via self-reports using the Personality Inventory for DSM-5 (PID-5). Both sets of trait scores were compared to self-report measures of general personality traits, internalizing symptoms, and externalizing behaviors. Inter-rater reliabilities for the clinicians’ ratings of impairment and the pathological traits were fair. The impairment ratings manifested substantial correlations with symptoms of depression and anxiety, DSM-5 PDs, and DSM-5 pathological traits. The clinician and self-reported personality trait scores demonstrated good convergence with one another, both accounted for substantial variance in DSM-IV PD constructs, and both manifested expected relations with the external criteria. The traits but not the impairment ratings demonstrated incremental validity in the prediction of the DSM-IV PDs. Overall, the current results support the general validity of several of the components of this new PD diagnostic system and point to areas that may require further modification.

A Head-to-Head Comparison of the Personality Inventory forDSM-5(PID-5) With the Personality Diagnostic Questionnaire-4 (PDQ-4) in Predicting the General Level of Personality Pathology Among Community Dwelling Subjects

“…Thus, when the PID-5 facet scales were used to predict the IPDS total score, the PID-5 performed even better than the PDQ-4+, although the difference was marginal (i.e., the difference in the proportion of variance explained was .02); indeed, statistical significance should not be considered synonymous with clinical relevance. This finding, as well as the moderately strong associations that were observed in this study between each PDQ-4+ PD scale and the PID-5 domain and trait scales, was consistent with previous studies which suggested that DSM-IV PDs (and DSM-5 Section II PDs) could be adequately described in terms of DSM-5 Alternative PD Model maladaptive personality traits and domains (e.g., Few et al, 2013;Hopwood et al, 2012;Miller, Few, Lynam, & MacKillop, 2015).…”

Clinical Utility of the DSM-5 Alternative Model of Personality Disorders

“…22 Another evaluation supported the interrater reliability of the LPFS. 23 These are promising and important features of a rating scale. Investigations have also verified the empirical structure of the PID-5, with generally good correspondence across different samples.…”

Pathological Personality Traits (DSM-5), Risk Factors, and Mental Health

“…(e.g., Chmielewski, Bagby, Markon, Ring, & Ryder, 2014;Fruyt et al, 2013;Gore & Widiger, 2013;Thomas et al, 2012), others have not found any association (Few et al, 2013;Quilty, Ayearst, Chmielewski, Pollock, & Bagby, 2013;Suzuki, Samuel, Pahlen, & Krueger, 2015;Watson et al, 2013). The debate has focused partly on how researchers define Openness to Experience/Intellect.…”