Reliability and construct validity of the general factor of personality disorder.

Abstract

Criterion B of the alternative model of personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), outlines maladaptive trait dimensions that characterize personality disorders. Emerging evidence from bifactor confirmatory factor analyses suggest these traits are related at a higher order level by a general factor of personality disorder (g-PD). Further, emerging evidence points to traits most closely related to borderline personality disorder as underpinnings of g-PD. Further investigation is required to better understand the shared basis of personality disorder, with attention to the reliability and validity of g-PD. The g-PD theory was examined in a clinical (n = 242), and community sample (n = 252) of adults, using a brief form of the Personality Inventory for DSM-5 (PID-5). Structural analyses supported a correlated 6-factor model and a bifactor solution, validating the g-PD structure. Reliability indices supported the unidimensionality, reliability, and replicability of the g-PD factor. The strongest loading and most unidimensional items on the g-PD factors were from the Negative Affectivity and Disinhibition trait domains, partially replicating the trait profile of borderline personality disorder traits. In validity analyses, the nomological network of the general and specific factors were examined. g-PD was more strongly correlated with internalizing measures and impairment than specific factors, but specific factors were more strongly correlated with thought disorder and externalizing measures than g-PD. Our results support the nature and reliability of a general factor characterized by Negative Affectivity and Disinhibition unifying personality disorder traits in a brief form of the PID-5. Implications for the alternative model of personality disorder, PID-5, and g-PD theory are discussed.

Psychotic spectrum features in borderline and bipolar disorders within the scope of the DSM-5 section III personality traits: a case control study

“…Additionally, other published studies found that bipolar disorder/mania symptoms loaded on either the psychosis or internalizing dimensions, with borderline PD and major depressive disorders equally fitting in this latter dimension, reflecting an affective dysregulation foundation [33,[40][41][42][43][44]. It can be argued that these data also feature psychoticism as a core trait domain posits as a general factor of personality disorder [45][46][47], or as a core personality dysfunction [48]. In this follow-up, there is evidence that psychoticism can capture clinically relevant aspects of severe mental illness associated with psychosis and other related characteristics, indicating possibly shared patterns of personality expression [14,49], demonstrating a degree of non-specificity in the patterns across symptoms of personality disorders and non-personality disorders, similarly to some other evidence in the literature [49].…”

Examining Measurement Invariance in the Personality Inventory for DSM-5 Brief Form Across Sexual and Gender Minority Status

“…Finally, we examined measurement invariance within the PID-5-BF in the context of a correlated factors model, which is empirically consistent with the original hypothesized structure of the PID-5-BF. Emerging evidence suggests higher order, and bifactor models also show good fit for PID-5 brief forms (e.g., Asadi et al, 2022; Bagby et al, 2022; Gomez et al, 2020; Hyatt et al, 2021), and future investigations should continue to examine the invariance of higher order dimensions of the PID-5 brief forms as well.…”

Readiness and Personality Disorders: Considering Patients’ Readiness for Change and Our System’s Readiness for Patients

“…toward a dimensional approach that focuses more on the degree of impairment in self and interpersonal functioning. 4,5 Readiness for change needs to be distinguished from readiness for treatment, which are related but different ideas. Readiness for change means a patient is prepared to alter a particular pattern of behavior in a general sense, typically with awareness and acknowledgement that the pattern is leading to distress or impairment.…”

“…We also highlight how the personality disorder literature is moving away from a purely descriptive nosology of distinct entities (e.g., BPD, ASPD, OCPD, etc.) toward a dimensional approach that focuses more on the degree of impairment in self and interpersonal functioning 4,5 …”