The structure of personality pathology: Both general (‘g’) and specific (‘s’) factors?

Abstract

Recent editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) conceptualize personality disorders (PDs) as categorical constructs, but high PD co-occurrence suggests underlying latent dimensions. Moreover, several borderline PD criteria resemble Criterion A of the new DSM-5 Section III general criteria for personality pathology (i.e., self and interpersonal dysfunction). We evaluated a bifactor model of PD pathology in which a general factor and several specific factors of personality pathology (PD 'g' and 's' factors, respectively) account for the covariance among PD criteria. In particular, we examined the extent to which the borderline PD criteria would load exclusively onto the g-factor versus on both the g- and one or more s-factors. A large (N = 966) sample of inpatients were interviewed for six DSM-IV (American Psychiatric Association, 1994) PDs using the (Structured Clinical Interview for Personality Disorders (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1994) with no skip-outs. We ran a series of confirmatory, exploratory, and bifactor exploratory factor analyses on the rated PD criteria. The confirmatory analysis largely replicated the DSM PDs, but with high factor correlations. The "standard" exploratory analysis replicated four of the DSM PDs fairly well, but nearly half the criteria cross-loaded. In the bifactor analysis, borderline PD criteria loaded only on the general factor; the remaining PDs loaded either on both the general and a specific factor or largely only on a specific factor. Results are interpreted in the context of several possibilities to define the nature of the general factor.

Development and Validation of Personality Disorder Spectra Scales for the MMPI–2–RF

“…Borderline PD was associated with the largest median discriminant correlation coefficient, which is not surprising for a scale whose underlying construct has been repeatedly criticized for its extreme heterogeneity (e.g., Tyrer, 2009). Additionally, recent work has indicated that borderline PD criteria might reflect a general personality dysfunction severity factor (Sharp et al, 2015). Thus, the finding that the borderline PD scale showed substantial PD-wide associations is consistent with this point of view.…”

Issues resolved and unresolved in pathological narcissism

“…We would further argue, based not only on the accumulated body of research on narcissistic vulnerability's nomological net [e.g., [33][34][35][36][37]40], but also recent structural research on personality disorder features [41][42], that high vulnerability reflects a narcissistic character structure operating at a borderline level of functioning, as has been articulated by clinical theorists [e.g., 43]. This explains the diffuse pattern of associations between vulnerability scales and virtually all DSM personality disorders and pathological personality disorder traits as it captures all personality disorders with similar levels of functioning.…”

Is emotional impulsiveness (Urgency) a core feature of severe personality disorder?

“…This will range from mild ("not associated with substantial harm to self or others") to severe 4 ("associated with a past history and future expectation of severe harm to self or others that has caused long-term damage or has endangered life" (Tyrer et al, 2015 p.722). In a bifactor analysis of PD traits, Sharp, Wright, Fowler, Frueh, Allen, Oldham and Clark (2015) identified a general (g) factor that transcended diagnostic boundaries and appeared to index overall PD severity. It represented a mixture of antisocial traits (irresponsible, disregard for safety, failure to conform, deceitfulness, impulsivity), traits related to cognitive disturbance (odd beliefs, ideas of reference), and traits related to internalising/neurotic introversion (socially inhibited, avoids social contacts at work, preoccupied with rejection), as well as traits related to obsessionality.…”