Comparison of alternative models for personality disorders, II: 6-, 8- and 10-year follow-up.

Abstract:

BACKGROUND:Several conceptual models have been considered for the assessment of personality pathology in DSM-5. This study sought to extend our previous findings to compare the long-term predictive validity of three such models: the five-factor model (FFM), the schedule for nonadaptive and adaptive personality (SNAP), and DSM-IV personality disorders (PDs). METHOD:An inception cohort from the Collaborative Longitudinal Personality Disorder Study (CLPS) was followed for 10 years. Baseline data were used to predict long-term outcomes, including functioning, Axis I psychopathology, and medication use. RESULTS:Each model was significantly valid, predicting a host of important clinical outcomes. Lower-order elements of the FFM system were not more valid than higher-order factors, and DSM-IV diagnostic categories were less valid than dimensional symptom counts. Approaches that integrate normative traits and personality pathology proved to be most predictive, as the SNAP, a system that integrates normal and pathological traits, generally showed the largest validity coefficients overall, and the DSM-IV PD syndromes and FFM traits tended to provide substantial incremental information relative to one another. CONCLUSIONS:DSM-5 PD assessment should involve an integration of personality traits with characteristic features of PDs.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Morey LC,Hopwood CJ,Markowitz JC,Gunderson JG,Grilo CM,McGlashan TH,Shea MT,Yen S,Sanislow CA,Ansell EB,Skodol AE

doi

10.1017/S0033291711002601

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

1705-13

issue

8

eissn

0033-2917

issn

1469-8978

pii

S0033291711002601

journal_volume

42

pub_type

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