Comparison of alternative models for personality disorders

Psychol Med. 2007 Jul;37(7):983-94. doi: 10.1017/S0033291706009482. Epub 2006 Nov 23.

Abstract

Background: The categorical classification system for personality disorder (PD) has been frequently criticized and several alternative dimensional models have been proposed.

Method: Antecedent, concurrent and predictive markers of construct validity were examined for three models of PDs: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP) model and the DSM-IV in the Collaborative Study of Personality Disorders (CLPS) sample.

Results: All models showed substantial validity across a variety of marker variables over time. Dimensional models (including dimensionalized DSM-IV) consistently outperformed the conventional categorical diagnosis in predicting external variables, such as subsequent suicidal gestures and hospitalizations. FFM facets failed to improve upon the validity of higher-order factors upon cross-validation. Data demonstrated the importance of both stable trait and dynamic psychopathological influences in predicting external criteria over time.

Conclusions: The results support a dimensional representation of PDs that assesses both stable traits and dynamic processes.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Male
  • Models, Psychological*
  • Personality Disorders / classification*
  • Predictive Value of Tests
  • Reproducibility of Results