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

Published online by Cambridge University Press:  02 December 2011

L. C. Morey ,
C. J. Hopwood ,
J. C. Markowitz ,
J. G. Gunderson ,
C. M. Grilo ,
T. H. McGlashan ,
M. T. Shea ,
S. Yen ,
C. A. Sanislow  and
E. B. Ansell
...Show all authors
L. C. Morey*
Affiliation:
Department of Psychology, Texas A&M University, College Station, TX, USA
C. J. Hopwood
Affiliation:
Department of Psychology, Michigan State University, East Lansing, MI, USA
J. C. Markowitz
Affiliation:
New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
J. G. Gunderson
Affiliation:
Department of Psychiatry, Harvard Medical School and McLean Hospital, MA, USA
C. M. Grilo
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
T. H. McGlashan
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
M. T. Shea
Affiliation:
Department of Veterans Affairs and Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
S. Yen
Affiliation:
Department of Veterans Affairs and Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
C. A. Sanislow
Affiliation:
Department of Psychology, Wesleyan University, Middletown, CT, USA
E. B. Ansell
Affiliation:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
A. E. Skodol
Affiliation:
University of Arizona School of Medicine and the Sunbelt Collaborative, Tucson, AZ, USA
*
*Address for correspondence: L. C. Morey, Ph.D., Department of Psychology, Texas A&M University, College Station, TX 77843-4235, USA. (Email: morey@tamu.edu)
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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.

Keywords

ClassificationDSM-5personality disorders.
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 8 , August 2012 , pp. 1705 - 1713
Copyright
Copyright © Cambridge University Press 2011

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