title: 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).
  
  
  METHODS
  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.
authors: Department of Psychology, Texas A&M University, College Station, TX 77843-4235, USA. morey@tamu.edu
authors: L C
authors: LC
authors: Morey
authors: C J
authors: CJ
authors: Hopwood
authors: J C
authors: JC
authors: Markowitz
authors: J G
authors: JG
authors: Gunderson
authors: C M
authors: CM
authors: Grilo
authors: T H
authors: TH
authors: McGlashan
authors: M T
authors: MT
authors: Shea
authors: S
authors: S
authors: Yen
authors: C A
authors: CA
authors: Sanislow
authors: E B
authors: EB
authors: Ansell
authors: A E
authors: AE
authors: Skodol
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010551:Personality; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010554:Personality Disorders / Q000145:classification* / Q000175:diagnosis; D010555:Personality Inventory / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D055815:Young Adult