title: Comparing criterion- and trait-based personality disorder diagnoses in DSM-5.
abstract: In the recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the official personality disorder (PD) classification system remains unchanged. However, DSM-5 also includes an alternative hybrid categorical-dimensional PD system in Section III to spur additional research. One defining feature of the alternative system is the incorporation of a trait model with PD-specific trait configurations, but relatively little work has evaluated how these traits map onto official PD diagnoses or their implications for diagnosis rates. To that end, we compared official PD criteria to Section III PD traits in a sample of current or recent psychiatric patients. We (a) evaluated the extent to which PD traits predicted traditional PD criterion counts, and (b) computed trait-based diagnosis rates and compared them to those reported in several published outpatient and epidemiological samples. Overall, PD traits generally predicted PD criterion counts, but with less than ideal specificity. In addition, we identified differences in diagnosis rates across approaches. These results provide some support for the Section III approach, but they also identify important areas in need of refinement and future study before the field could reasonably switch to a hybrid PD classification approach like that in Section III.
authors.affiliation: Department of Psychology, University at Buffalo, The State University of New York.
authors.forename: Wern How
authors.initials: WH
authors.lastname: Yam
authors.affiliation: Department of Psychology, University at Buffalo, The State University of New York.
authors.forename: Leonard J
authors.initials: LJ
authors.lastname: Simms
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis*; D010555:Personality Inventory; D011594:Psychometrics
references.citation: J Abnorm Psychol. 2012 May;121(2):424-32
references.pmid: 22250660
references.citation: J Pers. 2012 Dec;80(6):1565-91
references.pmid: 22321333
references.citation: J Pers Disord. 2007 Apr;21(2):199-224
references.pmid: 17492921
references.citation: J Abnorm Psychol. 2005 Nov;114(4):494-504
references.pmid: 16351373
references.citation: Assessment. 2013 Jun;20(3):286-94
references.pmid: 23297369
references.citation: Annu Rev Clin Psychol. 2005;1:355-80
references.pmid: 17716092
references.citation: Personal Disord. 2012 Oct;3(4):444-57
references.pmid: 22452765
references.citation: J Pers Disord. 2010 Aug;24(4):412-26
references.pmid: 20695803
references.citation: Multivariate Behav Res. 2012 Mar 30;47(2):224-46
references.pmid: 26734849
references.citation: Psychol Assess. 2009 Sep;21(3):365-379
references.pmid: 19719348
references.citation: Am J Psychiatry. 1999 Feb;156(2):258-72
references.pmid: 9989563
references.citation: J Pers Disord. 2005 Apr;19(2):110-30
references.pmid: 15899712
references.citation: J Pers Disord. 2010 Dec;24(6):694-708
references.pmid: 21158594
references.citation: Personal Disord. 2014 Jan;5(1):43-54
references.pmid: 24588061
references.citation: Assessment. 2013 Jun;20(3):269-85
references.pmid: 23610235
references.citation: J Pers Assess. 1995 Dec;65(3):428-33
references.pmid: 8609583
references.citation: J Pers Assess. 2011 Jul;93(4):380-9
references.pmid: 22804677
references.citation: Acta Psychiatr Scand. 1994 Aug;90(2):120-3
references.pmid: 7976457
references.citation: Am J Psychiatry. 2005 Oct;162(10):1911-8
references.pmid: 16199838
references.citation: Psychol Med. 2012 Sep;42(9):1879-90
references.pmid: 22153017
references.citation: Am Psychol. 2007 Feb-Mar;62(2):71-83
references.pmid: 17324033
references.citation: J Psychiatr Pract. 2013 May;19(3):179-93
references.pmid: 23653075
references.citation: Acta Psychiatr Scand. 1988 Sep;78(3):348-55
references.pmid: 3195356
references.citation: Assessment. 2013 Jun;20(3):353-61
references.pmid: 23588686
references.citation: J Abnorm Psychol. 2013 Nov;122(4):1057-69
references.pmid: 24364607
references.citation: Annu Rev Psychol. 2007;58:227-57
references.pmid: 16903806