title: A metastructural model of mental disorders and pathological personality traits.
abstract: BACKGROUND
  Psychiatric co-morbidity is extensive in both psychiatric settings and the general population. Such co-morbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions - internalizing, externalizing and psychoticism - can account for much of the observed covariation among common mental disorders. However, the location of personality disorders within this emerging metastructure has only recently been studied, and no studies have yet examined where pathological personality traits fit within such a broad metastructural framework.
  
  
  METHODS
  We conducted joint structural analyses of common mental disorders, personality disorders and pathological personality traits in a sample of 628 current or recent psychiatric out-patients.
  
  
  RESULTS
  Bridging across the psychopathology and personality trait literatures, the results provide evidence for a robust five-factor metastructure of psychopathology, including broad domains of symptoms and features related to internalizing, disinhibition, psychoticism, antagonism and detachment.
  
  
  CONCLUSIONS
  These results reveal evidence for a psychopathology metastructure that (a) parsimoniously accounts for much of the observed covariation among common mental disorders, personality disorders and related personality traits, and (b) provides an empirical basis for the organization and classification of mental disorder.
authors.affiliation: Department of Psychology,University of Pittsburgh,Pittsburgh,PA,USA.
authors.forename: A G C
authors.initials: AG
authors.lastname: Wright
authors.affiliation: Department of Psychology,University at Buffalo,The State University of New York,Pittsburgh,PA,USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Simms
mesh_terms: D000328:Adult; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010045:Outpatients; D010551:Personality; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D011599:Psychopathology
keywords: Co-morbidity; exploratory structure equation modeling; personality disorders; personality traits; structure of mental disorders