Psychological Medicine



Original Article

Comparison of alternative models for personality disorders


LESLIE C. MOREY a1c1, CHRISTOPHER J. HOPWOOD a1, JOHN G. GUNDERSON a2, ANDREW E. SKODOL a3, M. TRACIE SHEA a4, SHIRLEY YEN a4, ROBERT L. STOUT a5, MARY C. ZANARINI a2, CARLOS M. GRILO a6, CHARLES A. SANISLOW a6 and THOMAS H. McGLASHAN a6
a1 Texas A&M University, College Station, TX, USA
a2 McLean Hospital, Harvard Medical School, MA, USA
a3 New York State Psychiatric Institute, Columbia University, NY, USA
a4 Brown University, RI, USA
a5 Decision Sciences Institute, RI, USA
a6 Yale University School of Medicine, CT, USA

Article author query
morey lc   [PubMed][Google Scholar] 
hopwood cj   [PubMed][Google Scholar] 
gunderson jg   [PubMed][Google Scholar] 
skodol ae   [PubMed][Google Scholar] 
shea mt   [PubMed][Google Scholar] 
yen s   [PubMed][Google Scholar] 
stout rl   [PubMed][Google Scholar] 
zanarini mc   [PubMed][Google Scholar] 
grilo cm   [PubMed][Google Scholar] 
sanislow ca   [PubMed][Google Scholar] 
mcglashan th   [PubMed][Google Scholar] 

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.

(Published Online November 23 2006)


Correspondence:
c1 Psychology Department, Texas A&M University, College Station, TX 77843-4235, USA. (Email: lcm@psyc.tamu.edu)


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