Psychological Medicine

Original Articles

Initial construction of a maladaptive personality trait model and inventory for DSM-5

R. F. Kruegera1 c1, J. Derringera1, K. E. Markona2, D. Watsona3 and A. E. Skodola4

a1 Department of Psychology, University of Minnesota, Minneapolis, MN, USA

a2 Department of Psychology, University of Iowa, Iowa City, IA, USA

a3 Department of Psychology, University of Notre Dame, Notre Dame, IN, USA

a4 Department of Psychiatry, University of Arizona School of Medicine, Phoenix, AZ, USA


Background DSM-IV-TR suggests that clinicians should assess clinically relevant personality traits that do not necessarily constitute a formal personality disorder (PD), and should note these traits on Axis II, but DSM-IV-TR does not provide a trait model to guide the clinician. Our goal was to provide a provisional trait model and a preliminary corresponding assessment instrument, in our roles as members of the DSM-5 Personality and Personality Disorders Workgroup and workgroup advisors.

Method An initial list of specific traits and domains (broader groups of traits) was derived from DSM-5 literature reviews and workgroup deliberations, with a focus on capturing maladaptive personality characteristics deemed clinically salient, including those related to the criteria for DSM-IV-TR PDs. The model and instrument were then developed iteratively using data from community samples of treatment-seeking participants. The analytic approach relied on tools of modern psychometrics (e.g. item response theory models).

Results A total of 25 reliably measured core elements of personality description emerged that, together, delineate five broad domains of maladaptive personality variation: negative affect, detachment, antagonism, disinhibition, and psychoticism.

Conclusions We developed a maladaptive personality trait model and corresponding instrument as a step on the path toward helping users of DSM-5 assess traits that may or may not constitute a formal PD. The inventory we developed is reprinted in its entirety in the Supplementary online material, with the goal of encouraging additional refinement and development by other investigators prior to the finalization of DSM-5. Continuing discussion should focus on various options for integrating personality traits into DSM-5.

(Received April 13 2011)

(Revised July 27 2011)

(Accepted October 25 2011)

(Online publication December 08 2011)


c1 Address for correspondence: R. F. Krueger, Ph.D., Department of Psychology, University of Minnesota, N414 Elliott Hall, Minneapolis, MN 55455, USA. (Email: