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Personality Assessment in DSM--5: Empirical support for rating Severity, Style, and Traits

Christopher J. Hopwood, Michigan State University
Johanna C. Malone, Cambridge Hospital and Harvard Medical School
Emily B. Ansell, Yale University School of Medicine
Charles A. Sanislow, Wesleyan University
Carlos M. Grilo, Yale University School of Medicine
Thomas H. McGlashan, Yale University School of Medicine
Anthony Pinto, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons
John C. Markowitz, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons
M. Tracie Shea, Department of Veterans Affairs, and Department of Psychiatry and Human Behavior and Warren Alpert Medical School of Brown University
Andrew E. Skodol, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons
John G. Gunderson, McLean Hospital and Harvard Medical School
Mary C. Zanarini, McLean Hospital and Harvard Medical School
Leslie C. Morey, Texas A & M University - College Station

Abstract

Despite a general consensus that dimensional models are superior to the categorical representations of personality disorders in DSM-IV, proposals for how to depict personality pathology dimensions vary substantially. One important question involves how to separate clinical severity from the style of expression through which personality pathology manifests. This study empirically distinguished stylistic elements of personality pathology symptoms from the overall severity of personality disorder in a large, longitudinally assessed clinical sample (N = 605). Data suggest that generalized severity is the most important single predictor of current and prospective dysfunction, but that stylistic elements also indicate specific areas of difficulty. Normative personality traits tend to relate to the general propensity for personality pathology, but not stylistic elements of personality disorders. Overall, findings support a three-stage diagnostic strategy involving a global rating of personality disorder severity, ratings of parsimonious and discriminant valid stylistic elements of personality disorder, and ratings of normative personality traits.

Suggested Citation

Hopwood, C. J., Malone, J. C., Ansell, E. B., Sanislow, C. A., Grilo, C. M., Pinto, A., Markowitz, J. C., Shea, M. T., Skodol, A. E., Gunderson, J. G., Zanarini, M. C., & Morey, L. C. (2011). Personality Assessment in DSM-5: Empirical support for rating Severity, Style, and Traits. Journal of Personality Disorders, 25, 305-320.