Comparison of alternative models for personality disorders, II: 6-, 8- and 10-year follow-up. Academic Article uri icon


  • BACKGROUND: Several conceptual models have been considered for the assessment of personality pathology in DSM-5. This study sought to extend our previous findings to compare the long-term predictive validity of three such models: the five-factor model (FFM), the schedule for nonadaptive and adaptive personality (SNAP), and DSM-IV personality disorders (PDs). METHOD: An inception cohort from the Collaborative Longitudinal Personality Disorder Study (CLPS) was followed for 10 years. Baseline data were used to predict long-term outcomes, including functioning, Axis I psychopathology, and medication use. RESULTS: Each model was significantly valid, predicting a host of important clinical outcomes. Lower-order elements of the FFM system were not more valid than higher-order factors, and DSM-IV diagnostic categories were less valid than dimensional symptom counts. Approaches that integrate normative traits and personality pathology proved to be most predictive, as the SNAP, a system that integrates normal and pathological traits, generally showed the largest validity coefficients overall, and the DSM-IV PD syndromes and FFM traits tended to provide substantial incremental information relative to one another. CONCLUSIONS: DSM-5 PD assessment should involve an integration of personality traits with characteristic features of PDs.

published proceedings

  • Psychol Med

altmetric score

  • 4

author list (cited authors)

  • Morey, L. C., Hopwood, C. J., Markowitz, J. C., Gunderson, J. G., Grilo, C. M., McGlashan, T. H., ... Skodol, A. E.

citation count

  • 100

complete list of authors

  • Morey, LC||Hopwood, CJ||Markowitz, JC||Gunderson, JG||Grilo, CM||McGlashan, TH||Shea, MT||Yen, S||Sanislow, CA||Ansell, EB||Skodol, AE

publication date

  • August 2012