Dimensional models of personality disorder: coverage and cutoffs

Area of Science:

• Psychiatry
• Psychology
• Personality Science

Background:

• Current categorical systems for diagnosing personality disorders face challenges.
• Dimensional models offer potential alternatives but require addressing coverage and cutoff issues.
• Evaluating existing dimensional models is crucial for advancing personality disorder diagnostics.

Purpose of the Study:

• To evaluate dimensional models of personality and personality pathology.
• To address the challenges of coverage and cutoffs in dimensional diagnostic systems.
• To propose a framework for a dimensionally-based personality disorder diagnostic system.

Main Methods:

• Review and evaluation of several dimensional models of personality.
• Analysis of model coverage and cutoff criteria in relation to personality pathology.
• Identification of higher-order personality domains relevant to personality disorders.

Main Results:

• Growing consensus supports at least four higher-order personality domains relevant to pathology: neuroticism/negative affectivity/emotional dysregulation, extraversion/positive emotionality, dissocial/antagonistic behavior, and constraint/compulsivity/conscientiousness.
• These domains offer a foundation for addressing coverage and cutoff issues.
• The evaluated models highlight the need for a more nuanced approach to personality assessment.

Conclusions:

• Dimensional models show promise as alternatives to categorical systems for personality disorders.
• The identified higher-order domains are critical for developing a robust dimensional diagnostic system.
• A proposed dimensionally-based system incorporating these traits could improve personality disorder diagnosis and assessment.