Using clinician-rated five-factor model data to score the DSM-IV personality disorders

Proposals suggest that many or all of the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders (PDs) may be omitted from the DSM (5th ed.; DSM-V) and replaced with a dimensional trait model of personality pathology (Krueger, Skodol, Livesley, Shrout, & Huang, 2007; Skodol, 2009). Several authors have expressed concerns that this may be difficult for clinicians and researchers who are more comfortable with the extant PD diagnoses. In this study, we tested whether clinician ratings of traits from the Five-factor model (FFM; Costa & McCrae, 1990) can be used to recreate DSM-IV PDs. Using a sample of 130 clinical outpatients, we tested the convergent and discriminant validity of the FFM PD counts in relation to consensus ratings of the DSM-IV PDs. We then examined whether the FFM and DSM-IV PD scores correlate in similar ways with self-reported personality traits from the Schedule for Nonadaptive and Adaptive Personality (Clark, 1993). Finally, we tested the clinical utility of the FFM PD counts in relation to functional impairment. Overall, the FFM PD counts, scored using clinician ratings of the FFM traits, appeared to function like the DSM-IV PDs, thus suggesting that the use of a dimensional trait model of personality in the DSM-V may still allow for an assessment of the DSM-IV PD constructs.