Narrower Traits for Wider Reach: Capturing Personality Disorder Features and Outcomes Through DAPP-BQ Nuances

Area of Science:

• Psychiatry
• Psychology
• Clinical Psychology

Background:

• Dimensional models of personality disorder (PD) may be limited by broad trait domains.
• Greater specificity in trait assessment can improve coverage and prediction of maladaptive characteristics.

Purpose of the Study:

• To examine the impact of assessment granularity on capturing DSM PD criteria.
• To evaluate the predictive capacity of different hierarchical levels of personality assessment for clinical outcomes.

Main Methods:

• Utilized the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) in 774 outpatients.
• Assessed personality traits across four hierarchical levels: domains, facets, subfacets, and items.
• Compared the coverage of 93 DSM PD criteria and prediction of 55 clinical outcomes across these levels.

Main Results:

• Assessment specificity significantly increased coverage of PD criteria: 40% for facets, 60% for subfacets, and 81% for items compared to domains.
• Predictive accuracy improved for numerous outcomes, including education, social support, psychopathology, substance use, violence, arrests, self-harm, and suicide attempts.
• Gains in coverage were particularly notable for personality disorder Clusters A and B.

Conclusions:

• Finer-grained personality assessments offer more comprehensive and accurate diagnoses than broad domains.
• Increased specificity enhances the prediction of clinically relevant outcomes, supporting tailored interventions.
• Dimensional psychopathology systems hold promise for improved understanding and treatment of personality disorders through detailed assessment.