Can Personality Disorder Experts Recognize <em>DSM-IV</em> Personality Disorders From Five-Factor Model Descriptions of Patient Cases?
J Clin Psychiatry 2011;72(5):630-639
© Copyright 2016 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Dimensional models of personality are under consideration for integration into the next Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but the clinical utility of such models is unclear.
Objective: To test the ability of clinical researchers who specialize in personality disorders to diagnose personality disorders using dimensional assessments and to compare those researchers’ ratings of clinical utility for a dimensional system versus for the DSM-IV.
Method: A sample of 73 researchers who had each published at least 3 (median = 15) articles on personality disorders participated between December 2008 and January 2009. The Five-Factor Model (FFM), one of the most-studied dimensional models to date, was compared to the DSM-IV. Participants provided diagnoses for case profiles in DSM-IV and FFM formats and then rated the DSM-IV and FFM on 6 aspects of clinical utility.
Results: Overall, participants had difficulty identifying correct diagnoses from FFM profiles (t72 = 12.36, P < .01), and the same held true for a subset reporting equal familiarity with the DSM-IV and FFM (t23 = 6.96, P < .01). Participants rated the FFM as less clinically useful than the DSM for making prognoses, devising treatment plans, and communicating with professionals (all t69 > 2.19, all P < .05), but more useful for communicating with patients (t69 = 3.03, P < .01).
Conclusions: The results suggest that personality disorder expertise and familiarity with the FFM are insufficient to correctly diagnose personality disorders using FFM profiles. Because of ambiguity inherent in FFM profile descriptors, this insufficiency may prove unlikely to be attenuated with increased clinical familiarity with the FFM.
J Clin Psychiatry
Submitted: July 5, 2009; accepted October 30, 2009.
Online ahead of print: December 28, 2010 (doi:10.4088/JCP.09m05534gre).
Corresponding author: Benjamin M. Rottman, MS, Department of Psychology, Yale University, Box 208205, New Haven, CT 06520-8205 (email@example.com).