Improving characterization of psychopathy within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), alternative model for personality disorders: Creation and validation of Personality Inventory for DSM–5 Triarchic scales.

Abstract

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) bridges a significant gap in psychiatric nosology by providing trait-based characterizations of psychopathy along with antisocial personality disorder within the Section III alternative model for personality disorders (AMPD). However, the representation of psychopathy in the AMPD has met with some criticisms (Crego & Widiger, 2014; Few, Lynam, Maples, MacKillop, & Miller, 2015). The current study was undertaken to establish an improved means for characterizing psychopathy in DSM–5 Section III terms, by creating scale measures of triarchic psychopathy dimensions using items from the best-established assessment instrument for the AMPD, the Personality Inventory for DSM–5 (PID-5). Using data from a sample of community adults (N = 210), we employed a construct rating and psychometric refinement approach to develop item-based PID-5 Triarchic scales for measuring psychopathy dimensions of boldness, meanness, and disinhibition. The validity of the PID-5 Triarchic scales was then evaluated in relation to criteria including other scale measures of the triarchic constructs and psychopathy, self-reported antisocial behavior and substance use, empathy, internalizing and other clinical problems, and personality within the development sample and a separate independent sample of adults (N = 240) recruited to have elevated psychopathic traits. Results of this work provide a foundation for improved characterization of psychopathy in terms of the AMPD trait system and provide a mechanism for future research oriented toward clarifying the developmental interface between childhood conduct disorder and psychopathy, as well as identifying neurobiological correlates of dimensions of psychopathy.

Modeling Relations Between Triarchic Biobehavioral Traits and DSM Internalizing Disorder Dimensions

“…The Disinhibition scale is primarily composed of items from the PID-5 Irresponsibility and Impulsivity scales, with supplementary items from the Hostility, Suspiciousness, Deceitfulness, and Risk-Taking scales. All three PID-Tri scales have been found to exhibit strong convergent validity with their counterpart TriPM scales, with PID-Tri Meanness and Disinhibition scales providing effective coverage of antisocial personality disorder symptom criteria (Drislane et al, 2019; see also Strickland, Drislane, Lucy, Krueger, & Patrick, 2013). Internal consistencies (Cronbach’s alphas) for the PID-Tri scales in the current sample were: .70 for Boldness, .90 for Meanness, and .89 for Disinhibition.…”

“…The triarchic dimensions were assessed via three different questionnaire-scale assessments of these dispositional constructs: the TriPM subscales (Patrick, 2010), and triarchic scales composed of relevant items from the Multidimensional Personality Questionnaire (Brislin, Drislane, Smith, Edens, & Patrick, 2015), and the Personality Inventory for DSM-5 (Drislane et al, 2019).…”

“…Although prior studies in this area have yielded important foundational data, a number of limitations are evident in the current published literature that need to be addressed to further clarify how the triarchic model traits—as transdiagnostic biobehavioral dimensions—relate to internalizing forms of symptomatology. Importantly, all previous studies have quantified the triarchic trait constructs using single sets of manifest scales—although multiple scale measures of these constructs have been developed (for a review, see Patrick & Drislane, 2015; see also Drislane et al, 2019; Drislane, Jones, Brislin, & Patrick, 2018; Sellbom et al, 2016). The availability of alternative scale operationalizations allows for boldness, meanness, and disinhibition to be modeled as latent variables—thereby removing instrument-specific measurement error and enabling findings to be interpreted in terms of constructs rather than specific measures (Drislane & Patrick, 2017).…”

A Gut Feeling: The Importance of the Intestinal Microbiota in Psychiatric Disorders

“…Autism affects mental development that impacts communication and behavioral patterns, which may appear first in children aged two or younger. As noted in the Diagnostic and Statistical Manual of Mental Disorders and derived works, the patient has "difficulty with communication and interaction with other people, restricted interests and repetitive behaviors, and symptoms that hurt the person's ability to function properly in school, work, and other areas of life" (79). Although genetics is a risk factor, the causes of the disorder remain unknown.…”

“…While experimental models of the disorders suggest the existence of the link between the microbiota and disease, clinically mixed results support the possible crosstalk between the intestinal microbiota and ASD. Some of those studies reported different taxonomical profiles in the microbiota of ASD patients compared with non-ASD children (75,76,79,(82)(83)(84), while others did not support the association when comparing the microbiota of ASD children with siblings sharing environment (91,92). The presence of Clostridium perfringens was also used to link ASD with the microbiota.…”