Stability of the DSM-5 Section III pathological personality traits and their longitudinal associations with psychosocial functioning in personality disordered individuals.

Abstract

This study was conducted to establish (a) the stability of the DSM-5 Section III personality disorder (PD) traits, (b) whether these traits predict future psychosocial functioning, and (c) whether changes in traits track with changes in psychosocial functioning across time. Ninety-three outpatients (61% Female) diagnosed with at least one PD completed patient-report measures at two time-points (M time between assessments = 1.44 years), including the Personality Inventory for the DSM-5 and several measures of psychosocial functioning. Effect sizes of rank-order and mean-level change were calculated. In addition, Time 1 traits were used to predict functioning measures at Time 2. Finally, latent change score models were estimated for DSM-5 Section III traits and functioning measures, and correlations among latent change scores were calculated to establish the relationship between change in traits and functional outcomes. Findings demonstrated that the DSM-5 Section III traits were highly stable in terms of normative (i.e., mean-level) change and rank-order stability over the course of the study. Furthermore, traits prospectively predicted psychosocial functioning. However, at the individual level traits and functioning were not entirely static over the study, and change in individuals’ functioning tracked with changes in trait levels. These findings demonstrate that the DSM-5 Section III traits are highly stable consistent with the definition of PD, prospectively predictive of psychosocial functioning, and dynamically associated with functioning over time. This study provides important evidence in support of the DSM-5 Section III PD model.

Daily Interpersonal and Affective Dynamics in Personality Disorder

“…During this time, any manner of internal and external influences may have lead to changes in their clinical and psychological profile. Although detailed information on clinical interventions is not available, we note that on the average participants enrolled in this phase of the study were highly stable across the intervening time period on a host of PD and functioning variables, suggesting that they remained largely the same in terms of their features (see Wright, Calabrese, et al, in press for details).…”

“…Yet it is clear that important dynamic processes play out across several time-scales, ranging from the momentary (e.g., Russell et al, 2007; Sadkiaj et al, 2013; Trull et al, 2008) to the yearly (Morey & Hopwood, 2013), and everything in between (e.g., Wright et al, 2013; Wright et al, in press). Although end-of-day diaries are commonly used in the study of the types of processes examined here (e.g., Mroczek & Almeida, 2004; Bolger & Zuckerman, 1995), researchers are encouraged to give deep consideration to the precise level of temporal fidelity necessary to target the processes of interest in their study (Collins, 2006).…”

“…To the extent that maladaptive behavior is both variable and contextualized in its expression, it is important to sample and analyze behavior in such a way as to reflect these putative processes. The key to studying dynamic processes is leveraging time as a variable through the intensive and repeated assessment of target variables (Larsen, Augustine, & Prizmic, 2009; Moskowitz, Brown, & Cote, 1997; Wright & Markon, in press). A compelling approach for PD research is to capture thoughts, feelings, and behaviors as they are expressed in a patient’s natural environment via momentary or daily questionnaires.…”

Estudo das Propriedades Psicométricas - Formas Longa, Reduzida e Breve - da Versão Portuguesa do Inventário da Personalidade para o DSM-5 (PID-5)

“…Os modelos dimensionais permitem, igualmente, a integração de um vasto corpo de conhecimento científico que tem mostrado que as perturbações mentais se relacionam com a estrutura da personalidade (Clark, 2005;DeYoung, Carey, Krueger, & Ross, 2016;Kotov, Gamez, Schmidt, & Watson, 2010;Widiger & Trull, 2007;Wright et al, 2015).…”

“…Na mesma linha, as facetas e domínios da versão portuguesa do PID-5 revelaram adequada estabilidade após um intervalo temporal de 4 semanas. Dado que a instabilidade dos diagnósticos de perturbação da personalidade é uma das críticas mais substanciais à anterior abordagem categorial de classificação destas perturbações, estes resultados, concordantes com os obtidos por Wright et al (2015) e Zimmermann et al (2017), constituem uma evidência da estabilidade temporal dos traços de personalidade descritos no modelo de traços do DSM-5, permitindo, inclusivamente, sustentar o interesse da transição deste modelo alternativo de classificação das perturbações da personalidade para a secção principal do DSM-5. A validade concorrente da versão portuguesa do PID-5 foi estudada com o NEO-FFI (Costa & McCrae, 2000;Lima et al, 2014), uma medida dos cinco domínios da personalidade descritos no Modelo dos Cinco Factores (Costa, & Widiger, 2012) e com o BSI (Derogatis, 1982(Derogatis, /1983Canavarro, 2007), um inventário de sintomas psicopatológicos.…”