The Placement of Obsessive-Compulsive Symptoms Within a Five-Factor Model of Maladaptive Personality

Abstract

Dimensional models of obsessive-compulsive (OC) symptoms, as seen in obsessive-compulsive disorder (OCD), are instrumental in explaining the heterogeneity observed in this condition and for informing cutting-edge assessments. Prior structural work in this area finds that OC symptoms cross-load under both Negative Affectivity and Psychoticism traits within the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Alternative Model of Personality Disorder (AMPD). However, tests of OC symptoms in conjunction with assessments of the full AMPD structure and its 25 lower-level facets representing narrower symptom content are lacking. We applied joint exploratory factor analysis to an AMPD measure (Personality Inventory for DSM-5; PID-5) and OC symptom data from two separate samples (total N = 1,506) to locate OC symptoms within AMPD space. OC symptoms cross-loaded on Negative Affectivity, Psychoticism, and on the low end of Disinhibition. We also report exploratory analyses of OC symptom subscales with PID-5 variables. Results are discussed in the context OC symptoms’ location in PID-5 space, implications for assessment, and placement of OCD within the Hierarchical Taxonomy of Psychopathology.

Principles and procedures for revising the hierarchical taxonomy of psychopathology.

“…Other needed revisions include clarifying the placement of symptoms used to diagnose DSM-5 mania, which remain provisional aspects of the framework: Symptom-level analyses of mania criteria indicate that most dimensions align with thought disorder (Kotov et al, 2020), but the heterogeneity of mania criteria may require some symptoms to fall under other spectra (e.g., internalizing, externalizing, or as a unique mania-symptom spectrum; Carpenter et al, 2009; Forbes et al, 2021; Stanton et al, 2019; Watson & Naragon-Gainey, 2014). Similarly, the placements of symptoms that are used to diagnose obsessive–compulsive and related disorders and eating pathology have been a focus in several recent studies with implications for revisions and additions to the HiTOP framework (e.g., Cooper et al, 2023; Dunkley et al, 2020; Faure & Forbes, 2021; Marshall et al, 2020; Rossell et al, 2020). As research has begun to address disorder-level heterogeneity, it has become increasingly clear that symptom components from within one diagnosis can load on different HiTOP dimensions (e.g., negative schizophrenia symptoms loading on detachment, rather than thought disorder; Cicero et al, 2019; Kotov et al, 2022), so more fine-grained approaches to analysis may help to advance research in this area.…”

Integrating Threat Conditioning and the Hierarchical Taxonomy of Psychopathology (HiTOP) to Advance the Study of Anxiety-Related Psychopathology

“…Similarly, psychosis (including mania) is often an exclusionary criterion in conditioning research. Yet, some of the most severe obsessions and compulsions found in OCD can be considered delusional (Cederlöf et al, 2015), severe OCD is commonly comorbid with psychosis (Cederlöf et al, 2015), and OCD loads strongly onto a psychoticism factor in structural modeling (Cooper, Hunt, et al, 2022;Faure & Forbes, 2021).…”