Normative and maladaptive personality trait models of mood, psychotic, and substance use disorders

  • Laura M. Heath
  • Lauren Drvaric
  • Christian S. Hendershot
  • Lena C. Quilty
  • R. Michael Bagby


The Personality Inventory for DSM-5 (PID-5) is a questionnaire developed to assess the five domains represented in the alternative model for personality disorders proposed in Section III of the DSM-5. This study examined the ability of the PID-5 to distinguish between different mental disorders compared to a questionnaire measure of the five-factor model (FFM) of normative personality. The study included the administration of the PID-5 and Revised NEO Personality Inventory (NEO PI-R), a measure of the FFM, to treatment-seeking individuals with Depressive, Bipolar, Psychotic, and Alcohol Use Disorders (AUD). Diagnostic groups were compared at the domain level of PID-5 and NEO PI-R, with sex and age as covariates. The main findings on the PID-5 included higher Detachment scores for Bipolar and Depressive Disorders than Psychotic and AUDs, lower Psychoticism/higher Disinhibition scores for the AUD group compared to all other groups, and lower Negative Affect for the Psychotic Disorders versus AUD group. On the NEO PI-R, the AUD diagnostic group was associated with lower Conscientiousness and Agreeableness scores compared to all other groups, and lower Neuroticism scores than the Bipolar and Depressive groups. Group pairwise comparisons did not appear to show many differences between the PID-5 and NEO PI-R. The results suggest that the alternative DSM-5 model for personality disorders may have clinical utility in distinguishing personality profiles between diagnostic groups. These findings emphasize the importance of additional research on the capacity of maladaptive personality to contribute to the assessment of differential diagnoses.


Five Factor Model NEO PID-5 Psychopathology DSM-5 



Funding for parts of the data collection were received from the University of Minnesota Press and a grant from the McLaughlin Centre for Molecular Medicine.

Compliance with Ethical Standards

Conflict of interest

Laura M. Heath, Lauren Drvaric, Christian S. Hendershot, Lena C. Quilty and R. Michael Bagby declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Research Ethics Board of CAMH and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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  1. Abrams, D. J., Rojas, D. C., & Arciniegas, D. B. (2008). Is schizoaffective disorder a distinct categorical diagnosis? A critical review of the literature. Neuropsychiatric Disease and Treatment, 4(6), 1089–1109.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Al-Dajani, N., Gralnick, T. M., & Bagby, R. M. (2016). A psychometric review of the Personality Inventory for DSM-5 (PID-5): Current status and future directions. Journal of Personality Assessment, 98, 62–81.CrossRefPubMedGoogle Scholar
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.CrossRefGoogle Scholar
  4. Bagby, R. M., Bindseil, K. D., Schuller, D. R., Rector, N. A., Young, L. T., Cooke, R. G., et al. (1997). Relationship between the five-factor model of personality and unipolar, bipolar. and schizophrenic patients. Psychiatry Research, 70, 83–94.PubMedGoogle Scholar
  5. Benabarre, A., Vieta, E., Colom, F., Martínez-Arán, A., Reinares, M., & Gastó, C. (2001). Bipolar disorder, schizoaffective disorder and schizophrenia: Epidemiologic, clinical and prognostic differences. European Psychiatry, 16(3), 167–172.CrossRefPubMedGoogle Scholar
  6. Carlotta, D., Krueger, R. F., Markon, K. E., Borroni, S., Frera, F., Somma, A., et al. (2015). Adaptive and maladaptive personality traits in high-risk gamblers. Journal of Personality Disorders, 29(3), 378–392.CrossRefPubMedGoogle Scholar
  7. Chmielewski, M., Bagby, M., Markon, K., Ring, A. J., & Ryder, A. G. (2014). Openness to experience, intellect, schizotypal personality disorder, and psychoticism: Resolving the controversy. Journal of Personality Disorders, 28(4), 483–499.CrossRefPubMedGoogle Scholar
  8. Clark, L. A. (1993). Personality disorder diagnosis: Limitations of the five-factor model. Psychological Inquiry, 4, 100–104.CrossRefGoogle Scholar
  9. Clarke, D. E., Narrow, W. E., Regier, D. A., Kuramoto, S. J., Kupfer, D. J., Kuhl, E. A., et al. (2013). DSM-5 field trials in the United States and Canada, part I: Study design, sampling strategy, implementation, and analytic approaches. American Journal of Psychiatry, 170, 43–58.CrossRefPubMedGoogle Scholar
  10. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, N.J.: L. Erlbaum Associates.Google Scholar
  11. Costa Jr., P. T., & McCrae, R. R. (1992). Revised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI) professional manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
  12. Crego, C., & Widiger, T. A. (2016). Convergent and discriminant validity of alternative measures of maladaptive personality traits. Psychological Assessment, 28, 1561–1575.CrossRefPubMedGoogle Scholar
  13. Dinzeo, T. J., & Docherty, N. M. (2007). Normal personality characteristics in schizophrenia: A review of the literature involving the FFM. The Journal of Nervous and Mental Disease, 195(5), 421–429.PubMedGoogle Scholar
  14. First, M. B., & Gibbon, M. (2004). The Structured Clinical Interview for DSM-IV axis I disorders (SCID-I) and the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II). In M. J. Hilsenroth, D. L. Segal, & M. Hersen (Eds.), Comprehensive handbook of psychological assessment. Volume 2, Personality assessment (pp. 138–140). Hoboken, NH: John Wiley & Sons, Inc..Google Scholar
  15. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured clinical interview for DSM-IV axis I disorders. New York, NY: NY State Psychiatric Institute.Google Scholar
  16. Hink, L., Rhee, S., Corley, R., Cosgrove, V., Hewitt, J., Schulz-Heik, R., et al. (2013). Personality dimensions as common and broadband-specific features for internalizing and externalizing disorders. Journal of Abnormal Child Psychology, 41(6), 939–957.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Hopwood, C. J., Morey, L. C., Skodol, A. E., Stout, R. L., Yen, S., Ansell, E. B., et al. (2007). Five-factor model personality traits associated with alcohol-related diagnoses in a clinical sample. Journal of Studies on Alcohol and Drugs, 68(3), 455–460.CrossRefPubMedGoogle Scholar
  18. Kotov, R., Gamez, W., Schmidt, F., & Watson, D. (2010). Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychological Bulletin, 136(5), 768–821.CrossRefPubMedGoogle Scholar
  19. Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42, 1879–1890.CrossRefPubMedGoogle Scholar
  20. Krueger, R. F., Markon, K. E., Watson, D., & Skodol, A. E. (2013). The Personality Inventory for DSM-5 (PID-5)-Adult (Full Version). Arlington, VA: American Psychiatric Publishing.Google Scholar
  21. Malouff, J. M., Thorsteinsson, E. B., & Schutte, N. S. (2005). The relationship between the five-factor model of personality and symptoms of clinical disorders: A meta-analysis. Journal of Psychopathology and Behavioral Assessment, 27(2), 101–114.CrossRefGoogle Scholar
  22. Marneros, A. (2003). Schizoaffective disorder: Clinical aspects, differential diagnosis. and treatment. Current Psychiatry Reports, 5(3), 202–205.CrossRefPubMedGoogle Scholar
  23. McCrae, R. R., & John, O. P. (1992). An introduction to the five-factor model and its applications. Journal of Personality, 60(2), 175–215.CrossRefPubMedGoogle Scholar
  24. Narrow, W. E., Clarke, D. E., Kuramoto, S. J., Kraemer, H. C., Kupfer, D. J., Greiner, L., & Regier, D. A. (2013). DSM-5 field trials in the United States and Canada, Part III: development and reliability testing of a cross-cutting symptom assessment for DSM-5. American Journal of Psychiatry, 170, 71–82.CrossRefPubMedGoogle Scholar
  25. Quilty, L. C., Ayearst, L., Chmielewski, M., Pollock, B. G., & Bagby, R. M. (2013a). The psychometric properties of the Personality Inventory for DSM-5 in an APA DSM-5 field trial sample. Assessment, 20(3), 362–369.CrossRefPubMedGoogle Scholar
  26. Quilty, L. C., Pelletier, M., DeYoung, C. G., & Bagby, R. M. (2013b). Hierarchical personality traits and the distinction between unipolar and bipolar disorders. Journal of Affective Disorders, 147, 247–254.CrossRefPubMedGoogle Scholar
  27. Rector, N. A., Bagby, R. M., Huta, V., & Ayearst, L. E. (2012). Examination of the trait facets of the five-factor model in discriminating specific mood and anxiety disorders. Psychiatry Research, 199(2), 131–139.CrossRefPubMedGoogle Scholar
  28. Regier, D. A., Narrow, W. E., Clarke, D. E., Kraemer, H. C., Kuramoto, S. J., Kuhl, E. A., & Kupfer, D. J. (2013). DSM-5 field trials in the United States and Canada, part II: Test-retest reliability of selected categorical diagnoses. American Journal of Psychiatry, 170, 59–70.CrossRefPubMedGoogle Scholar
  29. Samuel, D. B., & Widiger, T. A. (2008). A meta-analytic review of the relationships between the five-factor model and DSM-IV-TR personality disorders: A facet level analysis. Clinical Psychology Review, 28(8), 1326–1342.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Skodol, A. E., Morey, L. C., Bender, D. S., & Oldham, J. M. (2015). The alternative DSM-5 model for personality disorders: A clinical application. The American Journal of Psychiatry, 172, 606–613.CrossRefPubMedGoogle Scholar
  31. Sleep, C. E., Hyatt, C. S., Lamkin, J., Maples-Keller, J. L., & Miller, J. D. (2017). Examining the relations among the DSM-5 alternative model of personality, the five-factor model, and externalizing and internalizing behavior. Personality Disorders: Theory, Research, & Treatment.
  32. Suzuki, T., Griffin, S. A., & Samuel, D. B. (2017). Capturing the DSM-5 alternative personality disorder model traits in the five-factor model's nomological net. Journal of Personality, 85(2), 220–231.CrossRefPubMedGoogle Scholar
  33. Tackett, J. L., Quilty, L. C., Sellbom, M., Rector, N. A., & Bagby, R. M. (2008). Additional evidence for a quantitative hierarchical model of mood and anxiety disorders for DSM-V: The context of personality structure. Journal of Abnormal Psychology, 117(4), 812–825.CrossRefPubMedGoogle Scholar
  34. Terracciano, A., Löckenhoff, C. E., Crum, R. M., Bienvenu, O. J., & Costa, P. T. (2008). Five-factor model personality profiles of drug users. BMC Psychiatry, 8, 1–10.CrossRefGoogle Scholar
  35. Trull, T. J., & Sher, K. J. (1994). Relationship between the five-factor model of personality and Axis I disorders in a nonclinical sample. Journal of Abnormal Psychology, 103(2), 350–360.CrossRefPubMedGoogle Scholar
  36. Watson, D., Stasik, S. M., Ro, E., & Clark, L. A. (2013). Integrating normal and pathological personality: Relating the DSM-5 trait-dimensional model to general traits of personality. Assessment, 20(3), 312–326.CrossRefPubMedGoogle Scholar
  37. Widiger, T. A., & Oltmanns, J. R. (2017). Neuroticism is a fundamental domain of personality with enormous public health implications. World Psychiatry, 16(2), 144–145.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Widiger, T. A., & Trull, T. J. (2007). Plate tectonics in the classification of personality disorder: Shifting to a dimensional model. American Psychologist, 62(2), 71–83.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Laura M. Heath
    • 1
  • Lauren Drvaric
    • 2
    • 3
  • Christian S. Hendershot
    • 1
    • 3
    • 4
  • Lena C. Quilty
    • 1
    • 3
  • R. Michael Bagby
    • 1
    • 4
  1. 1.Department of PsychologyUniversity of TorontoTorontoCanada
  2. 2.Institute of Medical ScienceUniversity of TorontoTorontoCanada
  3. 3.Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
  4. 4.Department of PsychiatryUniversity of TorontoTorontoCanada

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