The DSM-5 dimensional trait model included only 25. The relative simplicity of the proposed DSM-5 dimensional trait model (ie, unipolar structure and fewer traits) was perhaps a necessary compromise. The dimensional trait proposal for DSM-5 did meet considerable opposition within the personality disorder field72,79. A dimensional trait model consisting of over 100 SAR302503 traits would likely be considered way too complex for many clinicians to accept. Inhibitors,research,lifescience,medical Although the confinement of the DSM-5 trait model to just 25 traits would have resulted in a lack of adequate coverage (eg, obsessive-compulsive personality disorder was to be assessed by just the two traits of perfectionism
and perseveration, Inhibitors,research,lifescience,medical and narcissistic by just the two traits of grandiosity and attentionseeking),
it was perhaps necessary to keep the model as simple as possible for it to be considered acceptable. The convergence of the proposed DSM-5 dimensional trait model with the FFM, though, is far greater than the divergence. Therefore the proposal presented in Section 3 of DSM-5 appears to be taking a significant step closer to Inhibitors,research,lifescience,medical the FFM of personality disorder by conceptualizing personality disorders in large part as constellations of maladaptive personality traits organized within a five-domain dimensional trait model.5 Potential advantages of FFM personality disorder diagnosis Conceptualizing personality disorders from the perspective of the FFM has a number of potential advantages.9 One benefit is bringing to an understanding of personality disorder a
large body of scientific research that has accumulated concerning the etiology, course, temporal stability, genetics, Inhibitors,research,lifescience,medical neural functioning, life outcomes, and universality of the FFM. As acknowledged by the Chair of the DSM-5 Personality Disorders Work Group, “similar construct validity has been more elusive to attain with the current DSM-IV personality disorder categories.“80, p1923 Some of the FFM personality disorder research has in fact helped to address problems and gaps for the DSM-IV-TR personality disorders.84 For example, a major Inhibitors,research,lifescience,medical failing of the DSM-IV-TR diagnostic categories is their excessive diagnostic co-occurrence the and lack of adequate discriminant validity.9,57,82 The diagnostic co-occurrence obtained for the DSM-IV-TR personality disorders has in fact been so problematic that it is touted as the primary reason for the recommended deletion of four of the 10 categories.83 Some studies have suggested that the FFM is unable to provide an adequate differentiation among the personality disorders.84 This criticism is somewhat ironic, given the extensive overlap and excessive diagnostic co-occurrence among the DSM-IV-TR personality disorders. No instrument (including any instrument that assesses the FFM) can adequately differentiate the DSM-IV-TR personality disorders because they are inherently overlapping.