Using the Five-Factor Model to Represent the DSM-IV Personality Disorders: An Expert Consensus Approach

This study sought to extend previous work on the five-factor dimensional model (FFM) of personality disorder (PD) by developing more comprehensive FFM descriptions of prototypic cases. Specifically, the authors asked experts in each of the 10 DSM-IV PDs to rate the prototypic case by using all 30 facets of the FFM. Aggregating across raters of the given disorder generated a prototype for each disorder. In general, there was good agreement among experts and with previous theoretical and empirical FFM translations of DSM diagnostic criteria. Furthermore, the ability of the FFM explanation to reproduce the high comorbidity rates among PDs was demonstrated. The authors concluded that, with the possible exception of schizotypal PD, the DSM PDs can be understood from the dimensional perspective of the FFM. Future directions for research, including the use of the present prototypes to "diagnose " personality disorder, are discussed. The American Psychiatric Association's Diagnostic and Statis-tical Manual'of Mental Disorders, fourth edition (DSM-IV; Amer-ican Psychiatric Association, 1994), provides personality disorder diagnostic categories. There is good evidence that these diagnoses identify clinically meaningful maladaptive personality traits; sev-eral diagnoses seem especially well-validated, including antisocial (see Stoff, Breiling, & Maser, 1997), borderline (see Clarkin