Dimensional personality pathology and disordered eating in young adults: measuring the DSM-5 alternative model using the PID-5

A Hierarchical Model of the Symptom-Level Structure of Psychopathology in Youth

More comprehensive modelling of psychopathology in youth is needed to facilitate a developmentally informed expansion of the Hierarchical Taxonomy of Psychopathology (HiTOP) model. This study examined a symptom-level model of the structure of psychopathology in youth-most aged 11-17 years-bringing together data from large clinical, community, and representative samples (N = 18,290) and with coverage of nearly all major forms of mental disorders and related content domains (e.g., aggression). The resulting hierarchical and dimensional model was based on the points of convergence among three statistical approaches and included fifteen narrow dimensions nested under four broad dimensions of Internalizing; Externalizing; Eating Pathology; and Uncontrollable Worry, Obsessions, and Compulsions. We position these findings within the context of the existing literature, and articulate implications for future research. Ultimately, these findings add to the rapidly growing literature on the structure of psychopathology in youth and take us a step closer towards understanding (dis-)continuities in psychopathology's structure across the lifespan.

Using the alternative model of personality disorders for DSM-5 traits to identify personality types, and the relationship with disordered eating, depression, anxiety and stress

BACKGROUND

There is a substantial and growing evidence base that has identified three distinct personality types (Overcontrol, Undercontrol and Resilient) among samples of individuals with eating disorders, as well as non-clinical samples. Even in studies where up to six personality types have been identified, the three core types representing Overcontrol, Undercontrol and Resilient consistently emerge. The aim of the research was to explore whether latent Overcontrol and Undercontrol personality types could be identified using pathological personality types as part of the Alternative Model for Personality Disorders published in DSM-5. We further aimed to understand how these personality types were associated with eating pathology, depressed mood and anxiety.

METHODS

A total of 391 women, 167 men and 10 gender-diverse individuals aged 16 to 31 years completed measures of the alternative model of personality disorder traits, disordered eating behaviours, eating pathology, depression, anxiety and stress. A systematic four-step process using hierarchical, k-means, and random forest cluster analyses were used to identify the best fitting cluster solution in the data.

RESULTS

The results revealed a four-cluster solution that represented overcontrol, undercontrol, resilient and an antisocial/psychoticism cluster. The overcontrol, undercontrol, and antisocial/psychoticism types were all associated with increased disordered eating, eating pathology, depression, anxiety and stress compared to the resilient types, with the undercontrol cluster scoring significantly higher than the other three clusters on all measures of clinical pathology.

CONCLUSIONS

Pathological personality traits, as conceptualised within the DSM-5 alternative model of personality disorders may have merit for identifying overcontrol and undercontrol personality types. Our findings provide additional evidence that both overcontrol and undercontrol personality types are associated with increased eating pathology, depression, anxiety and stress.

Personality and Sleep Psychopathology: Associations Between the DSM-5 Maladaptive Trait Domains and Multiple Sleep Problems in an Adult Population

Given the lack of sufficient studies exploring the nature of sleep problems from the perspective of the alternative model of personality disorders (AMPD) proposed by the DSM-5, the present study is aimed at determining the associations between five trait domains such as negative affectivity and sleep problems (insomnia, parasomnia, hypersomnia, circadian rhythm sleep disorder, restless legs syndrome, and sleep-disordered breathing) in an adult population. Adults aged 18-65 from western Iran were invited to the study via virtual platforms (N = 928; 62% female) and responded online to the Brief Form of Personality Inventory for DSM-5 and the Holland Sleep Disorder Questionnaire to assess sleep problems. The regression analyses indicated that the AMPD trait domains could significantly predict both specific sleep problems (R2 ranges from 0.13 to 0.17; all p ≤ 0.001) and total score of sleep problems (R2 = 0.23; p < 0.001). Psychoticism (β ranges from 0.26 to 0.39; all p < 0.001) and negative affectivity (β ranges from 0.14 to 0.29; all p ≤ 0.002) were the strongest specific domains associated with all sleep problems. The findings highlighted links between maladaptive domains of the AMPD and multiple sleep problems. The unique profiles of each sleep problem are useful in selecting treatments tailored to specific sleep problems in adults.

Replicability of the five-factor structure of DSM-5 and ICD-11 trait systems and their associations with binge eating and bipolar spectrum psychopathology

Since the research on contemporary personality models-and psychopathology-mainly originate from the Western world, we aimed to test the factorial structure of two trait systems assessed with the Personality Inventory for DSM-5 (PID-5) in a non-Western sample and to compare the extracted models' relative associations with binge eating disorder (BED) and bipolar spectrum disorder (BSD) symptoms. A community sample (N = 516; 72% female) was administered the PID-5, which can operationalize both the DSM-5 and ICD-11 systems. The factor structures of both systems were tested using exploratory structural equation modeling (ESEM). The congruence coefficients of all factor loadings with international studies were calculated. The Binge Eating Scale (BES), Bipolar Spectrum Diagnostic Scale (BSDS), and Hypomania Checklist-32-Revised (HCL-32) were used to measure the criterion variables. Linear regression models were used for comparing the DSM-5 and ICD-11 systems in predicting the BED and BSD. The findings supported five-factor solutions for both trait systems. Both systems significantly predicted dimensional measures of both BED and BSD (all p < 0.001). The present findings support an acceptable five-factor structure for both personality systems in the non-Western sample. Different algorithms of maladaptive domains on both systems are related to binge eating and bipolar spectrum psychopathology.

Identifying overcontrol and undercontrol personality types among young people using the five factor model, and the relationship with disordered eating behaviour, anxiety and depression

BACKGROUND

Overcontrol and undercontrol personality types have been associated with an increase in eating pathology, depression and anxiety. The aim of the research was to explore whether latent overcontrol and undercontrol personality types could be identified using cluster analysis of the facets of the five factor model (FFM). We further aimed to understand how these personality types were associated with eating pathology, depressed mood and anxiety.

METHODS

A total of 561 participants (394 women and 167 men), aged 16-30 years in Australia completed a survey designed to assess disordered eating, FFM personality traits, anxiety, depression and stress. A systematic four-step process using hierarchical, k-means, and random forest cluster analyses were used to identify a meaningful 3-cluster solution.

RESULTS

The results revealed a cluster solution that represented overcontrol, undercontrol and resilient personality types, and highlighted facets of the FFM that were associated with each type. Both overcontrol and undercontrol personality types were associated with increased clinical symptoms compared to the resilient types.

CONCLUSIONS

It was concluded that FFM facets may potentially be more meaningful than broad domains in identifying personality types, and that both overcontrol and undercontrol personality types are likely associated with increased clinical symptoms.