The Hierarchical Structure of Clinician Ratings of Proposed DSM-5 Pathological Personality Traits

Preliminary explorations of the trait model for personality disorders provided in Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Section III suggest that the factor structure of proposed traits includes 5 higher order factors that resemble other dimensional trait models of personality. These prior investigations have been based on self-reported data obtained from personality questionnaires, as has much of the research literature from which such trait models have evolved. However, the DSM-5 itself involves judgments made by clinicians about their patients. Thus, it is important to examine whether this factor structure identified in recent studies can also be found in clinician rating data. This study examined the hierarchical structure of the 25 proposed DSM-5 traits in patient ratings provided by a sample of 337 mental health professionals. Exploratory factor analysis revealed a hierarchical structure that resembled previously reported trait structures. As with a prior investigation by Wright et al. (2012), the various solutions estimated in the hierarchy of the DSM-5 traits resembled existing models of common mental disorders, temperament, and personality pathology.