The DSM-5 Alternative Personality Disorder Model includes Personality Inventory for DSM-5 (PID-5) that assess 25 specific personality traits in 5 domains. The aim of this thesis was to evaluate the method and its clinical benefits, especially by comparing it with the IPDE structured interview method on a sample of N = 29 psychiatric patients. Quantitative analysis of the results of both methods revealed a number of statistically significant correlations between the IPDE dimensional scores and the individual PID-5 traits of corresponding disorders. For disorders equally defined by both approach, the IPDE dimensional scores and PID-5 individual traits correlated by majority. Due to the overall low prevalence of undisputed personality disorder diagnosis in the sample, a qualitative analysis of 11 selected cases was performed. This analysis revealed the overlapping of the personality traits derived from both methods in 10 of these 11 cases. The methods differ in the assignment of a specific personality disorder as a diagnosis, but this is due in particular to a different theoretical definition of the methods. Overall, the PID-5 method has been evaluated as clinically beneficial, with a promising future and wide use in clinical practice. KEYWORDS Personality disorders, diagnostics, PID-5, IPDE

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:25:54Z No. of bitstreams: 1 DIS_LIVIA_NORA_BRANDALISE_PARCIAL.pdf: 6570989 bytes, checksum: b62ad256dd548bf41239e556f8d77cc1 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:26:01Z (GMT) No. of bitstreams: 1 DIS_LIVIA_NORA_BRANDALISE_PARCIAL.pdf: 6570989 bytes, checksum: b62ad256dd548bf41239e556f8d77cc1 (MD5) / Made available in DSpace on 2017-06-30T18:26:08Z (GMT). No. of bitstreams: 1 DIS_LIVIA_NORA_BRANDALISE_PARCIAL.pdf: 6570989 bytes, checksum: b62ad256dd548bf41239e556f8d77cc1 (MD5) Previous issue date: 2017-03-20 / Background: Personality traits are an important construct in the study of obesity, both to understand its influence on this condition?s origins and to evaluate its role in responses to treatments, such as bariatric surgery. The main models used so far, are based on dimensions of normal personality traits, bringing conflicting results. Hence, there is a demand for instruments that can give more accuracy and improve the study of the personality in this population capturing more dysfunctional traits. In a special section for emerging measures, the new edition of the Diagnostic Statistical Manual of Psychiatric Disorders (DSM-5) proposed an instrument to measure personality mal-adaptive traits: the Personality Inventory for DSM-5 (PID-5), whose psychometric properties have been tested in several samples and localities. Despite promising results, PID-5 has not yet been evaluated psychometrically in other clinical populations where the "personality" construct can have an important impact (in etiologic and prognostic ways), such as obese candidates for bariatric surgery. Objective: The aim of this study is to investigate the psychometric properties of the PID-5 in the evaluation of pathological personality traits in obese candidates for bariatric surgery. This constitutes a fundamental step to assess whether the instrument keeps its original technical features allowing its use and correct interpretation in this population. Setting: Centro da Obesidade e S?ndrome Metab?lica, Pontif?cia Universidade Cat?lica do Rio Grande do Sul (COM-PUCRS), Porto Alegre, Brazil Methods: Cross-sectional study involving 312 medical records of patients who applied for bariatric surgery. We collected demographic data and scores from instruments applied in the psychiatric evaluation routine. The reliability of facets and domains was evaluated through internal consistency indices and the unidimensionality of facets was verified through factorial methods. Exploratory Structural Equations Modeling was performed to test the higher order structure of the model. To investigate convergent validity, linear correlations were calculated between PID-5 scales and instrument scores of correlated constructs (depression, anxiety, defensive styles, and quality of life). Given the characteristic of the sample, we also correlated PID-5 with body mass index (BMI) and binge eating symptoms. Data was analyzed by Factor and Mplus softwares. Results: Facets were unidimensional, with the exception of Risk Taking, better explained by two factors. We replicate the higher order structure of 5 factors of the original model, with good congruence coefficients. The internal consistency of the domains was satisfactory, however, some facets showed fragility of internal consistency, mainly when calculated with more robust methods. In general, the domains and facets correlated as expected with correlated constructs. Conclusion: This study found evidences of adequate psychometric properties of PID-5 for a sample of obese candidates for bariatric surgery. Our results indicate that the instrument is appropriate to be applied in this population, consistently evaluating personality domains and facets of the DSM-5 model. More studies in other centers are needed to replicate and reinforce our findings. / Introdu??o: Tra?os de personalidade s?o um construto importante no estudo da obesidade, tanto para entender sua influ?ncia na g?nese desta condi??o, quanto para avaliar o papel que desempenham nas respostas aos tratamentos, como a cirurgia bari?trica. At? o momento, os principais instrumentos utilizados para o estudo desta rela??o baseiam-se em modelos que avaliam dimens?es de tra?os normais da personalidade, trazendo resultados conflitantes. Existe portanto, uma demanda por instrumentos que possam fornecer maior acur?cia e aperfei?oar o estudo da personalidade nesta popula??o, captando tra?os mais disfuncionais. Em uma se??o especial para medidas emergentes, a nova edi??o do Manual Estat?stico Diagn?stico dos Transtornos Psiqui?tricos (DSM-5) prop?s um instrumento para mensurar tra?os mal-adaptativos de personalidade: o Personality Inventory for DSM-5 (PID-5), cujas propriedades psicom?tricas vem sendo testadas em diversas amostras e localidades. A despeito de promissores resultados, o PID-5 ainda n?o foi avaliado psicometricamente em outras popula??es cl?nicas onde o construto ?personalidade? pode ter um impacto importante (em termos etiol?gicos e progn?sticos), como a constitu?da por obesos candidatos a cirurgia bari?trica. Objetivo: Investigar as propriedades psicom?tricas do PID-5 na avalia??o dos tra?os patol?gicos de personalidade em pacientes obesos candidatos a cirurgia bari?trica. Esta ? uma etapa metodol?gica fundamental para verificar se o instrumento mant?m suas caracter?sticas t?cnicas originais viabilizando seu uso e correta interpreta??o nesta popula??o. Local: Centro da Obesidade e S?ndrome Metab?lica, Pontif?cia Universidade Cat?lica do Rio Grande do Sul (COM-PUCRS), Porto Alegre, Brasil M?todos: Estudo transversal envolvendo 312 prontu?rios de pacientes candidatos a cirurgia bari?trica. Foram coletados dados demogr?ficos e escores de instrumentos aplicados na rotina de avalia??o psiqui?trica pr?-operat?ria. A fidedignidade das facetas e dom?nios do PID-5 foi avaliada atrav?s de ?ndices de consist?ncia interna e a unidimensionalidade das facetas atrav?s de m?todos fatoriais. O teste da estrutura de ordem superior foi realizado por meio do Modelagem de Equa??es Estruturais Explorat?rias. Para investigar a validade convergente, foram calculadas correla??es lineares entre as escalas do PID-5 e os escores de instrumentos de construtos correlatos (depress?o, ansiedade, estilos defensivos e qualidade de vida). Dada a caracter?stica da amostra, tamb?m correlacionamos o instrumento com o ?ndice de massa corporal (IMC) e sintomas compulsivos alimentares. Os dados foram analisados pelos softwares Factor e Mplus. Resultados: As facetas de personalidade apresentaram-se de forma unidimensional, ? ?nica exce??o de Exposi??o a Riscos, melhor explicada por dois fatores. Replicamos a estrutura de ordem superior de 5 fatores do modelo original, com bons coeficientes de congru?ncia. A consist?ncia interna dos dom?nios foi satisfat?ria, entretanto algumas facetas demonstraram fragilidades de consist?ncia interna, sobretudo calculados com m?todos mais robustos. De forma geral, os dom?nios e facetas correlacionaram-se de forma esperada com os construtos correlatos. Conclus?o: Este estudo encontrou evid?ncias de propriedades psicom?tricas adequadas do PID-5 para uma amostra de obesos graves candidatos a cirurgia bari?trica. Nossos resultados indicam que o instrumento ? apropriado para ser aplicado nesta popula??o, avaliando coerentemente os dom?nios e facetas da personalidade do modelo DSM-5. Mais estudos em outros centros s?o necess?rios para replicar e refor?ar nossos achado.

2 ABSTRACT In the Alternative DSM-5 Model for Personality Disorders (AMPD), the diagnosis of specific personality disorders is obtained through an evaluation of the level of impairment in personality functioning and an assessment of dimensional personality traits associated in 25 "lower order" facets and 5 "higher order" domains. The Personality Inventory for DSM-5 (PID-5) was developed for examination of personality traits within this system. This Ph.D. thesis covers five relevant publications regarding AMPD, particularly PID-5. First, the authors introduce the theoretical background of the PID-5. Attention is paid on its ease of use, data interpretation and use of these data for treatment planning in different clinical settings. Two empirical studies test PID-5 psychometric properties (internal consistency, validity, discrimination capacity and unidimensional structure) in the sample of community volunteers (n=351) and a clinical sample of psychiatric patients (n=143). PID-5 was administered individually and in a group setting using pen-paper method and online data collection. 33 respondents completed the inventory twice to check test-retest reliability. Authors presumed, evidence will be found to support internal consistency and convergent validity of the PID-5 personality trait domains, as well as their...

The Personality Inventory DSM-5 (PID-5) was created to measure personality pathology and help in the development of a dimensional conceptualization of personality disorders (Krueger, Derringer, Markon, Watson, & Skodol, 2012). It measures five maladaptive personality traits: Negative Affect, Detachment, Antagonism, Disinhibition and Psychoticism. The PID-5 has also garnered significant support for its hierarchical structure, five-factor structure across samples and translations, and its ability to predict variance in internalizing and externalizing disorders (Krueger & Markon, 2014). The current study builds on this literature by translating the PID-5 into Spanish spoken in Latin America and testing the replicability of the five-factor structure, reliability, and validity of the PID-5-Sp facets in a Hispanic sample. Using Mechanical Turk, 305 participants completed the PID-5-Spanish, Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD7), Aggression Questionnaire-Revised (AQ-R) and the Big Five Inventory (BFI). EFA suggested a three-factor structure that resulted in two small factors that were conceptually similar to Antagonism and Detachment and one large global general distress factor. CFA results indicated that a five-factor solution had a poor fit for the current sample. Reliability was acceptable for most facets (α = .60-.95, M= .85). In general, PID-5-Sp domains showed moderate to strong correlations with theoretically congruent normative traits, with exception of Psychoticism, which was not significantly correlated with Openness to Experience (r = -.08, p = > .05). As expected, Detachment and Negative Affect predicted GAD-7 and PHQ-9 scores. Aggression scores were predicted by Negative Affect, Antagonism and Disinhibition. Overall, the PID-5-Sp partially replicated previous validity and reliability findings. However, future research is needed to further test the five-factor structure and its replicability in non-Western samples.

The Personality Inventory for DSM-5 (PID-5) is an emerging measure used to map pathological personality traits. In this thesis, the reliability and facet structure of the Swedish version of the PID-5 is evaluated. Further, the possible occurrence of higher-order factors of the pathological personality traits is explored. Using a sample of 275 observations, the facet structure and higher-order factors are investigated using structural equation modeling (SEM). Results show that the internal consistency, measured with Cronbach's alpha, is strong for the facets and adequate for the domains from the PID-5. The theorized facet structure could not be confirmed for the Swedish version of the PID-5. Treating the five domains as observed variables, support for a general factor of psychopathology and indications of the two factors internalizing and externalizing are found.

The fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM 5) presents an alternate model for personality disorders, blending categorical and dimensional assessment into a hybrid diagnostic procedure. Released concurrently, the Personality Inventory for DSM 5 (PID 5) measures the five domains and 25 facets that comprise the trait components of this hybrid model. However, the PID 5 currently lacks validity indicators to capture intentionally distorted responding. The current study investigated the susceptibility of the PID 5 to defensiveness and feigning among a large sample of undergraduate students. First, a detailed desirability analysis (N = 465) was conducted of the PID 5 items and response options. Responses from the study were used to create three desirability based validity scales. Next, in a between-subjects simulation design (N = 128), the effects of faking were explored at domain and facet levels. As a result, two symptom based validity scales were created. In a separate validation sample (N = 134), the five newly created validity scales were compared with the Paulhus Deception Scales for capturing both defensiveness and feigning. All five scales were evaluated for ruling out faking (i.e., identifying likely genuine respondents) and ruling in either defensiveness or feigning. In most areas, the symptom based scales were more successful than the desirability based scales, though all scales had difficulty identifying defensiveness. These initial results offer fertile ground for additional testing and development of PID 5 validity scales.

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Accurate self-report assessment of psychopathology depends on individuals responding honestly and accurately. Some respondents, however, may respond in a manner not representative of their traits/symptoms. The MMPI-2-RF contains “validity” scales to detect elevations on over-reporting (OR) or under-reporting (UR) scales which typically correspond to elevations on MMPI-2-RF substantive scales and on instruments administered alongside the MMPI-2-RF. We examined effects of OR and UR on the Personality Inventory for DSM-5 (PID-5); a self-report instrument that assesses 25 pathological traits used with other diagnostic criteria to diagnose personality disorders (PDs) in Section III of the DSM-5. Using MMPI-2-RF validity scale scores, 908 students and 255 psychiatric outpatients were classified into OR, UR or within normal limit response groups. Significant group differences were found such that differences in the frequency of PD diagnosis emerged across response groups. We believe the PID-5 is vulnerable to OR and UR responding, which potentially compromises its validity.

Accurate self-report assessment of psychopathology depends on individuals responding honestly and accurately. Some respondents, however, may respond in a manner not representative of their traits/symptoms. The MMPI-2-RF contains “validity” scales to detect elevations on over-reporting (OR) or under-reporting (UR) scales which typically correspond to elevations on MMPI-2-RF substantive scales and on instruments administered alongside the MMPI-2-RF. We examined effects of OR and UR on the Personality Inventory for DSM-5 (PID-5); a self-report instrument that assesses 25 pathological traits used with other diagnostic criteria to diagnose personality disorders (PDs) in Section III of the DSM-5. Using MMPI-2-RF validity scale scores, 908 students and 255 psychiatric outpatients were classified into OR, UR or within normal limit response groups. Significant group differences were found such that differences in the frequency of PD diagnosis emerged across response groups. We believe the PID-5 is vulnerable to OR and UR responding, which potentially compromises its validity.