The Psychometric Properties of the Personality Inventory for DSM-5 in an APA DSM-5 Field Trial Sample

Abstract

Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a hybrid model of personality pathology, in which dimensional personality traits are used to derive one of seven categorical personality disorder diagnoses. The Personality Inventory for DSM-5 (PID-5) was developed by the DSM-5 Personality and Personality Disorders workgroup and their consultants to produce a freely available instrument to assess the personality traits within this new system. To date, the psychometric properties of the PID-5 have been evaluated primarily in undergraduate student and community adult samples. In the current investigation, we extend this line of research to a psychiatric patient sample who participated in the APA DSM-5 Field Trial (Centre for Addiction and Mental Health site). A total of 201 psychiatric patients (102 men, 99 women) completed the PID-5 and the Revised NEO Personality Inventory (NEO PI-R). The internal consistencies of the PID-5 domain and facet trait scales were acceptable. Results supported the unidimensional structure of all trait scales but one, and the convergence between the PID-5 and analogous NEO PI-R scales. Evidence for discriminant validity was mixed. Overall, the current investigation provides support for the psychometric properties of this diagnostic instrument in psychiatric samples.

Keywords

personality assessment

The approaching publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has occasioned extensive research into the assessment and clinical utility of dimensional personality traits (Krueger et al., 2011). In response to the well-established limitations of the categorical personality disorders codified in the fourth edition of the DSM (DSM-IV), the DSM-5 Personality and Personality Disorders workgroup proposed a substantial revision to the diagnosis of personality pathology. This proposal included a hybrid model in which a categorical diagnosis of personality disorder is derived on the basis of dimensional, pathological personality traits as well as personality impairment. Workgroup members and consultants developed a freely available instrument for the assessment of the dimensional personality traits within this model—the Personality Inventory for the DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012)—which has demonstrated initial promise in undergraduate student and community adult samples (Ashton, Lee, deVries, Hendrickse, & Born, 2012; Hopwood, Thomas, Markon, Wright, & Krueger, 2012; Wright, Thomas, et al., 2012). The current investigation contributes to this line of investigation from an applied perspective, in a focused evaluation of the psychometric properties of the PID-5 required for use within a clinical setting.

As outlined in Section 3 of the DSM-5, 25 dimensional “lower-order” personality facet traits are used to derive one of seven possible personality disorder diagnoses: schizotypal, antisocial, borderline, narcissistic, avoidant, obsessive–compulsive, and trait-specified. These 25 traits are proposed to reside within one or more five “higher-order” personality domains: negative affect, detachment, psychoticism, antagonism, and disinhibition. These domains resemble those found in established models of personality pathology such as the Personality Psychopathology–Five (Harkness & McNulty, 1994) and/or measures of pathological personality such as the Dimensional Assessment of Personality Pathology–Basic Questionnaire (DAPP-BQ; Livesley, Jang, & Vernon, 1998) and the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993; Clark, Simms, Wu, & Casillas, in press). The domain and facet traits of the DSM-5 model were empirically derived from a larger set of 37 traits, identified by the DSM-5 Personality and Personality Disorders workgroup as a comprehensive collection of indicators of personality pathology. The convergence between the resultant DSM-5 proposal and accumulated empirical research in dimensional personality lends credence to the robustness and validity of its constituent traits (see Harkness, Finn, McNulty, & Shields, 2012; Samuel & Widiger, 2008).

The PID-5 has demonstrated acceptable to good psychometric properties in the published literature to date. The hierarchical structure of the PID-5 maps well onto extant models of personality and psychopathology, providing evidence for the construct validity of this measure (Wright et al., 2012). Furthermore, the traits of the PID-5 have been linked with traits of prominent models of personality, demonstrating the convergent and discriminant validity of scale scores (Ashton et al., 2012; Wright, Pincus, et al., 2012). Finally, and perhaps most important from a clinical perspective, the PID-5 scales account for a substantial amount of variance in DSM-IV personality disorder severity and are linked to DSM-IV personality disorders as designed (Hopwood et al., 2012). Taken together, these investigations provide initial support for the PID-5 as a measure of the dimensional model of personality proposed for use in the DSM-5.

The current investigation joins several other investigations in this special issue to address the limitations of the existing psychometric support for the PID-5. Of critical importance, the properties of the PID-5 have yet to be evaluated in a psychiatric sample (cf., Watson, Stasik, Ro, & Clark, 2013), which we believe is necessary prior to its use in clinical settings. Furthermore, the associations between the traits of the PID-5 and the Five Factor Model of personality have yet to be examined empirically (cf., De Fruyt et al., 2013; Thomas et al., 2013). The DSM-5 Personality and Personality Disorders workgroup argued that the traits of this widely used model do not capture pathological traits of clinical relevance in an optimal or comprehensive way. In particular, traits associated with paranoid, schizotypal, and schizoid personality are absent or inadequately represented by scales assessing Openness to Experience (Tackett, Silberschmidt, Krueger, & Sponheim, 2008; Watson, Clark, & Chmielewski, 2008). It is important to explore such associations in a sample likely to exhibit a range of such symptoms. We focus on these particular areas of need, to begin the research required to fully evaluate the validity of the proposed diagnostic scheme.

The Current Investigation

Our objective in the current investigation was to evaluate the psychometric properties of the PID-5 domain and facet scales with a psychiatric patient sample. In contrast to earlier investigations (e.g., Ashton et al., 2012; Hopwood et al., 2012; Wright et al., 2012), we evaluated the psychometric properties of the domain scales as calculated according to most recent guidelines, wherein each domain represents the average of three facet scales: Negative Affect is the average of the Emotional Lability, Anxiousness, and Separation Insecurity facet scales; Detachment of Withdrawal, Anhedonia, and Intimacy Avoidance; Antagonism of Manipulativeness, Deceitfulness, and Grandiosity; Disinhibition of Irresponsibility, Impulsivity, and Distractibility; and Psychoticism of Unusual Beliefs and Experiences, Eccentricity, and Perceptual Dysregulation. We hypothesized that the PID-5 domain and facet scales will exhibit adequate internal consistency and unidimensional structure, consistent with Krueger et al. (2012). We further hypothesized that the PID-5 facet scales will be positively associated due to saturation with general personality pathology and distress, but that the PID-5 facet scales within a domain will exhibit greater associations with each other than with facet scales of other domains. We also hypothesized that the PID-5 domain and facet scales will be moderately to strongly associated with thematically correspondent Revised NEO Personality Inventory (NEO PI-R) domain and facet scales, with the exception of the PID-5 Psychoticism domain and the Openness-to-Experience domain, which are likely to exhibit at best a weak association.

Method

Participants

The sample included 201 outpatients (102 men, 99 women) who had previously participated in the APA DSM-5 Field Trial at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada. Participants ranged in age from 19 to 73 years (M = 41.37, SD = 13.67). Current Axis I diagnoses included schizophrenia (n = 42), schizoaffective disorder (n = 36), attenuated psychosis (n = 14), personality disorder (n = 69), and other psychiatric diagnoses (n = 40) including mood, anxiety, substance use, impulse control, and pervasive developmental disorders.

All participants were required to meet the following criteria: (a) to endorse or exhibit current psychiatric symptoms, (b) to be 18 years of age or older, and (c) to be able to consent and complete the study protocol in English (see Clarke et al., 2013, for a full description of study procedures). Clinicians (provincially licensed psychiatrists or registered clinical psychologists at the CAMH site) recruited to participate in the DSM-5 Field Trial screened all consecutive patients for field trial eligibility, and informed all eligible patients of the opportunity to participate in the trial; interested patients were subsequently contacted by research staff to learn more about the protocol and to schedule research visits. Clinicians screened a total of 1,185 unique patients. Of these, 273 consented to participate and 242 were employed in trial analyses (see also Narrow et al., 2013; Regier et al., 2013). Participants of the current investigation attended an additional assessment session, including the measures described below.

Measures

Personality Inventory for the DSM-5

The PID-5 (Krueger et al., 2012) is a 220-item inventory newly developed to assess the pathological personality dimensions of the proposed hybrid model of personality pathology. This measure asks participants to rate statements on a 4-point Likert-type scale from 0 (Very False or Often False) to 3 (Very True or Often True). The PID-5 yields scale scores for five domain and 25 facet scale scores.

Revised NEO Personality Inventory

The NEO PI-R (Costa & McCrae, 1992) is a 240-item self-report measure frequently used to assess five higher-order domain traits and 30 lower-order facet traits of the Five Factor Model of personality. This measure asks participants to rate statements on a 5-point Likert-type scale from 1 (Strongly disagree) to 5 (Strongly agree). The NEO PI-R has been demonstrated to be a reliable and valid measure of the Five Factor Model traits (Costa & McCrae, 1992), including within clinical populations (Bagby et al., 1999; Costa, Bagby, Herbst, & McCrae, 2005; De Fruyt, Van Leeuwen, Bagby, Rolland, & Rouillon, 2006).

Statistical Analysis

To estimate the internal consistencies of the PID-5 domain trait scales, we calculated McDonald’s omega (ω) within a latent variable framework (McDonald, 1970). McDonald’s ω is particularly suited to estimating the reliability of a composite score (see Gignac, Bates, & Jang, 2007, for an application). To evaluate the internal consistencies of the PID-5 facet trait scales, we calculated Cronbach’s α coefficient and the average item correlation (AIC). The AIC statistic was used to supplement Cronbach’s α, as the AIC is less influenced by scale length.

To evaluate factor structure, we conducted a series of parallel analyses and Velicer’s minimum average partial (MAP) tests to determine how many factors to extract for each domain and facet scale (O’Connor, 2000). Parallel analysis involves the comparison of eigenvalues from a factor analysis of the actual data with eigenvalues from a factor analysis of a random dataset; the number of factors to retain is based on the number of actual data eigenvalues greater in size than random data eigenvalues (Horn, 1965). This empirical method is well suited to the current context due to the ability to generate random permutations of the existing data set, which maintain the same distributional properties as the original. We used 1,000 randomly generated permutations of the existing data set and compared actual data eigenvalues with the 95th percentile eigenvalues in the random data. Velicer’s MAP test involves a series of principal components analyses of the data, extracting an increasing number of principal components. These components are partialed from the correlations between variables. The number of factors to extract is the number of components that generated the lowest average squared partial correlation, which represent the systematic variance in the data (Velicer, 1976). For scales with more than one factor according to both indices, factor analyses were then conducted within MPlus 4.2, using a robust maximum-likelihood estimator and treating items as categorical (Muthén & Muthén, 1998-2006).

To evaluate convergent validity, we examined the associations of the PID-5 facet scales within and across each domain. Furthermore, we examined the associations between the PID-5 domain and facet scales and the analogous NEO PI-R domain scale. Finally, we examined the unique association of the NEO PI-R facet scales with the analogous PID-5 domain scales. To accomplish this, five linear regression models were evaluated, with each PID-5 domain scale serving as the criterion variable in separate models in turn. NEO PI-R facet scales of the analogous NEO PI-R domain were entered simultaneously as predictor variables. For example, the PID-5 Negative Affect domain scale was modeled as a criterion variable and the NEO PI-R Anxiety, Angry Hostility, Depression, Self-Consciousness, Impulsivity, and Vulnerability facet scales as predictor variables in the first model. Although Openness-to-Experience has been demonstrated to be distinct from Psychoticism and related traits (Tackett et al., 2008; Watson et al., 2008), this regression was included as well to explore Five Factor Model facet trait associations with this domain.

Results

The mean, standard deviation, and range of the PID-5 domain scales were as follows: Negative Affect M = 1.35, SD = 0.75, range = 0.00 to 2.95; Detachment M = 1.26, SD = 0.64, range = 0.00 to 2.85; Psychoticism M = 0.94, SD = 0.64, range = 0.00 to 2.51; Antagonism M = 0.66, SD = 0.56, range = 0.00 to 2.80; Disinhibition M = 0.99, SD = 0.63, range = 0.00 to 2.88. The mean, standard deviation, and range of the PID-5 facet scales are displayed in Table 1. To facilitate comparison, the mean and standard deviation of the PID-5 facet scales from the representative sample described in Krueger et al. (2012) are also displayed. Anxiousness and Depressivity were markedly elevated in the current sample as compared with Krueger et al. (ds .81 and .85, respectively). Other facet scales elevated as compared to this representative sample at a medium effect size include Anhedonia, Distractibility, Emotional Lability, Intimacy Avoidance, Perceptual Dysregulation, Perseveration, Suspiciousness, Unusual Beliefs and Perceptions, and Withdrawal (ds .52 to .72). Grandiosity and Manipulativeness were in fact lower in the current sample, albeit with small effect sizes.

Table 1.

Descriptive Data for PID-5 Facet Trait Scales.

Domains/Facets	α	AIC	Range	M (SD)	Krueger et al. (2012), M (SD)	d
Anhedonia	.89	.51	0.00-3.00	1.38 (0.79)	0.89 (0.64)	.69
Anxiousness	.93	.60	0.00-3.00	1.67 (0.88)	1.02 (0.73)	.81
Attention Seeking	.90	.52	0.00-3.00	0.83 (0.74)	0.81 (0.65)	.03
Callousness	.87	.34	0.00-2.29	0.47 (0.47)	0.40 (0.50)	.14
Deceitfulness	.90	.47	0.00-2.80	0.66 (0.66)	0.52 (0.54)	.24
Depressivity	.96	.63	0.00-3.00	1.17 (0.89)	0.53 (0.62)	.85
Distractibility	.91	.52	0.00-3.00	1.31 (0.81)	0.82 (0.69)	.66
Eccentricity	.95	.60	0.00-2.92	1.16 (0.83)	0.82 (0.76)	.43
Emotional Lability	.91	.59	0.00-3.00	1.38 (0.88)	0.94 (0.74)	.55
Grandiosity	.75	.33	0.00-3.00	0.66 (0.60)	0.82 (0.58)	−.27
Hostility	.88	.43	0.00-2.90	1.07 (0.71)	0.91 (0.67)	.23
Impulsivity	.89	.57	0.00-3.00	1.00 (0.79)	0.77 (0.57)	.34
Intimacy Avoidance	.87	.51	0.00-3.00	1.07 (0.85)	0.61 (0.65)	.62
Irresponsibility	.82	.40	0.00-2.86	0.66 (0.63)	0.39 (0.49)	.49
Manipulativeness	.85	.54	0.00-3.00	0.66 (0.69)	0.80 (0.67)	.21
Perceptual Dysregulation	.86	.34	0.00-2.58	0.83 (0.62)	0.44 (0.48)	.72
Perseveration	.88	.44	0.00-2.86	1.18 (0.72)	0.82 (0.62)	.54
Restricted Affectivity	.82	.40	0.00-3.00	0.92 (0.69)	0.97 (0.56)	−.08
Rigid Perfectionism	.91	.51	0.00-3.00	1.10 (0.76)	1.05 (0.68)	.07
Risk Taking	.87	.33	0.00-2.71	1.06 (0.57)	1.05 (0.66)	.02
Separation Insecurity	.89	.54	0.00-3.00	1.00 (0.84)	0.80 (0.68)	.27
Submissiveness	.79	.49	0.00-3.00	1.29 (0.75)	1.17 (0.66)	.17
Suspiciousness	.72	.27	0.00-3.00	1.26 (0.62)	0.95 (0.58)	.52
Unusual Beliefs & Perceptions	.85	.41	0.00-2.63	0.84 (0.72)	0.64 (0.63)	.30
Withdrawal	.92	.55	0.00-3.00	1.33 (0.81)	1.01 (0.72)	.42

Note. AIC = average interitem correlation.

Reliability

The internal consistencies of the PID-5 domain trait scales were as follows: Negative Affect ω = .84; Detachment ω = .75; Psychoticism ω = .87; Antagonism ω = .83; and Disinhibition ω = .80. Cronbach’s α and AIC values of the PID-5 facet trait scales are displayed in Table 1. All facet scales demonstrated Cronbach’s α values greater than .70; Callousness, Grandiosity, Perceptual Dysregulation, Risk Taking, and Suspiciousness exhibited AIC values below .40 (mean α = .87, mean AIC = .47).

Factor Structure

Both parallel analyses and MAP tests supported a one-factor structure for each of the domain scales. Parallel analyses supported a one-factor solution for all facet scales but Risk Taking. For this scale, the first three eigenvalues from the actual data were 5.49, 2.06, and 0.96; the corresponding first three 95th percentile random data eigenvalues were 1.59, 1.44, and 1.34, suggesting the retention of two components for rotation to solution. MAP tests supported a one-factor solution for all facet scales but Depressivity (average partial correlation = .0315), Hostility (average partial correlation = .0381), and Risk Taking as well (average partial correlation = .0197). Exploratory factor analysis of Risk Taking items revealed that seven of eight positively keyed items scored strongly on the first component (mean factor loading .67, range .50 to .82) and minimally on the second (mean factor loading .07, range −.10 to .37). In contrast, all negatively keyed items scored strongly on the second component (mean factor loading .60, range .50 to .81) and minimally on the second (mean factor loading .01, range −.30 to .21). Thus, the Risk Taking facet scale appears to exhibit a method effect reflecting item keying.

Convergent and Discriminant Validity

The univariate associations among the PID-5 facet scales, and between the PID-5 facet and domain scales, are presented in Table 2. Facet scales within each domain were strongly correlated: mean r = .41 for Negative Affect; mean r = .42 for Detachment; mean r = .53 for Antagonism; mean r = .39 for Disinhibition; and mean r = .68 for Psychoticism. Facet scales across domains were also significantly associated, although to a lesser degree: mean r = .36 for Negative Affect; mean r = .30 for Detachment; mean r = .29 for Antagonism; mean r = .35 for Disinhibition; and mean r = .38 for Psychoticism. There was considerable range in discriminant associations, however. For example, within Negative Affect, Anxiousness was strongly associated with Anhedonia (Detachment) at r = .72, whereas Submissiveness was not significantly associated with Risk Taking (Disinhibition) at r = −.05. All domain scales were significantly positively associated, rs ranging from .18 to .69 (mean r = .46).

Table 2.

Univariate Associations Between PID-5 Domain and Facet Trait Scales.

	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22	23	24
1	—
2	.72	—
3	−.01	.21	—
4	.27	.16	.29	—
5	.20	.26	.58	.63	—
6	.84	.80	.16	.34	.33	—
7	.58	.65	.33	.28	.44	.61	—
8	.45	.58	.34	.36	.42	.53	.60	—
9	.56	.74	.35	.18	.33	.67	.62	.48	—
10	−.03	.12	.52	.41	.49	.02	.21	.37	.10	—
11	.49	.58	.42	.57	.54	.62	.57	.48	.63	.34	—
12	.20	.39	.49	.36	.54	.36	.53	.45	.53	.30	.58	—
13	.18	.10	−.06	.15	.10	.12	.16	.15	−.05	.06	.01	−.07	—
14	.34	.38	.44	.52	.67	.49	.62	.47	.45	.29	.58	.58	.14	—
15	.10	.16	.59	.48	.79	.22	.29	.32	.21	.49	.40	.43	.02	.56	—
16	.45	.59	.36	.34	.45	.56	.54	.71	.48	.34	.44	.44	.22	.47	.38	—
17	.56	.69	.38	.27	.41	.59	.72	.59	.59	.31	.55	.45	.13	.48	.29	.58	—
18	.29	.13	.08	.43	.37	.23	.24	.43	−.09	.29	.21	.09	.38	.30	.34	.39	.25	—
19	.40	.46	.30	.30	.34	.42	.42	.50	.46	.37	.53	.31	.14	.25	.32	.42	.62	.25	—
20	−.07	.05	.41	.34	.36	.01	.20	.27	.18	.30	.30	.52	−.11	.32	.37	.20	.14	.07	.19	—
21	.41	.56	.44	.18	.39	.56	.51	.42	.59	.23	.53	.49	−.12	.46	.36	.46	.49	.04	.31	.16	—
22	.33	.44	.23	.07	.20	.43	.40	.35	.41	.10	.23	.28	.14	.30	.19	.42	.38	.15	.21	−.05	.42	—
23	.48	.66	.29	.32	.35	.57	.48	.56	.55	.28	.61	.45	.04	.38	.25	.49	.48	.16	.43	.26	.54	.40	—
24	.21	.33	.27	.24	.32	.29	.32	.66	.23	.42	.20	.31	.11	.30	.32	.69	.34	.31	.30	.11	.24	.29	.38	—
25	.60	.46	−.02	.42	.28	.52	.46	.49	.25	.18	.38	.18	.46	.37	.16	.50	.44	.58	.33	−.02	.22	.29	.39	.31	—
NA	.65	.89	.38	.20	.37	.78	.69	.67	.90	.17	.67	.54	−.03	.50	.28	.59	.68	.03	.47	.15	.82	.48	.67	.31	.36
DE	.75	.54	−.04	.36	.24	.62	.51	.46	.32	.10	.37	.12	.72	.36	.12	.50	.48	.53	.37	−.09	.21	.32	.38	.27	.88
AN	.11	.21	.67	.60	.90	.23	.37	.43	.25	.76	.50	.50	.07	.60	.90	.46	.40	.39	.40	.40	.38	.20	.34	.41	.24
DI	.45	.57	.49	.45	.64	.58	.86	.60	.64	.31	.68	.84	.08	.84	.50	.57	.66	.24	.39	.41	.58	.39	.52	.37	.39
PS	.42	.56	.36	.35	.45	.52	.55	.90	.44	.42	.42	.45	.18	.47	.38	.88	.57	.43	.46	.22	.42	.39	.54	.88	.49

Note. All correlations ≥ |.16| are significant at p < .05, all correlations ≥ |.20| are significant at p < .01. 1 = Anhedonia, 2 = Anxiousness, 3 = Attention Seeking, 4 = Callousness, 5 = Deceitfulness, 6 = Depressivity, 7 = Distractibility, 8 = Eccentricity, 9 = Emotional Lability, 10 = Grandiosity, 11 = Hostility, 12 = Impulsivity, 13 = Intimacy Avoidance, 14 = Irresponsibility, 15 = Manipulativeness, 16 = Perceptual Dysregulation, 17 = Perseveration, 18 = Restricted Affectivity, 19 = Rigid Perfectionism, 20 = Risk Taking, 21 = Separation Insecurity, 22 = Submissiveness, 23 = Suspiciousness, 24 = Unusual Beliefs and Experiences, 25 = Withdrawal; NA = Negative Affect, DE = Detachment, AN = Antagonism, DI = Disinhibition, PS = Psychoticism. Correlations between domain scales and the facet scales used in their calculation in gray.

The univariate associations between the PID-5 facet and domain scales and NEO PI-R domain scales are displayed in Table 3. The pattern of results was consistent with expectations. Neuroticism, Extraversion, Agreeableness, and Conscientiousness were moderately to strongly associated with the correspondent PID-5 domain scales and the facet scales used to calculate them (in boldface in Table 3 to facilitate review). Overall, Neuroticism demonstrated the greatest overall association with the PID-5 facets (mean r = .39), followed by Agreeableness (mean r = −.33) and Conscientiousness (mean r = −.32), reflecting the emotional distress and social and behavioral dysregulation typifying personality pathology. Of note, Openness-to-Experience was minimally associated with all the PID-5 scales with the exception of Risk Taking (r = .32).

Table 3.

Univariate Associations Between PID-5 Domain and Facet Trait Scales and NEO PI-R Domain Scales.

Domains/facets	N	E	O	A	C
Negative affect	.81	−.24	.08	−.26	−.52
Detachment	.49	−.71	−.21	−.22	−.37
Psychoticism	.39	−.24	.02	−.30	−.30
Antagonism	.13	.14	.06	−.60	−.22
Disinhibition	.59	−.10	.03	−.43	−.68
Anhedonia	.70	−.66	−.11	−.22	−.45
Anxiousness	.82	−.42	.06	−.23	−.46
Attention Seeking	.19	.38	.18	−.39	−.20
Callousness	.17	−.16	−.06	−.61	−.24
Deceitfulness	.26	.05	.00	−.58	−.39
Depressivity	.78	−.49	−.04	−.26	−.52
Distractibility	.62	−.29	.07	−.29	−.60
Eccentricity	.42	−.26	.06	−.33	−.34
Emotional Lability	.73	−.16	.14	−.19	−.46
Grandiosity	−.04	.11	.05	−.48	.06
Hostility	.63	−.16	.00	−.58	−.46
Impulsivity	.43	.10	.00	−.40	−.51
Intimacy Avoidance	.07	−.34	−.19	−.02	−.11
Irresponsibility	.44	−.05	.01	−.43	−.61
Manipulativeness	.11	.18	.10	−.47	−.20
Perceptual Dysregulation	.43	−.24	.00	−.26	−.31
Perseveration	.60	−.26	.16	−.30	−.40
Restricted Affectivity	.04	−.37	−.16	−.29	−.15
Rigid Perfectionism	.34	−.13	.21	−.32	.02
Risk Taking	.03	.33	.32	−.37	−.13
Separation Insecurity	.55	−.04	.00	−.26	−.42
Submissiveness	.41	−.17	−.12	−.03	−.29
Suspiciousness	.58	−.22	−.01	−.47	−.35
Unusual Beliefs & Perceptions	.17	−.12	−.02	−.20	−.13
Withdrawal	.39	−.67	−.19	−.28	−.32

Note. All correlations |.16| are significant at p < .05, all correlations |.20| are significant at p < .01. N = Neuroticism, E = Extraversion, O = Openness to Experience, A = Agreeableness, C = Conscientiousness.

The results of the linear regression analyses are presented in Table 4. NEO PI-R facet scales accounted for more than 50% of the variance in the analogous PID-5 domain scale for all domains but Psychoticism. Negative Affect was positively predicted by Anxiety and Angry Hostility. Detachment was negatively predicted by Warmth, Gregariousness, Assertiveness, and Positive Emotions. Antagonism was negatively predicted by Straightforwardness and Modesty. Disinhibition was positively predicted by Achievement Striving and negatively by Dutifulness, Self-discipline, and Deliberation. Finally, Psychoticism was positive predicted by Fantasy and negatively by Actions and Values.

Table 4.

Linear Regression Analyses of the NEO PI-R Facets Predicting PID-5 Domains.

Criterion/predictors	R ²	F	β	t
Negative Affect	.67	62.30**
Anxiety			.39	4.96**
Angry hostility			.22	3.75**
Depression			.09	1.05
Self-consciousness			.07	1.06
Impulsiveness			.04	.80
Vulnerability			.14	1.92
Detachment	.56	38.84**
Warmth			−.21	2.94**
Gregariousness			−.31	4.42**
Assertiveness			−.14	2.50*
Activity			−.09	1.54
Excitement-seeking			.09	1.49
Positive emotions			−.26	4.13**
Psychoticism	.25	10.08**
Fantasy			.36	5.09**
Aesthetics			.01	.11
Feelings			−.04	.52
Actions			−.29	4.06**
Ideas			.13	1.70
Values			−.25	3.73**
Antagonism	.52	33.37**
Trust			−.07	1.11
Straightforwardness			−.55	7.82**
Altruism			.03	.52
Compliance			−.05	.75
Modesty			−.24	3.98**
Tender-mindedness			.04	.64
Disinhibition	.56	39.94**
Competence			−.10	1.29
Order			−.01	.22
Dutifulness			−.19	2.69**
Achievement striving			.22	3.22**
Self-discipline			−.45	5.83**
Deliberation			−.31	4.80**

Note.*p < .05. **p < .01.

Discussion

These results contribute to a growing body of evidence supporting the validity of the trait model and clinical tool proposed by the DSM-5 Personality and Personality Disorders workgroup. As anticipated, the majority of trait scales were elevated in the current clinical sample as compared with the representative sample of Krueger et al. (2012); the decreased severity of Grandiosity and Manipulativeness may be related to the Axis I disorders characterizing the current sample. Domain and facet scales demonstrated acceptable levels of internal consistency, and factor analyses supported a unidimensional structure for all scales but one, supporting the interpretation of a single summary score. The impact of the method effect of the Risk Taking facet scale on measurement accuracy and validity requires further investigation, however.

The PID-5 facet scales within domains were strongly associated, although significant associations were also observed among facets across domains, consistent with our hypothesis that scales would be associated due to their saturation with personality pathology and associated distress, as well as with the strong secondary loadings evidenced in previous research (e.g., Krueger et al., 2012). The moderate associations between domain scales were also in line with these hypotheses and previous literature. The PID-5 domain and facet scales were also strongly associated with analogous NEO PI-R domain scales, supporting the convergent validity of these scales. Evidence for the discriminant validity of the PID-5 domain and facet scales was mixed, however. Disinhibition domain and associated facet scales were strongly associated with Neuroticism scores, and Negative Affect scales similarly with Conscientiousness; such patterns of association are captured in hierarchical models such as outlined by Wright et al. (2012). Numerous facets were associated with more than one NEO PI-R domain scale to a similar degree. In some cases (e.g., Unusual Beliefs and Perceptions scale) this may indicate the lack of available scales appropriate to gauge convergent and discriminant validity in the NEO PI-R; however, in others (e.g., Risk Taking) this may further indicate shortcomings in these forms of validity in these PID-5 scales.

The PID-5 domain scale associations with NEO PI-R facet scales provide further characterization of domains according to this novel scoring algorithm. Of note, Openness to Experience was minimally associated with all the PID-5 scales with the exception of Risk Taking (r = .32). NEO PI-R Openness facet scales accounted for a quarter of the variance in the PID-5 Psychoticism scale, which was uniquely associated with Fantasy in the positive direction, and Actions and Values in the negative direction. Thus, the trait domain associated with oddity, eccentricity, and peculiarity is clearly more consistent with the content domain of psychoticism as conceptualized by Harkness and McNulty (1994), as compared with the imaginativeness and exploration typifying openness/intellect—as well as the unsympathetic, nonconforming trait domain of the same name described by Eysenck, Eysenck, and Barrett (1985).

Previous investigations have provided critical evidence for the validity of this measure and model. The current investigation contributes to this line of research in being one of the first tests of the PID-5 in a psychiatric sample. This psychiatric sample exhibited a broad range of Axis I and II symptoms, as reflected by the range of psychiatric conditions including a significant proportion of patients meeting criteria for personality disorder diagnoses (34.3%). In this context, results generally supported the internal consistency, factor structure, and convergent validity of most of the PID-5 domain and facet scales in a clinical setting. Previous investigations have explored the hierarchical structure of the facet scales, which speaks to the validity of this measure via its convergence with established hierarchical models of personality (e.g., Anderson et al., 2013; Ashton et al., 2012; Wright et al., 2012). The current investigation maintained a more translational focus on the psychometric properties that may permit clinicians to confidently and knowledgeably interpret scale scores, with a nuanced understanding of how those scores are linked with a popular model of personality. Continued research such as that of Hopwood, Schade, Krueger, Wright, and Markon (in press), who demonstrated specific dysfunctional beliefs tied to the PID-5 personality domains, will further contribute to the evaluation of the clinical utility of the PID-5 traits, in psychological treatment as well as assessment.

Footnotes

Acknowledgements

We are indebted to all patients and clinicians for the time and effort they dedicated to their involvement in this research.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The operating costs of this research were supported by the CAMH Foundation.

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