A metastructural model of mental disorders and pathological personality traits
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Abstract
Background: Psychiatric co-morbidity is extensive in both psychiatric settings and the general population. Such co-morbidity challenges whether DSM-based mental disorders serve to effectively carve nature at its joints. In response, a substantial literature has emerged showing that a small number of broad dimensions – internalizing, externalizing and psychoticism – can account for much of the observed covariation among common mental disorders. However, the location of personality disorders within this emerging metastructure has only recently been studied, and no studies have yet examined where pathological personality traits fit within such a broad metastructural framework. Method: We conducted joint structural analyses of common mental disorders, personality disorders and pathological personality traits in a sample of 628 current or recent psychiatric out-patients. Results: Bridging across the psychopathology and personality trait literatures, the results provide evidence for a robust five-factor metastructure of psychopathology, including broad domains of symptoms and features related to internalizing, disinhibition, psychoticism, antagonism and detachment. Conclusions: These results reveal evidence for a psychopathology metastructure that ( a ) parsimoniously accounts for much of the observed covariation among common mental disorders, personality disorders and related personality traits, and ( b ) provides an empirical basis for the organization and classification of mental disorder.
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When PDs are examined in structural models with Axis I disorders, NPD typically forms an antagonism factor along with histrionic, paranoid, antisocial, and borderline PDs, although the exact nature varies.
“When PDs are examined in structural models along with Axis I disorders (e.g., depressive disorders), NPD again typically forms an antagonism factor along with histrionic, paranoid, antisocial, and borderline PDs, although the exact nature of this factor varies from study to study (Kotov et al. 2017, Roysamb et al. 2011, Wright & Simms 2015).”
From Controversies in Narcissism (2017) · cites this paper as Wright & Simms 2015
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- Authors
- Wright, A. G. C., & Simms, L. J.
- Affiliations
- University of Pittsburgh (US)
- University at Buffalo, State University of New York (US)
- Corresponding author
- Wright, A. G. C.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-04-23
- Volume
- 45
- Issue
- 11
- Pages
- 2309-2319
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC4498970
- OpenAlex
- W2141956580
- Cited by
- 177
- References
- 8
- Citations by year
- 2026: 11 · 2025: 5 · 2024: 8 · 2023: 16 · 2022: 14 · 2021: 27 · 2020: 24 · 2019: 21 · 2018: 12 · 2017: 16 · 2016: 19 · 2015: 4
- FWCI
- 21.11
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion)
- Funders
- National Institute of Mental Health (F32MH097325, R01MH80086, R01MH080086, L30-MH101760)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Keywords
- Big Five personality traits, personality disorders, pathological personality traits, psychiatric comorbidity, internalizing disorders, externalizing disorders, psychoticism, disinhibition, antagonism, detachment, mental disorder classification, psychiatric outpatients
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Models, Psychological, Outpatients, Personality, Personality Disorders, Psychopathology, Comorbidity, Diagnostic and Statistical Manual of Mental Disorders
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