Transdiagnostic dimensions towards personality pathology and childhood traumatic experience in a clinical sample: subtype classification by a cross-sectional analysis
Open accessAbstract
Psychiatric disorders are highly heterogeneous syndromes often explained by underlying and internalized personality disorder(PD) traits that are affected by externalized childhood trauma experiences(CTE). The present study investigated the differential subtype model by examining the association between PD traits and CTE in a clinical sample with transdiagnostic psychopathology. Outpatients(n = 2090) presenting for psychiatric treatment completed self-reported measures of PD traits(Personality Diagnostic Questionnaire) and the childhood adversity(Child Trauma Questionnaire). Canonical variates were generated by canonical correlation analysis(CCA) and then used for hierarchical cluster analysis to produce subtypes. A support vector machine(SVM) model was used and validated using a linear kernel to assess the utility of the extracted subtypes of outpatients in clinical diagnosis classifications. The CCA determined two linear combinations: emotional abuse related dissociality PD traits(antisocial and paranoid PD) and emotional neglect related sociality PD traits(schizoid, passive-aggressive, depressive, histrionic, and avoidant PD). A cluster analysis revealed three subtypes defined by distinct and relatively homogeneous patterns along two dimensions, and comprising 17.5%(cluster-1, n = 365), 34.8%(cluster-2, n = 727), and 47.8%(cluster-3, n = 998) of the sample, each with distinctive features of PD traits and CTE. These subtypes suggest more distinct PD trait correlates of CTE manifestations than were captured by clinical phenomenological diagnostic definitions. Our results highlight important subtypes of psychiatric patients that highlight PD traits and CTE that transcend current diagnostic boundaries. The three different subtypes reflect significant differences in PD and CTE characteristics and lend support to efforts to develop PD and childhood trauma targeted psychotherapy that extends to clinical diagnosis-based interventions.
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The PDQ-4+ has high sensitivity (0.89) and acceptable specificity (0.65) for screening DSM-IV PDs among Chinese psychiatric patients.
“The PDQ-4+ has high sensitivity (0.89) and acceptable specificity (0.65), making it a widely used tool for screening DSM-IV PDs among Chinese psychiatric patients.”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [14]
The Methods > Measures passage reports sensitivity of 0.89 and specificity of 0.65 for screening PD patients and says the PDQ-4+ measures DSM-IV PD traits. Methods > Subjects, settings and procedures shows its use to screen psychiatric outpatients in China. The paper calls specificity “moderate” and does not establish the citing sentence’s additional claim that the tool is widely used. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe more extensive the experience of CM, the higher the risk of developing BPD.
“Studies have consistently shown that the more extensive the experience of CM, the higher the risk of developing BPD.”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [14]
The cluster comparisons (Methods > Statistical analysis; page not provided) show that the group with the highest mean childhood-trauma score also had the highest proportion diagnosed with borderline personality disorder. But this cross-sectional association does not establish that progressively more extensive childhood maltreatment increases the risk of developing BPD; the paper says it cannot determine whether its subtypes predict symptom onset (Discussion > Strengths and limitations; page not provided). (LLM, conf=0.85)
Experimental — accuracy not yet measuredDifferent types of CM can uniquely contribute to specific BPD traits.
“Research indicates that different types of CM can uniquely contribute to specific BPD traits, highlighting the importance of addressing these experiences in therapeutic interventions (14–17).”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [14]
The Results (Correlations and Canonical correlation; page unavailable) associate different childhood trauma types with different personality-disorder traits. The reported associations concern traits such as antisocial, paranoid and avoidant traits, not specific borderline personality disorder (BPD) traits; the cross-sectional findings also do not establish that trauma types uniquely contribute to those traits. The Conclusion proposes further research on individualized interventions, rather than demonstrating their effectiveness. (LLM, conf=0.86)
Experimental — accuracy not yet measuredChildhood maltreatment is a well-documented risk factor for BPD.
“childhood maltreatment (CM) is a well-documented risk factor for BPD.”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [14]
The Results (Correlations; page not provided) report significant associations between childhood-trauma scores and personality-disorder traits, including Cluster B traits. The paper measures borderline traits, but its cross-sectional findings do not establish childhood maltreatment as a risk factor specifically for BPD. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe PDQ-4+ has high test-retest reliability (0.92) in the Chinese population.
“It has demonstrated high test-retest reliability (0.92) in the Chinese population, confirming its consistency in producing reliable results (5, 14, 21).”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [14]
The Methods > Measures passage reports PDQ-4+ sensitivity (0.89) and specificity (0.65), not test–retest reliability. It gives a test–retest value of 0.70 for a different instrument, the Chinese SCID-II. Searches for PDQ-4+ test–retest reliability and 0.92 found no passage supporting the claimed value. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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Self-citation
- Authors
- Wang, J., Sun, W., Tang, X., Xu, L., Wei, Y., Cui, H., Tang, Y., Hui, L., Jia, Q., Zhu, H., Wang, J., & Zhang, T.
- Affiliations
- Punan Hospital (CN)
- Shanghai Jiao Tong University (CN)
- Soochow University (CN)
- Corresponding author
- Zhu, Hongliang
- Zhang, TianHong
- Venue
- Scientific Reports
- Published
- 2019-08-02
- Volume
- 9
- Issue
- 1
- Pages
- 11248-11248
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC6677786
- OpenAlex
- W2965148987
- Cited by
- 14
- References
- 31
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 1
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Natural Science Foundation of China (81671329, 81671332, 13dz2260500, (81671329, 81671332)
- Science and Technology Commission of Shanghai Municipality (CRC2018ZD01, 18ZR1432600, 13dz2260500, 19441907800, 18411952400, 19441907800, 18411952400, 18ZR1432600)
- Suzhou Municipal Science and Technology Bureau (sys2018097)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- personality disorder traits, childhood trauma, transdiagnostic psychopathology, personality disorder subtypes, emotional abuse, emotional neglect, antisocial personality disorder, paranoid personality disorder, schizoid personality disorder, passive-aggressive personality disorder, histrionic personality disorder, avoidant personality disorder, depressive personality disorder, personality disorder diagnosis, psychiatric outpatients
- MeSH terms
- Adult Survivors of Child Adverse Events, Adult, Cross-Sectional Studies, Female, Humans, Male, Personality Disorders, Psychometrics, Psychotherapy, Cluster Analysis, Young Adult, Self Report, Support Vector Machine
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