Abstract
The National Institute of Mental Health has been encouraging the implementation of “translational” research, or studies that integrate basic science and applied, clinical practice. A potential exemplification of this effort would be the integration of basic science research on personality structure with the psychiatric classification of personality disorders; more specifically, a five-factor model of personality disorder. Advantages of a five-factor model of personality disorder include the provision of a precise yet comprehensive description of both normal and abnormal personality functioning, the avoidance of the many limitations and problems inherent to categorical diagnoses, and the incorporation of basic science research on general personality functioning into our understanding of personality disorders. An important goal of future research will be to evaluate its potential utility in clinical practice.
Introduction
The National Institute of Mental Health (NIMH) has been encouraging for some time the implementation of “translational” research, or studies that integrate basic science and applied, clinical practice. “NIMH has developed a number of initiatives designed to foster and speed the translation of basic behavioral and neuroscience work into research that addresses the etiology and treatment of mental disorders” (Cuthbert, 2002, p. 6). An intention of this mission is to have the clinical understanding of mental disorders be guided more heavily by basic scientific understanding of psychological functioning, as well as to in turn encourage basic science, laboratory research to have a more direct and clear relevance to clinical practice. NIMH is investing considerable effort and funding to build this bridge between science and clinical practice. “These initiatives include large-scale and comprehensive translational research centers in neuroscience and behavioral science that are designed to encourage large-scale, hypothesis-driven integration of basic and clinical research” (Cuthbert, 2002, p. 6). A potential exemplification of this effort would be the integration of basic science research on personality structure with the psychiatric classification of personality disorders.
As expressed well by Ball (2001) in his introduction to a special issue of Journal of Personality, “the application of personality trait models to the conceptualization of personality disorders has forged a much needed integration of what were separate areas of scientific study for most of the 20th century” (p. 151). The American Psychiatric Association’s (2000) classification of personality disorders within the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; APA, 2000) has been derived from treatment experiences and psychiatric research of clinical populations, largely divorced from the study of general personality structure ( Millon et al., 1996). DSM-IV currently includes 10 personality disorder diagnostic categories (i.e., antisocial, avoidant, borderline, dependent, histrionic, narcissistic, obsessive–compulsive, paranoid, schizoid, and schizotypal). The theoretical and clinical origins of these diagnoses are diverse, but none would trace its history to basic science research on general personality structure ( Frances and Widiger, 1986, Livesley, 2001 and Millon et al., 1996). It is proposed herein that the five-factor model (FFM) of general personality structure provides an effective means with which to integrate the applied psychiatric nomenclature with basic science personality research.
5. Conclusions
The integration of the FFM of general personality functioning with the DSM-IV personality disorders would help develop the basic science foundation of the APA diagnostic nomenclature. Advantages of the FFM approach include the provision of a precise yet comprehensive description of both normal and abnormal personality functioning, the avoidance of the many limitations and problems inherent to the categorical diagnostic system, and the incorporation of basic science research on general personality functioning into our understanding of personality disorders. It would also help in turn to develop the social and clinical utility of the FFM. As suggested by the NIMH translational initiative, the clinical understanding of mental disorders needs to be guided more heavily by basic scientific understanding of psychological functioning; likewise, basic science, laboratory research needs to in turn have a more direct and clear impact on clinical practice. An important goal of future research will be to evaluate the clinical utility of a five-factor model of personality disorder in clinical practice.
