621793

research-article2015
ASMXXX10.1177/1073191115621793AssessmentFossati et al.

Article
Assessment

The Personality Inventory for DSM-5

1­–17
© The Author(s) 2015
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DOI: 10.1177/1073191115621793

and Construct Validity in a Sample of asm.sagepub.com

Community-Dwelling Italian Adolescents

Andrea Fossati1,2, Antonella Somma1,2, Serena Borroni2,3,

Kristian E. Markon4, and Robert F. Krueger5

Abstract
To assess the reliability and construct validity of the Personality Inventory for DSM-5 Brief Form (PID-5-BF) among
adolescents, 877 Italian high school students were administered the PID-5-BF. Participants were administered also the
Measure of Disordered Personality Functioning (MDPF) as a criterion measure. In the full sample, Cronbach’s alpha values
for the PID-5-BF scales ranged from .59 (Detachment) to .77 (Psychoticism); in addition, all PID-5-BF scales showed
mean interitem correlation values in the .22 to .40 range. Cronbach’s alpha values for the PID-5-BF total score was .83
(mean interitem r = .16). Although 2-month test–retest reliability could be assessed only in a small (n = 42) subsample of
participants, all PID-5-BF scale scores showed adequate temporal stability, as indexed by intraclass r values ranging from
.78 (Negative Affectivity) to .97 (Detachment), all ps <.001. Exploratory structural equation modeling analyses provided at
least moderate support for the a priori model of PID-5-BF items. Multiple regression analyses showed that PID-5-BF scales
predicted a nonnegligible amount of variance in MDPF Non-Cooperativeness, adjusted R2 = .17, p < .001, and Non-Coping
scales, adjusted R2 = .32, p < .001. Similarly, the PID-5-BF total score was a significant predictor of both MDPF Non-Coping,
and Non-Cooperativeness scales.

Keywords
Personality Inventory for DSM-5 Brief Form, adolescence, reliability, validity

To address various concerns with personality disorder (PD)
categories in use since the third edition of Diagnostic and
Statistical Manual of Mental Disorders (DSM-III; American
Psychiatric Association, 1980)—for example, lack of
empirically validated cutoffs, extensive comorbidity, and
temporal instability (Widiger & Trull, 2007)—an Alternative
Model of Personality Disorder (AMPD) was provided in
DSM-5 Section III (American Psychiatric Association,
2013a), along with traditional PD symptom criteria listed in
DSM-5 Section II (which reprints DSM-IV [American
Psychiatric Association, 1994] Axis II PD symptom crite-
ria). DSM-5’s AMPD requires evidence for impaired self-
and interpersonal functions of personality (i.e., Criterion A)
of at least moderate severity level for PD diagnosis. A core
component (i.e., Criterion B) of the DSM-5 AMPD is an
empirically based model of maladaptive personality traits
(Krueger & Markon, 2014). In particular, the AMPD allows
clinicians to assess five major domains of maladaptive per-
sonality—namely, Negative Affectivity (frequent and
intense experiences of high levels of a wide range of nega-
tive emotions), Detachment (avoidance of socioemotional
experience), Antagonism (behaviors that put the individual
at odds with other people), Disinhibition (orientation toward
immediate gratification and impulsive behavior), and
Psychoticism (a wide range of culturally incongruent odd,
eccentric, or unusual behaviors and cognition).
This model did not arise de novo; rather, it represents a
synthesis of existing dimensional models of personality
pathology, focused on maladaptive variants (e.g., Clark,
2007; Harkness, McNulty, & Ben-Porath, 1995; Trull &
Durrett, 2005; Widiger & Simonsen, 2005). Although there
is a consensus that extremity on personality traits is
1
LUMSA University, Rome, Italy
2
San Raffaele Hospital, Milan, Italy
3
Vita-Salute San Raffaele University, Milan, Italy
4
University of Iowa, Iowa City, IA, USA
5
University of Minnesota, Minneapolis, MN, USA
Corresponding Author:
Antonella Somma, Department of Human Studies, LUMSA University,
Piazza Delle Vaschette, 101, 00193, Rome, Italy.
Email: a.somma@lumsa.it

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2 Assessment 
insufficient to identify personality disorder (e.g., Livesley
& Jang, 2000; Wakefield, 2008), it should be observed that
the PID-5 traits are maladaptive personality traits rather
than normative personality traits. Indeed, they operational-
ize five specific maladaptive personality trait dimensions
with a focus on the poles that are associated with tradition-
ally-defined PDs (i.e., detachment, antagonism, disinhibi-
tion, negative affectivity, and psychoticism).
Although assessment of severity level of impairment in
self and interpersonal function of personality cannot be
derived simply by the assessment of the level of DSM-5
AMPD dysfunctional PD traits, it should be stressed that
dysfunctional personality traits represent cognitive, behav-
ioral and affective indicators of personality dysfunction;
indeed, both moderate impairment or greater in personality
(self/interpersonal) functioning, and one or more pathologi-
cal personality traits are necessary to diagnose PD accord-
ing to DSM-5 AMPD (Skodol, 2014). Although thorough
assessment of both DSM-5 AMPD criteria is necessary to
yield PD diagnoses, subjects may be screened for possible
presence of PD psychopathology using either measures of
impairment in self/interpersonal function or measures of
pathological personality traits/domains. Indeed, specific
impairment in self/interpersonal function may also involve
pathological trait manifestations (e.g., grandiosity in DSM-
5 AMPD criteria for Narcissistic PD is present among pos-
sible impairment in self function and among defining traits,
along with Attention Seeking); similarly, several DSM-5
AMPD pathological traits and domains also involve impair-
ment in interpersonal functioning (e.g., Hostility, Intimacy
Avoidance, Callousness, Deceitfulness, Manipulativeness,
Withdrawal, Suspiciousness, Irresponsibility, etc.) and/or
self-function (e.g., Separation Insecurity, Submissiveness,
Anhedonia, Depressivity, Grandiosity, Attention Seeking,
etc.).
The Personality Inventory for DSM-5
Based on this model, Krueger, Derringer, Markon, Watson,
and Skodol (2012) developed the Personality Inventory for
DSM-5 (PID-5); the PID-5 is a 220-item self-report ques-
tionnaire with a 4-point response scale; it yields 25 primary
scales that can be combined to also delineate 5 higher order
scales (Negative Affectivity, Detachment, Antagonism,
Disinhibition, and Psychoticism). Indeed, a burgeoning lit-
erature is yielding consistent evidence for the validity of the
DSM-5 trait model as it is operationalized in the PID-5. A
substantial body of literature suggest that the PID-5 can
account for the reliable variance in DSM-IV personality dis-
orders, as well as for specific clinical constructs beyond
personality traits and personality disorders (e.g., dysfunc-
tional beliefs; Krueger & Markon, 2014); moreover, the
DSM-5 traits as they are operationalized in the PID-5 can be
well understood as a maladaptive extension of the
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five-factor model of personality (Suzuki, Samuel, Pahlen,
& Krueger, 2015). The PID-5 scales also proved useful in
provide orienting dimensions for identifying the empirical
structure of psychopathology (Wright & Simms, 2014).
Data strongly support a hierarchical structure of PID-5
pathological traits ranging from a general personality
pathology factor to a two-factor (i.e., internalizing patho-
logical trait factor vs. externalizing pathological trait factor)
and a three-factor (internalizing factor, externalizing factor,
and detachment factor) down to a five-factor model of mal-
adaptive personality domains (Wright et al., 2012). The
PID-5 has been translated and validated in a number of lan-
guages, including Italian (Fossati, Krueger, Markon,
Borroni, & Maffei, 2013).
In addition to the 220-item self-report version of PID-
5, a number of alternative forms of the PID-5 have been
developed in recent years; for instance, Markon, Quilty,
Bagby, and Krueger (2013) developed and validated the
informant-report form of the PID-5 (i.e., the PID-5-IRF).
Recently, Maples and colleagues (2015), through the use
of item response theory methods proposed a 100-item
version of the PID-5 to score the DSM-5 domains and
facets that resulted in nearly identical reliability and
validity and similar nomological networks with the PID-5
(Maples et al., 2015).
The Personality Inventory for DSM-5 Brief Form
Interestingly, a very brief form of the PID-5 (PID-5-BF) has
been made available to researchers and clinicians (American
Psychiatric Association, 2013b). The PID-5-BF is not pro-
posed as a fine-grained measure for assessing AMPD traits;
rather, it was designed to screen for possible personality
disorder by quantifying the overall elevation of scores
across the five broad maladaptive trait dimensions listed in
DSM-5 Criterion B. As a screening measure for personality
pathology, the PID-5-BF has several potentially attractive
features. The PID-5-BF is a 25-item self-rated measure for
maladaptive personality trait assessment which can be
administered to both adults and adolescents (namely, chil-
dren aged 11-17 years). The PID-5-BF items come from the
220-item self-report PID-5. As in the PID-5, each PID-5-BF
item is rated on a 4-point scale (American Psychiatric
Association, 2013b).
The PID-5-BF assesses the 5 AMPD maladaptive trait
dimensions of Negative Affectivity (NA), Detachment
(De), Antagonism (A), Disinhibition (Di), and Psychoticism
(Ps), with each domain scale consisting of 5 items; in addi-
tion, the PID-5-BF yields a score for the overall measure.
The availability and routine use of a brief screen for person-
ality pathology could potentially permit earlier detection of
personality pathology in samples of community-dwelling
adolescents (and hopefully also in clinically referred ado-
lescents), perhaps prior to the development of more severe
Fossati et al. 3
externalizing (e.g., drug abuse, deliberate self-harm, aggres-
sive behavior, etc.) and internalizing (e.g., depression, anxi-
ety symptoms, etc.) indicators. The availability of a brief
and reliable screen for maladaptive personality domains
would increase the likelihood that practitioners alerted to
the possibility of personality pathology would pursue a
more formal evaluation (Noblin, Venta, & Sharp, 2013;
Patel, Sharp, & Fonagy, 2011).
It should be noted that the PID-5-BF does not aim to
yield a measure of impairment in DSM-5 AMPD Criterion
A core functions (i.e., self/interpersonal functions); rather it
simply aims to screen for elevation in one or more of the
maladaptive trait dimensions and to evaluate the overall
profile elevation across the five maladaptive trait dimen-
sions. Importantly, the presence of personality dysfunction
as operationalized in Criterion A conveys information pri-
marily regarding disorder severity, rather than personality
“style,” which is reflected in traits (Morey et al., 2011;
Pincus, 2011; Tyrer et al., 2011).
Recently, supporting earlier research (Ro & Clark,
2013), Zimmermann et al. (2015) showed that the empiri-
cal structure of the Criterion A subdomains is broadly in
line with the theoretical model representing two highly
correlated factors of self- and interpersonal functioning,
and can be differentiated from Criterion B traits. Although
there is some evidence that pathological personality traits
may capture personality dysfunction (e.g., Few et al.,
2013; Hill, Fudge, Harrington, Pickles, & Rutter, 2000),
and Zimmermann et al.’s (2015) findings indicated that
the distinction between Criteria A and B may not be as
clear cut as the DSM-5 AMPD suggests, at the same time
their results also do not indicate that Criterion A and B
reference the same constructs. As such, the PID-5-BF
total score is expected to be associated with measures of
self and interpersonal dysfunction, but not to be entirely
redundant with detailed assessments of functioning in
these domains. In other words, the PID-5-BF total score
should not be considered as a measure of DSM-5 AMPD
Criterion A, but as an index reflecting the possible need
for a thorough clinical assessment of severity of self and
interpersonal impairments (as well as thorough assess-
ment of the full DSM-5 maladaptive trait model) in
selected individuals.
Although the PID-5-BF includes a total score intended
to serve the two functions of screening for and summa-
rizing overall profile elevation, its use might be taken to
suggest the presence of an overall general personality
pathology factor. The idea of such a factor is controver-
sial, however, with some suggesting such factors reflect
general psychopathology (e.g., Lahey et al., 2012), and
others suggesting that they are source-specific artifacts
or reflect response bias (e.g., Anusic, Schimmack,
Pinkus, & Lockwood, 2009). Our purpose here is not to
adopt a stance on these issues or to find support for the
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existence of a general personality pathology factor in a
wider conceptual sense, but to evaluate the tenability and
utility of the PID-5-BF total score from a psychometric
perspective.
The Assessment of Maladaptive Personality
Traits in Adolescence
The assessment of personality pathology in adolescence is
important, since personality dysfunction is commonly mis-
diagnosed or missed completely in the adolescent popula-
tion, in which clinically significant emotional dysregulation
and externalizing behavior are sometimes missed because
they are mistaken for developmentally appropriate behav-
iors (Sharp & Bleiberg, 2007). Although, a number of
recently published reviews discuss developmental anteced-
ents of personality pathology (for a review, see De Fruyt &
De Clercq, 2014), and a recent study (De Clercq et al.,
2014) showed that the PID-5 scales had generally accept-
able-to-good internal consistencies in adolescence, more
research is needed in evaluating maladaptive personality
traits in adolescence.
Previous studies (e.g., Marsh, Nagengast, & Morin,
2013) examined the role of gender differences in Five
Factor Model traits. For instance, Klimstra, Hale,
Raaijmakers, Branje, and Meeus (2009) in a sample of
Dutch adolescents, found that girls had consistently higher
scores than boys for Neuroticism, Agreeableness, with ten-
dencies toward higher scores for Openness and Extraversion.
However, this appears to be the first study to examine the
impact of gender on the PID-5-BF domain and total scores
in adolescence.
The Present Study
The PID-5-BF is an easy to administer (and score), very
short instrument specifically designed to screen for DSM-
5 AMPD maladaptive personality trait dimensions which
does not include any psychiatric symptom per se among
its items. These features seem to indicate the PID-5-BF
may be a viable tool for personality disorder screening
among adolescents. Notwithstanding these promising fea-
tures of the PID-5-BF as a screening instrument, to the
authors’ knowledge no study has been carried out on the
psychometric properties of the PID-5-BF up to now, par-
ticularly in adolescence. Moreover, no study addressed the
issue of the reliability and validity of the PID-5-BF in dif-
ferent linguistic or cultural contexts. The availability of
assessment instruments like the PID-5-BF, which have
been validated in different countries as a reliable and valid
measure of DSM-5 pathological traits, will help to address
concerns that useful clinical information is not lost in the
translation of PD diagnoses from a categorical framework
to a dimensional framework.
4 Assessment 
Starting from these considerations, we aimed at provid-
ing initial data on the reliability and construct validity of the
PID-5-BF. In order to obtain initial evidence of the ability
of PID-5-BF scores to predict the level of personality dys-
function, participants were administered also the Measure
of Disordered Personality Functioning (MDPF; Parker
et al., 2004). In the absence of agreed-upon, easy-to-admin-
ister measures of DSM-5 AMPD Criterion A, the MDPF
may be used as a “criterion A-like” measure of impairment
in core personality functions (Ro & Clark, 2013). As noted
earlier, some research suggests differentiation between dys-
function and traits (Zimmermann et al., 2015), and in the
AMPD personality dysfunction is necessary for a PD diag-
nosis, as the simple presence of extreme traits does not nec-
essarily indicate mental disorder (Livesley & Jang, 2005).
Finally, in the present study, we examined the role of gender
on the PID-5-BF domain and total scores.
Method
Participants
Participants were 1042 adolescents (52.9% female; mean
age = 15.65 years, SD = 2.10) who were attending one pub-
lic junior high school and six public high schools in
Southern Italy, Central Italy, and Sardinia Island, Italy,
respectively. Data were incomplete for 165 participants
(15.8%) (questionnaires were considered incomplete if
more than 10% of the items in any given scale were not
answered) and these participants were excluded from the
final sample. Participants with incomplete questionnaires
did not differ from participants with complete question-
naires on gender, χ2(1) = 1.52, p > .20, φ = .04, region of
Italy, χ2(2) = 0.22, p >.50, φ = .02, school that participants
were attending, χ2(6) = 5.21, p > .10, Cramer’s V = .07;
participants with incomplete questionnaires were signifi-
cantly, albeit slightly younger (mean age = 15.18 years, SD
= 2.16) than participants with complete questionnaires
(mean age = 15.74 years, SD = 2.07), age, t(1040) = −3.19,
p > .70, d = −0.20. The final sample was comprised of 877
adolescent students; 471 participants (53.7%) were female
and 406 (46.3%) were male, with a mean age of 15.74 years
(SD = 2.07). In order to participate in the present study, par-
ticipants were required to speak Italian as their first lan-
guage in order to avoid cultural and lexical bias in
questionnaire responses.
After obtaining institutional review board approval from
the university and the principals of the schools, researchers
recruited adolescents from classrooms (data were collected
in Autumn 2014–Spring 2015). Written informed parent
consent and adolescent assent were obtained prior to study
participation. Although socioeconomic status was not
directly controlled for in this study, it should be emphasized
that participants were selected from public high
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schools. Data from the National Institute of Statistics
of Italy (ISTAT; retrieved from http://dati.istat.it/Index.
aspx?DataSetCode=DCIS_SCUOLESECOND2) showed
that 95.28% of the Italian students attended public high
schools in 2013. In particular, ISTAT records (retrieved
from http://www.istat.it/it/archivio/17290) showed that
93.1% of the Italian adolescents were high school students
during 2012/2013 (the median percentage of the Italian who
were high school students from 2007 to 2013 was 94.3%,
with a mean value of 94.0%, SD = 0.79), thus suggesting
that samples of adolescents attending public high schools
may be representative of the Italian adolescent population.
The principals of the school in Southern Italy agreed to
participate in the test–retest study of the PID-5-BF. Among
the 306 community-dwelling adolescents who attended
school in the South of Italy and were included in the final
sample, 42 (13.7%) participants agreed to participate in the
2-month test–retest reliability study of the PID-5-BF scale
scores. In the test–retest subsample, 31 participants (73.8%)
were female and 11 (26.2%) were male, with a mean age of
15.00 years (SD = 1.06). A significantly lower proportion of
female adolescents (n = 440, 52.7%) was observed among
adolescents in the final sample who did not participate in the
test–retest study (N = 835) than among adolescents in the
test–retest subsample, χ2(1) = 7.17, p < .01, φ = .09, although
the effect size for this difference (i.e., φ coefficient value)
was small by conventional standards (Cohen, 1988). On
average, adolescents in the test–retest subsample were sig-
nificantly, albeit slightly (Cohen, 1988), younger than ado-
lescents who did not participate in the test-retest study (mean
age = 15.78 years, SD = 2.11), separate variance t(59) =
−4.36, p <.001, d = -0.36. Test–retest participants did not
show any significant difference from the participants who
did not take part in the test–retest study on the PID-5-BF
total score at the baseline, t(875) = −0.50, p > .60, d = −0.03,
and on any of the baseline PID-5-BF scale scores—mini-
mum t(875) = 0.10, d = 0.01 (Negative Affectivity); maxi-
mum t(875) = 0.80, d = 0.05 (Detachment)—except for the
Antagonism scale score, t(875) = −2.18, p < .05, d = −0.18,
although the effect size for this difference (i.e., d coefficient
value) was small by conventional standards (Cohen, 1988).
Measures
Cronbach’s alpha values for the PID-5-BF scales in the
whole sample and in the subgroups based on participants’
gender are listed in Table 1.
Personality Inventory for DSM-5 Brief Form. The PID-5-BF
(American Psychiatric Association, 2013b) is a 25-item
self-report questionnaire which was designed to assess the
five AMPD trait dimensions of Negative Affectivity (NA),
Detachment (De), Antagonism (An), Disinhibition (Di),
and Psychoticism (Ps) in both adults and adolescents; each
Fossati et al. 5

Table 1.  Descriptive Statistics, Cronbach’s α Values and Mean Interitem Correlations, and Gender Comparisons for the Personality
Inventory for DSM-5 Brief Form (N = 877).
Whole Sample (N = 877) Male Participants (n = 406) Female Participants (n = 471)  

  M SD α (MIC) M SD α (MIC) M SD α (MIC) t(875) d

PID-5-BF
Negative Affectivity 1.31 0.61 .64 (.26) 1.12 0.57 .64 (.26) 1.47 0.60 .62 (.25) –8.94*** –0.60
Detachment 0.79 0.50 .59 (.22) 0.72 0.48 .60 (.23) 0.85 0.50 .62 (.25) –3.92*** –0.27
Antagonism 0.58 0.51 .74 (.36) 0.71 0.56 .74 (.36) 0.47 0.42 .71 (.33) 7.16*** 0.48
Disinhibition 0.94 0.54 .62 (.24) 0.96 0.56 .60 (.23) 0.91 0.52 .57 (.21) 1.46 0.10
Psychoticism 1.04 0.67 .77 (.40) 0.93 0.64 .77 (.40) 1.14 0.68 .76 (.39) –4.78*** –0.32
PID-5-BF total score 0.93 0.37 .83 (.16) 0.89 0.38 .84 (.17) 0.97 0.36 .83 (.16) –3.28** –0.22

Note. PID-5-BF = Personality Inventory for DSM-5 Brief Form; MIC = mean interitem correlation.
*p < .05. **p < .01. *** p < .001.

domain scale consisting of 5 items. Each PID-5-BF item is
scored on only one PID-5-BF trait scale. The PID-5-BF
items come from the 220-item self-report PID-5. As in the
PID-5, each PID-5-BF item is rated on a 4-point scale (i.e.,
0 = very false or often false; 1 = sometimes or somewhat
false; 2 = sometimes or somewhat true; 3 = very true or
often true). Different from other versions of the PID-5, the
PID-5-BF yields a score for the overall measure (American
Psychiatric Association, 2013b).
Measure of Disordered Personality Functioning.  The Measure
of Disordered Personality Functioning (MDPF; Parker
et al., 2004) is a 20-item, Likert-type self-report question-
naire that has been explicitly designed to assess two broad
dimensions of personality dysfunction, namely, Non-Cop-
ing and Non-Cooperativeness. The MDPF provides 10
items assessing the Non-Coping dimension, and 10 items
assessing the Non-Cooperativeness dimension. Items are
simply summed to yield each dimension total score; on each
MDPF dimension, higher scores indicate higher levels of
personality dysfunction. Each MDPF item is measured on a
4-point scale (i.e., 0 = definitely false; 1 = mostly false; 2 =
mostly true; 3 = definitely true). Items are listed in the
MDPF in random order; 13 MDPF items are scored in
reversed order. The 20 items included in the MDPF came
from an original pool of 141 items that were selected and
reviewed by experienced clinicians to identify 17 constructs
historically defining personality dysfunction (Parker et al.,
2002). The final version of the MDPF was validated in both
nonclinical samples and clinical samples (Parker et al.,
2004) and is considered a reliable and valid self-report mea-
sure of personality dysfunction (Ro & Clark, 2013).
Although the MDPF does not explicitly assess Criterion A
of DSM-5 AMPD, it provides scores for two major dimen-
sions of personality dysfunction, namely, Non-Coping and
Non-Cooperativeness, which bear close resemblance to the
DSM-5 Criterion A constructs of self-dysfunction and inter-
personal dysfunction. Indeed, Criterion A from the DSM-5
AMPD defines the presence of a PD by the
degree of disturbance in self- and interpersonal functioning;
self-functioning involves identity and self-direction; inter-
personal functioning involves empathy and intimacy
(American Psychiatric Association, 2013a). For instance,
some of the MDPF items might be considered akin to empa-
thy (e.g. “I tend to be very understanding of other people’s
feelings and problems”), whereas other MDPF items are
more similar to self-direction construct (e.g. “I feel like I
am going around in circles in life”). MDPF items may be
easily administered to adolescent participants, with the pos-
sible exception of two Non-Cooperativeness items, “Even
when I have to, I am unable to get along with family or
people at work” and “People at work see me as cooperative
and agreeable”. To increase the adequacy of these items for
use of the MDPF with adolescents we rephrased them as
follows: “Even when I have to, I am unable to get along
with family or people at school” and “People at school see
me as cooperative and agreeable.”
Consistent with previous studies on adult participants
(e.g., Ro & Clark, 2013), in our adolescent sample the MDPF
Non-Coping (M = 10.25, SD = 5.19, Cronbach’s α = .79,
mean interitem correlation [MIC] = .28) and Non-
Cooperativeness (M = 8.33, SD = 4.10, Cronbach’s α = .74,
MIC = .22) scales showed adequate internal consistency reli-
ability in the whole sample, as well in the male subgroup
(Cronbach’s α = .78 for the MDPF Non-Coping scale, and
Cronbach’s α = .74 for the MDPF Non-Cooperativeness
scale) and in the female subgroup (Cronbach’s α = .79 for the
MDPF Non-Coping scale, and Cronbach’s α = .72 for the
MDPF Non-Cooperativeness scale). Marginally, according
to Fisher’s z test, no significant difference in MIC values for
MDPF Non-Coping scale (MIC female = .26, MIC male =
.28, z = −0.32, p > .50) and Non-Cooperativeness scale (MIC
female = .22, MIC male = .20, z = 0.31, p > .50) scores was
observed between male participants and female participant.
In the present study, female participants (M = 11.00, SD =
5.24) scored higher than male participants (M = 9.36, SD =
4.99) on the MDPF Non-Coping scale, t(875) = 4.57, p <
.001, d = 0.31, whereas male participants (M = 9.19, SD =

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6 Assessment 
4.16) scored higher than female participants (M = 7.60, SD =
3.80) on the MDPF Non-Cooperativeness scale, t(875) =
5.65, p <.001, d = 0.38. Finally, according to previous find-
ings (Parker et al., 2004; Ro & Clark, 2009), in our adoles-
cent sample, the MDPF Non-Coping and Non-Cooperativeness
scales were moderately intercorrelated (r = .32, p < .001).
Measure Translation Process
Participants were administered the PID-5-BF and the
MDPF in their Italian translation. The Italian translation of
the PID-5-BF was derived from the Italian translation of
the 220-item PID-5. The procedure of the translation PID-5
was detailed elsewhere (Fossati et al., 2013); equivalence
with the original meaning of the items was the guiding
principle in the translation process (Denissen, Geenen, van
Aken, Gosling, & Potter, 2008). First, the PID-5 was inde-
pendently translated into Italian by one of the authors
(A.F.), and by two other clinical psychologists who were
fluent in English. After reaching a consensus, we had an
English mother-tongue professional translator translate the
Italian version back into English, and this English back-
translation (Cha, Kim, & Erlen, 2007; Geisinger, 1994; van
De Vijver & Hambleton, 1996) was sent to the authors of
the PID-5. If the latest version differed from the English
original, the translators came to an agreement on the defin-
itive Italian translation. A similar procedure was followed
for translating the MDPF into Italian.
Procedures
Participants received the Italian translations of the instru-
ments. The questionnaires were administered in random
order and anonymously during class time in school by psy-
chology students when teachers were not present in the
classrooms. In order to be selected for the test–retest sub-
sample, participants were assigned by their respective
teachers an alphanumerical code based on their student
identification number; teachers were blind to adolescent
students’ questionnaire scores, and graduate psychology
students who administered and scored the questionnaires
were blind to participants’ identities.
Data Analyses
Cronbach’s alpha coefficient and mean interitem correla-
tion (MIC) were used to assess the internal consistency of
the scales; considering that the PID-5-BF items were mea-
sured on a four-point ordinal scale and showed a significant
multivariate kurtosis, z = 37.67, p < .001, polychoric corre-
lations coefficients were computed among the PID-5-BF
items. PID-5-BF item analyses were carried out according
to a multitrait paradigm (Nunnally & Bernstein, 1994),
which involved the computation of two distinct item-total
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correlation coefficients for each PID-5-BF item. PID-5-BF
item convergent validity was assessed through computation
of item–total correlations corrected for item–total overlap
(rit) between each item and the total score of the scale to
which the item was assigned. PID-5-BF item discriminant
validity was evaluated by correlating each PID-5-BF item
with the total score for the remaining four scales to which
the item was not assigned. Multitrait analysis determines
the extent to which items correlate more strongly with their
own domain than with other domains in the scale.
Differences in excess of twice the typical error of the cor-
1
relation coefficient—that is, 2 * ( ) —indicate the
N −3
strength of the association (e.g., Virtues-Ortega, Segui-
Duran, Descalzo-Quero, Carnerero, & Martin, 2010). In the
present study (N = 877), the critical value for a relevant dif-
ference was .07.
Intraclass r for absolute agreement based on random
effects one-way analysis of variance (ANOVA) were
used to evaluate the 2-month test–retest reliability of
PID-5-BF scores.
In the present study, we relied on a two-stage approach
to the assessment of the factor structure of the PID-5-BF.
First, we performed a dimensionality analysis of the PID-
5-BF item polychoric correlation matrix using differing cri-
teria in order to determine the number of factors underlying
the PID-5-BF item correlation matrix. Then, we performed
exploratory structural equation model (ESEM) analysis.1
Indeed, in recent literature, ESEM (Asparouhov & Muthén,
2009) has been suggested as a promising tool in personality
research, blending elements of confirmatory factor analysis
with those from exploratory factor analysis (Hopwood &
Donnellan, 2010; Marsh, Morin, Parker, & Kaur, 2014).
Rather than optimizing factor rotation to the characteristics
of the sample at hand, we used the a priori binary (i.e., 1s
and 0s) matrix of assignment of PID-5-BF items to scales
for oblique target rotation. Indeed, the use of target rotation
formalizes the view of ESEM as a primarily confirmatory
approach, as it allows the analyst much more a priori con-
trol on the expected factor structure (Marsh et al., 2014). In
line with previous studies of the PID-5 structure (e.g., De
Clercq et al., 2014), we used an oblique rotation allowing
the factors to be correlated. The replicability of the factor
structure across subsamples based on participants’ gender
was also assessed.
Differing criteria, consisting of Hull’s method
(Lorenzo-Seva, Timmerman, & Kiers, 2011; Wilderjans,
Ceulemans, & Meers, 2013) and parallel analysis (Buja &
Eyuboglu, 1992) were used for determining the number
of factors to be retained.
The logic behind Hull’s method is identifying a model
that optimally balances model goodness of fit/misfit and
model complexity (Wilderjans et al., 2013); recent Monte
Carlo data have shown the Hull method to be superior to
Fossati et al. 7
other methods in identifying the optimal number of factors
(Lorenzo-Seva et al., 2011). In the present study, the Hull
method was based on root mean square error of approxima-
tion (RMSEA). Parallel analysis contrasts each eigenvalue
of the real-data correlation matrix with the corresponding
average eigenvalue obtained from a large number (say,
≥1,000) random correlation matrices. Following Buja and
Eyuboglu’s (1992) suggestions, parallel analysis was based
on 1,000 independent polychoric correlation matrices that
were obtained by random permutations of the original data.
Monte Carlo studies showed parallel analysis to be one of
two methods most efficient for recovering the correct num-
ber of factors (Zwick & Velicer, 1986).
Weighted least square means and variance adjusted
(WLSMV) algorithm was used in ESEM analysis. Oblique
target rotation was used to rotate the ESEM factors. In order
to assess model fit, we calculated RMSEA, Tucker–Lewis
index (TLI), and comparative fit index (CFI) in addition to
goodness-of-fit chi-square test. Consistent with Hu and
Bentler’s (1999) indications, we used the following cutoff
values to evaluate the model fit: a TLI/CFI of .90 and
higher, and an RMSEA of .08 and lower are indications of
an adequate fit, while a TLI/CFI of .95 and higher and an
RMSEA of .05 and lower are indications of a good fit (but
see Marsh, Kit-Tai, & Zhonglin, 2004 for a comment on
these commonly applied cut-off values for assessing model
fit). To assess if a total score for the PID-5-BF items could
be structurally tenable, we also assessed a WLSMV ESEM
bifactor model with a general factor which all PID-5-BF
items were expected to load on, and five specific orthogonal
factors; bi-geomin orthogonal rotation was used to obtain
interpretable factors in bifactor analyses.
In the present study, we used multiple-group WLSMV
ESEM in order to test the replicability of the five-factor
structure of the PID-5-BF items across subgroups based on
participants’ gender. In particular, we tested the following
invariance models: (a) a configural invariance model with
invariant factor loading pattern and (b) a scalar invariance
model with invariant factor loadings and thresholds. The
DIFFTEST procedure was used to evaluate the presence of
significant differences in goodness-of-fit function between
nested models (Muthén & Muthén, 1998-2012). WLSMV
ESEM analyses were carried out using MPlus 7.3 (Muthén
& Muthén, 1998-2012).
Finally, multiple regression analyses were performed in
order to evaluate multivariate models in which the PID-
5-BF scores predicted the MDPF Non-Coping and Non-
Cooperativeness scale scores, respectively. Bivariate
correlations with Bonferroni-corrected (i.e., p < .005)
between PID-5-BF domain scales and MDPF dimensions
were used in order to select the initial set of predictors in
multiple regression analyses; the remaining PID-5-BF
scales were entered in Step 2 of the hierarchical regression
model in order to evaluate their possible significant role as
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predictors in the multivariate space. Change in adjusted R2
value was used as effect size measure; the variance inflation
factor (VIF) was computed in order to assess collinearity
(Cohen, Cohen, West, & Aiken, 2003). In all analyses, the
invariance of findings across subgroups based on gender
was formally assessed. The Hayes and Matthes (2009) pro-
cedure was used to detect significant interactions between
participants’ gender and each PID-5-BF scales in predicting
MDPF scale scores, holding the other PID-5-BF scales con-
stant; predictors and moderators were mean centered before
multiplication (Hayes, Glynn, & Huge, 2011).
Results
PID-5-BF Scale Descriptive and Reliability
Analysis Results
Descriptive statistics, Cronbach’s alpha and average MIC
values, and gender comparisons for the PID-5-BF scales are
listed in Table 1. According to Fisher’s z test, no significant
difference in MIC values for PID-5-BF scale and total
scores was observed between male participants and female
participants, minimum z value = −0.24 (Detachment), max-
imum z value = 0.57 (Antagonism), all ps > .50.
Although our adolescents participants scored on average
on the PID-5-BF scales in the 0.60 to 1.30 range, suggesting
that all PID-5-BF domains were usually very/often false or
sometimes/somewhat false for community-dwelling adoles-
cents, repeated-measures multivariate analysis of variance
(MANOVA) showed that in the whole sample the five PID-
5-BF domains scales did not yield equal average scores,
Pillai’s V = .52, p < .001; paired-sample t tests with
Bonferroni-corrected nominal significance level showed
that adolescent participants scored significantly higher on
Negative Affectivity than on all the other PID-5-BF scales,
whereas they scored significantly lower on Antagonism
than on all the remaining PID-5-BF scales. In our adoles-
cent sample, the average score on the PID-5-BF
Psychoticism domain scale was significantly lower than the
average score on the PID-5-BF Negative Affectivity domain
scale, but it was significantly higher than the average scores
on all the other PID-5-BF domain scales. This pattern was
somewhat reproduced across male and female subgroups,
although a significant gender-by-PID-5-BF scale interac-
tion was observed in repeated-measures MANOVA, Pillai’s
V = .18, p < .001.
With the partial exception of PID-5-BF Psychoticism
domain scale, r = −.09, p < .05, participants’ age correlated
trivially and nonsignificantly with all PID-5-BF scale score,
with r values ranging from −.04 (Disinhibition) to .06
(Negative Affectivity), all ps > .05.
On average, the five PID-5-BF scale scores were moder-
ately intercorrelated, median r value = .28, SD = .10, mini-
mum r value (Antagonism and Negative Affectivity) = .13,
8 Assessment 
maximum r value (Negative Affectivity and Psychoticism)
= .44, all ps < .001; correlation corrected for part–whole
overlap between PID-5-BF domain scale scores and PID-
5-BF total score were .42 for Negative Affectivity, .43 for
Detachment, .31 for Antagonism, .37 for Disinhibition, and
.55 for Psychoticism. This pattern of correlations among the
PID-5-BF domain scales was consistently replicated across
male subgroup, median r value = .31, SD = .09, minimum r
value = .15, maximum r value = .44, all ps < .001, and
female subgroup, median r value = .28, SD = .08, minimum
r value = .19, maximum r value = .40, all ps < .001.
Two-month test–retest reliability of the PID-5-BF scale
and total scores was assessed in a subsample of 42 adoles-
cents. In the test–retest subsample, the PID-5-BF Negative
Affectivity domain score at the baseline did not differ sig-
nificantly from PID-5-BF Negative Affectivity domain
score at retest, t(876) = −0.08, p > .10, d = −0.00; rather, the
intraclass correlation coefficient for absolute agreement
based on random effect one-way ANOVA (ρ1,1) was highly
significant, ρ1,1 = .78, p < .001. Similar results were observed
when we compared the PID-5-BF Detachment domain
score at the baseline and the PID-5-BF Detachment domain
score at retest, t(876) = −1.31, p > .10, d = −0.04, ρ1,1 = .92,
p < .001. Similarly, neither the PID-5-BF Antagonism
domain score at the baseline differ significantly from PID-
5-BF Antagonism domain score at retest, t(876) = 0.00, p >
.10, d = 0.00, ρ1,1 = .97, p < .001, nor the PID-5-BF
Disinhibition domain score at the baseline differ signifi-
cantly from PID-5-BF Disinhibition domain score at retest,
t(876) = −1.23, p > .10, d = −0.04, ρ1,1 = .96, p < .001. When
we considered the PID-5-BF Psychoticism domain score at
the baseline, it did not differ significantly from PID-5-BF
Psychoticism domain score at retest, t(876) = −0.26, p >
.10, d = −0.01, ρ1,1 = .92, p < .001. Finally, among the 42
adolescents who agreed to participate in the 2-month test–
retest study, no significant difference was observed between
the mean PID-5-BF total score at the baseline, and the mean
PID-5-BF total scores at follow-up, t(876) = −1.05, p > .10,
d = −0.04, ρ1,1 = .95, p < .001.
PID-5-BF item analysis results are summarized in Table
2. Considering that a large number of correlation coeffi-
cients (n = 125) were computed, the nominal significance
level (i.e., p <.05) was corrected according to the Bonferroni
procedure and set at p < .0004; r coefficients equal to or
greater than .12 were significant at p < .0004. In this study,
PID-5-BF item convergent validity was assessed through rit
coefficients. PID-5-BF item discriminant validity was eval-
uated by correlating each PID-5-BF item with the total
score for the remaining four scales to which the item was
not assigned. Differences between convergent validity coef-
ficients and discriminant validity coefficients in excess of
twice the typical error of the correlation coefficient indicate
the strength of the association (e.g., Virtues-Ortega et al.,
2010); in the present study the critical value for a relevant
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difference was .07. For instance, the item-total correlation
for item 8 is .40, therefore any discriminant validity coeffi-
cients greater than .33 would reflect poor discriminant
validity.
As it can be seen in Table 2, rit coefficients for the PID-
5-BF scales were significant and usually of moderate size,
with the exception of small rit values that were observed for
PID-5-BF Item 4 (“I often feel like nothing I do really mat-
ters,” Detachment) and Item 6 (“I’m not good at planning
ahead,” Disinhibition). Only 25 discriminant validity coef-
ficients did not reach statistical significance (i.e., they were
smaller than .12 in absolute value). A total of 19 (76.0%)
PID-5-BF items showed discriminant validity with the
other four scales. By contrast, Item 4, Item 6, Item 11 (“I get
stuck on one way of doing things, even when it’s clear it
won’t work,” Negative Affectivity), and Item 15 (“I get irri-
tated easily by all sorts of things,” Negative Affectivity)
showed rit values that were markedly (i.e., at least .07)
lower than one or more discriminant validity coefficients.
On average, PID-5-BF items showed moderate and sig-
nificant item-total correlations corrected for item–total
overlap with the PID-5-BF total score, median rit = .31, SD
= .10, minimum rit value (Item 18) = .18, maximum rit value
(Item 24) = .49, all ps < .001; rit values equal to or greater
than .30 were observed for 14 (56.0%) PID-5-BF items.
PID-5-BF ESEM Analysis Results
Dimensionality analyses consistently suggested that poly-
choric correlations that were observed among the PID-5-BF
items might be explained by five factors. The Hull method
based on minimizing RMSEA value (i.e., the ratio of the
goodness-of-fit measure to the number of estimated param-
eters) peaked at 1.20 for a three-factor model, 1.28 for a
four-factor model, 1.89 for a five-factor model, and 0.00 for
a six-factor model; according to the Hull method, a five-
factor model of the PID-5-BF items would provide the best
balance between goodness-of-fit and model complexity.
When the first five factors were extracted from the poly-
choric correlation matrix of the PID-5-BF items using ULS
EFA, the corresponding RMSEA value was .069. Parallel
analysis yielded similar findings. The first six eigenvalues
of the PID-5-BF items were 5.18, 2.64, 2.01, 1.41, 1.25, and
1.17, respectively; the first six average eigenvalues that
were computed from 1,000 random polychoric correlation
matrices that were obtained by random permutations of the
original data were 1.41, 1.35, 1.30, 1.26, 1.22, and 1.19,
respectively. According to parallel analysis results, only the
first five eigenvalues of the PID-5-BF item polychoric cor-
relation matrix exceeded the expected values of the corre-
sponding random eigenvalues. Parallel analysis results also
supported the hypothesis that five factors may adequately
explain the polychoric correlations that were observed
among the PID-5-BF items.
Fossati et al. 9

Table 2.  Personality Inventory for DSM-5 Brief Form (PID-5-BF) Item Analyses: Descriptive Statistics, Item–Total Correlations
Corrected for Item–Total Overlap, and Correlations Between Each PID-5-BF Item With the Total Score for the Scales to Which It
Was not Assigned (N = 877).

Personality Inventory for

DSM-5 Brief Form items M SD NA De A Di Ps r

Item 8, Negative Affectivity 1.59 1.00 .40* .16 –.05 .00 .20 .08
Item 9, Negative Affectivity 1.53 1.07 .43* .11 –.03 .10 .27 .11
Item 10, Negative Affectivity 1.12 1.06 .38* .15 .12 .13 .27 .14
Item 11, Negative Affectivity 1.31 0.91 .23 .15 .12 .20 .31 .17
Item 15, Negative Affectivity 1.00 0.91 .31 .38 .28 .27 .32 .30
Item 4, Negative Affectivity 1.21 1.02 .40 .13 .09 .23 .41 .32
Item 13, Detachment 0.77 0.89 .13 .29* .10 .02 .20 .11
Item 14, Detachment 0.28 0.65 .14 .31* .24 .09 .21 .17
Item 16, Detachment 0.88 0.88 .12 .35* .12 .06 .21 .12
Item 18, Detachment 0.83 0.91 .03 .25 .19 .05 .13 .09
Item 17, Antagonism 0.40 0.75 –.03 .23 .32* .17 .08 .12
Item 19, Antagonism 1.02 0.93 .18 .03 .23 .17 .16 .16
Item 20, Antagonism 0.69 0.90 .09 .17 .39* .11 .14 .13
Item 22, Antagonism 0.42 0.72 .10 .20 .50* .19 .16 .17
Item 25, Antagonism 0.37 0.69 .04 .17 .48* .25 .16 .16
Item 1, Disinhibition 0.99 0.96 .02 –.02 .20 .37* .19 .10
Item 2, Disinhibition 1.24 0.89 .21 .08 .14 .40* .20 .17
Item 3, Disinhibition 0.91 0.91 .23 .09 .18 .41* .27 .20
Item 5, Disinhibition 0.57 0.78 .04 .10 .23 .31* .17 .14
Item 6, Disinhibition 0.97 0.93 .17 .25 .09 .16 .18 .18
Item 7, Psychoticism 1.17 0.97 .35 .29 .12 .23 .44* .26
Item 12, Psychoticism 0.55 0.87 .24 .20 .16 .19 .38* .19
Item 21, Psychoticism 1.45 1.02 .33 .26 .17 .23 .54* .25
Item 23, Psychoticism 1.14 1.06 .30 .34 .10 .24 .48* .27
Item 24, Psychoticism 0.88 0.96 .28 .32 .20 .25 .52* .27
rit .38 .29 .39 .37 .48  

Note. NA = Negative Affectivity; De = Detachment; A = Antagonism; Di = Disinhibition; Ps = Psychoticism. Boldfaced entries indicate item–total
correlations corrected for item–total overlap; rit = median item-total correlation corrected for item-total overlap; r = median correlation between
item with the total score for the remaining four scales to which the item was not assigned. Correlation coefficient equal to or greater than .12 in
absolute value are significant at Bonferroni-corrected p-level (i.e., p < .0004). In the present study, the critical value for a relevant difference between
convergent validity (i.e., rit) coefficients and discriminant validity coefficients was .07: asterisk marks items whose rit values were greater than .07 than all
discriminant validity coefficients.

When we extracted the first five principal components
from the PID-5-BF polychoric correlation matrix, with the
partial exception of Item 18 (standardized loading = .28)
and Item 8 (standardized loading = .27), all other PID-5-BF
item showed substantial (i.e., >.30) loadings on the first
unrotated principal component, median standardized load-
ing value = .43, SD = .10, minimum standardized loading
value = .31 (Item 13), maximum standardized loading value
= .63 (Item 24). This finding was consistent with the pres-
ence of latent dimension common to all PID-5-BF items
along with group factors (Nunnally & Bernstein, 1994).
WLSMV ESEM results suggested adequate fit for a five-
factor model of PID-5-BF items, WLSMV χ2(185) = 419.13,
p < .001, RMSEA = .041, 95% confidence interval for
RMSEA = [0.036, 0.046], TLI = .92, CFI = .95. Most PID-
5-BF items showed a substantial degree of factor
complexity, showing significant factor loadings on two or
more WLSMV ESEM factors.
As it can be observed in Table 3, with the exception of
PID-5-BF item 11, all PID-5-BF items showed significant,
positive factor loadings on the factors which were assigned
to according to the PID-5-BF a priori model of item assign-
ment to scales. However, several PID-5-BF items did not
show their largest positive loading on their corresponding
expected factors; for instance, PID-5-BF Item 4, which was
expected to index the Detachment domain showed its larg-
est positive loading on the Negative Affectivity factor.
Similarly, PID-5-BF Item 5 (Disinhibition), Item 6
(Disinhibition), Item 11 (Negative Affectivity), Item 15
(Negative Affectivity), Item 19 (Antagonism), and even
Item 22 (Antagonism) did not show their largest positive
loading on their corresponding expected factors. All factor

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10 Assessment 

Table 3.  Personality Inventory for DSM-5 Brief Form: Exploratory Structural Equation Model Standardized Factor Loadings and
Factor Correlations (N = 877).

Personality Inventory for

DSM-5 Brief Form items NA De An Di Ps
Item 1, Disinhibition –.06 –.16*** .34*** .54*** .11*
Item 2, Disinhibition –.18*** .02 –.01 .82*** –.16**
Item 3, Disinhibition –.09 –.04 .06 .71*** .02
Item 4, Detachment .25*** .18*** –.19** .18*** .14*
Item 5, Disinhibition .12 .02 .32*** .30*** .07
Item 6, Disinhibition .04 .25*** –.05 .14** .01
Item 7, Psychoticism .21*** .17*** –.08 .08 .37***
Item 8, Negative Affect .31*** .17*** –.48*** .04 –.15*
Item 9, Negative Affect .27*** .08 –.46*** .16** –.05
Item 10, Negative Affect .41*** .04 –.20** .11* .01
Item 11, Negative Affect .09 .04 –.04 .24*** .21***
Item 12, Psychoticism .23*** .03 .06 .10* .41***
Item 13, Detachment –.08 .52*** –.05 –.15*** .12**
Item 14, Detachment .08 .70*** .13* –.13** .00
Item 15, Negative Affect .12* .46*** –.05 .32*** –.10*
Item 16, Detachment –.32*** .69*** –.08 .01 .08
Item 17, Antagonism .20** .29*** .55*** .08 –.06
Item 18, Detachment –.08 .42*** .11* –.03 .03
Item 19, Antagonism .29*** –.03 .21*** .17*** .03
Item 20, Antagonism .36*** .14** .40*** .02 .01
Item 21, Psychoticism .17* .03 –.02 .14*** .60***
Item 22, Antagonism .70*** .11** .71*** .00 –.04
Item 23, Psychoticism .00 .21*** –.11* .18*** .45***
Item 24, Psychoticism .09 .14*** .02 .19*** .49***
Item 25, Antagonism .50*** .07 .76*** .15** .01
Factor correlations
 NA —  
 De .34*** —  
 A –.34*** .07 —  
 Di .38*** .23*** –.10 —  
 Ps .23*** .30*** –.14 .34*** —

Note. NA = Negative Affectivity; De = Detachment; A = Antagonism; Di = Disinhibition; Ps = Psychoticism. Boldfaced entries indicate expected factor
loadings based on theoretical model of item assignment to scales.
*p <.05. **p < .01. ***p < .001.

correlations were in the small-to-moderate range, indicating
that the WLSMV ESEM factors represented non-isomor-
phic (e.g., separate) latent dimensions underlying the
observed polychoric correlations of the PID-5-BF items.
To test the factor structure invariance of PID-5-BF items
across subgroups based on participants’ gender, we per-
formed multi-group WLSMV ESEM analyses. First, we fit-
ted a model in which the pattern of factor loadings was
constrained to be invariant across groups (i.e., “configural”
invariance model). This model showed adequate values of
fit indices, WLSMV χ2(370) = 616.88, p < .001, TLI = .916,
CFI = .948, RMSEA = .039, test of close fit for RMSEA
(i.e., RMSEA ≤. 05) p > .90, supporting the hypothesis of
“configural” invariance. Then, we tested a “scalar” invari-
ance model to test the hypothesis of “strong factorial
invariance,” that is, a model with invariant factor loadings
and thresholds across subgroups based on participant’s gen-
der. We observed adequate values of fit statistics even for
the most restrictive model, WLSMV χ2(55) = 790.15, p <
.001, TLI = .933, CFI = .942, RMSEA = .035, test of close
fit for RMSEA (i.e., RMSEA ≤ .05) p > .90, even though
constraining thresholds across groups significantly wors-
ened the fit of the invariant model, DIFFTEST χ2(145) =
233.81, p < .001. Then, we could accept the hypothesis of
“configural” invariance of the PID-5-BF factor structure
across groups based on participants’ gender.
WLSMV ESEM bifactor analysis results suggested ade-
quate fit for a model assuming a general factor and five spe-
cific factors (as suggested by the current published scoring
guidelines) underlying the polychoric correlation matrix of

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Fossati et al. 11

Table 4.  Personality Inventory for DSM-5 Brief Form Scales and Total Scores as Predictors of Measure of Disordered Personality
Functioning Scales: Multiple Regression Analysis Results in the Whole Sample and Broken Down by Participants’ Gender (N = 877).

MDPF Non-Coping  

Whole sample Male participants Female participants

  (N = 877) (n = 406) (n = 471)  

PID-5-BF β β β VIF
  Negative Affectivity .28*** .21***a .31***a 1.28
 Detachment .20*** .15**a .23***a 1.28
 Antagonism –.07* –.10*a –.02a 1.13
 Disinhibition .21*** .20***a .23***a 1.17
 Psychoticism .15*** .20***a .13**a 1.49
Adjusted R2 .32*** 24***a .36***a  

PID-5-BF β β β VIF
a b
  Total Score .53*** .45*** .58*** 1.00
Adjusted R2 .28*** .20*** .33***  

MDPF Non-Cooperativeness

Whole sample Male participants Female participants

  (N = 877) (n = 406) (n = 471)  

PID-5-BF β β β VIF
Step 1  
 Detachment .19*** .23***a .19***a 1.31
 Antagonism .24*** .13*a .27***b 1.22
 Disinhibition .19*** .25***a .12*a 1.17
 Psychoticism .02 .03a .04a 1.58
Adjusted R2 .15*** .14*** .15***  
Step 2  
  Negative Affectivity –.18*** –.16**a –.13**a 1.31
Adjusted R2 .17*** .16*** .16***  

PID-5-BF β β β VIF
a a
  Total Score .26*** .29*** .28*** 1.00
Adjusted R2 .07*** .08*** .08***  

Note. PID-5-BF = Personality Inventory for DSM-5 Brief Form scales; VIF = variance inflation factor. Within each regression equation, β coefficients
with different superscripts were significantly different (i.e., interaction effect p < .05) in male participants and in female participants.
*p < .05. **p < .01. ***p < .001.

the PID-5-BF items, WLSMV χ2(165) = 350.15, p < .001,
RMSEA = .036, 95% confidence interval for RMSEA =
[0.031, 0.041], TLI = .94, CFI = .97; with the possible
exception of item 18 (standardized factor loading = .17), all
PID-5-BF items showed positive, moderate loadings on the
PID-5-BF general factor, median factor loading value = .40,
SD = .12.
Relationships Between the PID-5-BF Domain
and Total Scores and the MDPF
The PID-5-BF total score correlated significantly with
both MDPF Non-Coping, r = .53, p < .001, and
Non-Cooperativeness scale scores, r = .26, p < .001. All
PID-5-BF domain scales showed significant, positive
correlations with MDPF Non-Coping scales, with r val-
ues ranging from .11 (An) to .45 (NA), median r = .37,
SD = .14, all ps < .005. With the exception of PID-5-BF
NA scale, r = −.03, p > .30, all the remaining PID-5-
BF showed significant bivariate correlations with MDPF
Non-Cooperativeness scale, as it was indicated by r coef-
ficient values ranging from .13 (Ps) to .32 (An), median
r = .24, SD = .08, all ps <.001.
Multiple regression analysis results in the whole sample
and broken down by participants’ gender are summarized in
Table 4. The hypothesis of slope parallelism (i.e., equality of

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12 Assessment 
regression coefficients) in subgroups based on participants’
gender was tested using moderated regression analysis.
Although PID-5-BF NA scale did not show a significant
bivariate correlation with MDPF Non-Cooperativeness
scale, in multiple regression analyses it added a significant
contribution in predicting MDPF Non-Cooperativeness
scores when it was entered in Step 2 of a hierarchical multi-
ple regression model. VIF values did not suggest any col-
linearity problem for the PID-5-BF scales. As a whole, the
PID-5-BF scales and total scores predicted a significant and
nonnegligible amount of variance in the MDPF scales, par-
ticularly in the Non-Coping scale. As it can be observed in
Table 4, moderated regression analyses showed that the
majority of regression coefficients linking each PID-5-BF
scale to each MDPF dependent variables did not signifi-
cantly differ in male participants and in female participants.
Indeed, significant interaction effects (i.e., significant differ-
ences in β coefficient values) were observed only for PID-
5-BF Antagonism scale as predictor of MDPF
Non-Cooperativeness scale, gender-by-Antagonism scale
interaction b coefficient = 1.09, SE = 0.54, p < .05, and for
the PID-5-BF total score as predictor of the MDPF Non-
Coping scale, gender-by-PID-5-BF total score interaction b
coefficient = 2.46, SE = 0.84, p < .01.
Discussion
To our knowledge, this study represents the first attempt at
providing data on the psychometric properties of the PID-
5-BF, particularly in a sample of community-dwelling ado-
lescents. Our findings extended the results of previous
studies on the applicability of the PID-5 in adolescence (De
Clercq et al., 2014), supporting the hypothesis that also the
PID-5-BF may represent a reliable measure of the DSM-5
AMPD maladaptive domains. Confirming and extending
previous studies on the crosscultural applicability of the
PID-5 (e.g., Bastiaens et al., 2015) our results suggested
that the 25-item version of the PID-5 (i.e., the PID-5-BF)
could prove useful in capturing personality pathology, at
least in its Italian translation.
Our study yielded mixed results concerning the reliability
of the PID-5-BF scales and total score. On one hand, MIC
values were adequate according to conventional standards
(Clark & Watson, 1995) for all PID-5-BF scales, as well as
for PID-5-BF total score. On the other hand, Cronbach’s
alpha values were at best modest for PID-5-BF Detachment,
Negative Affectivity, and Disinhibition scales; Cronbach’s
alpha values greater than .70 were observed only for PID-
5-BF Antagonism and Psychoticism scales, and for the PID-
5-BF total score. However, it should be observed that
Cronbach’s alpha is an ambiguous indicator of internal con-
sistency because it is a function of the number of test items
and the MIC (Clark & Watson, 1995; Cortina, 1993;
Cronbach, 1951). Whereas the degree of interitem
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correlation is a direct indicator of internal consistency, the
number of items is not relevant (Clark & Watson, 1995).
Accordingly, in our study we observed adequate internal
consistency for all PID-5-BF scales, at least as it is measured
by the MIC, which is considered a straightforward measure
of internal consistency (Clark & Watson, 1995).
Despite the evidence of a significant effect of partici-
pants’ gender on the PID-5-BF scale scores in our sample,
fairly similar Cronbach’s alpha values were observed in
male participants and in female participants; this finding
suggests that the PID-5-BF scales may require different
norms for male adolescents and female adolescents while
maintaining the same internal consistency properties, at
least in a sample of Italian community-dwelling adoles-
cents. Moreover, the significant gender differences in PID-
5-BF domain average scores for Negative affectivity,
Detachment, Antagonism, and Psychoticism may be par-
ticularly important for the early identification and preven-
tion of PDs in adolescence. Indeed, identifying specific
gender differences in maladaptive personality domains may
be particularly important in order to prevent the clinical and
social burden that are frequently associated with personality
disorders diagnosis in adults (e.g., Michonski, Sharp,
Steinberg, & Zanarini, 2013). For instance, adolescent girls
appear to be at particularly high risk for Borderline
Personality Disorder features and their detrimental conse-
quences, and negative emotionality (i.e., high Negative
Affectivity) and poor impulse control (i.e., high
Disinhibition) are widely recognized in virtually all etio-
logical theories as early markers or precursors of Borderline
Personality Disorder (see, e.g., Stepp et al., 2014).
At first glance, our findings seem to suggest that PID-
5-BF scale may be too short (they list only five items) to
yield adequate Cronbach’s alpha coefficient values, with
the possible exception of Antagonism and Psychoticism
scales. However, the results of PID-5-BF item analyses in
our sample seem to suggest a different possible scenario.
With the exception of PID-5-BF Psychoticism scale, all
other scales showed one (i.e., 20.0%) or two (i.e., 40.0%) of
the items with poor convergent (i.e., item–total correlation
corrected for item–total overlap) and/or discriminant valid-
ity. The problem was particularly significant for PID-5-BF
Item 4 (“I often feel like nothing I do really matters,”
Detachment) and Item 6 (“I’m not good at planning ahead,”
Disinhibition). This finding suggests that the internal con-
sistency of the PID-5-BF scales could be improved by
selecting the five best performing PID-5 items for each
domain using item response theory, without necessarily
increasing scale length. It should be observed that this strat-
egy has been recently used by Maples and colleagues (2015)
in developing a 100-item version of the PID-5 which yields
scores both for DSM-5 AMPD traits and DSM-5 AMPD
domains. Moreover, a high MIC/alpha for the PID-5-BF
scales might be undesirable because it could indicate an
Fossati et al. 13
overrepresentation of one particular PID-5 trait of a domain
rather than a representative sampling consistent with the
goal of content validity.
In our study, we were able to evaluate the two-month
test-retest reliability of the PID-5-BF scores only in a
small subsample of adolescents who volunteered to par-
ticipate in the longitudinal part of the study; moreover,
this subsample was too small to allow for testing gender
effects on test–retest reliability coefficients. Even keep-
ing these limitations in mind, we would like to stress that
intraclass r coefficient values suggested adequate consis-
tency over 2 months of the scores for all PID-5-BF scales,
as well as for the PID-5-BF total score. As a whole, our
data suggest that the PID-5-BF total score is provided
with adequate internal consistency reliability and 2-month
test–retest reliability as a measure of overall personality
pathology. Despite mixed findings concerning Cronbach’s
alpha values, MIC values and 2-month test–retest reli-
ability results that were observed in our study suggest that
PID-5-BF scales may yield reliable scores purportedly
measuring the corresponding DSM-5 domains.
In our study, we observed moderate factor intercorrela-
tions (median r = .24) among the PID-5-BF scales. Our
findings seem to suggest that the 25-item version of the
PID-5 (i.e., the PID-5-BF) scale scores assess distinguish-
able constructs (i.e., Negative Affectivity, Detachment,
Antagonism, Disinhibition, Psychoticism). Although
moderate factor intercorrelation values that were observed
in our study hint at adequate discriminant validity of the
PID-5-BF trait scales, it should be observed that they
were somewhat smaller than previously reported correla-
tions among domains based on 220-item version and 100-
item version of the PID-5 (e.g., Maples et al., 2015). We
feel that these differences may stem from a number of
factors, such as sampling differences, participants’ age,
number of PID-5 items per factor, and method of factor
rotation. Future research may clarify which of these
potential explanations is most plausible.
Overall, our ESEM findings seem to support the factor
structure validity of the PID-5-BF, at least in our adoles-
cent sample, and seem to further stress the potential use-
fulness of refining the PID-5-BF selecting the five best
performing PID-5 items for each domain through IRT.
Indeed, this approach may allow for a more in-depth
examination of the properties of PID-5-BF items and their
relations with latent traits.
ESEM solutions are also valuable in the study of person-
ality (Booth & Hughes, 2014) because they allow advanced
analyses, such as investigating measurement invariance
(Marsh et al., 2010; Marsh et al., 2014). When we tested
multiple groups, the WLSMV ESEM factor structure of the
PID-5-BF items that was observed in our male subsample
could not be considered exactly equal (within sampling
error) to the PID-5-BF items factor structure that was
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observed in our female subsample in terms of absolute fit.
However, our findings seemed to indicate that the PID-5-BF
item factor structure that was observed in our male adoles-
cent subgroup closely matched the PID-5-BF factor struc-
ture that was observed in our female adolescent subgroup,
although the differences between corresponding sets of fac-
tor loadings may not be exactly zero in the population.
Finally, the PID-5-BF includes a total score intended to sum-
marize the overall profile elevation (American Psychiatric
Association, 2013b). Consistent with item analysis finding
and principal component analysis results, ESEM bi-factor
analysis data seemed to yield structural support to the use of
a general score for the PID-5-BF items, at least in a sample
of Italian community-dwelling adolescents.
External validity data for the PID-5-BF were somewhat
limited, but in our opinion still interesting. Indeed, in our
study we relied on the MDPF as a measure of level of per-
sonality dysfunction (Ro & Clark, 2009). The MDPF is a
personality functioning measure that was developed for use
in the context of personality disorder and personality traits
(Ro & Clark, 2009); limitations in coping and cooperative-
ness formed the higher order constructs defining personality
dysfunction (Parker et al., 2004).
Although the term personality functioning is not iso-
morphic with personality traits, measures of personality
functioning (e.g., the MDPF), and measures of personality
traits have common elements (Clark & Ro, 2014; Ro &
Clark, 2009). Consistent with our hypotheses, regression
analysis showed that the overall elevation of PID-5-BF
profile (i.e. the PID-5-BF total score) was a positive, sig-
nificant, and moderately strong predictor of the two MDPF
scale scores, at least in our adolescent sample. In particular,
the PID-5-BF total score predicted a moderate and non-
trivial amount of variance in the MDPF Non-Coping scale
score, and a less albeit significant amount of variance in
the Non-Cooperativeness scale.
Confirming and extending Zimmermann et al.’s (2015)
findings, our data suggested that self-dysfunction, as it was
operationalized in the MDPF Non-Coping scale, was most
consistently associated with self-report measures of maladap-
tive personality traits (i.e., PID-5-BF trait scores), at least in a
group of Italian community-dwelling adolescents. Indeed, the
PID-5-BF trait scales predicted a moderate amount of vari-
ance in the MDPF Non-Coping scale score, a measure which
bear close resemblance to the DSM-5 Criterion A constructs
of self-dysfunction. Specifically, in our study frequent and
intense experiences of high levels of negative emotions (i.e.
Negative Affectivity), an orientation toward immediate grati-
fication without regard for past learning (or consideration of
future consequences; i.e. Disinhibition), avoidance of socio-
emotional experience, and a tendency toward exhibiting cul-
turally incongruent or unusual behaviors and cognition (i.e.
Psychoticism) were the main predictor of MDPF Non-Coping
scale, in both male and female adolescents.
14 Assessment 
In agreement with our hypotheses, behaviors that put the
individual in disagreement with other people (i.e. high
Antagonism) and orientation toward immediate gratifica-
tion (i.e. high Disinhibition) significantly predicted the
MDPF Non-Cooperativess scale score, a measure which
was selected because of its close resemblance to the DSM-5
Criterion A construct of interpersonal dysfunction.
Moreover, high Detachment scale scores (i.e., avoidance of
socioemotional experience), and low Negative Affectivity
(i.e., frequent and intense experiences of high levels of neg-
ative emotions) scale score, significantly predicted a failure
to cooperate, at least as it is measured by the MDPF Non-
Cooperativess scale (Parker et al., 2004).
Although additional studies would be needed before
accepting our findings, our results seem to suggest that the
PID-5-BF scales assess maladaptive personality trait dimen-
sions that are related to the subjects’ level of personality
dysfunction, at least as measured by the MDPF scales. Our
findings appear to empirically support the hypothesis that
DSM-5 AMPD Criterion A constructs of self-dysfunction
and interpersonal dysfunction, at least as they are measured
by the MDPF scales, and DSM-5 AMPD Criterion B mal-
adaptive personality traits, at least as measured by the PID-
5-BF, are not isomorphic, and seemed to stress the
importance of considering both DSM-5 AMPD Criterion A
and Criterion B in the assessment of personality pathology.
Thus, although the PID-5-BF represents a short measure of
the broad DSM-5 AMPD maladaptive personality trait
dimensions, our data suggest that it may represent a useful
tool for screening for personality pathology among commu-
nity-dwelling adolescents, particularly when used in con-
junction with a “DSM-5 Criterion A–like” measure of level
of personality dysfunction such as the MDPF.
In summary, our findings suggest that the PID-5-BF has
several advantages since it proved to be an easy-to-admin-
ister screening instrument for pathological personality
domains. Moreover, the PID-5-BF total score might repre-
sent a tenable variable; indeed, its reliability coefficient
value was adequate, at least in our adolescent sample and it
was consistently associated with self-reports of levels of
impairments in self function and interpersonal function, at
least as they were operationalized in MDPF Non-Coping
and Non-Cooperativeness scales, respectively. For clinical
decision-making it should be emphasized that scores on the
PID-5-BF total score may be easily converted to dichoto-
mous evaluations (e.g., “possible maladaptive domain func-
tioning” vs. “no maladaptive domain functioning”), and it
may help in understanding why the overall score is elevated,
at a greater level of detail.
Despite positive findings, there are several limitations
that should be acknowledged. Although the current study
included a moderately large number of participants (N =
877), it was based on community-dwelling adolescents; our
sample represented a convenient study group rather than a
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sample representative of the Italian population. Moreover,
all participants in our study were community-dwelling ado-
lescents; thus, our findings should not be extended to ado-
lescents from clinical or forensic setting. In our study,
participants were adolescent volunteers who received no
incentive for taking part in the research; extant research
indicates that differences exist in the motivation between
paid and nonpaid research participants (Gerstein, Wilkeson,
& Anderson, 2004). However, research data offer conflict-
ing findings as to using incentives for participants (particu-
larly economic incentives) lead to improved commitment or
to biased findings (e.g., Grady, 2005). Interestingly, Russell,
Moralejo, and Burgess (2000) reported that most unpaid
volunteers disagreed with paying research participants; the
themes arising from their comments are similar to those that
have been raised by ethicists and suggest that recognizing
the time and effort of participants should receive greater
emphasis than presently occurs.
We used a single measure for each construct, which lim-
its the generalizability of our results to other measures. We
administered only the MDPF scale as a measure of impair-
ment included in Criterion A; although the MDPF was used
to assess personality functioning in previous studies (e.g.
Clark & Ro, 2014), our findings should not be extended to
other Criterion A measures, particularly to the Level of
Personality Functioning Scale (Bender, Morey, & Skodol,
2011). In our regression analyses we relied on self-report
measures to assess both predictive variables (i.e., the PID-
5-BF domain scales and total score) and criterion variables
(i.e., MDPF scales). Indeed, this may have led to a spurious
increase of the associations between the PID-5-BF trait and
total scores and the external measure because of shared
method variance.
As a whole, these limitations stress the need for further
replications and extensions before accepting our results.
Even keeping the limitations of our study in mind, we feel
that our findings may prove useful in providing the first evi-
dence of the reliability of the PID-5-BF as a brief screen for
personality pathology in community-dwelling adolescents,
at least in its Italian translation.
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 received no financial support for the research, author-
ship, and/or publication of this article.
Note
1. Confirmatory factor analysis results are reported as
Supplemental Material (available at http://asm.sagepub.com/
content/by/supplemental-data).
Fossati et al. 15
References
American Psychiatric Association. (1980). Diagnostic and statis-
tical manual of mental disorders (3rd ed.). Washington, DC:
Author.
American Psychiatric Association. (1994). Diagnostic and statis-
tical manual of mental disorders (4th ed.). Washington, DC:
Author.
American Psychiatric Association. (2013a). Diagnostic and statis-
tical manual of mental disorders (5th ed.). Washington, DC:
Author.
American Psychiatric Association. (2013b, June 15). Online
assessment measures: The Personality Inventory for DSM-
5–Brief Form (PID-5-BF)—Child Age 11–17. Retrieved from
http://www.psychiatry.org/practice/dsm/dsm5/online-assess-
ment-measures
Anusic, I., Schimmack, U., Pinkus, R. T., & Lockwood, P. (2009).
The nature and structure of correlations among Big Five rat-
ings: The Halo-Alpha-Beta model. Journal of Personality and
Social Psychology, 97, 1142-1156.
Asparouhov, T., & Muthén, B. (2009). Exploratory structural equa-
tion modeling. Structural Equation Modeling, 16, 397-438.
Bastiaens, T., Claes, L., Smits, D., De Clercq, B., De Fruyt, F.,
Rossi, G., . . . De Hert, M. (2015). The construct validity
of the Dutch Personality Inventory for DSM-5 Personality
Disorders (PID-5) in a clinical sample. Assessment. Advance
online publication. doi:10.1177/1073191115575069
Bender, D. S., Morey, L. C., & Skodol, A. E. (2011). Toward
a model for assessing level of personality functioning in
DSM-5. Part I: A review of theory and methods. Journal of
Personality Assessment, 93, 332-346.
Booth, T., & Hughes, D. J. (2014). Exploratory structural equation
modeling of personality data. Assessment, 21, 260-271.
Buja, A., & Eyuboglu, N. (1992). Remarks on parallel analysis.
Multivariate Behavioral Research, 27, 509-540.
Cha, E. S., Kim, K. H., & Erlen, J. A. (2007). Translation of scales
in cross-cultural research: issues and techniques. Journal of
Advance Nursing, 58, 386-395.
Clark, L. A. (2007). Assessment and diagnosis of personality
disorder: Perennial issues and emerging conceptualization.
Annual Review of Psychology, 58, 227-258.
Clark, L. A., & Ro, E. (2014). Three-pronged assessment and
diagnosis of personality disorder and its consequences:
Personality functioning, pathological traits, and psychoso-
cial disability. Personality Disorders: Theory, Research, and
Treatment, 5, 55-69.
Clark, L. A., & Watson, D. (1995). Constructing validity:
Basic issues in objective scale development. Psychological
Assessment, 7, 309-319.
Cohen, J. (1988). Statistical power analysis for the behavioral sci-
ences (2nd ed.). New York, NY: Academic Press.
Cohen, J., Cohen, P., West, S.G., & Aiken, L.S. (2003). Applied
multiple regression/correlation analysis for the behavioral
sciences (3rd ed.). Hillsdale, NJ: Lawrence Erlbaum.
Cortina, J. M. (1993). What is coefficient alpha? An examination
of theory and applications. Journal of Applied Psychology,
78, 98-104.
Cronbach, L. J. (1951). Coefficient alpha and the internal structure
of tests. Psychometrika, 16, 297-334.
Downloaded from asm.sagepub.com at UNIV CALIFORNIA SAN DIEGO on January 30, 2016
De Fruyt, F., & De Clercq, B. (2014). Antecedents of personality
disorder in childhood and adolescence: Toward an integrative
developmental model. Annual Review of Clinical Psychology,
10, 449-476.
Denissen, J. J., Geenen, R., van Aken, M. A., Gosling, S. D., &
Potter, J. (2008). Development and validation of a Dutch
translation of the Big Five Inventory (BFI). Journal of
Personality Assessment, 90, 152-157.
De Clercq, B., De Fruyt, F., De Bolle, M., Van Hiel, A., Markon,
K. E., & Krueger, R. F. (2014). The hierarchical structure and
construct validity of the PID-5 trait measure in adolescence.
Journal of Personality, 82, 158-169.
Few, L. R., Miller, J. D., Rothbaum, A. O., Meller, S., Maples,
J., Terry, D. P., . . . MacKillop, J. (2013). Examination of
the Section III DSM-5 diagnostic system for personality dis-
orders in an outpatient clinical sample. Journal of Abnormal
Psychology, 122, 1057-1069.
Fossati, A., Krueger, R. F., Markon, K. E., Borroni, S., & Maffei,
C. (2013). Reliability and validity of the Personality Inventory
for DSM-5 (PID-5) predicting DSM-IV personality disor-
ders and psychopathy in community-dwelling Italian adults.
Assessment, 20, 689-708.
Geisinger, K. F. (1994). Cross-cultural normative assessment:
Translation and adaptation issues influencing the norma-
tive interpretation of assessment instruments. Psychological
Assessment, 6, 304-312.
Gerstein, L. H., Wilkeson, D. A., & Anderson, H. (2004).
Differences in motivations of paid versus non-paid volun-
teers. Psychological Reports, 94, 163-175.
Grady, C. (2005). Payment of clinical research subjects. Journal
of Clinical Investigation, 115, 1681-1687.
Harkness, A. R., McNulty, J. L., & Ben-Porath, Y. S. (1995). The
Personality Psychopathology Five (PSY-5): Constructs and
MMPI-2 scales. Psychological Assessment, 7, 104-114.
Hayes, A. F., Glynn, C. J., & Huge, M. E. (2011). Cautions regard-
ing the interpretation of regression coefficients and hypoth-
esis tests in linear models with interactions. Communication
Methods and Measures, 6, 1-11.
Hayes, A. F., & Matthes, J. (2009). Computational procedures
for probing interactions in OLS and logistic regression: SPSS
and SAS implementations. Behavior Research Methods, 41,
924-936.
Hill, J., Fudge, H., Harrington, R., Pickles, A., & Rutter, M.
(2000). Complementary approaches to the assessment of per-
sonality disorder: The Personality Assessment Schedule and
Adult Personality Functioning Assessment compared. British
Journal of Psychiatry, 176, 434-438.
Hopwood, C. J., & Donnellan, M. B. (2010). How should the
internal structure of personality inventories be evaluated?
Personality and Social Psychology Review, 14, 332-346.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes
in covariance structure analysis: Conventional criteria versus
new alternatives. Structural Equation Modeling, 6, 1-55.
Klimstra, T. A., Hale, W. W., III, Raaijmakers, Q. A. W., Branje,
S. J. T., & Meeus, W. H. J. (2009). Maturation of personality
in adolescence. Journal of Personality and Social Psychology,
96, 898-912.
Krueger, R. F., & Markon, K. E. (2014). The role of the DSM-5
personality trait model in moving toward a quantitative and
16 Assessment 
empirically based approach to classifying personality and
psychopathology. Annual Review of Clinical Psychology, 10,
477-501.
Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol,
A. E. (2012). Initial construction of a maladaptive personal-
ity trait model and inventory for DSM-5. Psychological
Medicine, 42, 1879-1890.
Lahey, B. B., Applegate, B., Hakes, J. K., Zald, D. H., Hariri, A.
R., & Rathouz, P. J. (2012). Is there a general factor of preva-
lent psychopathology during adulthood? Journal of Abnormal
Psychology, 121, 971-977.
Livesley, W. J., & Jang, K. L. (2000). Toward an empirically based
classification of personality disorder. Journal of Personality
Disorders, 14, 137-151.
Livesley, W. J., & Jang, K. L. (2005). Differentiating normal,
abnormal, and disordered personality. European Journal of
Personality, 19, 257-268.
Lorenzo-Seva, U., Timmerman, M. E., & Kiers, H. A. L. (2011).
The Hull method for selecting the number of common factors.
Multivariate Behavioral Research, 46, 340-364.
Maples, J. L., Carter, N. T., Few, L. R., Crego, C., Gore, W. L.,
Samuel, D. B., . . . Miller, J. D. (2015). Testing whether the
DSM-5 personality disorder trait model can be measured with
a reduced set of items: An item response theory investiga-
tion of the Personality Inventory for DSM-5. Psychological
Assessment. Advance online publication. doi:10.1037/
pas0000120
Markon, K. E., Quilty, L. C., Bagby, R. M., & Krueger, R. F.
(2013). The development and psychometric properties of an
informant-report form of the personality inventory for DSM-5
(PID-5). Assessment, 20, 370-383.
Marsh, H. W., Kit-Tai, H., & Zhonglin, W. (2004). In search of
golden rules: comment on hypothesis-testing approaches to
setting cutoff values for fit indexes and dangers in overgener-
alizing Hu and Bentler’s (1999) findings. Structural Equation
Modeling, 11, 320-341.
Marsh, H. W., Lüdtke, O., Muthén, B., Asparouhov, T., Morin,
A. J. S., Trautwein, U., & Nagengast, B. (2010). A new look
at the Big-Five factor structure through exploratory structural
equation modeling. Psychological Assessment, 22, 471-491.
Marsh, H. W., Morin, A. J., Parker, P. D., & Kaur, G. (2014).
Exploratory structural equation modeling: An integration of
the best features of exploratory and confirmatory factor analy-
sis. Annual Review of Clinical Psychology, 10, 85-110.
Marsh, H. W., Nagengast, B., & Morin, A. J. (2013). Measurement
invariance of Big-Five factors over the life span: ESEM tests
of gender, age, plasticity, maturity, and La Dolce Vita effects.
Developmental Psychology, 49, 1194-1218.
Michonski, J. D., Sharp, C., Steinberg, L., & Zanarini, M. C.
(2013). An item response theory analysis of the DSM-IV
borderline personality disorder criteria in a population-based
sample of 11- to 12-year-old children. Personality Disorders:
Theory, Research, and Treatment, 4, 15-22.
Morey, L. C., Berghuis, H., Bender, D. S., Verheul, R., Krueger,
R. F., & Skodol, A. E. (2011). Toward a model for assessing
level of personality functioning in DSM-5. Part II: Empirical
articulation of a core dimension of personality pathology.
Journal of Personality Assessment, 93, 347-353.
Downloaded from asm.sagepub.com at UNIV CALIFORNIA SAN DIEGO on January 30, 2016
Muthén, L. K., & Muthén, B. O. (1998-2012). MPlus user’s guide
(7th ed.). Los Angeles, CA: Muthén & Muthén.
Noblin, J. L., Venta, A., & Sharp, C. (2013). The validity of
the MSI-BPD among inpatient adolescents. Assessment, 21,
210-217.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory
(3rd ed.). New York, NY: McGraw-Hill.
Parker, G., Both, L., Olley, A., Hadzi-Pavlovic, D., Irvine, P., &
Jacobs, G. (2002). Defining disordered personality function-
ing. Journal of Personality Disorders, 16, 503-522.
Parker, G., Hadzi-Pavlovic, D., Both, L., Kumar, S., Wilhelm,
K., & Olley, A. (2004). Measuring disordered personality
functioning: To love and to work reprised. Acta Psychiatrica
Scandinavica, 110, 230-239.
Patel, A. B., Sharp, C., & Fonagy, P. (2011). Criterion validity of
the MSI-BPD in a community sample of women. Journal of
Psychopathology and Behavioral Assessment, 33, 403-408.
Pincus, A. L. (2011). Some comments on nomology, diagnostic
process, and narcissistic personality disorder in the DSM-5
proposal for personality and personality disorders. Personality
Disorders: Theory, Research, and Treatment, 2, 41-53.
Ro, E., & Clark, L. A. (2009). Psychosocial functioning in the
context of diagnosis: Assessment and theoretical issues.
Psychological Assessment, 21, 313-324.
Ro, E., & Clark, L. A. (2013). Interrelation between psychosocial
functioning and adaptive- and maladaptive-range personality
traits. Journal of Abnormal Psychology, 122, 822-835.
Russell, M. L., Moralejo, D. G., & Burgess, E. D. (2000). Paying
research subjects: Participants’ perspectives. Journal of
Medical Ethics, 26, 126-130.
Skodol, A. E. (2014). Personality disorder classification: stuck in
neutral, how to move forward? Current Psychiatry Reports,
16, 1-10.
Sharp, C., & Bleiberg, E. (2007). Borderline personality disorder
in children and adolescents. In A. Martin & F. Volkmar (Eds.),
Lewis’ child and adolescent psychiatry: Comprehensive text-
book (pp. 680-691). Baltimore, MD: Lippincott Williams &
Wilkins.
Stepp, S. D., Whalen, D. J., Scott, L. N., Zalewski, M., Loeber, R.,
& Hipwell, A. E. (2014). Reciprocal effects of parenting and
borderline personality disorder symptoms in adolescent girls.
Development and Psychopathology, 26, 361-378.
Suzuki, T., Samuel, D. B., Pahlen, S., & Krueger, R. F. (2015).
DSM-5 alternative personality disorder model traits as mal-
adaptive extreme variants of the five-factor model: An item-
response theory analysis. Journal of Abnormal Psychology,
124, 343-354.
Trull, T. J., & Durrett, C. A. (2005). Categorical and dimensional
models of personality disorder. Annual Review of Clinical
Psychology, 1, 355-380.
Tyrer, P., Crawford, M., Mulder, R., Blashfield, R., Farnam,
A., Fossati, A., . . . Reed, G. M. (2011). The rationale for
the reclassification of personality disorder in the 11th revi-
sion of the International Classification of Diseases (ICD-11).
Personality and Mental Health, 5, 246-259.
van de Vijver, F. J. R., & Hambleton, R. K. (1996). Translating
tests: Some practical guidelines. European Psychologist, 1,
89-99.
Fossati et al. 17

Virtues-Ortega, J., Segui-Duran, D., Descalzo-Quero, A.,
Carnerero, J. J., & Martin, N. (2010). Caregivers’ agreement
and validity of indirect functional analysis: A cross-cultural
evaluation across multiple problem behavior topographies.
Journal of Autism and Developmental Disorders, 41, 82-91.
Wakefield, J. C. (2008). The perils of dimensionalization:
Challenges in distinguishing negative traits from personality
disorders. Psychiatric Clinics of North America, 31, 379-393.
Widiger, T. A., & Simonsen, E. (2005). Alternative dimensional
models of personality disorder: Finding a common ground.
Journal of Personality Disorders, 19, 110-130.
Widiger, T. A., & Trull, T. J. (2007). Plate tectonics in the classifica-
tion of personality disorder. American Psychologist, 62, 71-83.
Wilderjans, T. F., Ceulemans, E., & Meers, K. (2013). CHull: A
generic convex-hull- based model selection method. Behavior
Research Methods, 45, 1-15.
Wright, A. G., & Simms, L. J. (2014). On the structure of person-
ality disorder traits: Conjoint analyses of the CAT-PD, PID-5,
and NEO-PI-3 trait models. Personality Disorders: Theory,
Research, and Treatment, 5, 43-54.
Wright, A. G., Thomas, K. M., Hopwood, C. J., Markon, K. E.,
Pincus, A. L., & Krueger, R. F. (2012). The hierarchical
structure of DSM-5 pathological personality traits. Journal of
Abnormal Psychology, 121, 951-957.
Zimmermann, J., Böhnke, J. R., Eschstruth, R., Mathews, A.,
Wenzel, K., & Leising, D. (2015). The latent structure of per-
sonality functioning: Investigating Criterion A from the alter-
native model for Personality Disorders in DSM-5. Journal of
Abnormal Psychology, 124, 532-548.
Zwick, W. R., & Velicer, W. F. (1986). Factors influencing five
rules for determining the number of components to retain.
Psychological Bulletin, 99, 432-442.

Downloaded from asm.sagepub.com at UNIV CALIFORNIA SAN DIEGO on January 30, 2016