Additional evidence for a quantitative hierarchical model of mood and anxiety disorders for DSM-V: the context of personality structure.

Recent progress toward the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders includes a proposed quantitative hierarchical structure of internalizing pathology with substantial, supportive evidence (D. Watson, 2005). Questions about such a taxonomic shift remain, however, particularly regarding how best to account for and use existing diagnostic categories and models of personality structure. In this study, the authors use a large sample of psychiatric patients with internalizing diagnoses (N = 1,319) as well as a community sample (N = 856) to answer some of these questions. Specifically, the authors investigate how the diagnoses of obsessive-compulsive disorder (OCD) and bipolar disorder compare with the other internalizing categories at successive levels of the personality hierarchy. Results suggest unique profiles for bipolar disorder and OCD and highlight the important contribution of a 5-factor model of personality in conceptualizing internalizing pathology. Implications for personality-psychopathology models and research on personality structure are discussed.