Una versión reducida y modificada del Inventario de Personalidad para el DSM-5 (PID-5) en la Argentina / A reduced and modified version of the Personality Inventory for the DSM-5 (PID-5) in Argentina

Resumen El modelo dimensional alternativo para los trastornos de personalidad incluye 25 facetas (rasgos patológicos) organizadas en cinco dominios de orden superior (Desapego, Afectividad Negativa, Psicoticismo, Antagonismo y Desinhibición). Para evaluar este modelo, se desarrolló el Personality Inventory for DSM-5 (PID-5), que posee dos versiones: una extensa (220 ítems) que evalúa dominios y facetas, y una breve (25 ítems) que evalúa solo los dominios. En un trabajo anterior, se brindó evidencia favorable para una versión breve (31 ítems) adaptada para ser utilizada en población argentina. En el presente trabajo se estudian las propiedades psicométricas de una versión reducida y modificada del PID-5 que permite evaluar ambos componentes por medio de una cantidad de ítems (108). La validez convergente se evaluó a través de la relación con una medida de rasgos de personalidad normal del Modelo de los Cinco Grandes Factores. Se trabajó con una muestra de tipo no probabilística de n = 525 sujetos de población general, que respondieron la versión adaptada del PID-5 y el Listado de Adjetivos para Evaluar la Personalidad. Los resultados brindaron evidencia de validez y confiabilidad para el instrumento. El Análisis Factorial Exploratorio y Confirmatorio sugirió un buen ajuste de la estructura pentafactorial. La consistencia interna resultó adecuada y los ítems presentaron buenos índices de discriminación. Se observaron diferencias de género y edad, y correlaciones con los factores correspondientes de los cinco grandes. Esta versión puede ser utilizada para evaluar el modelo, con fines tanto clínicos como de investigación, y con ventajas respecto al tiempo de administración respecto a la versión extensa original.

Abstract The official classification of personality disorders in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) remains categorical. However, a dimensional alternative for personality disorders is presented as an emerging model. The model is organized in five higher order domains (Negative Affectivity, Detachment, Antagonism, Disinhibition and Psychoticism), with relationships with the Big Five Model of Personality, strongly established within the Personality Psychology. The proposal also includes 25 facets or second-order traits, included within the main domains. Domains and facets represent psychopathological traits with clinical relevance. To assess this model, the Personality Inventory for DSM-5 (PID-5) was developed. PID-5 has two forms: extensive (220 items) that assesses domains and facets, and brief (25 items) that assesses only the domains. In a previous study, evidence for a short version (31 items) adapted to the Argentine population was provided, that overcomes some of the limitations of the original one. In this work, the psychometric properties of a reduced and modified version of the PID-5 are studied, which allows evaluating five domains and 25 facets, through a reduced number of items (108). We worked with a non-probabilistic sample of n = 525 subjects from the general population, who answered the adapted version of the PID-5 and the Adjectives Checklist to Assess the Big Five Personality Factors (AEP), a Big Five Model measure. The following data analyses were performed: (1) Exploratory and Confirmatory Factor Analysis to evaluate the internal structure of PID-5; (2) reliability analysis to assess the internal consistency of the PID-5 scales; (3) item analysis to assess discriminating power; (4) multivariate analysis of variance (MANOVA) to examine significant differences due to gender and age; and (5) bivariate correlation analysis to analyze PID-5 convergent validity. The results provided evidence of validity and reliability. Exploratory and Confirmatory Factor Analysis suggested a five-factor structure. The facets presented factor loadings in the domain theoretically expected, with some exceptions: Suspiciousness (loaded in Psychoticism), Hostility (loaded in Disinhibition), Depressivity (loaded in Detachment) and Insensitivity (loaded in Detachment). CFA also suggested a good model fit (CFI = .98; RMSEA = .04; SRMR = 0.083). Psychoticism, Detachment, and Disinhibition facets had their higher factor loadings in the expected domain. Negative affectivity showed higher correlations with the rest of the scales. Internal consistency was satisfactory, especially at the domain level, and the items had good discrimination indices. Correlations with the corresponding of the Big Five factors were observed, similar to previous studies. The five PID-5 domains were also found positively correlated. Additionally, gender and age differences were found. In line with previous literature, results suggest that some facets scales are "pure" markers of these domains (e. g., Psychoticism and Antagonism facets), whereas others (e. g., Negative Affectivity facets such as Depressiveness, Suspicion, Hostility), are located "in between" domains since they share features of more than one domain. Psychoticism facets presented higher loadings in their domains and lower in the rest. This is not surprising; although most of psychopathology cannot be understood as categories, schizophyte and Schizotypal Personality Disorder are exceptions, and Psychoticism would be the representation of these categories in the APA model. Findings also provide evidence of convergent validity for the instrument, as well as theorical evidence regarding the relationship between normal and pathological personality traits. This version can be used to evaluate the model, both in research and clinical practice. It has advantages over the original longer version, in terms of administration time and participants' fatigue, while maintaining its psychometric properties. The results are also expected to contribute to the recent literature on the dimensional approach to personality psychopathology. However, complementary studies, particularly with a clinical population, are needed.

Evaluación fenotípica del Trastorno por Déficit de Atención e Hiperactividad (TDAH): existencia de un continuo de gravedad en niños / Phenotypic evaluation of Attention Deficit Hyperactivity Disorder (ADHD): existence of a continuum of severity in children

Resumen: Antecedentes: Dentro del estudio de la estructura del TDAH existe un debate en curso sobre si las diferencias fenotípicas se deben a diferencias en la gravedad de los síntomas de falta de atención, hiperactividad e impulsividad a lo largo de un continuo subyacente o si las diferencias lo que reflejan son subtipos cualitativamente distintos con etiologías únicas. Objetivo: Analizar si los comportamientos de inatención, hiperactividad e impulsividad en población infantil reflejan presentaciones cualitativamente distintas dentro del TDAH, variaciones a lo largo de un único continuo de gravedad o diferentes niveles de gravedad dentro de las representaciones. Método: Se llevó a cabo un estudio a través de análisis factorial confirmatorio (AFC), análisis de clases latentes (ACL) y modelos factoriales mixtos (MFM) del fenotipo del TDAH según los datos recogidos mediante el inventario de comportamiento infantil y adolescente (CABI) de 632 participantes (M=10,46 años; DT=2,35) de la ciudad de Talca (Chile) en población general. Resultados: De los 16 modelos analizados se infirió que el MFM de tres factores (IN, HI e IM) y cuatro clases, una mayoritaria de puntación baja (no afectados) y otra minoritaria de puntuación alta (afectados), junto con dos categorías intermedias muy similares, mostraba el mejor ajuste. Conclusiones: Los MFM mostraron que el TDAH variaría a lo largo de un continuo de gravedad, dentro de los síntomas del trastorno de leves, a moderados o graves, en lugar de existir como categorías discretas de diagnóstico.

Abstract: Background: Within the study of the structure of ADHD there is an ongoing debate as to whether phenotypic differences are due to differences in the severity of symptoms of inattention, hyperactivity, and impulsivity along an underlying continuum or whether the differences reflect are qualitatively distinct subtypes with unique etiologies. Objective: To analyze whether the behaviors of inattention, hyperactivity and impulsivity in children reflect qualitatively different presentations within ADHD, variations along a single continuum of severity or different levels of severity within the representations. Method: A study was carried out through confirmatory factor analysis (CFA), latent class analysis (LCA) and factor mixture models (FMM) of the ADHD phenotype according to the data collected through the Child and Adolescent Behavior Inventory (CABI) of 632 participants (M = 10.46 years; SD = 2.35) from the city of Talca (Chile) in general population. Results: For the 16 models analyzed, it was inferred that the MFM of three factors (IN, HI and IM) and four classes, a majority with a low score (unaffected) and a minority with a high score (affected), with two very similar intermediate categories, showed the best fit. Conclusions: The FMM showed that ADHD would vary along a continuum of severity, within symptoms of the disorder from mild, to moderate, or severe, rather than existing as discrete diagnostic categories.

Development of the Dimensional Clinical Personality Inventory - avoidant version based on the HiTOP / Desenvolvimento do Inventário Dimensional Clínico da Personalidade - versão evitativo baseado no HiTOP / Desarrollo del Inventario Dimensional Clínico de la Personalidad - versión evitativa basada en el HiTOP

This study aimed to develop a specific version of the Dimensional Clinical Personality Inventory 2 (IDCP-2), focused on the assessment of avoidant personality disorder (AvPD) according to the Hierarchical Taxonomy of Psychopathology (HiTOP). First, we developed the IDCP-Av, composed of one new factor and four factors from the IDCP-2. A total of 436 adults completed this, and two external measures (PID-5 and FFAvA). The IDCP-Av factors and its total score presented high reliability. Correlations and group comparisons were coherent, corroborating expectations. Favorable evidence was observed for the use of the IDCP-Av for the measurement of AvPD, although future studies should replicate the findings in samples composed of patients.(AU)

O objetivo deste estudo foi desenvolver uma versão específica do Inventário Dimensional Clínico da Personalidade 2 (IDCP-2), focada na avaliação do transtorno da personalidade evitativo (TPE) de acordo com o Hierarchical Taxonomy of Psychopathology (HiTOP). Primeiro foi desenvolvido o IDCP-Av, composto por um novo fator e quatro fatores do IDCP-2. 436 adultos responderam-no, além de medidas externas (PID-5 e FFAvA). Os fatores do IDCP-Av e o escore total apresentaram alta precisão. Correlações e comparações entre grupos foram coerentes e corroboraram as expectativas. Evidências favoráveis foram observadas para o uso do IDCP-Av para avaliação do TPE, embora futuros estudos devem tentar replicar os achados em amostras compostas por pacientes.(AU)

El objetivo de este estudio fue desarrollar una versión específica del Inventario Dimensional Clínico de la Personalidad 2 (IDCP-2), centrado en la evaluación del trastorno de la personalidad evitativa (TPE) de acuerdo con el Hierarchical Taxonomy of Psychopathology (HiTOP). Primeramente se desarrolló el IDCP-Av, compuesto por un nuevo factor y por cuatro factores del IDCP-2. 436 adultos lo contestaron juntamente con medidas externas (PID-5 y FFAvA). Los factores IDCP-Av y su puntuación total presentaron una alta fiabilidad. Las correlaciones y las comparaciones de los grupos fueron coherentes, corroborando con las expectativas. Se observaron evidencias favorables para el uso del AvPD-Av para evaluar el TPE. Sin embargo, estudios posteriores deberían replicar los hallazgos presentes en muestras compuestas por pacientes.(AU)

Personality Types and Personality Traits in DSM-5: Do They Really Match? / Tipos e Traços de Personalidade no DSM-5: Eles Realmente Combinam?

Abstract The alternative model of personality disorders introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders provides a diagnostic system that is expected to correspond to the well-known categorical approach of personality disorder diagnoses. The current study aims to improve knowledge about the relationship between pathological personality traits and their corresponding personality types. A Brazilian sample of 1,162 people took part in this study. The results point to some level of continuity between the two models when the variables were treated as dimensional. Contrariwise, there is a lack of strong scientific evidence to justify the maintenance of the categorical approach. We recommend the exclusion of the categorical approach from personality disorder diagnosis systems.

Resumo O modelo alternativo de transtornos da personalidade introduzido na quinta edição do Manual Diagnóstico e Estatístico de Transtornos Mentais oferece um sistema diagnóstico que supostamente deve corresponder ao bem conhecido modelo de diagnóstico categórico dos transtornos da personalidade. O presente estudo tem por objetivo incrementar os conhecimentos sobre a relação entre os traços de personalidade e seus correspondentes tipos de personalidade. Uma amostra brasileira de 1.162 pessoas participou deste estudo. Os resultados indicaram algum nível de continuidade entre os dois modelos quando as variáveis foram consideradas dimensionais. Por outro lado, existe uma falta de evidência científica que justifique a manutenção da abordagem categórica. Recomenda-se a exclusão da abordagem categórica de sistemas diagnósticos de transtornos da personalidade.

Importancia diferencial de los componentes fundamentales de la esquizotipia: un metaanálisis / Differential importance of the basic components of schizotypy: A meta-analysis

Resumen La esquizotipia puede entenderse como un trastorno incluido en el espectro de la esquizofrenia o como rasgo psicométrico que comprende 3 dimensiones: cognitivo-perceptual, interpersonal y desorganización cognitiva. La primera se relaciona con creencias extrañas y experiencias perceptuales inusuales; la segunda, con anhedonia y déficit en relaciones interpersonales, y la desorganización se identifica con pensamientos, conductas y lenguaje raros. Diferentes estudios han intentado esclarecer cuál de estas dimensiones es el componente esencial del constructo. Para dar respuesta a esta cuestión se llevó a cabo un metaanálisis en el que se realizó una revisión sistemática de las principales bases de datos que comparan las dimensiones de esquizotipia asociadas con diferentes áreas temáticas: composición factorial, síntomas clínicos y marcadores de vulnerabilidad. A partir de 300 artículos encontrados, se seleccionaron 27 estudios. Los resultados indicaron que la dimensión interpersonal parece estar más relacionada con la sintomatología clínica, mientras que la dimensión cognitivo-perceptual predomina en la investigación sobre marcadores de vulnerabilidad. La desorganización cognitiva contribuye a ambas temáticas. Se concluye que las dimensiones de esquizotipia tienen una importancia diferencial en función de las áreas de funcionamiento psicológico en estudio.

Abstract Schizotypy can be understood as a disorder included in the schizophrenia spectrum or as a psychometric trait that includes three factors: cognitive-perceptual, interpersonal, and disorganized. The first relates to strange beliefs and unusual perceptual experiences; the second, with anhedonia and deficits in interpersonal relationships, and the third, disorganisation, is identified with strange thoughts, behaviors, and language. Several studies have attempted to clarify which of these dimensions is more relevant when predicting the construct. To answer this question, a meta-analysis was conducted using a systematic review of the major databases comparing schizotypy dimensions associated with different categories: structure, health, and vulnerability markers. A total of 27 studies were selected from 300 items found. The results indicate that the interpersonal dimension seems to be related to clinical symptoms, while the cognitive-perceptual dimension dominates research on vulnerability markers. Cognitive disorganization contributes to both topics. It is concluded that the dimensions of schizotypy have a differential importance in terms of the areas of psychological functioning under study.