NRSA Fellowship for Joshua Oltmanns: A Longitudinal Investigation of Maladaptive Personality Traits as Reported by the Self and Others in the Prediction of Physical Health

Compared to traditional DSM personality disorder (PD) diagnostic categories, dimensional representations of PD provide a more comprehensive framework from which to understand and conceptualize maladaptive personality functioning (Clark, 2007; Widiger & Trull, 2007), consistent with the RDoC emphasis on dimensional models relative to traditional DSM syndromes. The five-factor model (FFM) of personality is widely regarded as the leading dimensional model of personality, and is supported by an extensive amount of empirical support spanning over 30 years. The FFM consists of 30 lower-order facet scales (as conceptualized by McCrae and Costa, 2003) from which both high and low levels can be used to describe PD. FFM descriptions of PD have been shown to account for the variance of all ten categorical DSM PD types (Livesley, 2001; Miller, 2012). In addition, personality science has demonstrated that "normal" range domains and facets of the FFM significantly predict disease and mortality (Friedman & Kern, 2014; Smith & Mackenzie, 2006). However, symptoms of personality disorder have even larger associations with health outcomes (Gleason, Weinstein, Balsis, & Oltmanns, 2014). Recently, FFM-based dimensional measures of PD have been developed (Widiger, Lynam, Miller, & Oltmanns, 2012), providing an exciting opportunity to measure PD within the comprehensive framework of the FFM. The present line of research will incorporate this novel analytic and conceptual approach into an ongoing longitudinal study with a representative sample of 1,630 older adults in the St. Louis area. FFM-PD measures of neuroticism, conscientiousness, and extraversion (the Five-Factor Borderline, Obsessive-Compulsive, and Avoidant Inventories, respectively), which are most frequently associated with health (Smith, Williams, & Segerstrom, 2015) will be employed. Latent growth curve modeling will be used to analyze longitudinal data and, specifically, to compare the predictive and incremental validity of FFM PD measures with and over DSM PD measures and normal personality measures in the prediction of self- and informant-reported general health status, major disease (including cancer, diabetes, and lung and heart disease), biological markers of stress and inflammation (levels of cortisol and interleukin-6, respectively), and mortality. The dimensional FFM PD measurement perspective will provide incremental validity over and above traditional measures of PD and normal personality measures in the prediction of these both subjective and objective measures of health. Results will be imperative to developing a comprehensive framework for understanding the longitudinal relationship between maladaptive personality disorder traits and risk of physical disease and mortality. This proposal will provide the PI with the opportunity to unite cutting-edge personality research laboratories while advancing knowledge about the relationship between personality and health and developing research skills and clinical training that will facilitate the goal of conducting and disseminating personality research as an academic professor.