The DSM Should Replace Maladaptive Traits With the Five-Factor Model: Comment on Clark and Watson (2022)

In their target article, Watson and Clark made a number of useful suggestions for improving Criterion B of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, alternative model of personality disorders, all of which assume that personality variation will be represented in the next iteration of the Diagnostic and Statistical Manual of Mental Disorders as a maladaptive trait variation diagnostic of personality disorders (PDs). I describe how maladaptive traits are not equivalent to normal-range five-factor model traits in terms of domain structure, range, and stability, and I conclude that rather than making subtle changes to the existing maladaptive trait model for PDs, it would be better to replace it with a genuine five-factor model that could be used to conceptualize all patients, whether or not they are diagnosed with a PD.