Exploring Personality Correlates of Psychiatric Hospitalization: A Cross-Sectional Comparison of Section II Personality Disorder Model and Alternative Model for Personality Disorders

Our cross-sectional study provides a head-to-head comparison of Section II and Section III of Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic models of personality disorders (PDs) in identifying significant personality correlates of psychiatric hospitalization (PH). PH is an indicator of a breakdown in one's existing ability to manage mental crisis. The sample was recruited from psychiatric clinical services (N = 60) as well as universities and the local community (N = 49). We used the Structured Clinical Interview for DSM-5 PD (SCID-5-PD) for Section II DSM-5 diagnosis, the Self and Interpersonal Functioning Scale (SIFS) for Criterion A and the Personality Inventory for DSM-5 (PID-5) for Criterion B. Separate logistic regressions analyses showed high discriminative utility for all diagnostic models: the number of Section II diagnosis, level of personality functioning, and five maladaptive traits (AUC between .89 and .97). Binomial logistic regression with a forward stepwise procedure showed that Section II number of diagnoses revealed incremental utility over Criteria A and B in distinguishing between individuals experiencing a mental health crisis requiring PH and those not requiring immediate intervention. We conclude that each diagnostic model, when considered individually, exhibits a high degree of discriminatory performance. However, employing all these models concurrently for identifying personality correlates of PH proves impractical.