An empirically derived hierarchical tree typology of DSM-5 pathological personality traits in adolescence

Traditional personality disorder (PD) taxonomies have been developed for adult populations. We aimed to identify an adolescent hierarchical tree typology of PD indicators to provide classification into broad severity classes but also more fine-grained classification within those classes. A large sample of community adolescents (N = 1,940) completed a validated dimensional measure that covers a comprehensive range of pathologically formulated personality traits, the Personality Inventory for DSM-5. Latent class tree modeling suggested three classes at the first level of the tree representing high, medium, and low PD-trait levels-thus spanning the range between normal and pathological personality. These classes were divided into subclasses lower in the hierarchy, which suggested subclinical variants of patterns that are often found in clinical samples, medium levels of externalizing and internalizing behaviors, and differential profiles of thriving in the low-risk classes. The identified classes had promising initial criterion validity based on meaningful relations with self- and peer-reported measures of friendship and social functioning with peers. Our hierarchical PD tree typology may represent groups at differential risk for developing PDs and could therefore be useful for preventive purposes.