 36. Personality and Personality Disorder  765
ic findings for the personality disorders are 
largely resolved when they are understood 
as maladaptive variants of the FFM. For 
instance, diagnostic co-  occurrence among 
the DSM-IV personality disorders has been 
highly problematic, providing a primary ra -
tionale for the deletion of half of the diag -
noses in DSM-5 (Skodol, 2012). However, 
this co-  occurrence is largely explained by 
the extent of shared FFM traits (Lynam & 
Widiger, 2001; O’Connor, 2005). Gender 
differences have also been very controversial 
for the personality disorders (T. Oltmanns 
& Powers, 2012) but the differential sex 
prevalence rates are consistent with the sex 
differences that would be predicted if the 
personality disorders were understood to be 
maladaptive variants of the FFM (Lynam & 
Widiger, 2007b).
There are studies on the childhood and 
development antecedents of the DSM per -
sonality disorders (e.g., Cohen, Crawford, 
Johnson, & Kasen, 2005; Wetzel & Robins, 
2016). However, most would agree that this 
has been a sorely neglected area of research 
(Cohen & Crawford, 2005; De Clercq & 
De Fruyt, 2007). Tyrer (2015), Chair of the 
WHO ICD-11 Personality Disorders Work 
Group, lamented the reluctance of child -
hood clinicians and researchers to recognize 
childhood antecedents of adult personality 
disorders. In contrast, there is a considerable 
body of research on the childhood and de -
velopment antecedents of general personal -
ity traits (Widiger, De Clercq, & De Fruyt, 
2009). De Clercq, De Fruyt, Van Leeuwen 
and Mervielde (2006) have even developed 
an FFM instrument for the assessment of the 
maladaptive personality traits in childhood. 
As indicated by De Fruyt and De Clerq 
(2014), “An integrative model of personal -
ity pathology precipitants for childhood and 
adolescence is available now” (p. 469).
The FFM provides a reasonably compre -
hensive lexicon of adaptive and maladaptive 
personality traits. As such, one can use the 
FFM lexicon to define and diagnose new 
constellations of personality traits (i.e., syn -
dromes) of current interest to a particular 
clinical, social, business, or public health 
care setting. Miller (2012) indicates how a 
researcher or a clinician can use an existing 
measure of the FFM to assess for each of the 
DSM-IV personality disorders by correlat -ing the FFM profile of a patient with the 
FFM profile for a prototypical case of the 
respective personality disorder (Lynam & 
Widiger [2001] provide a prototypical FFM 
profile for each of the DSM-IV personality 
disorders). This correlation (or simply the 
sum of the scores on the respective facets 
that identify a prototypical case) can serve 
as an index for the presence of that personal -
ity disorder. This FFM index can provide as 
valid an assessment of a particular personal -
ity disorder as any existing direct measure 
of that personality disorder (e.g., Trull, Wi -
diger, Lynam, & Costa, 2003).
One can similarly create FFM profiles for 
additional personality disorder constructs 
not currently included in DSM-5 then match 
individuals’ FFM profiles to these proto -
types to obtain an index for that respective 
syndrome. Illustrations of this approach 
have been provided for constructs such as 
depressive personality disorder (Bagby, Wat -
son, & Ryder, 2013), pathological narcissism 
(Glover et al., 2011), alexithymia (Taylor & 
Bagby, 2013), and successful psychopathy 
(Mullins-  Sweatt, Glover, Derefinko, Miller, 
& Widiger, 2010).
A currently heavily researched personal -
ity disorder construct is the “dark triad,” 
combining key traits from psychopathy, 
narcissism, and Machiavellianism into one 
“super” or “meta” evil syndrome (Paulhus 
& Williams, 2002). The dark triad is in -
triguing in part because it is considered to 
be evident in persons who are below thresh -
old for an existing DSM-5 diagnosis, mov -
ing under the radar of both psychopathy 
and narcissism, yet given the combination 
of traits, they might be as dangerous and 
problematic, seeking out multiple casual 
sex partners, manipulating others out of 
personal self-  interest, and acting aggres -
sively to take what they want when they 
want it. Furnham, Richards, Rangel, and 
Jones (2014) demonstrated through a meta- 
analysis of dark triad FFM research that the 
three dark triad constructs can be largely 
understood as maladaptive variants of FFM 
antagonism, albeit they can also be distin -
guished in terms of other domains of the 
FFM, with Machiavellianism and psychopa -
thy including aspects of low conscientious -
ness and low neuroticism, and psychopathy 
involving facets of extraversion.