ISSN 1678-7153 Psychology/Psicologia Reflexão e Crítica, 28(2), 322-330. – DOI: 10.1590/1678-7153.

201528212

Development and Internal Structure Investigation

of the Dimensional Clinical Personality Inventory

Desenvolvimento e Investigação da Estrutura Interna

do Inventário Dimensional Clínico da Personalidade (IDCP)

Lucas de Francisco Carvalho & Ricardo Primi

Universidade São Francisco, Itatiba, SP, Brazil

Abstract
This study aimed to develop a dimensional instrument to assess personality disorders based on
Millon’s theoretical perspective and on DSM-IV-TR diagnoses criteria, and seek validity evidence
based on internal structure and reliability indexes of the factors. In order to do that, a self-report
test composed of 215 items, the Dimensional Clinical Personality Inventory (DCPI) was developed
and applied to 561 respondents aged between 18 and 90 years (M = 28,8; SD = 11.4), with 51.8%
females. Exploratory factor analysis and verification of reliability were performed using Cronbach’s
alpha. Data provided validity evidence based on internal structure of the instrument according to the
theory of Millon and DSM-IV-TR.
Keywords: Test development, psychiatric disorders, psychometric properties.

Resumo
Este estudo teve como objetivo desenvolver um instrumento de caráter dimensional para avaliação
dos transtornos da personalidade baseado na teoria de Millon e nos critérios diagnósticos do DSM-
-IV-TR, e buscar evidências de validade com base na estrutura interna e índices de fidedignidade
dos fatores. Para tanto, foi desenvolvido e aplicado um teste de autorrelato composto por 215 itens, o
Inventário Dimensional Clínico da Personalidade (IDCP), em 561 pessoas com idade variando entre
18 e 90 anos (M=28,8; DP=11,4), sendo 51,8% do sexo feminino. Procedeu-se a análises fatoriais
exploratórias e verificação da fidedignidade por meio do alfa de Cronbach. Os dados encontrados
favorecem as evidências de validade do instrumento de acordo com a teoria de Millon e o DSM-IV-TR.
Palavras-chave: Construção de instrumentos, transtornos psiquiátricos, propriedades psicométricas.

Personality traits can manifest in a healthier or more In general, the reactions displayed by people diag-
pathological way, and a continuum is established between nosed with personality disorders are inflexible, implying
these poles (Widiger & Trull, 2007). A more pathologi- conflicts in the ability to deal with the environment, as
cal personality functioning may be characterized by three well as significant disruptions in their lives. Personality
global attributes: adaptive inflexibility, vicious circle, and disorders can be understood as representations of many
tenuous stability (Millon, Millon, Meagher, Grossman, & styles or patterns in which personality is mal-adapted to
Ramanath, 2004). its environment, bringing major disruptions in one’s life
Adaptive inflexibility refers to a small number of little (Millon, 1999; Millon & Davis, 1996; Millon, Grossman,
effective strategies employed to achieve objectives, relate & Tringone, 2010). This definition is consistent with
to others, or deal with stress; the vicious circle relates to the proposal of Skodol et al. (2011) for the future edi-
perceptions, needs, and behaviors that perpetuate and tion of the Diagnostic and Statistical Manual of Mental
intensify pre-existing difficulties in the individual; and Disorders (DSM), DSM-5, which also emphasizes the
the tenuous stability is related to a lower resilience of the disability to present an adaptive functioning. In this
individual against psycho-stressor conditions. People who study, Millon’s definition for personality disorders will
tend to manifest these characteristics at high levels may be used as a basis.
have a diagnosis of personality disorders. Various models and theories for the evaluation and
diagnosis of personality disorders are found in the scientific
literature. Among these proposals, the theory by Theodore

Mailing address: Rua Alexandre Rodrigues Barbosa, Millon (Millon & Davis, 1996; Strack & Millon, 2007) is
45, Itatiba, SP, Brazil 13251-900. E-mail: lucas@labape. characterized as an integrative and evolutionary model,
[Link]
Grant: This research was supported by the São Paulo
encompassing perspectives of individual (ontogenetic),
Research Foundation (Fapesp). cultural, and human (phylogenetic) learning. In addition,

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for the understanding of personality disorders we consider self-propagating, individuals more focused on the self, or,
attributes of the categorical diagnosis and the dimensional strategies aimed at the care of offspring, or individuals
diagnosis, from which the prototypical perspective of these more focused on others.
disorders originates (Millon et al., 2004). From this theoretical proposal, Millon and colleagues
The prototypes proposal by Millon (Millon & Gross- developed the Millon Clinical Multiaxial Inventory
man, 2007a, 2007b; Millon et al., 2010) aims to integrate (MCMI), used for the evaluation and diagnosis of not only
the categorical and dimensional models for the understand- personality disorders, but also clinical disorders described
ing of personality. It considers that certain features tend on Axis I of DSM-IV-TR (APA, 2003). The group’s goal
to covariate more than others, so they may be grouped was to develop a self-report instrument for the assessment
(categorical perspective), although there is no absolute of psychiatric disorders. Therefore, at the end of the same
feature that defines a group of categories and, thus, all decade the MCMI was launched. In the 10 following
characteristics should be assessed (dimensional perspec- years adjustments to the DSM-III were performed, also
tive). It should be emphasized that, despite the prototypical based upon reformulations on Millon’s theory. By the
character of Millon’s theory, the system of evaluation and late 1980s the MCMI-II was launched. Similarly, based
diagnosis proposed by the author approaches a continuous on the MCMI-II, new reformulations were made to the
version of the categorical model, which may be observed, instrument; all based on the DSM-IV-TR, having as a final
for instance, in the instrument for assessing personality product the MCMI-III (Millon et al., 1994).
disorders developed by Millon, Millon, and Davis (1994), Specifically in relation to the MCMI-III, the instrument
which presents the results on a continuous scale (T scores), was administered to 1079 patients of clinics, psychologists,
as well as on the categories (dependent, paranoid, among and psychiatrists, who completed a document evaluating
others) proposed by DSM-IV-TR (American Psychological several characteristics of patients’ personality disorders.
Association [APA], 2003). Therefore, since the release of the first version of the
Grounded on the ontogenetic, cultural, and phyloge- MCMI, there was always a concern to operationalize
netic basis, Millon (Millon & Grossman, 2007a, 2007b) symptoms (characteristics) described on the DSM, as
proposes fifteen pathological personality types (or styles). well as a strong clinical and theoretical basis. Therefore,
They are: Schizoid, Avoidant, Depressive, Dependent, we did not adopt a dimensional perspective seeking to
Histrionic, Narcissistic, Antisocial, Sadistic, Compulsive, discover empirically how many variables are required to
Negativistic, Masochist, Paranoid, Schizotypal, Border- represent the disorders in terms of profiles; instead, we used
line, and Hypomanic. Currently the literature based on a prototypical perspective investigating a set of correlated
Millon’s theory has been developing on the hypomanic features that could represent the disorder in a continuous
style, so this pathological personality style was not con- manner by means of scales. This line of reasoning is close
sidered in the present study. to the system in which the current version of DSM is
The proposal in fifteen styles is based on three levels, grounded, since both cases consider the clinical support for
the evolutionary phases, which are consistent with the the cluster of symptoms and the possibility of developing
evolutionary principles, each represented by a bipolarity. diagnostic characteristics, even though the DSM is not
The phases are: Existence, Adaption, and Replication. characterized as a prototypical system, mainly because it
Each phase represents a period of development based on is a dichotomous way of diagnosis.
evolutionary assumptions (Davis, 1999; Millon & Davis, Besides this, there are studies on the literature
1996; Millon et al., 2010; Millon et al., 2004; Strack & investigating the internal structure of both the MCMI
Millon, 2007). (Cuevas, García, Aluja, & García, 2008; Rossi, Elklit,
The first phase, Existence, is related to the tendency & Simonsen, 2010) and the DSM-IV-TR (Huprich,
to express mechanisms that favor the pursuit of pleasure, Schmitt, Richard, Chelminski, & Zimmerman, 2010)
focus on the search for pleasurable experiences and gains, through factor analysis. In such cases, the results are
and the avoidance of pain, focus on avoiding actions or not favorable according to what is expected a priori,
situations that are dangerous and bring damage. Once the which is probably due to the reasoning underlying Mil-
individual is oriented, he needs to maintain his existence lon’s theory and the DSM-IV-TR (i.e., the focus on the
through a complex relationship with the environment. grouping of people and not on the investigation of the
The second evolutionary phase, Adaption, is related to possible grouping of variables).
ways of adapting that enable an interaction between the From the theoretical and clinical perspective, Millon’s
individual and the environment. Some people tend to proposal presents gains at the expense of other restricted
change the environment around (active trend), and others models in this perspective. However, from a pragmatic-
are more likely to accommodate to the environment in empirical point of view, even because it is a complex
which they live (passive trend). After Adaption, the third proposal, there is no robust evidence supporting the whole
evolutionary phase (Replication) is about the continuity of theoretical framework proposed by Millon. Thus, despite
the individual, which is limited by time. This evolution- the theoretical strength of this proposal, the lack of empiri-
ary phase concerns the strategies developed by people to cal evidence testing its assumptions is not consistent with
overcome the limitation of existence itself, which can be the guide of changes for the next edition of DSM, DSM

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5, proposing that the choice should be based on a large members: the authors of this study, two Psychology PhD
number of studies demonstrating the empirical strength students who had performed studies in the area of mental
of the model, besides the theoretical robustness (Kendler, health and psychometrics, and one Psychology Masters
Kupfer, Narrow, Phillips, & Fawcett, 2009). student with expertise in psychometrics. The aim of these
According to what was presented, on the one hand, meetings was to increase knowledge on the model of
one can notice the theoretical force permeated in Millon’s personality disorders based on Millon and on DSM-IV-
theory, allowing an exhaustive and thorough understanding TR, and to select the items regarded as the most adequate
about the pathological personality styles. On the other, it among those developed by the authors on this research.
faces a lack of empirical support of the instrument’s scales Furthermore, we sought to classify items according to the
(and, therefore, of the types of functioning which seeks to DSM-IV-TR criteria.
evaluate), based on the categories of DSM-IV-TR (APA, As a result of the meetings, we created a database
2003) that are proposed in the MCMI-III. Considering composed of 541 items which were ranked, according to
the various criticisms in the literature to the categorical the content, in the following criteria: respective personality
perspective for the assessment and diagnosis of personality disorder according to Millon’s theory and the DSM-IV-
disorders (Brown & Barlow, 2005; Widiger & Trull, 2007; TR; respective DSM-IV-TR criteria; compatible item of
Zimmerman, 2011) to the detriment of the dimensional the MCMI-III (when existing); and, compatible item of
perspective (which seems to be more robust from the em- the IDTP (when existing). We sought to develop at least
pirical point of view), we considered the development of two items by DSM-IV-TR criterion, and in most cases we
an instrument that would follow similar steps to those used developed a higher number than the minimum established.
on the construction of the MCMI, but that were subjected As an illustration of the developed items, stand out the
to more traditional procedures of empirical test to verify items “I do not mind exaggerating to get attention from
its internal structure. In this perspective, the present study others”, assessing typical characteristics of the histrionic
aimed to develop an instrument of dimensional character to functioning, and “usually people are not trustworthy”, as-
assess personality disorders based on Millon’s theoretical sessing typical characteristics of paranoid functioning. In
perspective and in diagnostic criteria established by the Table 1 we present the distribution of items according to
DSM-IV-TR (APA, 2003), as well as to submit it to an the criteria presented in DSM-IV-TR (APA, 2003), which
empirical testing on the internal structure validity and the was also done by Millon et al. (1994).
reliability indices of the scales. Table 1 presents the columns relating to the DSM-
IV-TR criteria (C1-C9), a column containing the criteria
Method respective to the disorders, and another column with the
total number of items per disorder. Columns C8 and C9
This topic has been subdivided into two distinct steps, obtained number zero when the disorders (for instance,
as follows: Phase I, development of the instrument; and, schizoid and avoidant) had a number of criteria lower
Phase II, search for evidence of validity based on internal than eight and nine.
structure, and investigation of the reliability of the scales From the items developed by the authors of this study,
of the instrument developed in Phase I. we selected those which, according to the research group,
better represented the characteristics and symptoms of
Phase I – Construction of the Instrument the different personality disorders. As a result, we have
At this initial stage, the aim was to develop an reached a number of 215 items representing the instrument,
instrument for assessing personality disorders based called Dimensional Inventory of Personality Disorders (In-
on Millon’s theory (Millon & Davis, 1996; Millon & ventário Dimensional Clínico da Personalidade [IDCP]).
Grossman, 2007a, 2007b; Millon et al., 2010; Millon et The items were distributed according to the diagnostic
al., 2004) and on the diagnostic criteria of the categories characteristics of personality disorder, as follows: schizoid
presented on axis II of DSM-IV-TR (APA, 2003). We (14 items), avoidant (14 items), depressive (14 items),
also considered the data presented in the literature based dependent (16 items), histrionic (16 items), narcissistic
on the MCMI-III (Millon et al., 1994) and a national (18 items), antisocial (14 items), sadistic (16 items), com-
instrument constructed in accordance with Millon’s pulsive (16 items), negativistic (14 items), masochist (15
theory, the Dimensional Inventory of Personality items), paranoid (14 items), schizotypal (18 items) and
Disorders (Inventário Dimensional dos Transtornos da borderline (16 items).
Personalidade [IDTP]; Carvalho, 2008). It is observed that the number of items for the IDCP
To this end, the authors of the present study developed disorder ranged from 14 (schizoid, avoidant, depressive,
items operationalizing the DSM-IV-TR (APA, 2003) cri- antisocial, negativistic, and paranoid) and 18 (narcissistic
teria relating to personality disorders and also reviewed and schizotypal). Moreover, it is noteworthy that all criteria
items previously established (Carvalho, 2008). From are represented on the 215 items selected. Next, the 215
the items developed, we formed a group of systematic items were ordered in the following sequence: compulsive,
study throughout one semester, with weekly meetings of narcissistic, borderline, antisocial, dependent, depressive,
about 3 hours each. The meetings were performed by five schizoid, schizotypal, avoidant, histrionic, masochist,

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Table 1
Descriptive Data of Items According to the DSM-IV-TR Criteria
Criteria

Disorder Total C1 C2 C3 C4 C5 C6 C7 C8 C9

Schizoid 33 9 4 3 4 6 4 3 - -
Avoidant 46 7 6 6 10 8 5 3 - -
Depressive 38 13 4 4 2 5 5 4 - -
Dependent 38 9 6 5 5 3 4 3 3 -
Histrionic 42 7 7 6 5 3 6 4 4 -
Narcissistic 66 10 10 9 8 5 7 8 5 4
Antisocial 54 9 9 6 6 7 7 10 - -
Sadistic 41 8 7 6 4 3 5 5 3 -
Compulsive 39 6 5 6 8 2 5 4 3 -
Negativistic 37 6 5 4 4 10 5 3 - -
Masochist 40 8 5 4 4 5 3 7 4 -
Paranoid 31 8 4 5 4 3 3 4 - -
Schizotypal 43 3 8 4 7 5 5 3 4 3
Borderline 38 8 5 4 4 4 2 3 3 5

negativistic, paranoid, and sadistic and then again the same axis II. With regard to the patients of the psychiatric clinic,
ordering (completing 28 groups of items). In the instru- we observed an almost absence of the diagnosis of axis
ment, each subgroup of items is highlighted by color lines II and, regarding axis I, there was a greater prevalence of
(white or light gray). Still, we were careful to start with substance abuse and mood disorders.
the compulsive and narcissistic disorders as they present Instruments. We applied the IDCP instrument, which
items whose pathological aspect is not so clear. was developed in Phase I of this study. As previously
described, it is a self-report inventory consisting of 215
Phase II – Validity Evidence Based on Internal Structure, items, representing typical features of personality disor-
and Investigation of the Reliability of the Instrument’s ders. The instrument must be responded on a Likert-like
Scales scale of four points for the responses on the IDCP, being,
Participants. There were 561 participants, aged be- 1 for “nothing – it has nothing to do with me”, 2 for “little
tween 18 and 90 years (M=28.8; SD=11.4), and 293 were – it has a little to do with me”, 3 for “moderately – it has
women (51.8%). The sample was composed of university something to do with me” and 4 for “much – it has much
students without psychiatric diagnosis (n=434) and by pa- to do with me”. The approximate time of application was
tients diagnosed with psychiatric disorders (n=127) from 30 minutes.
axis I and/or axis II according to the DSM-IV-TR (APA, Procedure and Design. Participants completed the
2003), from a private clinic and a psychiatric hospital. Psy- instrument, and all received the Term of Informed Consent
chiatric patients were diagnosed by psychiatrists through (Protocol CAAE 0350.0.142.000-08), which included
unstructured evaluations (n=77) and by the Structured the main objective of the study and dissemination of the
Clinical Interview for DSM IV axis II (SCID-II; n=50). results according to ethical standards. The applications
Most participants responded “graduate level” (76%) in were accomplished, in the case of university students, in
school, and all subjects were from the state of São Paulo. private universities in the state of São Paulo; and in the
Table 2 presents the diagnostic prevalence in the sample case of psychiatric patients, in the waiting rooms of the
of patients diagnosed with psychiatric disorders. state of São Paulo, be it in private clinic or public hospi-
It can be observed that for patients from the psychiatric tals. For most of the data analysis, the Statistical Package
hospital, there was a higher prevalence of mood and anxiety for the Social Sciences version 15 was used. Moreover,
disorders in relation to axis I of the DSM-IV-TR (APA, we also used the programs R version 2.15.3 and MPLUS
2003), and avoidant and obsessive personality disorders in version 6.12.

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Table 2
Prevalence of Disorders in Individuals with Psychiatric Diagnosis

Axis Psychiatric Hospital Psychiatric Clinic

Disorders
(DSM-IV-TR) (n=77) (n=50)

Mood disorders 55 (60.6%) 22 (44%)

Drug addiction 2 (2.5%) 34 (68%)
Anxiety disorders 29 (37.6%) 15 (30%)
Psychotic disorders 5 (6.4%) 10 (20%)
Axis I
Other disorders 5 (6.4%) 5 (10%)
Eating disorder 4 (5.1%) --
Adjustment disorder 1 (1.2%) --
Somatoform disorders 5 (6.4%) --

Dependent personality disorder 5 (6.4%) --

Obsessive personality disorder 17 (22%) --
Avoidant Personality Disorder 20 (25.9%) --
Borderline Personality Disorder 10 (12.9%) 1 (2%)

Axis II Histrionic Personality Disorder 5 (6.4%) --

Schizoid Personality Disorder 3 (3.8%) --
Paranoid Personality Disorder 12 (15.5%) --
Narcissistic Personality Disorder 7 (9%) --
SOE Personality Disorder 12 (15.5%) --
Schizotypal personality disorder 3 (3.8%) --

Results factors. The simulations were performed considering 561

subjects, total number of the sample. A total of 1,000 ex-
First, we sought to determine how many dimensions tractions of random correlation matrices were simulated
would be required to explain the structure of correlations and we considered the eigenvalue corresponding to the
between the items that were developed. As these items 95th percentile, resulting in a minimum criterion of 2.02 to
were created to represent the typical characteristics of consider a factor as relevant (Hayton, Allen, & Scarpello,
the 14 disorders, we expected to find factors that were 2004; Watkins, 2006). Also, the R software version 2.15.3
consistent with these types of pathological functioning. was used to check the maximum number of non-random
For this, we used exploratory factors analysis by principal factors that could be considered, since this statistical
axes (principal axis factoring)1. This method analyzes program allows determining the minimum eigenvalue for
only the shared variance between variables (Tabachnick retaining factors based on the extraction by principal axes
& Fidell, 2007). (common variance) in polychoric correlation matrices.
Initially, a parallel analysis was used as a criterion for Considering these criteria for extraction, we found 12
determining the minimum eigenvalue to retain relevant factors, which were subjected to analysis by orthogonal
rotation (varimax), since the oblique rotation, attempted
initially, was not justified due to the low magnitude of
1 MPLUS software version 6.12
was also used to verify factor solution. MPLUS allows correlation between the factors (lower than .30).
the specification of categorical variables from which Before proceeding to the factor analysis, we verified
it estimates the polychoric correlations. The structures
evidenced in this case in terms of the items that would
sampling adequacy for the analysis, using the Kaiser-
be grouped by factor were quite similar to that extracted Meyer-Olkin (KMO) index and the Bartllet’s sphericity
using Pearson’s correlation, showing that in this case the test. The KMO was .92, indicating a good data adequacy
method of calculation of the correlations wouldn’t change
the composition of the factors that are presented. for factor analysis, and the Bartlett’s sphericity test was

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significant at .001 (χ2= 72561.900; df= 23005), showing were able to explain 40.6% of the total variance (the first
that there were sufficient correlations between variables factor explaining 23.4%). It should be pointed out that
for the use of factor analysis. factors 13 and 14 also reached the eigenvalue criterion >
Table 3 presents a summary of the data found in the 2.02, but did not obtain more than one item, so they could
exploratory factor analysis. We obtained twelve factors not be interpreted. The same table also presents a summary
with more than one item and eigenvalues above 2.02, which of the items’ factor loadings on factors.

Table 3
Summary of Data Found in Exploratory Factor Analysis

Factor Loadings N. of items Eigenvalue Explained Variance (%) Predominance PD

1 .31-.69 57 50.4 23.4 Dependent (24.5%)

2 .30-.65 47 10.1 4.7 Sadistic (319%)
3 .30-.65 43 5.6 2.6 Borderline (30.2%)
4 .31-.64 35 5.2 2.4 Schizotypal (34.2%)
5 .30-.66 19 4.5 2 Histrionic (57.8%)
6 .30-.53 20 3.6 1.7 Paranoid (45%)
7 .30-.47 13 3.3 1.5 Narcissistic (61.5%)
8 .30-.54 10 2.6 1.2 Schizoid (50%)
9 .33-.56 9 2.6 1.2 Avoidant (44.4%)
10 .46-.61 7 2.4 1.1 Masochist (71.4%)
11 .30-.56 10 2.2 1 Compulsive (70%)
12 .32-.48 7 2.1 1 Antisocial (42.8%)

In Table 3, the first column refers to the sequence found the items of such disorders in independent dimensions,
on the factors. The “loading” column shows the lowest they were grouped into coherent factors.
factor loading (having a cutoff previously established at Continuing the refinement of the scale, items that did
.30) and the highest. The next column describes the number not reach the factor loading of .30 on the theoretically
of items with factor loading equal or greater than .30 on consistent factor were eliminated. Thus, we kept items that
each factor, and the columns that follow, the eigenvalues optimized internal consistency for each scale (i.e., items
and their explained variance. Finally, the “Predominance with relatively high load). We also favored items whose
PD” column reports what was the predominance of items content was appropriate from the theoretical point of view
in that factor in relation to the personality disorder (PD) and not imprecise items, and therefore, better operational-
that the items represented. ized. Furthermore, a more detailed analysis of the content
As it can be observed, there was a significant variation of the items was conducted to formulate a nomenclature
between the number of items found in each of the 12 factors that would capture the general meaning of the items. Table
retained from the factor analysis, and the same goes for the 4 presents the number of items selected by factors, the
eigenvalue and the explained variance. Besides, we also names of factors considering the set of items that com-
verified that each of the factors was marked by features pose them, the total number of items, the coefficient of
more related to a particular style or pathological personal- internal consistency of the factors, and a sample item for
ity functioning, as shown in the last column of Table 3. each factor. It is noteworthy that the total number of items
Such a trend does not suggest that each personality style is composing the instrument was 162, however, the sum of
represented by one dimension, but each dimension should the items presented in Table 4 results in 176, since some
present a greater relevance in relation to the different styles. items are overlapping more than one scale. We chose to
The only disorders that were not distinctly represented on keep these items, albeit overlapping, since the qualitative
a factor were the depressive and negativistic. The items of analysis of their contents suggested the adequacy for be-
the former were distributed in the factors 1, 3, and 4 and the ing kept in more than one scale. Moreover, we calculated
latter, in factors 2 and 3. Even though we did not recover the descriptive data of participants’ scores on the factors.

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Table 4
Summarized Data of the Factors and Internal Consistency after Selecting Items

Factor X (SD) Min.-Max. Items α Examples of items

It is common for me to let others

1. Dependence 1.8 (.6) 1.0-3.7 20 .92
make important decisions for me.
I tend to get violent when my wishes
2. Aggressiveness 1.6 (.5) 1.0-3.8 27 .91
are not met.
Sometimes, I feel a great emptiness
3. Mood instability 2.0 (.6) 1.0-3.9 27 .94
inside me.
4. Eccentricity 1.6 (.6) 1.0-3.8 20 .92 People often say I’m weird.
5. Attention Seeking 2.2 (.5) 1.0-3.8 16 .84 I can seduce people with ease.
Others always try to hurt me, use me
6. Distrust 2.1 (.6) 1.0-4.0 13 .83
or cheat on me, but I’m always alert.
It is natural that special people like
7. Grandiosity 1.9 (.6) 1.0-3.8 12 .86
me should receive special treatment.
8. Insulation 1.9 (.6) 1.0-3.8 11 .85 I am little interested in making friends.
I try not to talk to people, as not to
9. Avoidance of Criticism 1.6 (.7) 1.0-4.0 7 .86
run the risk of being ridiculed.
I do everything to help others,
10. Self-Sacrifice 2.2 (.7) 1.0-4.0 7 .85
no matter what will cost me.
Tasks should always be performed
11. Conscientiousness 2.5 (.5) 1.3-3.8 11 .69
to perfection.
12. Impulsiveness 1.7 (.7) 1.0-3.8 5 .72 I don’t mind if I have to hit someone.

Therefore, Factor 1, Dependence, consists of items The seventh factor, Grandiosity, groups items reporting
about beliefs in the individuals’ lack of self-trust to make irritability due to lack of recognition of the other, show-
decisions, for believing that he doesn’t make things right, ing an exaggerated need for admiration by others with
depending on others for decision-making. The second underlying beliefs of merit and superiority. The Insular
factor, Aggression, is related to reactions in which the factor, number 8, is represented by items reporting the
individual does not consider the other to get what they preference by being alone, irritability with taking orders
want, and are inconsequent, often violent. Mood Insta- from others, a decreased pleasure with relationships and
bility, Factor 3, is represented by a group of items with avoidance of social interaction. The items representing
respect to the tendency to a sad and irritable mood, but factor 9, Avoidance of Criticism, are about generalized
also mood oscillations, which make individuals present beliefs of incapacity and consequently, that others will
impulsive and extreme reactions that often generate guilt. humiliate and criticize them. In factor 10, Self-sacrifice,
In the next factor, Eccentricity, items are grouped regarding the items relate to an exaggerated disregard of the self
the absence of pleasure in being with others, difficulty in with evident tendencies to help others. Conscientiousness,
trusting others, and beliefs of being different from other factor 11, is related to a need to do things as organized
people, expressing eccentric, and idiosyncratic behaviors. and orderly as possible, with a focus on responsibility and
In factor 5, Attention Seeking, items relate to the exagger- obligations, demonstrating excessive worry, perfection-
ated need for attention from others, using mechanisms ism, strict rules in relationships, and focus on work duties.
such as seduction, overreactions, and intensive search Finally, the Impulsiveness factor (12) deals with reactions
for friendships. In Distrust (6), there are characteristics of impulsivity and carelessness, with a taste for activities
related to constant worry of being deceived, beliefs that involving violence, ease of making excuses and getting
there are always “second intentions”, showing preference involved in problems.
by what is known, strictness in relationships, and persecu- Regarding internal consistency, 11 scales presented
tory delusions. reliability indices greater than or equal to .72 (M=.85),

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except for factor 11, whose index was .69. Also, regarding related to typical characteristics of obsessive-compulsive
the descriptive data of the participants in the dimensions, it and histrionic personality functioning (Hopwood, Thomas,
is possible to observe that virtually all the factors presented Markon, Wright, & Krueger, 2012; Widiger, 2011).
minimal scores (1.0) and all of them presented scores at In addition, another indicative of the adequacy of
least near to the maximum (4.0). The lowest means were the internal structure for the IDCP is the reliability
in the factors Aggression (F2) and Avoidance of Criticism index, coefficient alpha. This index was satisfactory for
(F9). In contrast, the highest means were found in the fac- almost all dimensions of the instrument, establishing
tors Conscientiousness (F11), Attention Seeking (F5), and .70 as the cutoff point. An exception to that was the
Self-Sacrifice (F10). Conscientiousness dimension, whose alpha coefficient
was equal to .69.
Discussion We suggest the use of the final version found in this
study consisting of 162 items (the sum of items from the
The present study aimed to developed a dimensional factors is 176, but some items overlap in different dimen-
instrument to assess personality disorders based on sions). Future research should continue to evidence the
Millon’s theoretical perspective and in the diagnostic validity of the IDCP, since the verification of the internal
categories of DSM-IV-TR axis II, as well as to empirically structure of the instrument is only a first step towards
investigate evidence based on the validity of the internal a more complete understanding of its functioning. We
structure and reliability indices of the scales. In general, we should also seek to optimize the reliability index (pos-
consider that the main scope of the study was achieved, as sibly adding new items) found for the Conscientious-
we obtained an instrument based on Millon’s theoretical ness dimension, and verify how this dimension and the
perspective and on the characteristics of personality Attention-Seeking dimension actually assess pathological
disorders presented in DSM-IV-TR, comprising 12 distinct personality traits. Furthermore, the reliability indices of
dimensions related to the styles proposed by Millon (Millon the factors that showed an uncertain coefficient (that is,
& Davis, 1996; Millon & Grossman, 2007a, 2007b), based close to .70) should be reviewed in future studies. We
on a dimensional design. Furthermore, the dimensions also suggest the use of the Item Response Theory (IRT),
that compose the instrument seem to be in agreement verifying possible impacts on the reliability of the scales
with what is theoretically expected, and it is possible to due to discrepancies between the level of the latent trait
establish relationships between these dimensions and the measured by the instrument and the level of the latent
personality disorders. trait of the sample.
However, the data provide evidence of validity based An also important limitation of this study may guide
on the internal structure for the IDCP once 12 interpretable the direction of future research using the IDCP. That is,
dimensions were found, related to the characteristics of the present sample consisted mainly of people without a
all types of pathologic personality functioning according diagnosis of personality disorders, and, considering the
to Millon’s theory (Millon & Grossman, 2007a, 2007b) characteristics assessed by the instrument, it is important
and the DSM-IV-TR (APA, 2003). The number of items that further studies use samples predominantly with patho-
on the dimensions ranged from 5 and 27 (M=14.6). On logical personality traits.
the one hand, this finding indicates that, for most part of
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Received: 20/08/2013
Personality Disorders: Theory, Research, and Treatment, 1st revision: 06/02/2014
2(1), 54-67. doi:10.1037/a0021855 Accepted: 02/07/2014

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