The latent structure of personality functioning: Investigating criterion a from the alternative model for personality disorders in DSM–5.

BackgroundThe DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DSM categorical diagnoses to be retained in this system – antisocial, avoidant, borderline, narcissistic, obsessive–compulsive and schizotypal personality disorders. The goal of the current study was to describe the empirical relationships between the DSM-5 section III pathological traits and DSM-IV/DSM-5 section II personality disorder diagnoses.MethodData were obtained from a sample of 337 clinicians, each of whom rated one of his or her patients on all aspects of the DSM-IV and DSM-5 proposed alternative model. Regression models were constructed to examine trait–disorder relationships, and the incremental validity of core personality dysfunctions (i.e. criterion A features for each disorder) was examined in combination with the specified trait clusters.ResultsFindings suggested that the trait assignments specified by the Work Group tended to be substantially associated with corresponding DSM-IV concepts, and the criterion A features provided additional diagnostic information in all but one instance.ConclusionsAlthough the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

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Assessment of Pathological Traits in DSM-5 Personality Disorders By the DAPP-BQ: How Do These Traits Relate to the Six Personality Disorder Types of the Alternative Model?

Journal of Personality Disorders ◽

10.1521/pedi_2017_31_329 ◽

2019 ◽

Vol 33 (1) ◽

pp. 49-70 ◽

Cited By ~ 2

Author(s):

Han Berghuis ◽

Theo J. M. Ingenhoven ◽

Paul T. van der Heijden ◽

Gina M. P. Rossi ◽

Chris K. W. Schotte

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Alternative Model ◽

Psychiatric Patients ◽

Personality Pathology ◽

Personality Functioning ◽

Dsm 5 ◽

Criterion A ◽

Dsm Iv ◽

Dimensional Assessment

The six personality disorder (PD) types in DSM-5 section III are intended to resemble their DSM-IV/DSM-5 section II PD counterparts, but are now described by the level of personality functioning (criterion A) and an assigned trait profile (criterion B). However, concerns have been raised about the validity of these PD types. The present study examined the continuity between the DSM-IV/DSM-5 section II PDs and the corresponding trait profiles of the six DSM-5 section III PDs in a sample of 350 Dutch psychiatric patients. Facets of the Dimensional Assessment of Personality Pathology—Basic Questionnaire (DAPP-BQ) were presumed as representations (proxies) of the DSM-5 section III traits. Correlational patterns between the DAPP-BQ and the six PDs were consistent with previous research between DAPP-BQ and DSM-IV PDs. Moreover, DAPP-BQ proxies were able to predict the six selected PDs. However, the assigned trait profile for each PD didn't fully match the corresponding PD.

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Age-Neutrality of a Brief Assessment of the Section III Alternative Model for Personality Disorders in Older Adults

Assessment ◽

10.1177/1073191118754706 ◽

2018 ◽

Vol 25 (3) ◽

pp. 310-323 ◽

Cited By ~ 10

Author(s):

Inge Debast ◽

Gina Rossi ◽

S. P. J. van Alphen

Keyword(s):

Older Adults ◽

Personality Disorders ◽

Alternative Model ◽

Convergent Validity ◽

Short Form ◽

Community Sample ◽

Personality Functioning ◽

Dsm 5 ◽

Criterion A ◽

The Impact

The alternative model for personality disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5) is considered an important step toward a possibly better conceptualization of personality pathology in older adulthood, by the introduction of levels of personality functioning (Criterion A) and trait dimensions (Criterion B). Our main aim was to examine age-neutrality of the Short Form of the Severity Indices of Personality Problems (SIPP-SF; Criterion A) and Personality Inventory for DSM-5–Brief Form (PID-5-BF; Criterion B). Differential item functioning (DIF) analyses and more specifically the impact on scale level through differential test functioning (DTF) analyses made clear that the SIPP-SF was more age-neutral (6% DIF, only one of four domains showed DTF) than the PID-5-BF (25% DIF, all four tested domains had DTF) in a community sample of older and younger adults. Age differences in convergent validity also point in the direction of differences in underlying constructs. Concurrent and criterion validity in geriatric psychiatry inpatients suggest that both the SIPP-SF scales measuring levels of personality functioning (especially self-functioning) and the PID-5-BF might be useful screening measures in older adults despite age-neutrality not being confirmed.

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Interrater Reliability of the Structured Clinical Interview for the DSM–5 Alternative Model of Personality Disorders Module i: Level of Personality Functioning Scale

Journal of Personality Assessment ◽

10.1080/00223891.2018.1483377 ◽

2018 ◽

Vol 100 (6) ◽

pp. 630-641 ◽

Cited By ~ 14

Author(s):

Tore Buer Christensen ◽

Muirne C. S. Paap ◽

Marianne Arnesen ◽

Karoline Koritzinsky ◽

Tor-Erik Nysaeter ◽

...

Keyword(s):

Personality Disorders ◽

Alternative Model ◽

Interrater Reliability ◽

Clinical Interview ◽

Personality Functioning ◽

Dsm 5

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Personality functioning scale: A scale to assess DSM-5’s Criterion A personality disorders

Interpersona An International Journal on Personal Relationships ◽

10.5964/ijpr.v14i1.3925 ◽

2020 ◽

Vol 14 (1) ◽

pp. 40-53

Author(s):

Juliana Beatriz Stover ◽

Mercedes Fernández Liporace ◽

Alejandro Castro Solano

Keyword(s):

Mental Health ◽

Personality Disorders ◽

Short Form ◽

Personality Inventory ◽

Check List ◽

Personality Functioning ◽

Dsm 5 ◽

Short Scale ◽

Criterion A ◽

Symptom Check List

The Section III on Emerging Measures and Models included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, introduces a hybrid alternative approach, dimensional-categorical, to diagnose personality disorders. The Criterion A establishes the assessment of the impairment in personality functioning in terms of two dimensions: self and interpersonal. The present study was aimed at developing a short scale to measure both dimensions. The sample was composed of 342 adults from Buenos Aires city and its outskirts, with ages ranging from 19 to 82 years old (M = 39.90, SD = 13.75). Data were gathered using the Personality Functioning Scale, developed in this study, as well as the Personality Inventory for DSM‐5 Brief Form, the Mental Health Continuum Short Form, and the Symptom Check List-27. A principal components analysis conducted on 28 items found 2 factors, interpersonal and self. Internal consistency, estimated by ordinal Alphas, achieved values between .92 and .86 whilst Cronbach’s Alphas were .88 and .87. Significant and positive correlations between the Personality Functioning Scale scores on the one hand, and the Personality Inventory for DSM‐5 Brief Form scores and the Symptom Check List-27 score on the other, were found. Negative correlations between PFS scores and the Mental Health Continuum Short Form were calculated. As a result, a short scale with adequate psychometric features, suitable to assess Criterion A in adult Argentinian population has been developed.

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A Psychometric Analysis of the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I (SCID-5-AMPD-I): Level of Personality Functioning Scale

Assessment ◽

10.1177/1073191120967972 ◽

2020 ◽

pp. 107319112096797

Author(s):

Benjamin Hummelen ◽

Johan Braeken ◽

Tore Buer Christensen ◽

Tor Erik Nysaeter ◽

Sara Germans Selvik ◽

...

Keyword(s):

Personality Disorders ◽

Alternative Model ◽

Latent Variable ◽

Latent Trait ◽

Clinical Interview ◽

Fine Tuning ◽

Personality Functioning ◽

Dsm 5 ◽

Wide Range ◽

Level 2

The current study aims to examine the psychometric properties of the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I (SCID-5-AMPD-I) assessing the Level of Personality Functioning Scale (LPFS) in a heterogeneous sample of 282 nonpsychotic patients. Latent variable models were used to investigate the dimensionality of the LPFS. The results indicate that the LPFS, as assessed by the SCID-5-AMPD-I, can be considered as a unidimensional construct that can be measured reliably across a wide range of the latent trait. Threshold parameters for the 12 indicators of the LPFS increased gradually over the latent scale, indicating that the five LPFS levels were ordered as predicted by the model. In general, the increase of threshold parameters was relatively small for the shift from Level 2 to Level 3. A better distinction among the different severity levels might be obtained by fine-tuning the interview guidelines or the Level 2 indicators themselves.

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Examining the Structure and Validity of Self-Report Measures of DSM-5 Alternative Model for Personality Disorders Criterion A

Journal of Personality Disorders ◽

10.1521/pedi_2021_35_531 ◽

2021 ◽

pp. 1-33

Author(s):

Chloe F. Bliton ◽

Michael J. Roche ◽

Aaron L. Pincus ◽

David Dueber

Keyword(s):

Personality Traits ◽

Personality Disorders ◽

Alternative Model ◽

Explanatory Power ◽

Principal Component ◽

Incremental Validity ◽

Self Report ◽

Measurement Development ◽

Dsm 5 ◽

Criterion A

The Level of Personality Functioning Scale (LPFS) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. Despite progress in LPFS measurement development and validation, there is a lack of research, and some disagreement, concerning structural, convergent, and incremental validity of LPFS self-report measures. The present study aimed to compare the LPFS Self-Report, LPFS Self-Report of Criterion A, and LPFS Brief Form. Internal structure was assessed through principal component analyses, factor analyses, and bifactor analyses of unidimensionality. Associations with both pathological and basic personality characteristics among the LPFS measures were explored. Incremental validity of LPFS severity in predicting pathological personality outcomes controlling for basic personality traits, and the reverse, were examined. Results suggest a unidimensional structure robustly associated with other pathological personality assessments. LPFS severity and basic personality traits mutually offered unique explanatory power. We discuss the implications of assessing personality pathology using LPFS self-report measures.

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The Inter-Rater Reliability and Validity of the Italian Translation of the Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders Module I and Module II: A Preliminary Report on Consecutively Admitted Psychotherapy Outpatients

Journal of Personality Disorders ◽

10.1521/pedi_2020_34_511 ◽

2020 ◽

Vol 34 (Supplement C) ◽

pp. 95-123

Author(s):

Antonella Somma ◽

Serena Borroni ◽

Giulia Gialdi ◽

Davide Carlotta ◽

Laura Emanuela Giarolli ◽

...

Keyword(s):

Personality Disorders ◽

Alternative Model ◽

Convergent Validity ◽

Clinical Utility ◽

Reliability And Validity ◽

Clinical Interview ◽

Self Report ◽

Rater Reliability ◽

Personality Functioning ◽

Dsm 5

To evaluate the reliability and convergent validity of the Structured Clinical Interview for DSM-5 Alternative Model for Personality Disorders (SCID-5-AMPD) Module I and Module II, 88 adult psychotherapy participants were administered the Italian translations of the SCID-5-AMPD Module I and Module II, Level of Personality Functioning Scale-Brief Form (LPFS-BF), Level of Personality Functioning Scale-Self Report (LPFS-SF), Personality Inventory for DSM-5 (PID-5), Personality Diagnostic Questionnaire-4+ (PDQ-4+), and Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) relying on a Williams crossover design. SCID-5-AMPD Module I and Module II showed excellent inter-rater reliability. In terms of convergent validity, meaningful associations were observed between SCID-5-AMPD Module I scores and self-report measures of Criterion A; similarly, SCID-5-AMPD Module II trait scores were meaningfully related to PID-5 trait scores. As a whole, our preliminary findings supported the clinical utility of DSM-5 AMPD.

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Evaluation of Diagnostic Thresholds for Criterion A in the Alternative DSM-5 Model for Personality Disorders

Journal of Personality Disorders ◽

10.1521/pedi_2019_33_455 ◽

2019 ◽

pp. 1-22 ◽

Cited By ~ 3

Author(s):

Tore Buer Christensen ◽

Benjamin Hummelen ◽

Muirne C. S. Paap ◽

Ingeborg Eikenaes ◽

Sara Germans Selvik ◽

...

Keyword(s):

Personality Disorders ◽

Clinical Sample ◽

Decision Rules ◽

Personality Functioning ◽

Dsm 5 ◽

Criterion A ◽

Diagnostic Thresholds ◽

Diagnostic Threshold ◽

Diagnostic Decision ◽

Present Rule

The Level of Personality Functioning Scale (LPFS) of the Alternative DSM-5 Model for Personality Disorders (AMPD) was formulated to assess the presence and severity of personality disorders (PDs). Moderate impairment (Level 2) in personality functioning, as measured by the LPFS, was incorporated into the AMPD as a diagnostic threshold for PD in Criterion A of the general criteria, as well as for the “any two areas present” rule for assigning a specific PD diagnosis. This study represents the first evaluation of the diagnostic decision rules for Criterion A, in a clinical sample (N = 282). The results indicate that an overall diagnostic threshold for PDs should be used with caution because it may not identify all DSM-IV PDs. The “any two areas present” rule proved to be a reasonable alternative, although this finding should be interpreted with caution because the LPFS does not measure the disorder-specific A criteria.

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