An Empirical Evaluation of the DSM-5 Alternative Model of Personality Disorders in Later Life

2020 ◽  
pp. 009141502098076
Author(s):  
Lisa E. Stone ◽  
Daniel L. Segal
Keyword(s):  
Older Adults ◽  
Personality Traits ◽  
Personality Disorders ◽  
Alternative Model ◽  
Empirical Evaluation ◽  
Self Report ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Age Related ◽  
Pathological Personality Traits

Personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5) are conceptualized as distinct clinical syndromes. However, debate persists about the clinical utility of this categorical model, with many researchers supporting a dimensional model that focuses on pathological personality traits and personality dysfunction. This model was published in Section III of DSM-5 and named the Alternative Model of Personality Disorders (AMPD). This study evaluated the AMPD by examining relationships between traits and dysfunction with traditional categorical PD constructs among older adults. Older adults ( N = 202) completed the Personality Inventory for DSM-5, Levels of Personality Functioning Scale-Self-Report, and Coolidge Axis II Inventory. Results indicated that pathological personality traits do not relate to categorical PDs in directions predicted by the AMPD. Personality functioning related to categorical PDs in expected theoretical patterns according to the AMPD but lacked incremental validity above pathological personality traits. An implication of these findings is that the AMPD does not fully resolve the age-related issues with the traditional categorical PD model.

The “Lost” Personality Disorders and Their Relationships to the Alternative Model of Personality Disorders Among Older Adults

GeroPsych ◽  
2021 ◽  
pp. 1-9
Author(s):  
Lisa E. Stone ◽  
Daniel L. Segal ◽  
Frederick L. Coolidge
Keyword(s):  
Older Adults ◽  
Personality Traits ◽  
Personality Disorders ◽  
Diagnostic Criteria ◽  
Personality Trait ◽  
Alternative Model ◽  
The Self ◽  
Personality Functioning ◽  
Novel Approach ◽  
Pathological Personality Traits

Abstract. Four personality disorders (PD) have become “lost” throughout the various editions of the DSM: Depressive, Passive-Aggressive, Sadistic, and Self-Defeating. The Alternative Model of Personality Disorders (AMPD) is a novel approach to PD classification, containing two diagnostic criteria: personality functioning and pathological personality traits. This study identifies the personality functioning and pathological personality trait features of the Lost PDs among older adults ( N = 202; Mage = 67.47 years). Results indicate that the Lost PDs related more strongly with the self-functioning domains (versus the interpersonal domains). Some pathological traits emerged in expected directions, whereas others did not, which is consistent with research on the traditional PDs. The AMPD appears to have mixed validity in capturing the Lost PDs in older adults, though overall it performed comparably well and warrants further examination.

Relating DSM-5 section III personality traits to section II personality disorder diagnoses

2015 ◽  
Vol 46 (3) ◽  
pp. 647-655 ◽  
Author(s):  
L. C. Morey ◽  
K. T. Benson ◽  
A. E. Skodol
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Personality Disorders ◽  
Alternative Model ◽  
Work Group ◽  
Taxonomic Structure ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Criterion A ◽  
Dsm Iv

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.

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

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.

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

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.

scholarly journals The Connections between Pathological Personality Traits and Interpersonal Behavior

2017 ◽  
Vol 26 (1) ◽  
pp. 163-178 ◽  
Author(s):  
Gillian A. McCabe ◽  
Jennifer K. Vrabel ◽  
Virgil Zeigler-Hill
Keyword(s):  
Personality Traits ◽  
Big Five ◽  
Alternative Model ◽  
Negative Affectivity ◽  
Interpersonal Behavior ◽  
Future Research ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Big Five Model ◽  
Pathological Personality Traits

An alternative model of pathological personality traits was recently developed in an effort to address the challenges associated with the categorical model of personality disorder classification (e.g., high rates of comorbidity, minimal overlap with modern conceptualizations of personality structure). More specifically, this alternative model provides a dimensional framework through which personality disorders can be understood in terms of their level of impairment in personality functioning. The development of this alternative model led to the construction of the Personality Inventory for the DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) which assesses the presence and level of the following pathological personality traits: negative affectivity, detachment, antagonism, disinhibition, and psychoticism. These pathological personality traits are considered to be maladaptive variants of the basic personality dimensions described by the Big Five model (i.e., neuroticism, extraversion, agreeableness, conscientiousness, and openness; Thomas et al., 2013). We will focus our review on previous research concerning the interpersonal outcomes associated with the PID-5 pathological personality traits and suggest possible directions for future research.

scholarly journals The Interpersonal Circumplex and the Alternative Model of Personality Disorders: Relationships among Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 898-899
Author(s):  
Lisa Stone ◽  
Daniel Segal
Keyword(s):  
Older Adults ◽  
Personality Trait ◽  
Alternative Model ◽  
Self Report ◽  
Interpersonal Circumplex ◽  
Circumplex Model ◽  
Personality Functioning ◽  
Inventory Of Interpersonal Problems ◽  
Interpersonal Dysfunction ◽  
Pathological Personality Traits

Abstract Introduction The interpersonal circumplex model measures interpersonal dysfunction along two axes (communion and agency), resulting in eight unhealthy patterns: Domineering, Vindictive, Cold, Socially Avoidant, Nonassertive, Exploitable, Overly Nurturant, and Intrusive. It is unclear how the circumplex model applies to older adults and their unique biopsychosocial contexts. This study examined relationships between the circumplex and personality disorder features, using the Alternative Model of Personality Disorder’s (AMPD) personality functioning and pathological personality trait constructs. Method: Older adults (N = 202) completed the Inventory of Interpersonal Problems-Short Circumplex (IIP-SC), the Levels of Personality Functioning Scale-Self-Report (LPFS-SR), and the Personality Inventory for DSM-5 (PID-5) to measure pathological personality traits. Results Correlations were computed between the IIP-SC’s eight circumplex scales with the LPFS-SR’s four personality functioning domains and with the PID-5’s five domains. All circumplex scales significantly (p < .001) and positively correlated with all LPFS-SR and PID-5 domains, with large effect sizes (> .45). Next, regressions were conducted, with the LPFS-SR and PID-5 domains predicting each IIP-SC scale. Across the eight regressions, the AMPD constructs accounted for significant variance in the IIP-SC scales, ranging from 38% (Nonassertive) to 64% (Domineering and Cold). Discussion Significant overlap between the interpersonal circumplex and the AMPD was demonstrated, but patterns are distinct from previous research among younger adults. The circumplex was limited in its relation to the AMPD’s personality functioning, but the pathological personality trait model was well represented through the circumplex. Results indicate that the circumplex may have some validity among older adults and warrants further investigation.

Do DSM-5 Section II personality disorders and Section III personality trait domains reflect the same genetic and environmental risk factors?

2017 ◽  
Vol 47 (12) ◽  
pp. 2205-2215 ◽  
Author(s):  
T. Reichborn-Kjennerud ◽  
R. F. Krueger ◽  
E. Ystrom ◽  
F. A. Torvik ◽  
T. H. Rosenström ◽  
...  
Keyword(s):  
Risk Factors ◽  
Personality Traits ◽  
Personality Disorders ◽  
Environmental Risk ◽  
Personality Trait ◽  
Alternative Model ◽  
Environmental Risk Factors ◽  
Self Report ◽  
Dsm 5 ◽  
Dsm Iv

BackgroundDSM-5 includes two conceptualizations of personality disorders (PDs). The classification in Section II is identical to the one found in DSM-IV, and includes 10 categorical PDs. The Alternative Model (Section III) includes criteria for dimensional measures of maladaptive personality traits organized into five domains. The degree to which the two conceptualizations reflect the same etiological factors is not known.MethodsWe use data from a large population-based sample of adult twins from the Norwegian Institute of Public Health Twin Panel on interview-based DSM-IV PDs and a short self-report inventory that indexes the five domains of the DSM-5 Alternative Model plus a domain explicitly targeting compulsivity. Schizotypal, Paranoid, Antisocial, Borderline, Avoidant, and Obsessive-compulsive PDs were assessed at the same time as the maladaptive personality traits and 10 years previously. Schizoid, Histrionic, Narcissistic, and Dependent PDs were only assessed at the first interview. Biometric models were used to estimate overlap in genetic and environmental risk factors.ResultsWhen measured concurrently, there was 100% genetic overlap between the maladaptive trait domains and Paranoid, Schizotypal, Antisocial, Borderline, and Avoidant PDs. For OCPD, 43% of the genetic variance was shared with the domains. Genetic correlations between the individual domains and PDs ranged from +0.21 to +0.91.ConclusionThe pathological personality trait domains, which are part of the Alternative Model for classification of PDs in DSM-5 Section III, appears to tap, at an aggregate level, the same genetic risk factors as the DSM-5 Section II classification for most of the PDs.

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

Assessment ◽  
2018 ◽  
Vol 25 (3) ◽  
pp. 310-323 ◽  
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.

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

2018 ◽  
Vol 100 (6) ◽  
pp. 630-641 ◽  
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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