Comparing Measures of Criterion A to Better Understand Incremental Validity in the Alternative Model of Personality Disorders

Assessment ◽

10.1177/10731911211059763 ◽

2021 ◽

pp. 107319112110597

Author(s):

Michael J. Roche ◽

Sarah Jaweed

Keyword(s):

Mental Health ◽

Personality Disorders ◽

Undergraduate Students ◽

Alternative Model ◽

Incremental Validity ◽

Strongly Correlated ◽

Criterion A ◽

Personality Dysfunction ◽

Additional Variance ◽

Variance Explained

The Alternative Model of Personality Disorders distinguishes between the severity of personality dysfunction (Criterion A) and individual differences in personality disorder expression (Criterion B). Several Criterion A measures exist, but few studies have compared these measures with each other. Moreover, debates about whether the constructs of Criteria A and B are redundant (i.e., weak incremental validity) should be framed around how different Criterion A measures perform relative to others. This study of 204 undergraduate students evaluated multiple measures of Criterion A. These measures were strongly correlated with Criterion B, but evidenced incremental validity (39% of outcomes, 5% average additional variance explained) with outcomes of psychopathology and interpersonal impairments, and less consistent incremental validity with suicidality, aggression, and mental health utilization. We discuss how these results inform the construct of Criterion A relative to Criterion B and evaluate strengths/weaknesses of Criterion A measures.

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An evaluation of DSM-5 Section III Personality Disorder Criterion A (Impairment) in accounting for psychopathology

10.31234/osf.io/z48tv ◽

2018 ◽

Cited By ~ 2

Author(s):

Chelsea Sleep ◽

Donald Lynam ◽

Thomas A. Widiger ◽

Michael L Crowe ◽

Josh Miller

Keyword(s):

Personality Disorders ◽

Discriminant Validity ◽

Factor Model ◽

Incremental Validity ◽

Self Report ◽

Statistical Prediction ◽

Dsm 5 ◽

Criterion A ◽

Personality Dysfunction ◽

Axis I

An alternative diagnostic model of personality disorders (AMPD) was introduced in DSM-5 that diagnoses PDs based on the presence of personality impairment (Criterion A) and pathological personality traits (Criterion B). Research examining Criterion A has been limited to date, due to the lack of a specific measure to assess it; this changed, however, with the recent publication of a self-report assessment of personality dysfunction as defined by Criterion A (Levels of Personality Functioning Scale – Self-report; LPFS-SR; Morey, 2017). The aim of the current study was to test several key propositions regarding the role of Criterion A in the AMPD including the underlying factor structure of the LPFS-SR, the discriminant validity of the hypothesized factors, whether Criterion A distinguishes personality psychopathology from Axis I symptoms, the overlap between Criterion A and B, and the incremental predictive utility of Criterion A and B in the statistical prediction of traditional PD symptom counts. Neither a single factor model nor an a priori four-factor model of dysfunction fit the data well. The LPFS-SR dimensions were highly interrelated and manifested little evidence of discriminant validity. In addition, the impairment dimensions manifested robust correlations with measures of both Axis I and II constructs, challenging the notion that personality dysfunction is unique to PDs. Finally, multivariate regression analyses suggested that the traits account for substantially more unique variance in DSM-5 Section II PDs than does personality impairment. These results provide important information as to the functioning of the two main components of the DSM-5 AMPD and raise questions about whether the model may need revision moving forward.Keywords: dysfunction, impairment, personality disorders, Section III, incremental validity Public Significance: The alternative model of personality disorders included in Section III of the 5th addition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes two primary components: personality dysfunction and maladaptive traits. The current results raise questions about how a new, DSM-5 aligned measure of personality dysfunction operates with regard its factor structure, discriminant validity, ability to differentiate between personality and non-personality based forms of psychopathology, and incremental validity in the statistical prediction of traditional DSM personality disorders.

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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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Examining the Alternative Model of Personality Disorder in Daily Life: Evidence for Incremental Validity

10.31234/osf.io/yrfzc ◽

2018 ◽

Author(s):

MICHAEL J ROCHE

Keyword(s):

Alternative Model ◽

Discriminant Validity ◽

Temporal Dynamics ◽

Incremental Validity ◽

Electronic Diary ◽

Cross Sectional ◽

Five Dimensions ◽

Longitudinal Methods ◽

Criterion A ◽

Personality Dysfunction

The Alternative Model for Personality Disorders (AMPD) includes a single dimension of personality dysfunction severity (Criterion A), and five dimensions of personality dysfunction styles (Criterion B). Some consider Criterion A and B distinctions redundant, and this appears mostly true in cross-sectional designs. The present research demonstrated that incremental validity can be found when examining personality dysfunction longitudinally. Participants (n=175) completed a 14-day electronic diary, capturing daily levels of Criterion A and B, along with daily outcomes of personality dysfunction across several domains. Criterion A and B incremented each other across these domains. Moreover, Criterion B trait scores were associated with expected domains of functioning, evidencing convergent and discriminant validity. We discuss the implications for the AMPD model, and the usefulness of longitudinal methods to uncover temporal-dynamics in personality dysfunction.

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

Psychological Medicine ◽

10.1017/s0033291715002226 ◽

2015 ◽

Vol 46 (3) ◽

pp. 647-655 ◽

Cited By ~ 42

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.

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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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