Application of the DSM-5 Level of Personality Functioning Scale by Lay Raters

2018 ◽  
Vol 32 (5) ◽  
pp. 709-720 ◽  
Author(s):  
Leslie C. Morey
Keyword(s):  
College Students ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Clinical Experience ◽  
Alternative Model ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Undergraduate College Students ◽  
The Individual ◽  
Considerable Experience

One concern that has been expressed with the Alternative Model for Personality Disorders (AMPD) presented in DSM-5 is that the description of characteristic impairments in personality function uses concepts requiring considerable experience and clinical inference to apply. To examine this question, the individual indicators included in the AMPD's Level of Personality Functioning Scale (LPFS) that describes these core impairments were abstracted as individual items, and then rated on a target acquaintance by 194 undergraduate college students with minimal training in personality disorder and no training in the AMPD. Results indicated that the LPFS indicators were highly internally consistent as rated in this sample, and that the degree of discrimination between groups corresponded very well with the putative level of severity represented for each indicator in the LPFS. These findings support the contention that using the LPFS might not require any particular clinical experience or training.

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.

scholarly journals Borderline personality disorder diagnosis in a new key

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Abby L. Mulay ◽  
Mark H. Waugh ◽  
J. Parks Fillauer ◽  
Donna S. Bender ◽  
Anthony Bram ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Theory And Practice ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Whole Person ◽  
Highly Correlated ◽  
The Individual

Abstract Background Conceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD). Method Raters of varied professional backgrounds possessing substantial knowledge of PDs (N = 20) characterized BPD criteria with the four domains of the Level of Personality Functioning Scale (LPFS) and 25 pathological personality trait facets. Mean AMPD values of each BPD criterion were used to support a nosological cross-walk of the individual BPD criteria and study various combinations of BPD criteria in their AMPD translation. The grand mean AMPD profile generated from the experts was compared to published BPD prototypes that used AMPD trait ratings and the DSM-5-III hybrid categorical-dimensional algorithm for BPD. Divergent comparisons with DSM-5-III algorithms for other PDs and other published PD prototypes were also examined. Results Inter-rater reliability analyses showed generally robust agreement. The AMPD profile for BPD criteria rated by individual BPD criteria was not isomorphic with whole-person ratings of BPD, although they were highly correlated. Various AMPD profiles for BPD were generated from theoretically relevant but differing configurations of BPD criteria. These AMPD profiles were highly correlated and showed meaningful divergence from non-BPD DSM-5-III algorithms and other PD prototypes. Conclusions Results show that traditional DSM BPD diagnosis reflects a common core of PD severity, largely composed of LPFS and the pathological traits of anxiousness, depressively, emotional lability, and impulsivity. Results confirm the traditional DSM criterion-based BPD diagnosis can be reliably cross-walked with the full AMPD scheme, and both approaches share substantial construct overlap. This relative equivalence suggests the vast clinical and research literatures associated with BPD may be brought forward with DSM-5-III diagnosis of BPD.

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?

2019 ◽  
Vol 33 (1) ◽  
pp. 49-70 ◽  
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.

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

scholarly journals 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 ◽  
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.

Examining the Incremental Utility of DSM-5 Section III Traits and Impairment in Relation to Traditional Personality Disorder Scores in a Female Correctional Sample

2018 ◽  
Vol 32 (6) ◽  
pp. 738-752 ◽  
Author(s):  
Chelsea E. Sleep ◽  
Dustin B. Wygant ◽  
Joshua D. Miller
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Alternative Model ◽  
Female Inmates ◽  
Societal Costs ◽  
Dsm 5 ◽  
Narcissistic Personality ◽  
Categorical Models ◽  
Personality Psychopathology ◽  
Personality Disordered

Personality disorders (PDs) are challenging to assess and are associated with great individual and societal costs. In response to the limitations of categorical models, the DSM-5 included an alternative model (i.e., Section III), which uses impairment (Criterion A) and pathological traits (Criterion B) to diagnose PDs. Although numerous studies have illustrated dimensional trait models' ability to capture personality psychopathology, less attention has been paid to personality impairment. The present investigation sought to examine Criterion A's ability to contribute incrementally to the prediction of antisocial (ASPD), borderline (BPD), and narcissistic personality disorders (NPD), and Interpersonal-Affective (F1) and Impulsive-Antisocial (F2) features of psychopathy. The current study used 200 female inmates and found that impairment contributed to the prediction of BPD, NPD, and psychopathy F1 scores and did not add to the prediction of ASPD and psychopathy F2 scores. Difficulties in distinguishing between personality impairment and personality disordered traits are discussed.

scholarly journals Sociocultural Context and the DSM-5 Alternative Model of Personality Disorder: Comment on Widiger & Hines

2022 ◽  
Author(s):  
Craig Anthony Rodriguez-Seijas
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Alternative Model ◽  
Sociocultural Context ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Psychological Stressors ◽  
And Gender ◽  
Theory Research

Widiger and Hines provide a brief overview of the development of the Alternative Model of Personality Disorder (AMPD) housed within Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). They highlight eight issues and controversies related to the AMPD in need of resolution for improvement of both the AMPD model itself as well as the field of personality disorders more broadly. In this brief commentary, I add a ninth issue in need of attention both with respect to the AMPD but also within the field of personality disorders more broadly: 9) How is sociocultural context to be accommodated in AMPD—and more generally personality disorder—theory, research, and treatment? The historical intra-individual, deficit-based models for conceptualizing personality disorders linger in current personality disorder discourse. However, failure to appropriately consider sociocultural context that systematically predisposes wide swaths of the population to unequal access to resources and exposure to psychological stressors, which can impact the appearance of personality pathology, serves to stigmatize minoritized individuals. The personality disorder field, and the AMPD discourse, must appropriately contend with sociocultural context in its models otherwise it risks developing models with limited generalizability and which hold potential to adversely affect sexual and gender minoritized populations, among others.

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.

Personality Disorders in the DSM-5: Proposed Revisions and Critiques

2012 ◽  
Vol 34 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Emily Good
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Personality Disorders ◽  
Diagnostic Criteria ◽  
Rating Scale ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Categorical Model ◽  
Dsm Iv

This article discusses the Personality and Personality Disorder Work Group's proposed changes for Personality Disorders in the DSM-5: (a) adoption of a hybrid dimensional-categorical model; (b) utilization of 6 personality disorder types instead of the previous 10 personality disorders; (c) addition of personality traits and facets to define personality disorders; (d) addition of a rating scale for levels of personality functioning; (e) revised diagnostic criteria; and (f) the collapsing of Axes I, II, and III. Also discussed are ways in which the DSM-5 proposals are reactions to criticisms of the DSM-IV-TR (APA, 2000) and criticisms of the proposed changes.

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