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?

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.

Download Full-text

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.

Download Full-text

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

Journal of Mental Health Counseling ◽

10.17744/mehc.34.1.w3364g3u72541724 ◽

2012 ◽

Vol 34 (1) ◽

pp. 1-13 ◽

Cited By ~ 1

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.

Download Full-text

Examining the Contribution of Perfectionistic Traits to the Construct Validity of the DSM-5 Alternative Model of Personality Disorder

Journal of Personality Disorders ◽

10.1521/pedi_2020_34_476 ◽

2020 ◽

pp. 1-18

Author(s):

Azad Hemmati ◽

Brandon Weiss ◽

Atefeh Mirani ◽

Farzin Rezaei ◽

Joshua D. Miller

Keyword(s):

Personality Disorder ◽

Construct Validity ◽

Personality Disorders ◽

Alternative Model ◽

Clinical Utility ◽

Personality Pathology ◽

Obsessive Compulsive ◽

Large Sample ◽

Dsm 5 ◽

Do So

Scholars of perfectionism have proposed significant modifications to DSM-5's alternative model of personality disorders (AMPD), such that (1) perfectionism be expanded beyond the inclusion of a singular trait—rigid perfectionism—and (2) perfectionistic traits be specified as trait descriptors of personality disorders (PDs) other than obsessive-compulsive PD. In this study, we evaluate these proposals by examining the degree to which (a) perfectionistic traits are already instantiated in Section II and Section III models of personality pathology; and (b) perfectionistic traits meaningfully augment the construct validity of AMPD PDs. We conducted these approaches in a large sample (N =3D 435) from an Iranian undergraduate population that is atypically found in the literature. Results showed that perfectionistic traits are already fairly well instantiated in Section III Criterion B. Perfectionistic traits minimally improved the construct validity of OCPD, but did not meaningfully do so for other PDs. Future investigation into the clinical utility of perfectionistic traits is needed.

Download Full-text

Supplemental Material for The Latent Structure of Personality Functioning: Investigating Criterion A From the Alternative Model for Personality Disorders in DSM–5

Journal of Abnormal Psychology ◽

10.1037/abn0000059.supp ◽

2015 ◽

Keyword(s):

Personality Disorders ◽

Alternative Model ◽

Latent Structure ◽

Personality Functioning ◽

Dsm 5 ◽

Criterion A

Download Full-text

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

Journal of Abnormal Psychology ◽

10.1037/abn0000059 ◽

2015 ◽

Vol 124 (3) ◽

pp. 532-548 ◽

Cited By ~ 45

Author(s):

Johannes Zimmermann ◽

Jan R. Böhnke ◽

Rhea Eschstruth ◽

Alessa Mathews ◽

Kristin Wenzel ◽

...

Keyword(s):

Personality Disorders ◽

Alternative Model ◽

Latent Structure ◽

Personality Functioning ◽

Dsm 5 ◽

Criterion A

Download Full-text

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

Journal of Personality Disorders ◽

10.1521/pedi_2017_31_305 ◽

2018 ◽

Vol 32 (5) ◽

pp. 709-720 ◽

Cited By ~ 9

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.

Download Full-text

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.

Download Full-text

Criterion A of the DSM-5 Alternative Model for Personality Disorders in MMPI-2/RF Personality Disorder Scales

Frontiers in Psychology ◽

10.3389/fpsyg.2021.735848 ◽

2021 ◽

Vol 12 ◽

Author(s):

Mark H. Waugh ◽

Abby L. Mulay ◽

E. Bailey Crittenden ◽

Gina Rossi

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Alternative Model ◽

Minnesota Multiphasic Personality Inventory ◽

General Factor ◽

Item Pool ◽

Personality Functioning ◽

Criterion A ◽

Personality Psychopathology ◽

Personality Disorder Scales

The Minnesota Multiphasic Personality Inventory (MMPI) instruments are frequently used to assess personality and psychopathology. Recent publications of personality disorder (PD) spectra scales for dimensionalized PD syndromes with MMPI instruments may advance PD assessment. To this end, we examined MMPI-Second Edition (2) and MMPI-2-Restructured Form (-RF) PD Spectra scales within the lens of a contemporary dimensional model of PDs, the alternative model for personality disorders (AMPD). The core dimension of PD, Criterion A of the AMPD or level of personality functioning (LPF), was characterized quantitatively within the PD Spectra scales. By sequentially factor analyzing the scales of the Severity Indices of Personality Problems (SIPP-118) to a common general factor of PD, an index of LPF external to the MMPI item pool was established. This LPF dimension was strongly represented across most PD Spectra scales. LPF variances within the PD Spectra scales were deconstructed using measures of general demoralization (RCdemoralization) and maladaptive personality traits indexed by the Personality Psychopathology-5 (PSY-5). Nuanced LPF and PD Spectra scale relationships were discerned. Dimensionalized Antisocial PD, Borderline PD, Dependent PD, and Paranoid PD showed meaningful association with LPF after demoralization, and maladaptive trait variances were removed. The examination of the MMPI-3 item pool reveals that the existing PD Spectra scale item sets are largely carried forward in the new edition of the MMPI. This suggests PD Spectra scale correlates, including LPF relationships, may be discernable in the newest edition of the MMPI, pending future study.

Download Full-text

Comparison of alternative models for personality disorders, II: 6-, 8- and 10-year follow-up

Psychological Medicine ◽

10.1017/s0033291711002601 ◽

2011 ◽

Vol 42 (8) ◽

pp. 1705-1713 ◽

Cited By ~ 68

Author(s):

L. C. Morey ◽

C. J. Hopwood ◽

J. C. Markowitz ◽

J. G. Gunderson ◽

C. M. Grilo ◽

...

Keyword(s):

Personality Disorders ◽

Factor Model ◽

Five Factor Model ◽

Personality Pathology ◽

Diagnostic Categories ◽

Dsm 5 ◽

Axis I ◽

Dsm Iv ◽

Characteristic Features

BackgroundSeveral conceptual models have been considered for the assessment of personality pathology in DSM-5. This study sought to extend our previous findings to compare the long-term predictive validity of three such models: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP), and DSM-IV personality disorders (PDs).MethodAn inception cohort from the Collaborative Longitudinal Personality Disorder Study (CLPS) was followed for 10 years. Baseline data were used to predict long-term outcomes, including functioning, Axis I psychopathology, and medication use.ResultsEach model was significantly valid, predicting a host of important clinical outcomes. Lower-order elements of the FFM system were not more valid than higher-order factors, and DSM-IV diagnostic categories were less valid than dimensional symptom counts. Approaches that integrate normative traits and personality pathology proved to be most predictive, as the SNAP, a system that integrates normal and pathological traits, generally showed the largest validity coefficients overall, and the DSM-IV PD syndromes and FFM traits tended to provide substantial incremental information relative to one another.ConclusionsDSM-5 PD assessment should involve an integration of personality traits with characteristic features of PDs.

Download Full-text