Patient-Reported ICD-11 Personality Disorder Severity and DSM-5 Level of Personality Functioning

2020 ◽  
Vol 34 (2) ◽  
pp. 231-249 ◽  
Author(s):  
Bo Bach ◽  
Jaime L. Anderson
Keyword(s):  
Personality Disorder ◽  
Clinical Sample ◽  
Standardized Assessment ◽  
Regression Analyses ◽  
Potential Harm ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Patient Reported ◽  
Harm To Others ◽  
Two Measures

This study evaluated the Standardized Assessment of Severity of Personality Disorder (SASPD) proposed for ICD-11 and the Level of Personality Functioning Scale–Brief Form 2.0 (LPFS-BF) developed for DSM-5 Section III and their relationships with external correlates. We used a clinical sample (N = 150; 33% women) of 65 psychiatric outpatients and 85 incarcerated addicts, who self-reported the SASPD and the LPFS-BF. We conducted correlation and regression analyses in order to determine the relative associations of these two measures with relevant external criteria. SASPD predominantly captured externalizing and other-related problems (e.g., potential harm to others), whereas LPFS-BF predominantly captured internalizing and self-related problems (e.g., identity and distress). Generally, LPFS-BF explained more variance of the external criteria relative to SASPD. The findings seem to reflect that the ICD-11 oriented SASPD emphasizes interpersonal and aggressive features, whereas the DSM-5–oriented LPFS-BF emphasizes self-pathology and distress. More conclusive findings warrant interview-rated personality functioning.

scholarly journals ASSOCIATIONS BETWEEN DSM-5 PERSONALITY PATHOLOGY AND HORNEY’S INTERPERSONAL TRENDS AMONG OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S162-S163
Author(s):  
Daniel L Segal ◽  
Lisa E Stone ◽  
Frederick L Coolidge ◽  
Gabrielle Krus
Keyword(s):  
Older Adults ◽  
Negative Affect ◽  
Zero Order ◽  
Personality Pathology ◽  
Strongly Correlated ◽  
Regression Analyses ◽  
Limited Evidence ◽  
Dsm 5 ◽  
Two Measures ◽  
Compliance Model

Abstract Introduction: The Personality Inventory for DSM-5 (PID-5) is a measure of the alternative model of personality disorders with limited evidence of validity among older adults. This study examined validity of the model through associations with the Horney-Coolidge Tridimensional Inventory (HCTI). Method: Older adults (N=125) completed the PID-5 and the HCTI. Results: Zero-order correlations were computed between the PID-5’s five domains (Negative Affect, Detachment, Antagonism, Disinhibition, and Psychoticism) and the HCTI’s three domains (Compliance, Aggression, and Detachment). Compliance was moderately negatively correlated with Detachment (r = -.27), as expected. Aggression was significantly positively related to all five PID-5 domains and was most strongly correlated with Antagonism (r = .56), Psychoticism (r = .48), and Disinhibition (r = .32). As predicted, Horney’s Detachment was most strongly related to the PID-5’s Detachment (r = .48). Regression analyses were also conducted with PID-5 domains predicting each HCTI type. The Compliance model was significant, with PID-5 domains predicting 13% of variability in Compliance. Negative Affect (positive) and Detachment (negative) were significant predictors. The Aggression model was also significant, with the PID-5 domains accounting for 40% of variability. Antagonism was the only significant positive predictor. Lastly, the Detachment model was significant, with the PID-5 domains predicting 29% of variance in Detachment scores. Negative Affect (negative) and Detachment (positive) were significant predictors. Discussion: Results indicate that the two measures of personality pathology generally converge regarding theoretically similar constructs and diverge around dissimilar domains, providing evidence of validity of the PID-5 for its ability to capture personality traits.

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 Evaluating the Assessment of the ICD-11 Personality Disorder Diagnostic System

2018 ◽  
Author(s):  
Joshua R. Oltmanns ◽  
Thomas A. Widiger
Keyword(s):  
Personality Disorder ◽  
Factor Model ◽  
Five Factor Model ◽  
Diagnostic System ◽  
Severity Rating ◽  
Personality Functioning ◽  
Dsm 5 ◽  
System P ◽  
Pattern Scale ◽  
Direct Measures

Proposed for the ICD-11 is a dimensional model of personality disorder that, if approved, would be a paradigm shift in the conceptualization of personality disorder. The proposal consists of a general severity rating, five maladaptive personality trait domains, and a borderline pattern qualifier. The general severity rating can be assessed by the Standardized Assessment of Severity of Personality Disorder (SASPD), the trait domains by the Personality Inventory for ICD-11 (PiCD) , and the borderline pattern by the Borderline Pattern Scale (BPS), which is developed in the present study. To date, no study has examined the relations among all three components, due in part to the absence of direct measures for each component (until recently). The current study develops and provides initial validation evidence for the BPS, and examines the relations among the BPS, SASPD, and PiCD. Also considered is their relationship with the five-factor model of general personality as well as with two other measures of personality disorder severity (including the DSM-5 Level of Personality Functioning Scale [LPFS]). Further, an alternative trait-based coding of the DSM-5 LPFS is examined (modeled after the ICD-11 SASPD), suggesting that its coverage of diverse maladaptivity may not be because it assesses the core of personality disorder, but rather because it has items specific to the different domains of personality.

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.

An Integration of Normal and Abnormal Personality Structure: The Five-Factor Model

2012 ◽  
pp. 81-107
Author(s):  
Thomas A. Widiger ◽  
Douglas B. Samuel ◽  
Stephanie Mullins-Sweatt ◽  
Whitney L. Gore ◽  
Cristina Crego
Keyword(s):  
Personality Disorder ◽  
Factor Model ◽  
Five Factor Model ◽  
Empirical Support ◽  
Personality Structure ◽  
Dimensional Model ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Diagnosis And Classification

It is evident that the conceptualization, diagnosis, and classification of personality disorder is shifting toward a dimensional model and, more specifically, the Five-Factor Model (FFM) in particular. The purpose of this chapter is to provide an overview of the FFM of personality disorder. It will begin with a description of this dimensional model of normal and abnormal personality functioning, along with a brief overview of its empirical support. This will be followed by a discussion of its potential advantages, and a comparison with the current proposals for DSM-5.

DSM-5 Level of Personality Functioning: Refocusing Personality Disorder on What It Means to Be Human

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Carla Sharp ◽  
Kiana Wall
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Adult Life ◽  
Annual Review ◽  
Publication Date ◽  
Self Identity ◽  
Personality Functioning ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Life Tasks

Level of Personality Functioning (LPF) represents the entry criterion (Criterion A) of the Alternative Model for Personality Disorders (AMPD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is defined as a dimensional general severity criterion common to all personality disorders and conceptually independent of personality types or traits, and it represents maladaptive self (identity and self-direction) and interpersonal (empathy and intimacy) functioning. We review the history, measurement, and significance of LPF. We show that the inclusion of LPF in the AMPD is well justified if it is defined as a general adaptive failure of a subjective intrapsychic system needed to fulfill adult life tasks. If so defined, LPF distinguishes itself from maladaptive traits (Criterion B of the AMPD) and captures the contribution humans make as agentic authors to the interpretation and management of the self. While Criterion B maladaptive traits provide important descriptive nuance to manifestations of personality pathology, maladaptive LPF is conditional to the diagnosis of personality disorder. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 17 is May 7, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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.

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

2019 ◽  
pp. 1-22 ◽  
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.

A psychometric evaluation of the Standardized Assessment of Severity of Personality Disorder (SASPD) in non-clinical and clinical German samples

2019 ◽  
Author(s):  
Katharina Rek ◽  
Isabel Thielmann ◽  
Miriam Henkel ◽  
Mike Crawford ◽  
Luigi Piccirilli ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Clinical Sample ◽  
Psychometric Evaluation ◽  
Symptom Distress ◽  
Self Report ◽  
Standardized Assessment ◽  
Clinical Samples

The Standardized Assessment of Severity of Personality Disorder (SASPD) is a nine-item self-report screening instrument and was developed to assess personality disorder (PD) severity according to the initial proposal of ICD-11. Our aim was to investigate the psychometric properties of the German version of the SASPD in non-clinical and clinical samples. A total of 1,991 participants (N = 888 from non-clinical and N = 1,103 from clinical samples) provided ratings on the SASPD as well as other measures of psychopathology and personality. We examined the SASPD regarding its factor structure, internal consistency, and construct validity. A unidimensional structure of the SASPD provided inadequate model fit, whereas a three-factor solution provided good fit in both the non-clinical and clinical samples. Internal consistency of the SASPD total score was acceptable in the clinical and in the non-clinical sample based on this multi-factorial model. In terms of convergent validity, SASPD scores correlated fairly with other measures of PD severity across samples. Discriminant validity with measures of general symptom distress and measures of (normal) personality traits was mixed. In addition, the SASPD scores predicted levels of PD severity above and beyond a measure of symptom distress. The SASPD captures some theoretically expected features of PD severity. However, the multidimensional structure and limited convergent and discriminant validity may hamper future usage of the SASPD as a short screening tool of PD severity according to ICD-11.

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.

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