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

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.

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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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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

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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

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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?

Journal of Personality Disorders ◽

10.1521/pedi_2017_31_329 ◽

2019 ◽

Vol 33 (1) ◽

pp. 49-70 ◽

Cited By ~ 2

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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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.

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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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Psychometric properties of the Personality Inventory for DSM-5 Brief Form in Chinese undergraduate students and clinical patients

10.21203/rs.3.rs-45917/v3 ◽

2020 ◽

Author(s):

Panwen Zhang ◽

Zirong Ouyang ◽

Shulin Fang ◽

Jiayue He ◽

Lejia Fan ◽

...

Keyword(s):

Factor Analysis ◽

Psychometric Properties ◽

Personality Disorders ◽

Measurement Invariance ◽

Undergraduate Students ◽

Factor Model ◽

Clinical Sample ◽

Personality Inventory ◽

Dsm 5 ◽

Test Retest Reliability

Abstract Background: The Personality Inventory for DSM-5 Brief Form (PID-5-BF) is a 25-item measuring tool evaluating maladaptive personality traits for the diagnosis of personality disorders(PDs). As a promising scale, its impressive psychometric properties have been verified in some countries, however, there have no studies about the utility of PID-5-BF in Chinese settings. The current study aimed to explore the maladaptive personality factor model which was culturally adapted in China and examine psychometric properties of the Personality Inventory for DSM-5 Brief Form among Chinese undergraduate students and clinical patients.Methods: 7155 undergraduate students and 451 clinical patients completed the Chinese version of PID-5-BF. 228 students were chosen randomly for test-retest reliability at a 4-week interval. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to discover the most suitable construct in Chinese, measurement invariance(MI), internal consistency, and external validity were also calculated.Results: An exploratory six-factor model was supported more suitable in both samples(Undergraduate sample: CFI = 0.905, TLI = 0.888, RMSEA = 0.044, SRMR = 0.039; Clinical sample: CFI = 0.904, TLI = 0.886, RMSEA = 0.047, SRMR = 0.060), adding a new factor“Interpersonal Relationships”. Measurement invariance across non-clinical and clinical sample was established (configural, weak, strong MI, and partial strict MI). Aside from acceptable internal consistency (Undergraduate sample: alpha=0.84, MIC=0.21; Clinical sample: alpha=0.86, MIC=0.19) and test-retest reliability(0.73), the association with 220-item PID-5 was significant(r = 0.93, p < 0.01), and six PDs measured by Personality diagnostic questionnaire-4+ (PDQ-4+) were correlated with expected domains of PID-5-BF.Conclusions: The PID-5-BF is a convenient and useful screening tool for personality disorders with a novel six-factor model in Chinese settings, with the main difference for the Negative Affect domain.

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