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

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.

scholarly journals Obsessive-Compulsive (Anankastic) Personality Disorder in the ICD-11: A Scoping Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Julija Gecaite-Stonciene ◽  
Christine Lochner ◽  
Clara Marincowitz ◽  
Naomi A. Fineberg ◽  
Dan J. Stein
Keyword(s):  
Personality Disorder ◽  
Scoping Review ◽  
Alternative Model ◽  
Clinical Utility ◽  
Diagnostic Validity ◽  
Factorial Structure ◽  
Factor Analyses ◽  
Dimensional Model ◽  
Obsessive Compulsive ◽  
Dsm 5

Introduction: With the shift from a categorical to a dimensional model, ICD-11 has made substantial changes to the diagnosis of personality disorders (PDs), including obsessive-compulsive (anankastic) personality disorder (OCPD). The ICD-11 PD model proposes a single diagnosis of PD with specifications regarding severity and domains. However, a systematic overview of ICD-11 anankastia is lacking. In this review we address the reformulation of the OCPD diagnosis in the ICD-11, and draw comparisons with the DSM-5, with a particular focus on diagnostic validity and clinical utility. We hypothesized that the ICD-11 PD model provides a diagnostically valid and clinically useful approach to OCPD, with specific emphasis on the anankastia domain as the primary trait qualifier.Methods: Literature published from 2010 to 2020 was systematically searched using the PubMed/MEDLINE, PsychInfo, Cochrane, and Web of Sciences search engines, in order to find all articles that addressed ICD-11 anankastia. Relevant articles were collated, and themes of these articles subsequently extracted.Results: Out of the 264 publications identified, 19 articles were included in this review. Four themes were identified, namely (a) overlap of DSM-5 OCPD with the ICD-11 PD model, (b) the factorial structure of the ICD-11 PD model with respect to the anankastia domain, (c) the clinical utility of the ICD-11 PD model, and (d) comparison of the ICD-11 PD model of anankastia with the DSM-5 alternative model for OCPD.Conclusions: The ICD-11 anankastia domain overlaps with DSM-5 OCPD traits, and the factor analyses of the ICD-11 PD model further support the diagnostic validity of this domain. There is some support for the clinical utility of the ICD-11 PD model of anankastia but further studies are needed, including of its relationship to obsessive-compulsive and related disorders.

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.

Clinical Utility of the DSM-5 Alternative Model of Personality Disorders

2015 ◽  
Vol 21 (1) ◽  
pp. 3-25 ◽  
Author(s):  
BO BACH ◽  
KRISTIAN MARKON ◽  
ERIK SIMONSEN ◽  
ROBERT F. KRUEGER
Keyword(s):  
Personality Disorders ◽  
Alternative Model ◽  
Clinical Utility ◽  
Dsm 5

Personality Disorders as Collections of Traits

2019 ◽  
pp. 40-70
Author(s):  
Joshua D. Miller
Keyword(s):  
Personality Disorder ◽  
Construct Validity ◽  
Personality Traits ◽  
Personality Disorders ◽  
General Model ◽  
Alternative Model ◽  
Factor Model ◽  
Five Factor Model ◽  
Empirical Relations ◽  
Expert Ratings

This chapter argues that personality disorders can and should be understood as collections of basic personality traits from a general model of personality, namely the five-factor model (FFM). It reviews evidence for the convergence of FFM personality disorder profiles across multiple approaches—expert ratings (i.e., researchers and clinicians) and empirical relations. It discusses how to score the personality disorders from the FFM and provides evidence for the convergent, discriminant, and construct validity of this approach. The chapter also demonstrates how the new alternative model for personality disorders can be embedded within the more established and robust FFM literature.

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.

The DSM’s Reconnection to Psychoanalytic Theory through the Alternative Model for Personality Disorders

2019 ◽  
Vol 67 (6) ◽  
pp. 1023-1045 ◽  
Author(s):  
Adam P. Natoli
Keyword(s):  
Personality Disorders ◽  
Alternative Model ◽  
Psychoanalytic Theory ◽  
Diagnostic System ◽  
Personality Pathology ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Psychodynamic Diagnostic Manual ◽  
Current Systems

Often believed to have Kraepelinian origins, the Diagnostic and Statistical Manual of Mental Disorders—5th Edition (DSM-5) defines personality disorders using a categorical, hierarchical taxonomic system. This system possesses many long-standing problems for clinical practice, including a large assortment of symptom combinations that contribute to problematic heterogeneity and likely impair diagnostic validity. The DSM diagnostic system was at one time heavily influenced by psychoanalytic theory (Shorter 2005). A desire for greater theoretical neutrality then encouraged a shift away from psychoanalytic theory, resulting in the problematic atheoretical model of personality pathology introduced in DSM-III (1980) and still used today. The Alternative Model for Personality Disorders (AMPD), introduced in DSM-5 (2013), is an attempt to reconcile many of the categorical model’s issues and directly parallels primary themes that characterize psychoanalytic models of personality. After a review of the historical development of DSM, three current systems for diagnosing personality pathology—the DSM-5’s categorical model (2013), its AMPD (2013), and the Psychodynamic Diagnostic Manual (2nd ed.; Alliance of Psychoanalytic Organizations 2017) are compared. The comparison illustrates how the AMPD brings psychoanalytic theory back into the DSM system and acknowledges the implications of a more psychoanalytic DSM.

scholarly journals Assessing mentalization in psychotherapy: first validation of the Mentalization Imbalances Scale

2018 ◽  
Vol 21 (3) ◽  
Author(s):  
Giulia Gagliardini ◽  
Salvatore Gullo ◽  
Edgardo Caverzasi ◽  
Annalisa Boldrini ◽  
Stefano Blasi ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Personality Disorder ◽  
Personality Disorders ◽  
National Sample ◽  
Personality Pathology ◽  
Valid Measure ◽  
Obsessive Compulsive ◽  
Significant Relationships ◽  
Assessment Measure ◽  
Preliminary Validation

The aim of this study was to provide data on the preliminary validation of a clinician-report multidimensional assessment measure of mentalization (Mentalization Imbalances Scale, MIS). A random national sample of psychotherapists (N=190) completed the MIS to identify mentalization imbalances, and the Personality Disorder Checklist to assess the personality disorders (PDs) of randomly selected patients currently in their care. Factor analysis confirmed the presence of six factors that represented different imbalances of mentalization: cognitive, affective, automatic, external, imbalance toward others, and imbalance toward self. We found several significant relationships between patients’ mentalization imbalances and personality pathology. Paranoid, schizoid, and schizotypal PDs were predicted by an imbalance toward self, an imbalance the patients shared with histrionic, avoidant, and obsessive compulsive PDs, whereas dependent, borderline, and histrionic PDs were related to an imbalance toward others. Cognitive imbalance was related to schizoid, narcissistic, and obsessive compulsive PDs, whereas affective imbalance predicted antisocial, borderline, narcissistic and histrionic PDs. Automatic imbalance was related to schizotypal, antisocial, and borderline PDs. MIS represents a reliable and valid measure that can help clinicians at understanding patients’ specific difficulties of mentalization.

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.

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