The DSM-5 Section III Personality Disorder Criterion A in relation to both pathological and general personality traits

2019 ◽  
Author(s):  
Chelsea Sleep ◽  
Donald Lynam ◽  
Josh Miller

Following the introduction of the DSM-5 Section III Alternative Model of Personality Disorder (AMPD), much of the empirical attention has been directed towards testing the performance of Criterion B (i.e., pathological traits). Much more recently, with the development of assessment tools related to Criterion A (i.e., personality impairment), a burgeoning literature base is forming for it as well. A closer look at the Criterion A component, however, reveals disagreements around its structure, discriminant validity, ability to distinguish between personality-based and non-personality-based forms of psychopathology, overlap between the two criteria, and incremental validity. The goal of the current study (N = 365 undergraduates) was to test Criterion A in relation to both pathological personality traits, as specified in the DSM-5, as well as general personality traits as suggested might be more appropriate by some scholars. The results suggest that impairment domains overlap substantially with pathological and general traits, and these traits account for considerable variance in impairment domains. Most importantly, the findings suggest that general and pathological traits functioned in nearly identical ways, as evidenced by the similar relations that they evinced with traditional DSM-5 PD constructs. In line with previous work, the present findings demonstrate limited discriminant validity among impairment domains, and an inability to distinguish between Axis I and II symptoms. Further research on the AMPD is needed to test the necessity and sufficiency of its constituent components.

2018 ◽  
Author(s):  
Chelsea Sleep ◽  
Donald Lynam ◽  
Thomas A. Widiger ◽  
Michael L Crowe ◽  
Josh Miller

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.


Assessment ◽  
2020 ◽  
pp. 107319112094716
Author(s):  
Gillian A. McCabe ◽  
Joshua R. Oltmanns ◽  
Thomas A. Widiger

The alternative model of personality disorder was created to address the apparent failings of Diagnostic and Statistical Manual of Mental Disorders–Fourth edition–text revision personality disorder diagnostic categories and consists of Criterion A (i.e., personality functioning) and Criterion B (i.e., pathological personality traits). There are now four alternative measures of the Criterion A impairments but, perhaps surprisingly, no study has yet compared any one of them with any one of the other three. The current study assesses the convergent (and discriminant) validity of all four, as well as their structural relationship with the five-factor model (FFM), a widely accepted model for understanding the structure of normal and pathological personality traits. Exploratory structural equation modeling analyses of the Criterion A measures and FFM scales demonstrate that the Criterion A self-identity scale can be understood as a maladaptive variant of FFM neuroticism. Moreover, results indicate no appreciable discriminant validity in the assessment of the Criterion A impairments—the Criterion A scales correlated more highly within measures than across alternative measures, even when measuring the same construct. Implications of these findings for the conceptualization and assessment of Criterion A self and interpersonal impairments are discussed.


2015 ◽  
Vol 46 (3) ◽  
pp. 647-655 ◽  
Author(s):  
L. C. Morey ◽  
K. T. Benson ◽  
A. E. Skodol

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.


2020 ◽  
Vol 11 (3) ◽  
pp. 202-212 ◽  
Author(s):  
Chelsea E. Sleep ◽  
Brandon Weiss ◽  
Donald R. Lynam ◽  
Joshua D. Miller

2021 ◽  
pp. 1-33
Author(s):  
Chloe F. Bliton ◽  
Michael J. Roche ◽  
Aaron L. Pincus ◽  
David Dueber

The Level of Personality Functioning Scale (LPFS) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. Despite progress in LPFS measurement development and validation, there is a lack of research, and some disagreement, concerning structural, convergent, and incremental validity of LPFS self-report measures. The present study aimed to compare the LPFS Self-Report, LPFS Self-Report of Criterion A, and LPFS Brief Form. Internal structure was assessed through principal component analyses, factor analyses, and bifactor analyses of unidimensionality. Associations with both pathological and basic personality characteristics among the LPFS measures were explored. Incremental validity of LPFS severity in predicting pathological personality outcomes controlling for basic personality traits, and the reverse, were examined. Results suggest a unidimensional structure robustly associated with other pathological personality assessments. LPFS severity and basic personality traits mutually offered unique explanatory power. We discuss the implications of assessing personality pathology using LPFS self-report measures.


2018 ◽  
Vol 34 ◽  
Author(s):  
Lucas de Francisco Carvalho ◽  
Jonatha Tiago Bacciotti ◽  
Catarina Possenti Sette ◽  
Ana Maria Reis

Abstract The aim of this study was to investigate the combined use of two pathological personality tests, the Dimensional Clinical Personality Inventory (IDCP) and the Personality Inventory for DSM-5 (PID-5), within the context of incremental validity in order to verify the increasing severity of the constructs used. We generated item maps for sets of items based on three dimensions of IDCP and five facets of PID-5, selected according to the possibility of pairing between scales. The study included 642 individuals, predominantly women aged over 18, divided into three groups according to the dimensions and facets. There was an increase in the level of severity, typically related to the different personality disorders, in addition to the complementation between instruments, providing incremental validity. The use of item mapping helped us understand the increasing severity of the traits, and allowed the verification of the clinical relevance of the constructs.


Author(s):  
David Watson ◽  
Michael W. O’Hara

This chapter reviews major findings reported in earlier chapters. First, previous findings confirm the existence of specific symptom dimensions that are highly robust and that show strong convergent and discriminant validity. Second, they establish the existence of multiple symptom dimensions within several disorders. Third, they demonstrate that these specific symptom dimensions have differential criterion validity, differential diagnostic specificity, and differential incremental validity. These symptom data can be used to improve various DSM diagnoses, such as major depression and posttraumatic stress disorder. More fundamentally, they provide the basis for a comprehensive symptom-based model of psychopathology. In addition to the IDAS-II, other instruments assess dimensions underlying sleep disorders, eating disorders, schizotypy, personality disorder, and hypochondriasis. These instruments jointly provide broad coverage of the 19 diagnostic classes contained in DSM-5. These measures support movement away from disorder-based models of psychopathology to ones focused on homogeneous symptom dimensions.


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