Supplemental Material for The Alternative DSM–5 Personality Disorder Traits Criterion: A Comparative Examination of Three Self-Report Forms in a Danish Population

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.


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.


Author(s):  
Joshua D. Miller ◽  
Lauren R. Few ◽  
Thomas A. Widiger

The assessment of personality disorders and related traits is at an important crossroads with the imminent release of DSM-5. In this chapter we first review assessment techniques and measures as they pertain to the DSM-IV-TR personality disorders and pathological personality traits, focusing in particular on the many self-report inventories and semistructured interviews that have been developed. Second, we discuss the proposed changes to the diagnosis of personality disorder in DSM-5, which are substantial, and their ramifications for the assessment of personality disorder, including the (now abandoned) proposal to replace explicit diagnostic criterion sets with a prototype matching technique, the proposal to delete and/or shift a number of diagnoses from the personality disorders section, the provision of a new dimensional trait model of personality pathology, and the provision of new rating of impairment pertaining to self and interpersonal functioning.


2019 ◽  
Vol 31 (10) ◽  
pp. 1181-1191 ◽  
Author(s):  
Chelsea E. Sleep ◽  
Donald R. Lynam ◽  
Thomas A. Widiger ◽  
Michael L. Crowe ◽  
Joshua D. Miller

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

2019 ◽  
Vol 31 (10) ◽  
pp. 1200-1205 ◽  
Author(s):  
Chelsea E. Sleep ◽  
Donald R. Lynam ◽  
Thomas A. Widiger ◽  
Michael L. Crowe ◽  
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.


2019 ◽  
Vol 33 (2) ◽  
pp. 185-213 ◽  
Author(s):  
Casey M. Strickland ◽  
Christopher J. Hopwood ◽  
Marina A. Bornovalova ◽  
Elizabeth C. Rojas ◽  
Robert F. Krueger ◽  
...  

Symptom-based models, typically operationalized through diagnostic interview, and trait models, typically operationalized via questionnaire inventories, reflect historically competing conceptions of personality disorder (PD). DSM-5 includes models of both types, in Sections II and III, respectively. In this study, we sought to synthesize these alternative conceptualizations by fitting bifactor models to data for both Section II PD symptoms (assessed using the SCID-II interview protocol) and dimensional traits for the six PDs retained in Section III (assessed using the Personality Inventory for DSM-5). Bifactor models fit the data effectively for all six PDs, and trait and symptom indicators both loaded appreciably on general factors reflecting cross-domain PD constructs. These results provide the basis for a principled, quantitative synthesis of categorical/interview and dimensional/self-report approaches to operationalizing and studying PDs, with considerable implications for diagnosis, research, and practice.


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