The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM–5) alternative model of personality disorders (AMPD) has now been available for researchers and clinicians for a decade. The present article aims to provide a narrative review of literature on the AMPD framework with particular emphasis on its clinical utility, inclusive of clinicians’ and patients’ acceptability, ease of use, diagnostic accuracy, continuity with clinically familiar constructs, and proposed utility for treatment planning, case-formulation, and clinical management. The review specifically covers the utility of Criterion A (i.e., Level of Personality Functioning Scale) and Criterion B (i.e., maladaptive personality traits) in relation to common disorders of personality. By drawing on empirical studies, surveys, clinical cases, and recommendations, the current review points to various aspects of clinical utility as well as areas for improvement. One way of increasing the AMPD’s feasibility for clinicians is to omit the transitional personality disorder (PD) hybrid types while retaining a purer diagnostic classification of PD severity and traits that also align with the International Classification of Diseases, Eleventh Revision (ICD-11), PD classification. This would allow for a more efficient assessment for busy practitioners working in general psychiatry and primary care while retaining the possibility of a more fine-grained elaboration of the PD diagnosis in high-resource specialist settings. Such revision could possibly be introduced in DSM–5.1 or DSM–6. We also propose that future exploration of the AMPD’s clinical utility may involve its potential value for allocation of clinical resources, communication between clinicians and their patients’ relatives, and utility for informing different treatment modalities.

Objectives: A diagnostic system that fails to deliver clinically useful information will not be utilized and consequently will be unable to provide valuable data for health policy and clinical decision making. Therefore, it is imperative to obtain an accurate depiction of the clinical utility of the eleventh revision of the International Classification of Diseases (ICD-11) Personality Disorder (PD) model. The current mixed-methods systematic review aimed to determine the clinical utility of the ICD-11 PD classification system. Method: An electronic screening of six databases was conducted and resulting studies were subjected to specific exclusion criteria, which elicited eight studies of interest. Study characteristics were tabulated and methodological quality was appraised. Results: Four studies offered strong support for the model’s clinical utility, three offered some support accompanied by notable limitations and one study could only offer criticisms. Conclusion: Future investigation of the ICD-11 PD classification system’s (a) communicative value between clinicians and their patients, and between clinicians and their patient’s families; (b) ease of use; and (c) feasibility in terms of practical application is required to achieve a complete understanding of its clinical utility and ultimately bring clarity to the current ambiguous findings.

The DSM‐5 Section III alternative model of personality disorder (AMPD) and the International Classification of Diseases – 11th Edition's (ICD‐11) personality disorder classification allow clinicians to identify individual trait domains in which people score highly. However, how these domains relate to constructs associated with efficacious treatment approaches is unclear. The current study aimed to determine whether constructs from two evidence‐based treatments (schema therapy [ST] and dialectical behavior therapy [DBT]) were associated with maladaptive personality traits in a way consistent with underlying theories. We examined associations between ST constructs, DBT skill use and maladaptive coping styles, and personality traits in a sample of 525 adults. Bivariate intercorrelations and a series of multiple regression analyses were conducted to investigate the associations. As hypothesized, maladaptive coping was strongly associated with all trait domains. Surprisingly, poor DBT‐skill use was only associated with negative affectivity, detachment, and disinhibition trait domains. Specific schema domains were associated with each personality trait domain, supporting trait domain‐schema domain specificity. The current study highlights the potential clinical utility of the AMPD and ICD‐11 trait models and ultimately contributes to the dearth of evidence on their likely usefulness for treatment selection, planning, and applications.