A bifactor model of personality organization in adolescence: the validity of a brief screening measure assessing severity and core domains of functioning

Abstract

Background Both the latest edition of the DSM-5 as well as the new ICD-11 have established a new focus in the diagnosis of personality disorders: the assessment of personality functioning. This recent shift in focus converges with long-standing psychodynamic conceptualizations of personality pathology, particularly Kernberg’s object relations model. Although a significant amount of research supports these models in adults, much less is known about the validity of these frameworks in youth. Considering the paucity of brief measures of personality functioning in adolescents, the current study aimed to develop and investigate the validity of the Inventory of Personality Organization for Adolescents—Short Form, a theoretically-informed measure assessing severity and core domains of functioning in adolescents. Methods A total sample of N = 525 adolescents aged 13 to 19 years were recruited through a community University-Health Psychology Clinic as current patients (n = 94) or who responded to an online research call (n = 431). Results Results indicate that a bifactor model provided the best fit to the data and consisted of a general factor reflecting core self-other functioning and three specific factors, representing additional dimensions of personality organization. Conclusions A brief 15-item version of the IPO-A was successfully derived for time-efficient screening of personality pathology in youth. Similarities with the ICD-11 framework are discussed.

Unpacking the p-factor. Associations Between Maladaptive Personality Traits and General Psychopathology in Female and Male Adolescents

“…This is likely particularly relevant in adolescents because, as Sharp points out, “ developmental research suggests that Criterion A concepts (identity, self-direction, empathy, and intimacy) coalesce around the development of self, marking a discontinuous (qualitative) shift in development that enables the adolescent to take on independent adult role function, which is demanded from the environment ” (Sharp, 2020 , p. 202). Consistent with this, impaired self-development has been identified by studies showing that borderline personality disorder features are robust markers of personality pathology (Biberdzic et al, 2022 ; Sharp & Fonagy, 2015 ; Sharp & Wall, 2018 ). Gender differences in borderline features have been identified by some studies showing that males display more aggressive and antisocial traits (Bradley et al, 2005 ), while other studies find more commonalities than differences (Johnson et al, 2003 ; Silberschmidt et al, 2015 ).…”

“…Maladaptive personality traits are associated with internalizing and externalizing dimensions of psychopathology (Gjerde et al, 2023 ; Sharp & Wall, 2018 ; Shields et al, 2021 ). Indeed, previous research on emerging personality pathology in adolescents suggests that there is an interplay between internalizing and externalizing features and borderline personality disorder features indicative of impairments in self-development (i.e., instability of self-image, emotional dysregulation and relationship problems) (Benzi et al, 2022 , 2023a , b ; Biberdzic et al, 2022 ; Bleiberg et al, 2012 ; Chanen et al, 2017 ; Conway et al, 2015 , 2016 ; Stepp et al, 2016 ). Sharp and Wall ( 2018 ) suggest integrating Criterion A of the Alternative Model for Personality Disorders (AMPD) adopted by the DSM-5 (APA, 2013 ), which focuses on impairments in self and interpersonal functioning (Sharp & Wall, 2018 ; Sharp et al, 2018 ).…”

A borderline personality assessment for adolescents: Validity and reliability of the Chinese languages borderline personality features scale (short form version) for adolescents/children

“…Over the last decade, many studies have employed the BFSFC-SF to screen personality features of adolescents ( 39 – 43 ). For example, Biberdzic et al used the BFSFC-SF to assess adolescents' core domains of functioning; Barkauskiene et al used BFSFC-SF to screen adolescent borderline personality features to provided information for the established DSM-V. Hendriks et al used the BFSFC-SF to explore the psychopathological correlates of implicit and explicit shame and guilt; Sharp et al used the BFSFC-SF to investigate maladaptive identity formation in adolescence.…”

Operationalizing intimacy and identity aspects of personality functioning in relation to personality disorder in adolescents

“…For the assessment of AMPD Criterion A, a range of self-report and interview-based measures have been developed. These measures show strong validity and reliability in adults [see ( 15 ) and ( 16 ) for a review] and there is an emerging literature validating Criterion A-related measures in adolescents [e.g., ( 17–20 )]. The limitations of self-report measures to adequately assess Criterion A function, given the known impairment in self-reflection associated with personality pathology, have been noted ( 21 , 22 ), and the potential of using experimental or more performance-based measures has been suggested—in particular for Criterion A ( 23 ).…”