A framework for treating DSM‐5 alternative model for personality disorder features

Hopwood, Christopher J.

doi:10.1002/pmh.1414

Cited by 98 publications

(107 citation statements)

References 109 publications

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“…Thus, providers could anticipate that individuals might require further clinical attention and support on these issues and employ staff with appropriate skills to deliver strategically targeted interventions to ensure that individuals' needs are met. There are various recent examples of the clinical utility of dimensional conceptualizations of personality functioning for the development of individualized treatment plans [21,25,51]. Given its ability to disentangle current personality functioning from stable traits and personality disorders, mapping characteristic adaptations can allow clinicians to develop subgroup norms with similar characteristics, identify which types of client respond better to what type of treatment and subsequently facilitate the development of personorientated clinical formulations.…”

Section: Discussionmentioning

confidence: 99%

The role of personality functioning in drug misuse treatment engagement

et al. 2019

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Background and aim Personality functioning is predictive of drug misuse and relapse, yet little is known about the role of personality in engagement with the treatment process. This study aimed to estimate the extent to which broad‐ and facet‐level characteristic adaptations contribute to or hinder treatment engagement, while controlling for psychosocial indicators. Design Multi‐site cross‐sectional survey. Setting In‐patient treatment units covering 80% of residential treatment entries in Greece. Participants A total of 338 service users, 287 (84.9%) male, 51 (15.1%) female, average age 33.4 years. Measurements Expressions of personality functioning (characteristic adaptations) were assessed using the Severity Indices of Personality Problems (SIPP‐118). Treatment engagement was measured using the Client Evaluation of Self and Treatment, in‐patient version (CEST). Findings Dysfunctional levels of relational capacities predicted counselling rapport [β = 1.50, 95% confidence interval (CI) = 0.326–2.69, P = 0.013], treatment participation (β = 2.09, 95% CI = 1.15–3.11, P < 0.001) and treatment satisfaction (β = 1.65, 95% CI = 0.735–2.57, P < 0.001). Counselling rapport was also predicted by dysfunctional levels in self‐control (β = 1.78, 95% CI = 0.899–2.67, P < 0.001), self‐reflective functioning at the facet‐level (β = 2.24, 95% CI = 1.01–3.46, P < 0.001) and aggression regulation (β = 1.43, 95% CI = 0.438–2.42, P = 0.005). Dysfunctional levels on social concordance (β = −1.90, 95% CI = −2.87 to –0.941, P = 0.001), emotional regulation (β = 1.90, 95% CI = 0.87–2.92, P < 0.001) and intimacy (β = 2.04, 95% CI = 1.31–3.05, P < 0.001) were significant predictors of treatment participation. Treatment readiness and desire for help predicted treatment engagement. Conclusions In people attending substance use treatment services, maladaptive interpersonal patterns and relational intimacy, emotional dysregulation and impulse control may be associated with low levels of counselling rapport and treatment participation. Low frustration tolerance and aggressive impulses also appeared to predict low participation.

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Section: Discussionmentioning

confidence: 99%

The role of personality functioning in drug misuse treatment engagement

et al. 2019

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“…A promising way to deal with such response patterns is using alternative measures that employ forced choice technique such as the Goldsmiths-60-item questionnaire [99]. [115][116][117][118][119][120][121][122][123]. In the following, we provide an updated, comprehensive summary of research on the AMPD.…”

Section: Further Issuesmentioning

confidence: 99%

A Brief but Comprehensive Review of Research on the Alternative DSM-5 Model for Personality Disorders

Zimmermann

Kerber

Kappelmann

et al. 2019

Curr Psychiatry Rep

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Purpose of Review Both the Alternative DSM-5 Model for Personality Disorders (AMPD) and the chapter on personality disorders (PD) in the recent version of ICD-11 embody a shift from a categorical to a dimensional paradigm for the classification of PD. We describe these new models, summarize available measures, and provide a comprehensive review of research on the AMPD. Recent Findings A total of 237 publications on severity (criterion A) and maladaptive traits (criterion B) of the AMPD indicate (a) acceptable interrater reliability, (b) largely consistent latent structures, (c) substantial convergence with a range of theoretically and clinically relevant external measures, and (d) some evidence for incremental validity when controlling for categorical PD diagnoses. However, measures of criterion A and B are highly correlated, which poses conceptual challenges. Summary The AMPD has stimulated extensive research with promising findings. We highlight open questions and provide recommendations for future research.

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“…therapeutic alliance, therapist empathy and client expectations). 8,9 Although much of the past treatment research has focused on specific disorders, meta-analytic findings suggest that major classes of treatments tend to perform similarly across categorical disorders [10][11][12] and are used to treat a diverse number of psychological disorders. [12][13][14] Additionally, treatments that are developed for a specific disorder often improve other psychological symptoms, in part, perhaps, because many forms of psychopathology may be manifestations of relatively few transdiagnostic latent factors 15 ; indeed, the high rates of diagnostic co-morbidity provide additional evidence for this possibility.…”

Section: History Of Evidence-based Practice For Psychological Disordersmentioning

confidence: 99%

“…'Given that evidence supports the multidimensional structure of both personality and intervention strategies, a useful approach to treating [personality pathology] should integrate multidimensional models of personality and intervention rather than be organized around specific disorders and specific treatment packages. 8 Utilizing a technique-driven approach consistent with the direction research is moving in personalized medicine 42 and in psychotherapy research. 43,44 Hopwood 8 provides a comprehensive review of the common and specific factors specific to personality pathology in the psychotherapy research literature.…”

Section: Treatment Implications For Hierarchical Taxonomy Of Psychopamentioning

confidence: 99%

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Treatment of personality pathology through the lens of the hierarchical taxonomy of psychopathology: Developing a research agenda

Mullins‐Sweatt

Hopwood

Chmielewski

et al. 2019

Personality & Mental Health

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Despite the emphasis on evidence‐based treatment for psychological disorders, to date, there has been limited research examining treatment for nine of the 10 categorical personality disorders in DSM‐5 Section 2. This is perhaps not surprising given the complex heterogeneity and co‐morbidity within personality pathology. The hierarchical taxonomy of psychopathology (HiTOP) was proposed to address limitations within the traditional categorical model of the diagnostic system. Within this system are five spectra: detachment, antagonistic externalizing, disinhibited externalizing, thought disorder and internalizing. These foundational personality traits potentially have direct and specific treatment implications. The purpose of this paper is to highlight potential psychotherapeutic and pharmacological treatment recommendations within the personality spectra. Additionally, we outline the advantages of considering the personality science found within dimensional models of psychopathology in clinical assessment and intervention to aid in treatment planning. © 2019 John Wiley & Sons, Ltd.

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A framework for treating DSM‐5 alternative model for personality disorder features

Cited by 98 publications

References 109 publications

The role of personality functioning in drug misuse treatment engagement

The role of personality functioning in drug misuse treatment engagement

A Brief but Comprehensive Review of Research on the Alternative DSM-5 Model for Personality Disorders

Treatment of personality pathology through the lens of the hierarchical taxonomy of psychopathology: Developing a research agenda

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