Differentiating normal and disordered personality using the General Assessment of Personality Disorder (GAPD)

Abstract

Criteria to differentiate personality disorder from extremes of normal personality variations are important given growing interest in dimensional classification because an extreme level of a personality dimension does not necessarily indicate disorder. The DSM-5 proposed classification of personality disorder offers a definition of general personality disorder based on chronic interpersonal and self/identity pathology. The ability of this approach to differentiate personality disorder from other mental disorders was evaluated using a self-report questionnaire, the General Assessment of Personality Disorder (GAPD). This measure was administered to a sample of psychiatric patients (N = 149) from different clinical sub-sites. Patients were divided into personality disordered and non-personality disordered groups on the basis of the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). The results showed a hit rate of 82% correct identified patients and a good accuracy of the predicted model. There was a substantial agreement between SCID-II interview and GAPD personality disorder diagnoses. The GAPD appears to predict personality disorder in general, which provides support of the DSM-5 general diagnostic criteria of personality disorder.

The Alternative DSM-5 Model for Personality Disorders: A Clinical Application

“…Self-interpersonal problems such as insecure attachment and maladaptive schemas have been shown to be associated significantly with personality disorder psychopathology and impairments in psychosocial functioning in general, as well as to affect treatment alliance and outcome (e.g., [24][25][26][27][28][29][30][31][32][33][34]. Furthermore, self pathology has been shown to have incremental validity over interpersonal pathology in predicting overall severity of personality pathology (35), so both components are represented in the DSM-5 Level of Personality Functioning Scale.…”

Lack of meaning, purpose and direction in life in personality disorder: A comparative quantitative approach using Livesley's General Assessment of Personality Disorder

“…As illustrated in Figure 1, in both PD groups (with and without depression), the mean score on the subscale LMPD was 3.4 (SD = 0.9 and 1.0, resp.). Normative comparison showed that this score is in the 95th through 100th percentile (very high) of a normal population group, 25 as was the case for non-PD patients with depression, with a mean score of 3.1 (SD = 1.1) and for the non-PD patients without depression with a mean score of 2.7 (SD = 1.1). For normal controls, the mean score was 1.6 (SD = 0.6), which is consistent with the 20th through 80th percentile Meaning in life as a facet of personality functioning in personality disorder (average) of a normal population group.…”

“…the General Assessment of PD (GAPD)) . For low self‐directedness, the GAPD distinguishes three subscales: (1) lack of autonomy and agency, (2) LMPD in life and (3) difficulty setting and attaining rewarding goals . The second subscale, LMPD, is relevant for the present study and contains items that are similar to other meaning‐in‐life self‐report questionnaires, such as the Purpose in Life scale, the Life Regard Index or the Meaning in Life Questionnaire …”

“…23 For low self-directedness, the GAPD distinguishes three subscales: (1) lack of autonomy and agency, (2) LMPD in life and (3) difficulty setting and attaining rewarding goals. 24,25 The second subscale, LMPD, is relevant for the present study and contains items that are similar to other meaning-in-life self-report questionnaires, such as the Purpose in Life scale, 26 the Life Regard Index 27 or the Meaning in Life Questionnaire. 28 The frequently used Purpose in Life scale has a broader range, including affective aspects of meaning in life, 2,26 and the Life Regard Index also has items on fulfilment of meaning in life.…”