Examining the Structure and Validity of Self-Report Measures of <i>DSM-5</i> Alternative Model for Personality Disorders Criterion A

Bliton, Chloe F.; Roche, Michael J.; Pincus, Aaron L.; Dueber, David

doi:10.1521/pedi_2021_35_531

Cited by 19 publications

(17 citation statements)

References 62 publications

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“…Accordingly, a review indicates that various self-report and expert-Table 1 Domains and Subdomains of the Level of Personality Functioning Scale rating studies based on LPFS subdomains support a model with two strongly correlated factors (Zimmermann et al, 2019), which may justify the use of an overall score (Zimmermann et al, in press). Studies that pointed to a multidimensional structure (Bliton et al, 2021;Sleep et al, 2019Sleep et al, , 2020 conducted item-level factor analyses with comprehensive self-report measures and cannot inform about the structure at the level of subdomains.…”

Section: Research On Lpfs-based Interviewsmentioning

confidence: 99%

Reliability, structure, and validity of module I (personality functioning) of the Structured Clinical Interview for the alternative DSM–5 model for personality disorders (SCID-5-AMPD-I).

Ohse¹,

Zimmermann²,

Kerber³

et al. 2023

Personality Disorders: Theory, Research, and Treatment

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According to the alternative model for personality disorders (AMPD) of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), a moderate or greater impairment in personality functioning is the essential criterion for a personality disorder diagnosis. Personality functioning is operationalized in the Level of Personality Functioning Scale via 4 domains (identity, self-direction, empathy, and intimacy) and 2 higher order dimensions (self and interpersonal functioning). The current study examined the reliability (interrater, test–retest), structure, and validity (convergent, discriminant, and incremental) of the Structured Clinical Interview for the AMPD–Module I (SCID-5-AMPD-I). A clinical sample (n = 121) completed the SCID-5-AMPD-I, along with an interview for DSM–5 Section II personality disorders and self-reports for personality pathology (personality functioning, personality organization, personality structure, and pathological personality traits) and other forms of psychopathology (depression, anxiety, somatization, and general disability). Interrater and test–retest reliability was excellent for overall personality functioning, the higher order dimensions, and the domains, except for the empathy domain in the test–retest condition. Factor analyses suggest that personality functioning is an essentially unidimensional construct. Personality functioning demonstrated high convergence with other forms of personality pathology and showed good discriminant validity in relation to depression, anxiety, and somatization but not in relation to the broader construct of general disability. Personality functioning (Criterion A) showed incremental validity over pathological personality traits (Criterion B) in predicting interview-assessed DSM–5 Section II personality disorders but not in predicting self-reported personality and general psychopathology. The present study suggests that the SCID-5-AMPD-I is a viable measure for personality functioning.

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Section: Research On Lpfs-based Interviewsmentioning

confidence: 99%

Reliability, structure, and validity of module I (personality functioning) of the Structured Clinical Interview for the alternative DSM–5 model for personality disorders (SCID-5-AMPD-I).

Ohse¹,

Zimmermann²,

Kerber³

et al. 2023

Personality Disorders: Theory, Research, and Treatment

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“…At Time 1, Mr. D’s LPFS score showed severe impairment in personality functioning ( Table 1 ). Although the LPFS model is understood as a unidimensional index of severity ( Bliton et al, 2021 ), nuanced clinical information regarding personality functioning can be gleaned from the four domains of identity, self-direction, intimacy, and empathy. Depicted in Figure 1 at Time 1 (green bars), Mr. D showed extreme impairment in self-direction and severe impairment in identity, intimacy, and empathy.…”

Section: Resultsmentioning

confidence: 99%

“…Since its inception, AMPD research has boomed with focus on the psychometric properties, validity, and reliability of Criterion A and Criterion B (e.g., Krueger et al, 2012 ; Few et al, 2013 ; Morey, 2017 ; Zimmermann et al, 2019 ; Bliton et al, 2021 ). However, exploring the clinical application and utility of the AMPD has received comparatively less attention.…”

Section: Introductionmentioning

confidence: 99%

Trading Patients: Applying the Alternative Model for Personality Disorders to Two Cases of DSM-5 Borderline Personality Disorder Over Time and Across Therapists

2022

Self Cite

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The DSM-5 Alternative Model for Personality Disorders (AMPD) dimensionally defines personality pathology using severity of dysfunction and maladaptive style. As the empirical literature on the clinical utility of the AMPD grows, there is a need to examine changes in diagnostic profiles and personality expression in treatment over time. Assessing these changes in individuals diagnosed with borderline personality disorder (BPD) is complicated by the tendency for patients to cycle through multiple therapists over the course of treatment leaving the potential for muddled diagnostic clarity and disjointed case conceptualizations. Following patient trajectories across therapists offers a unique opportunity to examine the AMPD’s sensitivity to and utility for capturing personality stability and change over time for patients with BPD. This article demonstrates the utility of the AMPD for two clinical cases in three distinct ways: (i) highlighting heterogeneity in BPD between patients, (ii) comparing improvements in personality severity and style over time, and (iii) elucidating profile change across therapist ratings. We present two patients diagnosed with DSM-5 Section II BPD, crossing between two therapists over the course of 3 years of psychodynamic psychotherapy. Treating clinicians rated patients for their respective treatment phases using the Level of Personality Functioning Scale (LPFS), capturing severity, and the Personality Inventory for the DSM-5 (PID-5), capturing style. AMPD diagnostic profiles differentiated patients with BPD in both severity and style, and captured within-patient change beyond within-therapist response bias. Results indicated greater improvements in personality severity while personality style remained more stable. Implications for the patients’ treatment progress and associated challenges are discussed, as are considerations for the utility of the AMPD in therapy.

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“…Results consistently supported a one-factor structure across measures, with bifactor models specifically supporting this unidimensional structure. In addition, the measures demonstrated convergent validity with both normal and pathological personality constructs (Bliton et al, 2022).…”

Section: The Ampdmentioning

confidence: 99%

Criterion a of the alternative model of personality disorders: Structure and validity in a community sample.

Uliaszek¹,

Amestoy²,

Fournier³

et al. 2023

Psychological Assessment

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The alternative model of personality disorders were designed to represent the presence of personality dysfunction (Criterion A) and pathological personality traits (Criterion B). Much of the empirical attention toward this model has been directed toward testing the performance of Criterion B. However, the development of the Levels of Personality Functioning Scale–Self-Report (LPFS-SR) has sparked a growing amount of interest and debate around Criterion A. Specifically, there is significant disagreement in the research examining the validity of the LPFS-SR, with ongoing discrepancies regarding the measure’s underlying structure and measurement of Criterion A. The present study aimed to compare four models (one-factor, four-factor, higher order, and bifactor models) in a sample of 416 adults (49.5% women, 63.5% White) to better understand the structure of the LPFS-SR. This study also built on existing efforts to establish convergent and divergent validity of the LPFS-SR by examining how criteria are related to independent measures of both self and interpersonal pathology. The results from the present study supported a bifactor model. Additionally, the four subscales of the LPFS-SR each captured unique variance above and beyond the general factor. Structural equation models predicting identity disturbance and interpersonal traits demonstrated that while the strongest relationships were found between the general factor and the scales, some support was found for the convergent and discriminant validity of the four factors. This work advances our understanding of the LPFS-SR and provides support for the LPFS-SR as a valid marker of personality pathology in clinical and research settings.

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Examining the Structure and Validity of Self-Report Measures of DSM-5 Alternative Model for Personality Disorders Criterion A

Cited by 19 publications

References 62 publications

Reliability, structure, and validity of module I (personality functioning) of the Structured Clinical Interview for the alternative DSM–5 model for personality disorders (SCID-5-AMPD-I).

Reliability, structure, and validity of module I (personality functioning) of the Structured Clinical Interview for the alternative DSM–5 model for personality disorders (SCID-5-AMPD-I).

Trading Patients: Applying the Alternative Model for Personality Disorders to Two Cases of DSM-5 Borderline Personality Disorder Over Time and Across Therapists

Criterion a of the alternative model of personality disorders: Structure and validity in a community sample.

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