Applying the DSM-5 Alternative Model of Personality Disorders and the Shedler-Westen Assessment Procedure to the Classic Case of "Madeline G.": Novice and Expert Rater Convergences and Divergence.

Alisa R Garner,Rebecca Skadberg,Alayna Watson,Megan Baumgardner,David Tierney,Gloria Romero,Mark H Waugh,Taylor Younginer,Natalie Blocher

doi:10.3389/fpsyg.2022.794616

Abstract

Prior research supports the learnability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alternative Model of Personality Disorders (AMPD). However, researchers have yet to compare novice ratings on the AMPD’s Level of Personality Functioning Scale and the 25 pathological personality traits with expert ratings. Furthermore, the AMPD has yet to be examined with the idiographic Shedler-Westen Assessment Procedure (SWAP). We compared the aggregated AMPD clinical profile of a group of psychology doctoral students who learned the AMPD to high levels of reliability to that of an expert rater using the crucible of the classical case of “Madeline G.” Examination of AMPD and SWAP ratings of “Madeline G.” revealed excellent overall concordance but suggests that novice raters tend to perceive lower levels of personality impairment.

Highlights

The categorical model of psychiatric classification, including personality disorders, is increasingly criticized (Widiger and Samuel, 2005; Widiger and Trull, 2007; Krueger et al, 2014; Krueger and Hobbs, 2020)
Interrater reliability for the Shedler-Westen Assessment Procedure (SWAP) was fair for single rater, intraclass correlation coefficient (ICC) [2, 1] = 0.55, and excellent for average, ICC [2, 17] = 0.96
Agreement for the SWAP was excellent for both single rater, ICC [2, 1] = 0.78, and average, ICC [2, 2] = 0.89

Summary

Introduction

The categorical model of psychiatric classification, including personality disorders, is increasingly criticized (Widiger and Samuel, 2005; Widiger and Trull, 2007; Krueger et al, 2014; Krueger and Hobbs, 2020). The categorical diagnostic paradigm is incorporated within the various editions of and up to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; American Psychiatric Association [APA], 2013). The AMPD incorporates a pan-theoretical approach to personality assessment (Pincus, 2011). It includes Criterion A and B, both of which draw from important historical traditions in personality and psychopathology (Skodol et al, 2015; Waugh et al, 2017).

Methods

Results

Conclusion