Model-based PID-5 domain clusters and levels of impairment in self and interpersonal functioning

Abstract

In the DSM-5 Section III Alternative Model for Personality Disorders (AMPD), the severity of personality pathology (criterion A) and the presence of pathological personality trait domains and facets (criterion B) are assessed independently. Recent studies have challenged this assumption of independence but the interplay between criterion A and criterion B remains subject of further research. Using model-based cluster analysis on the criterion B trait domains, we compared criterion B trait domain clusters with respect to criterion A severity measures. Results revealed a six-cluster solution. Four of the six clusters represented a gradual increase in criterion B trait domains, paralleling an increase in criterion A severity. Two clusters did not follow this pattern: an Anxious-Detached type exhibiting overall high criterion A severity scores, and an emotionally stable psychopathy type exhibiting a number of low criterion A severity scores. Our findings indicate that criterion B domain clusters are informative of criterion A severity, relevant for future conceptualizations of the AMPD.