Alternative DSM-5 Model For Personality Disorders Research Articles

Confirmatory Factor Analysis of Alternative DSM-5 Model for Personality Disorders: on PAI

이 연구는 Ruiz et al.(2018)이 PAI 문항을 사용하여 성격장애에 대한 대안적 DSM-5 모델(AMPD)의 병리적 성격특질(부정적 정서성, 애착상실, 적대성, 탈억제, 정신병적 경향성)을 도출한 결과가 우리나라 대학생, 성인, 수형자 집단에게도 적용될 수 있는지를 알아보았다. 이를 위해 성격평가질문지(PAI) 증보판 표준화 과정에서 수집한 대학생, 성인 및 수형자의 자료에서 각각 400명의 자료를 무선 표집 하고 PAI 문항을 사용하여 PAI_병리적 성격특질을 구성하여 확인적 요인분석을 실시하였다. 확인적 요인분석 결과 모든 집단에서 적합도가 적절하여 PAI로 AMPD의 개념을 측정할 수 있다는 것을 확인하였다. 이후 PAI의 척도와 PAI_병리적 성격특질 간의 상관 분석과 집단 간 분석을 통해 PAI_병리적 성격특질의 특징과 제한점을 확인하였다. 이 연구의 결과들은 PAI_병리적 성격특질과 AMPD의 병리적 성격특질 간의 유사성을 지지하며, 다양한 장면에서 활발하게 사용되고 있는 PAI의 활용성을 증대시킨다. 아울러 새롭게 제시된 성격장애 모델을 PAI와 같은 다차원적인 성격평가 도구에 적용하는 것은 개인의 포괄적인 성격특성을 평가하는 심리학적 장면에 도움을 줄 것으로 기대된다.The purpose of this study was to examine whether Ruiz et al. (2018) findings that the pathological personality characteristics (negative affectivity, detachment, antagonism, disinhibition, psychoticism) of the alternative DSM-5 model for personality disorders (AMPD) can be evaluated through the personality assessment inventory (PAI) can be applied to each students, adults and prisoners. For this, 400 samples were collected from the data of university students, adults, and prisoners of national size collected during the PAI standardization process in Korea. This study constructed PAI_pathological personality via PAI questions and performed confirmatory factor analysis. As a result, it showed that there is a possibility of generalization in Korea by showing acceptable level of fitness in all groups. The characteristics and limitations of PAI_pathological personality were identified through correlation analysis and group analysis between PAI and PAI_pathological personality. These results show that PAI can measure some concepts of AMPD. These results show that PAI can measure some concepts of AMPD.

The Differential Profile of Social Anxiety Disorder (SAD) and Avoidant Personality Disorder (APD) on the Basis of Criterion B of the DSM-5-AMPD in a College Sample.

BackgroundThe present study was conducted to determine the differential profile of social anxiety disorder (SAD) and avoidant personality disorder (APD) based on dimensional diagnosis in criterion B of the DSM-5 Alternative Model for Personality Disorders (DSM-5-AMPD) in a college sample.MethodsSamples of this cross-sectional study included 320 (23.08 ± 2.66 years; 57% female) college students in western Iran during February 2015 to December 2017. Liebowitz-social anxiety scale, PID-5, SCID-II, SCID-II-SQ and diagnostic interview for SAD were the tools. The data were analysed using Pearson correlation and multiple linear regression analysis.ResultsForty-three and 38 participants met criteria for SAD alone and APD, respectively. Five main domains of PID-5 could explain 29% and 54% of the variance of SAD and APD, respectively. Facets of negative affect, detachment, antagonism, disinhibition, and psychoticism could explain 25% versus 43%, 26% versus 54%, 7% versus 27%, 21% versus 41%, 13% versus 30% of the variance of SAD and APD, respectively.ConclusionSAD and APD probably refer to two distinct mental states having prominent anxiety, emotional instability, and interpersonal pattern of avoidance and detachment of challenge. SAD is a simple form of mental disturbances with anxiety in its core features; although, APD is possibly referring to more complicated psychopathology.

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

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. 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. The AMPD has stimulated extensive research with promising findings. We highlight open questions and provide recommendations for future research.

Schizotypy from the Perspective of the DSM-5 Alternative Model of Personality Traits: a Study on a Sample of 1056 Italian Adult University Students

To assess the relationships between schizotypy measures and DSM-5 Alternative Model of Personality Disorders (AMPD) traits, 1056 (69.4% female; mean age = 23.30 years) University students, were administered the Italian translation of the Schizotypal Personality Questionnaire (SPQ), Schizotypal Personality Scale (STA), Schizotypy Scale (SS), and Personality Inventory for DSM-5 (PID-5). Exploratory structural equation modeling (ESEM) suggested that the SPQ, STA, and SS Schizofrenism scale total scores may represent primary measures of schizotypy/Schizotypal personality disorder (PD), whereas the SS anhedonia (AH) total score represent an index of the general anhedonia level. MAMBAC, MAXCOV, and LMode taxometric analyses showed that both schizotypy and anhedonia constructs had a dimensional distribution (all comparison curve fit index values<.40). Bayesian confirmatory factor analysis (CFA) supported a two-factor model of SPQ, STA, SS SZ and SS AH scale total scores. Hierarchical regression analyses showed that DSM-5 AMPD traits that were hypothesized to define the Schizotypal PD profile (i.e., Cognitive and Perceptual Dysregulation, Unusual Beliefs and Experiences, Eccentricity, Restricted Affectivity, Withdrawal, and Suspiciousness), as well as the additional specifiers (i.e., Anxiousness, and Depressivity) explained 66.0% of the systematic variance in the schizotypy factor scale scores. Our findings suggested that schizotypy could be represented as a continuously-distributed latent variable which may be effectively described in terms of a coherent system of dysfunctional personality traits.

Diagnosis and classification of personality disorders: novel approaches.

To provide an update of the recent studies, which have evaluated the radical changes in personality disorder classification in DSM-5 and ICD-11. Although the DSM-5 Committee rejected the personality disorders Work Group proposal for personality disorder classification, the model was published in DSM-5 Section III. This Alternative Model of Personality Disorders (AMPD) has been widely adopted by the research community resulting in multiple studies evaluating its reliability and clinical utility. The ICD-11 Personality Classification has recently been accepted by the WHO and is also receiving increasing study. Both models emphasize personality disorder severity, which most studies report is consistently linked to impairment and outcome. Both models propose five descriptive domains, which appear to capture most of the current personality disorder diagnoses, and can also be linked to disease extremes of normal personality such as the Five Factor Model. The changes in DSM-5 AMPD and ICD-11 represent a significant paradigm shift in the diagnosis of personality disorders. Early research suggests that the changes may be beneficial for clinicians and researchers. The models more closely align with the large body of literature supporting dimensional models of normal personality. The severity dimensions are consistent with the large body of evidence that personality disorder severity is a strong determinant of impairment and outcome. It remains to be seen if clinicians will use the classification to plan and predict treatment for a wide range of mental disorders.

Substance and Evaluation in Personality Disorder Diagnoses.

Like person judgments in everyday life, diagnoses of personality disorders (PDs) reflect at least two influences: first, the actual characteristics of the target person (substance), and second, the more positive or negative view that the perceiver has of the target person (evaluation). In this article, we present a systematic account of substance and evaluation in PD diagnoses, using a modified version of Brunswik's (1956) lens model. An empirical study shows that the items of the alternative DSM-5 model for personality disorders (AMPD) are in fact saturated with evaluation, that this evaluation is largely the same as "social desirability," and that the two mandatory components of the AMPD (criterion A and B) are not easily distinguishable from one another in that regard. We provide concrete recommendations as to how the conceptual clarity of PD diagnostics may be improved, by distinguishing people's personality dispositions from their (likely) long-term consequences.

On the relationships between DSM-5 dysfunctional personality traits and social cognition deficits: A study in a sample of consecutively admitted Italian psychotherapy patients.

This study aims at testing the hypothesis that the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) alternative model of personality disorder (AMPD) traits may be significantly associated with deficits on 2 different social cognition tasks, namely, the Reading the Mind in the Eyes Test and the Movie for the Assessment of Social Cognition, in a sample of consecutively admitted inpatients and outpatients. The sample was composed of 181 consecutively admitted participants (57.5% women; mean age=38.58years). Correlation coefficients and partial correlation coefficients were computed in order to assess the associations among social cognition tasks, DSM-5 AMPD traits, and dimensionally assessed DSM-5 Section II personality disorders. Specific maladaptive traits listed in the DSM-5 AMPD were significantly associated with Reading the Mind in the Eyes Test scores and Movie for the Assessment of Social Cognition scores, even when the effect of selected DSM-5 Section II personality disorders was controlled for. Our results support the relevance of studying social cognitive functioning in subjects suffering from personality disorders.

Reliability and clinical usefulness of the personality inventory for DSM-5 in clinically referred adolescents: A preliminary report in a sample of Italian inpatients

BackgroundThe DSM-5 Alternative Model of Personality Disorders (AMPD) provides the opportunity to integrate the needed developmental perspective in the assessment of personality pathology. Based on this model, Krueger and colleagues (2012) developed the Personality Inventory for DSM-5 (PID-5), which operationalizes the proposed DSM-5 traits. MethodsEighty-five consecutively admitted Italian adolescent inpatients were administered the Italian translation of the PID-5, in order to obtain preliminary data on PID-5 reliability and clinical usefulness in clinically referred adolescents. ResultsWith the possible exception of the PID-5 Suspiciousness scale, all other PID-5 scales evidenced adequate internal consistency reliability (i.e., Cronbach's α values of at least .70, most being greater than .80). Our data seemed to yield at least partial support for the construct validity of the PID-5 scales also in clinical adolescents, at least in terms of patterns of associations with dimensionally assessed DSM-5 Section II PDs that were also included in the DSM-5 AMPD (excluding Antisocial PD because of the participants' minor age). Finally, our data suggested that the clinical usefulness of the PID-5 in adolescent inpatients may extend beyond PDs to profiling adolescents at risk for life-threatening suicide attempts. In particular, PID-5 Depressivity, Anhedonia, and Submissiveness trait scales were significantly associated with adolescents' history of life-threatening suicide attempts, even after controlling for a number of other variables, including mood disorder diagnosis. DiscussionAs a whole, our study may provide interesting, albeit preliminary data as to the clinical usefulness of PID-5 in the assessment of adolescent inpatients.

The latent structure of personality functioning: Investigating criterion a from the alternative model for personality disorders in DSM-5.

The alternative model for the classification of personality disorders (PD) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Section III comprises 2 major components: impairments in personality functioning (Criterion A) and maladaptive personality traits (Criterion B). In this study, we investigated the latent structure of Criterion A (a) within subdomains, (b) across subdomains, and (c) in conjunction with the Criterion B trait facets. Data were gathered as part of an online study that collected other-ratings by 515 laypersons and 145 therapists. Laypersons were asked to assess 1 of their personal acquaintances, whereas therapists were asked to assess 1 of their patients, using 135 items that captured features of Criteria A and B. We were able to show that (a) the structure within the Criterion A subdomains can be appropriately modeled using generalized graded unfolding models, with results suggesting that the items are indeed related to common underlying constructs but often deviate from their theoretically expected severity level; (b) the structure across subdomains is broadly in line with a model comprising 2 strongly correlated factors of self- and interpersonal functioning, with some notable deviations from the theoretical model; and (c) the joint structure of the Criterion A subdomains and the Criterion B facets broadly resembles the expected model of 2 plus 5 factors, albeit the loading pattern suggests that the distinction between Criteria A and B is somewhat blurry. Our findings provide support for several major assumptions of the alternative DSM-5 model for PD but also highlight aspects of the model that need to be further refined.