Alternative Model For Personality Disorders Research Articles

Changes in the classification of personality disorders: Comparing the DSM-5 Section II personality disorder model to the alternative model for personality disorders using structured clinical interviews.

The current study examined the continuity of personality disorder (PD) diagnoses from Section II to Section III (alternative model for personality disorders [AMPD]) when using structured interviews. We investigated the continuity both in terms of stability of prevalence rates and in terms of convergent validity. A clinical sample of 189 participants were concurrently administered both Section II PD and AMPD interviews for diagnosing PD by 2 independent interviewers. Stability of prevalence between the models for specific PD diagnoses was generally supported. A higher prevalence of trait-specified PD in the AMPD model resulted in higher prevalence of PD in general when using the AMPD model compared with the Section II PD model. Correlations between matching criterion counts according to both models were generally high. Convergence between the Section II PD and AMPD model categorical diagnoses was adequate for the most frequently diagnosed and studied PDs (i.e., avoidant-, borderline-, and antisocial PD), but lower than previously found, likely due to the stringent test-retest design used in this study. Convergence between the models for narcissistic and obsessive-compulsive PD was low and could not be estimated for schizotypal PD. Future studies should investigate which of both models may prove to be most valid in terms of predicting current and future impairments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The incremental utility of maladaptive self and identity functioning over general functioning for borderline personality disorder features in adolescents.

A debate has emerged regarding the nature of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Level of Personality Functioning (LPF; Criterion A) of the alternative model of personality disorder. The aim of the current study was to evaluate the distinctiveness of an aspect of LPF, namely, maladaptive self and identity function, from general psychosocial disability by evaluating its incremental utility over that of general psychosocial disability for personality disorder in adolescents. To this end, a measure of maladaptive self and identity function was administered alongside measures of general psychiatric impairment, peer problems, life satisfaction, and academic functioning in 2 samples of adolescents: a community-dwelling sample (n = 379; Mage = 14.70, SD = 1.74) and a sample of clinically-referred adolescents (n = 74; Mage = 15.05, SD = 1.47). Using hierarchical regression analyses to test our hypotheses, and consistent with the results from studies in adults, our findings showed that maladaptive self and identity function incremented general psychosocial disability in the association with borderline features with similar magnitude for clinical and community samples when considered together and separately. Results are discussed in the context of current views on the nature and meaning of LPF. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cross-cultural Study of the Personality Inventory for the DSM-5 (PID-5) across the Portuguese and the United Arab Emirates (UAE) Community and Clinical Populations.

The present paper focused on compare the PID-5 mean score levels across two matched community and clinical samples of Portugal and the UAE. The generalizability and universality of the Alternative Model of Personality Disorders has been thoroughly studied through the Personality Inventory for DSM-5 (PID-5) across countries and languages. However, studies comparing Western and Middle Eastern countries are still limited, in particular those who assess the PID-5 measurement invariance. We examined measurement invariance of the PID-5 scales across matched Emirati and Portuguese clinical and nonclinical groups, as well as compare and contrast the PID-5 mean score levels across both countries and samples. The Arabic and the Portuguese versions of the PID-5 was administered to Emirati community participants (N = 300, 80% women and 20% men, Mage = 27.95) which were matched with Portuguese community participants (N = 300, 80.3% women and 19.7% men, Mage = 28.96), as well as clinical participants of the UAE (N = 150, 61.3% women and 38.7% men, Mage = 31.29) and Portugal (N = 150, 52% men and 48% women, Mage = 44.97). We examined measurement invariance through an unrestricted Factor Analysis based program, and mean scores levels were compared and analyzed. Our findings supported the PID-5 measurement invariance across the Emirati and Portuguese clinical samples pointing to the universality and generalizability of the Alternative Model of Personality Disorders. The Emirati psychiatric sample exhibited somehow higher results than the Portuguese psychiatric participants, albeit the small effect size for most of the PID-5 scales. Further research is needed to examine the applicability of the PID-5 across non-clinical representative samples of Portugal and the UAE, and other Middle Eastern countries.

Le modèle alternatif des troubles de la personnalité en population française : évaluation avec des outils brefs

ObjectivesThe aim of this work was to study whether the French versions of the brief tools available to clinicians within the framework of the Alternative Model of Personality Disorders (AMPD) can account for the risks of personality disorders in the general population. Tools are available to accurately investigate either the Level of Personality Functioning (LPF) or the Pathological Personality Dimensions (PPD) which in turn allow the validation of the relevance of the AMPD for its criteria A and B. As these tools, such as Morey's Level of Personality Functioning Scale Self Rated (LPFS-SR) for Criteria A or the Personality Inventory for DSM-5 (PID5) by Krueger et al. for Criteria B, are lengthy, the question arises as to the use of the short tools derived from them. MethodData was collected from a sample of 433 people recruited on a volunteer basis with a complete protocol. The sample was predominantly female (83% female, 16% male, 2 people who did not wish to report their gender) and rather young (67% were 18–24 years old). The short version, the LPFS- BF of Hutsbaut et al., which we used in this work allows, as confirmed by several works, to consider on the basis of 12 items the global level of personality functioning. In order to assess the pathological dimensions of personality (PPD), we chose the short version of the Personality Inventory for DSM 5 (PID 5 BF) by Krueger et al. and used its validated French translation that satisfies the factor composition of the original version: Negative Affectivity, Antagonism, Detachment, Disinhibition and Psychoticism. To assess the intensity of personality disorders we used the dedicated subscale (Items 19 and 20) that the DSM 5 proposes in its Cross-Cutting Symptoms Measures of Level 1, in its French translation. A score higher than 2 was our Gold Standard when we tested the metric capacity of the two questionnaires to evaluate the A Criteria and then the B Criteria of the AMPD. ResultsThe overall results (Table 1) show levels that place the group in a non-clinical level. In terms of the severity of personality disorders it can be seen that 27 % are at risk of personality disorder (PDs>2). Comparing these two sub-groups (Table 1), we observed significant differences for all the factors studied, pointing towards a higher score for people at risk of PDs. A logistic regression analysis of the evaluation of persons at risk lead us to find that gender and age do not have a significant influence (p=0.225 and p=0.065 respectively) in a valid model (chi square=157, df=4, p<0.001) including the overall score on the LPFS (z=5.76, p<0.001) and the PID 5 (z=2.26, p<0.001). The Area Under the Curve (AUC=0.859) of this translation (Table 3) is consistent with the original version (AUC=0.84). It has metrological qualities (Sn=73.91%, Sp=85.33%, LR+=5.1, LR−=0.3005) that allowed us to use a threshold of 24 as a discriminant of a risk of moderate or severe personality disorder. In addition, if we followed the AMPD and considered the threshold of 24 on the LFPS-BF to be a risk score for personality disorder, we could see (Fig. 2) that the scores on the PID 5 BF fairly well reflected the expected pattern with a large AUC (0.901). According to the AMPD, the cut-points for the dimensions that would evoke the presence of criteria B in the case of the presence of criterion A (LPFS-BF>24) could be either a score greater than 2 for Negative Affectivity, a score greater than 0.8 for Detachment, Antagonism and Disinhibition, or a score greater than 1.2 for Psychoticism (Table 4). DiscussionThe translation of the LPFS-BF that we used in this work has sufficient qualities to assess situations at risk of personality disorders when higher than 24. Its consistency was good (=0.84), and its factor composition in two factors (Self and Interpersonal Relations) was equivalent to the original version. The use of PID5-BF could therefore be used as a complement to the screening of AMPD A criteria, with a 25 for cut-point. The evaluation of the AMPD B criteria with the PID5-BF seemed relevant in view of our results; each of the subscales seemed to be able to correctly evaluate (AUC) persons with an LPFS-BF score at risk. However, the risk thresholds need to be confirmed in further work because of the essential role that the dimensions play in the diagnosis of types of personality disorders.

The interplay of Criterion A of the Alternative Model for Personality Disorders, mentalization and resilience during the COVID-19 pandemic.

Background and aimsThe COVID-19 pandemic has been accompanied by a worsening of mental health levels in some, while others manage to adapt or recover relatively quickly. Transdiagnostic factors such as personality functioning are thought to be involved in determining mental health outcomes. The present study focused on two constructs of personality functioning, Criterion A of the Alternative Model for Personality Disorders (AMPD, DSM-5) and mentalization, as predictors of depressive symptoms and life satisfaction during the COVID-19 pandemic. A second focus of the study was to examine whether this relationship was mediated by resilience.MethodsLinear regression analyses were used to examine the relationship between personality functioning measured by Criterion A (AMPD, DSM-5) and mentalizing abilities as predictors, and depression and life satisfaction as mental health outcomes. To assess the hypothesis that this relationship is mediated by resilience a structural equation modeling approach was conducted. Data from N = 316 individuals from the general population were collected.ResultsLinear regression models revealed highly significant associations between Criterion A/mentalization and both outcome measures. Structural equation models showed a significant partial mediation by resilience of these relationships.ConclusionOur results support the hypothesis that mentalizing serves as a protective function by promoting resilience to the impact of stress and threats. Criterion A and mentalization performed similarly as predictors of mental health outcomes, providing empirically overlapping operationalizations of personality functioning. This finding emphasizes the importance of personality functioning in positive and negative mental health outcomes. Furthermore, our results are consistent with a mediating role of resilience.

Психопатология личности и роль самосострадания

&lt;p&gt;Previous research has examined the relationship between particular personality disorders (PDs) and self-compassion. However, the field has developed new methods for assessing and diagnosing personality psychopathology, and previous work has not extended to the Alternative Model for Personality Disorders (AMPD) of the DSM-5. The current study aimed to examine associations between self-compassion and personality psychopathology using an evidence-based assessment and diagnosis approach. The study used Neff&amp;rsquo;s Self-Compassion Scale (SCS) in addition to Criterion A (elements of personality functioning) and Criterion B (pathological traits) of the AMPD in order to observe associations between PDs and self-compassion. The results indicated that there were strong associations between identity and self-compassion, as well as that self-compassion and its components were moderately negatively associated with the majority of the AMPD personality traits. The findings can help to establish working treatment methods for individuals with PDs as well as provide support for the evidence-based hybrid dimensional-categorical model of personality assessment.&lt;/p&gt;

Sociocultural context and the DSM-5 alternative model of personality disorder: Comment on Widiger and Hines (2022).

Widiger and Hines (2022) provide a brief overview of the development of the alternative model of personality disorder (AMPD) housed within Section 3 of the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013). They highlight 8 issues and controversies related to the AMPD in need of resolution for improvement of both the AMPD model itself as well as the field of personality disorders more broadly. In this brief commentary, I add a 9th issue in need of attention both with respect to the AMPD but also within the field of personality disorders more broadly: (9) How is sociocultural context to be accommodated in AMPD-and more generally personality disorder-theory, research, and treatment? The historical intraindividual, deficit-based models for conceptualizing personality disorders linger in current personality disorder discourse. However, failure to appropriately consider sociocultural context that systematically predisposes wide swaths of the population to unequal access to resources and exposure to psychological stressors, which can impact the appearance of personality pathology, serves to stigmatize minoritized individuals. The personality disorder field, and the AMPD discourse, must appropriately contend with sociocultural context in its models otherwise it risks developing models with limited generalizability and that hold potential to adversely affect sexual and gender minoritized populations, among others. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The alternative model of personality disorder is inadequate for capturing obsessive-compulsive personality disorder.

The alternative model of personality disorder (AMPD) included in Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) reconceptualized personality pathology in terms of pathological traits and impairments in functioning. For example, the construct of obsessive-compulsive personality disorder (OCPD) was reconceptualized via the traits of rigid perfectionism as well as at least 2 of perseveration, intimacy avoidance, and restricted affectivity. We review the literature to summarize how effectively the legacy construct of OCPD is captured by the AMPD. We conclude that although the trait of rigid perfectionism is highly related to scores on OCPD measures, the AMPD as a whole fails to adequately account for the broader features of the legacy OCPD construct. Specifically, the AMPD trait model lacks a number of traits, such as workaholism, excessive deliberation, and moral scrupulousness, which are necessary for a fulsome dimensional trait system. These limitations in the inclusion of important traits stem from the AMPD's development process that left out crucial content. We outline how the AMPD could be improved in its ability to account for problems of overcontrolled behavior. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The trait model of the DSM-5 alternative model of personality disorder (AMPD): A structural review.

Publication of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (American Psychiatric Association, 2013), which included an alternative model of personality disorders (AMPD), was followed by an explosion of publications on the new model. The large majority of these publications focused on the AMPD's Criterion B, which consists of 25 trait facets arranged in 5 broad domains that bear strong similarity to the established five-factor model (FFM) of personality. The operationalization of AMPD traits that has received the most research attention is its self-report measure, the Personality Inventory for Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (PID-5; Krueger et al., 2012). Much of this literature concerns its internal structure and relations with FFM measures. Many of these studies report that a number of the facets appear to be (a) interstitial (cross-loading on 2 or more factors), (b) placed in the wrong domain (i.e., considered by the AMPD to be a facet of a different domain from the one on which it typically loads), or (c) both. Clarifying the structural location of measures is fundamental in understanding their nomological net-and, thereby, the constructs they assess. Therefore, this review focuses on the PID-5 structure in the context of the broader domain of personality, especially the FFM, and primarily examines (1) which facets are interstitial and (2) the best domain(s) in which to place each facet. Also considered are important PD constructs-including multiple facets and one domain-that the AMPD does not include. The review ends with a set of recommendations for AMPD-5.1 and PID-5.1. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, alternative model conceptualization of borderline personality disorder: A review of the evidence.

In the 10 years following the publishing of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), studies have accumulated testing the validity and utility of the alternative model for personality disorders (AMPD) in the context of borderline personality disorder (BPD). In this article, we review the studies that have tested how well the AMPD conceptualization of BPD captures the traditional (DSM-5, Section II) conceptualization of BPD. Although we note that studies that measure the full conceptualization of the AMPD-BPD are limited compared with studies focusing on a single aspect of the AMPD, studies reviewed suggest that the AMPD conceptualization of BPD largely overlaps with Section II, is associated with a similar range of external constructs, and can be measured with similar levels of interrater reliability. This evidence is promising in terms of the goal of the AMPD developers to not lose relevant and clinically meaningful information associated with traditional conceptualizations of BPD. However, further applied research is needed to understand how the AMPD may improve upon our existing categorical conceptualization of BPD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Progress but no cigar: Comment on Bach and Tracy (2022).

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model of personality disorder (AMPD) introduced innovations that are likely to be enduring features of a scientific classification of personality disorder: (a) an explicit definition of personality disorder, (b) a description of levels of severity, (c) a dimensional model of individual differences, and (d) the important principle that classifications should use and be consistent with the findings of normal personality science. Bach and Tracy's review of evidence of the clinical utility of the alternative model compared with traditional typal diagnoses clearly demonstrates that dimensional classification does not adversely affect clinical utility. Based on this evidence, they propose that the AMPD minus the hybrid component be adopted as the Diagnostic and Statistical Manual of Mental Disorders classification of personality disorder. It is argued that the recommendation is premature because evidence of clinical utility is insufficient in the absence of evidence of construct validity. The rest of the commentary explores the conceptual and methodological problems arising from the way the AMPD's innovative features are translated into a diagnostic classification. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Is the alternative model for personality disorders able to capture avoidant personality disorder according to Section II of the DSM-5? A systematic review.

This review aims at examining the continuity between the categorical model for personality disorders (PDs) as defined by Section II of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the alternative model for personality disorders (AMPD) with respect to Section II avoidant personality disorder (AvPD). Because the Criterion A of the AMPD, that is, the Level of Personality Functioning Scale (LPFS), is a prerequisite for a PD diagnosis, only studies assessing the LPFS were included, whether or not the Criterion B, that is, pathological personality traits, were assessed as well. A total of 13 studies met the inclusion criteria, with 6 studies comprising community/undergraduate samples and 7 studies comprising clinical samples. Weighted correlation between global LPFS and AvPD was .39 (rw = .55 for community/undergraduate studies; rw =.17 for clinical studies). When AvPD-specific impairment was evaluated, that is, impairment of personality functioning characterizing AvPD in the AMPD, correlations were substantially larger. In studies using regression analyses, the Criterion B appeared to have incremental utility in predicting the presence of Section II AvPD. To capture Section II AvPD in a sufficient degree by the AMPD, it might be necessary to use an AvPD-specific impairment questionnaire. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Clinical utility of the alternative model of personality disorders: A 10th year anniversary review.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) alternative model of personality disorders (AMPD) has now been available for researchers and clinicians for a decade. The present article aims to provide a narrative review of literature on the AMPD framework with particular emphasis on its clinical utility, inclusive of clinicians' and patients' acceptability, ease of use, diagnostic accuracy, continuity with clinically familiar constructs, and proposed utility for treatment planning, case-formulation, and clinical management. The review specifically covers the utility of Criterion A (i.e., Level of Personality Functioning Scale) and Criterion B (i.e., maladaptive personality traits) in relation to common disorders of personality. By drawing on empirical studies, surveys, clinical cases, and recommendations, the current review points to various aspects of clinical utility as well as areas for improvement. One way of increasing the AMPD's feasibility for clinicians is to omit the transitional personality disorder (PD) hybrid types while retaining a purer diagnostic classification of PD severity and traits that also align with the International Classification of Diseases, Eleventh Revision (ICD-11), PD classification. This would allow for a more efficient assessment for busy practitioners working in general psychiatry and primary care while retaining the possibility of a more fine-grained elaboration of the PD diagnosis in high-resource specialist settings. Such revision could possibly be introduced in DSM-5.1 or DSM-6. We also propose that future exploration of the AMPD's clinical utility may involve its potential value for allocation of clinical resources, communication between clinicians and their patients' relatives, and utility for informing different treatment modalities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model of personality disorder.

The fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) includes within a section for emerging measures and models an alternative model of personality disorder (AMPD). This article provides a brief overview of its development, noting, in particular, issues and controversies. The article concludes with a discussion of and recommendations for further research in regard to 8 issues: (a) whether the DSM-5 AMPD offers any incremental validity over DSM-IV with respect to the validity or clinical utility; (b) development of the treatment implications for the AMPD components; (c) whether the DSM-5 AMPD level of personality functioning (LPF) is a unitary construct; (d) whether the LPF does in fact identify the core of personality disorder, (e) whether the LPF is even necessary; (f) whether the AMPD trait model is sufficiently comprehensive in its coverage; (g) the synchronization of International Classification of Diseases, Eleventh Revision, and DSM-5 Section III; and (h) whether the future classification of personality disorder should continue to include any of the DSM-IV syndromes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An agenda for establishing the DSM-5 alternative model of personality disorder (AMPD) trait model in adolescence: Comment on Clark and Watson (2022).

In the years since the publication of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013), considerable progress has been made in understanding the structure of the traits included in the Alternative Model of Personality Disorders (AMPD) in adulthood. In the next phase of research, the structure of the pathological trait model needs to be established more firmly in adolescence as well. There is promising evidence from studies of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012) that the structure of pathological traits in adolescents shows considerable overlap with the structure in adult samples, but it is premature to conclude that the structure is entirely the same. To make additional progress in assessing personality pathology in youth, measures should be developed in multiple formats and for multiple informants; normal-range personality trait constructs should be included in measures for research and clinical use in young people; and research should incorporate Clark and Watson's (2022) recommendations to add new facets and the domain of Anankastia to adolescent measures of personality pathology. Adolescents stand to benefit from a trait taxonomy in the AMPD that more explicitly includes them. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Schizotypal personality disorder in the alternative model for personality disorders.

Schizotypal personality disorder (SPD) first appeared in the American Psychiatric Association diagnostic nosology in 1980, although its roots stretch back more than 100 years under labels such as borderline, ambulatory, and latent schizophrenia. SPD is unique in that it is conceptualized both as stable personality pathology and also as a milder manifestation of schizophrenia-spectrum psychopathology. The categorical operationalization of SPD has remained largely unchanged for the last 40 years, with emphasis on interpersonal deficits, cognitive and perceptual distortions, and odd and eccentric behaviors. The alternative model for personality disorders (AMPD) retained many of the aspects of SPD while offering a hybrid model that includes both disturbances in personality functioning and specific pathological personality traits. The present review examined the empirical literature on the success of the AMPD model in capturing SPD. Although research specifically examining AMPD SPD is limited, there is converging evidence that the six trait facets proposed for the AMPD SPD provide good coverage of SPD and correspond closely to criterion counts from the categorical SPD diagnosis. Furthermore, most studies find that the inclusion of additional facets not proposed for SPD do not account for appreciable variance. However, SPD offers a rather heterogeneous construct, and future studies should consider whether specifying positive, negative, and disorganized traits within the disorder might improve the clarity of the diagnosis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Revising the trait model of the alternative model of personality disorders: Comment on Clark and Watson's structural review.

In their review of examination of the self-report Personality Inventory for Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5; PID-5) factor structure and joint factor analysis of this instrument with other self-report measures of personality and psychopathology, Clark and Watson (2022) make argument for a set of modifications to the DSM-5 alternative model of personality disorders (AMPD)-the AMPD-5.1. In this commentary we offer opinion that their proposed modifications to the AMPD are problematic. In particular, we express concern that their modifications are based solely on research that uses a single instrument to measure the model and that this instrument employs a self-report measure methodology. We argue further that this method of assessment is vulnerable to response bias which could potentially alter the substantive structure of the model. We suggest that any proposed revised model should also be informed by other forms of measurement (e.g., informant report and structured interviews). In addition, we also argue that the best approach to delineating the universe of pathological personality traits should also include clinician input. Such input would maximize the clinical utility of any revised model. We believe that to propose a modified model that is based on self-report only and does not include other sources of information is presumptive and premature. At best, we think that Clark and Watson (2022) have only provided suggestions for a revision and expansion of the Personality Inventory for DSM-5 (i.e., the PID-5.1). (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The problems with Criterion A: A comment on Morey et al. (2022).

The alternative model of personality disorder (American Psychiatric Association, 2013), introduced in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, represents a significant advancement in our understanding of personality disorders. Despite this advancement, nearly 10 years after its introduction, considerable debate remains regarding the conceptualization, operationalization, and ultimately the utility of personality impairment (i.e., Criterion A). Morey et al. (2022) review the impetus for, conceptualization of, the current state of our understanding of Criterion A, and conclude that Criterion A is a valid and clinically useful component of the alternative model of personality disorder. In our commentary, we present a more pessimistic view and review literature critical of Criterion A not included in the main text of their review. We conclude that Criterion A, as currently operationalized by the Level of Personality Functioning Scale, does not provide the functionality or utility as suggested by Morey and colleagues in their review. Instead, we suggest that pathological traits are well-positioned to capture severity of dysfunction and likely carry the most clinically useful information. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Opportunities and challenges of new classification systems for personality disorders: Commentary on "clinical utility of the AMPD: A 10th year anniversary review".

At the time of publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model of personality disorders, skepticism regarding the clinical utility of a dimensional conceptualization of personality disorders was high including questions about its feasibility for clinicians, its reliability, predictive value, and implications for science and treatment. Following huge research activities summarized by the article of Bach and Tracy (2022), there is meanwhile convincing evidence that a dimensional classification of personality disorders that meets with high utility for clinical decision-making is accepted by clinicians and meets with patients´ needs because it can be easily connected with treatment planning oriented at functional impairments rather than diagnostic categories. Being close to mechanistic models of psychopathology, the alternative model of personality disorders provides a suitable framework to converge self- and interpersonal dysfunctioning indicated in Criterion A with (sub-)domains of the Research Domain Criteria and Hierarchical Taxonomy of Psychopathology systems and, thus, to inspire research to better understand the psychological and neurobiological mechanisms of change. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Ten-year retrospective on the DSM-5 alternative model of personality disorder: Seeing the forest for the trees.

This is an introduction to the special issue "The DSM-5 Alternative Model of Personality Disorders: A Ten-Year Retrospective." The authors begin by summarizing the main findings and recommendations from each target review and its commentaries, as well as the shorter review articles, after which they offer additional remarks in the hopes of contributing to the setting of an agenda for the next iteration of the DSM. Their main conclusion is that the experts invited to participate in this special issue agree on the value of dimensionalization of personality pathology-that is, describing personality from typical to atypical (Criterion A) and using dimensions that explain covariation of symptoms of psychopathology (Criterion A and Criterion B), instead of categories, to denote personality pathology (PsycInfo Database Record (c) 2022 APA, all rights reserved).