Level Of Personality Functioning Research Articles

Associations between borderline personality disorder symptoms and personality functioning in adolescents: A brief report.

Borderline personality disorder (BPD) is a serious mental disorder, which has been linked to a number of negative outcomes in adolescents and adults. BPD is generally linked to more severe impairments in personality functioning. The (differential) association of specific BPD symptoms with severity level, however, has not been explored yet. The present study explores the relationship between all nine BPD symptoms and impairments in personality functioning in adolescents using a cross-sectional design. A total of 116 treatment-seeking adolescents were administered semistructured interviews for DSM-IV Axis I and Axis II disorders and the semistructured interview for personality functioning DSM-5 (STiP-5.1). Furthermore, the potential association of symptom disorders, and more specifically mood disorders, with level of personality functioning was assessed. Together, the nine BPD criteria were significantly related to STiP-5.1 total score, even when controlling for the presence of a mood disorder. However, when taking the effect of number of symptom disorders and the other BPD symptoms into account, only the presence of recurrent self-harm and/or suicidal behavior and intense anger, were associated with a higher level of impairment in personality functioning. These findings emphasize the diagnostic importance of repeated self-harm and suicidality and provide additional evidence for the value of using BPD criteria to easily identify teenagers at risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

First psychometric evaluation of the Level of Personality Functioning Scale-Brief Form 2.0 in adolescents.

Reflecting the recent consensus that challenges in personality functioning often onsets in adolescence, and the move toward dimensional models of personality pathology such as the level of personality functioning (LPF) of the alternative model for personality disorders, it is important to have validated measures that can assess LPF in young people. The Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0) is the briefest measure of LPF and may be particularly well suited for assessing LPF in youth; however, it has yet to be formally validated in youth. Therefore, the current investigation evaluated the psychometric properties of the LPFS-BF 2.0 in adolescents drawn from a community sample of ethnically diverse North American youth (N = 194, age 12-18; 58% female). Factor structure, gender invariance, reliability, convergent validity, incremental validity, and criterion validity were evaluated. Results demonstrated support for the LPFS-BF 2.0's unidimensional factor structure, as well as high internal consistency. Configural, metric, and scalar measurement invariance was supported across male and female genders, as well as convergent validity. Relative to the Personality Inventory for the DSM-5 Brief Form and Levels of Personality Functioning Questionnaire 12-18, the LPFS-BF 2.0 demonstrated additional variance in predicting borderline personality features, and internalizing and externalizing problems. Study findings support the English version of the LPFS-BF 2.0 as a brief and psychometrically sound instrument for assessing LPF in youth and adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Comparing the DSM-5 categorical model of personality disorders and the alternative model of personality disorders regarding clinician judgments of risk and outcome.

The goal of this study was to compare the predictive validity of the alternative model for personality disorders (AMPD) versus the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Section II categorical model regarding clinician judgments about mental health outcomes. To do so, we instructed a national sample of 136 mental health professionals to provide clinical judgments on a random subset of four (out of a possible 12) case vignettes. For each case, they made a variety of diagnostic judgments corresponding to each model, as well as clinical outcome judgments (e.g., prognosis). Our analyses included hierarchical and individual regressions to compare the predictive value of each diagnostic system toward these clinical outcome judgments. We found that the AMPD predictors consistently added unique variance beyond the Section II predictors, whereas the Section II predictors were rarely incremental above the AMPD. Further, the AMPD judgments predicted outcome judgments very consistently (98.3% of regressions) compared to the Section II predictors (70% of regressions), and the single Criterion A judgment (level of personality functioning) was the strongest overall predictor. Finally, the categorical borderline personality disorder diagnoses from the two systems performed similarly in predicting clinical outcomes and agreed in 79% of cases. We interpreted our results to suggest that the AMPD is at least as effective, and by some measures more effective, than the DSM-5 categorical model at predicting clinician's judgment of outcomes in clinical cases. We conclude by discussing the value of this evidence in relation to the broader AMPD literature, as well as possible paths forward for the diagnosis of personality disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Establishing Levels of Personality Functioning Using the Structured Interview of Personality Organization (STIPO-R): a Latent Profile Analysis

Both the new ICD-11 and the latest Alternative DSM-5 Model for Personality Disorders focus on self and interpersonal functioning as the central feature of personality pathology, also acknowledging that personality disorders are organized along a dimensional continuum of severity. This revised understanding is in line with long-standing psychodynamic conceptualisations of personality pathology, in particular Kernberg’s object relations model of personality organization. Despite existing evidence for the clinical utility of the derived Structured Interview of Personality Organization (STIPO-R), empirical support for the identification of clear cut-points between the different levels of personality functioning is missing. For this purpose, a total of 764 adult participants were recruited across two clinical (outpatient and inpatient) settings (n = 250) and two non-clinical (university students and general community) samples (n = 514). Results from the mixture modeling suggested the existence of five groups across the clinical and non-clinical samples that covered: healthy personality functioning, maladaptive personality rigidity, and mild, moderate, and severe levels of personality pathology. All five indicators of personality organization were found to be reliable predictors of personality pathology. Of the five STIPO-R indicators, Aggression and Moral Values had the most discriminative power for differentiating between the Mild, Moderate, and Severe personality disorder groups. Implications of these findings are discussed.

Personality traits and identity statuses as predictors of personality functioning in mid and late adolescence

This study had four objectives: (a) examining the sex-related differences in the level of personality functioning (LOPF), (b) exploring the association between personality traits (PT) and LOPF, (c) exploring the association between identity statuses (IS) and LOPF, (d) exploring whether PT and IS can predict LOPF. A sample of 1450 students aged 15–21 years from high schools and universities from all the governorates of Lebanon participated in this online study. The Arabic version of three measures were used: (a) Revised Personality Inventory: Honesty-Humility, Emotionality, EXtraversion, Agreeableness (versus Anger), Conscientiousness, Openness to Experience (HEXACO) – PI – R, (b) Extended Objective Measure of Ego Identity Status (EOM-EIS), (c) Level of Personality Functioning Screener- Brief Form 2.0 (LOPF-BF-2.0) were rated for the sample. Results showed no statistical differences in LOPF between males and females; IS and LOPF were correlated similarly in both males and females except for Achievement (Ach), which did not correlate significantly with LOPF in males, but correlated negatively and significantly among females. Conversely, Moratorium (M), Foreclosure (F) and Diffusion (D) correlated positively with LOPF in both males and females. All Identity statuses could predict LOPF, except for F; likewise, all personality dimensions Humility (H), Extraversion (X), Agreeableness (A), and Conscientiousness (C) could predict LOPF except for Openness to experience (O). Implications of the results are discussed.

Prevalence of the alternative model of personality disorders diagnoses in populational and at-risk samples, gender and age groups comparisons, and normative data for the LPFS-SR and PID-5.

The Alternative Model of Personality Disorders (AMPD), introduced in Section III of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), was proposed as a new operationalization of personality disorders (PDs) aiming to overcome the several limitations of the traditional symptom-based model (Waugh et al., 2017; Zimmerman et al., 2019). In the AMPD, PDs are defined by two-dimensional criteria (the level of personality functioning and maladaptive personality traits), but as a hybrid model, it also allows for categorical assessment of PDs (i.e., "hybrid types") to facilitate continuity with clinical practice. The present study aimed to provide normative data for two widely used instruments assessing Criterion A (Level of Personality Functioning Scale-Self-Report; Morey, 2017) and B (Personality Inventory for DSM-5; Krueger et al., 2012) in a large populational French-Canadian sample. Regarding the categorical assessment, Gamache et al. (2022) recently tested scoring approaches for extracting the PD hybrid types from dimensional measures of the AMPD. In the present study, these approaches were used to estimate prevalence rates for these PD hybrid types in two samples. In the populational sample, results showed that prevalence rates varied from 0.2% (antisocial PDs) to 3.0% (trait-specified PDs), with an overall prevalence of 5.9% to 6.1% for any PD hybrid type. Prevalence was higher in men than in women in the populational sample, but the contrary was observed in the at-risk sample. Prevalence was higher in younger adults than in middle-aged and older adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"Alone Again, Naturally": Mental Health Problems, Level of Personality Functioning, Social Withdrawal and Loneliness in Adolescents Admitted as Acute Inpatients in the Aftermath of the COVID-19 Pandemic.

(1) Background: Adolescents admitted as acute inpatients belong to a particularly psychosocially vulnerable population. This study aimed to examine the clinical characteristics of an affected population in Germany using a theory-based approach. (2) Methods: We assessed the mental health problems, levels of personality functioning, and the severity of social withdrawal and loneliness in n = 62 adolescents admitted to an acute psychiatric inpatient unit. Cases were investigated cross-sectionally utilizing standardized psychometric questionnaires from the perspective of the patients and clinical experts. (3) Results: Mental health, level of impaired personality functioning, social withdrawal, and loneliness were all positively associated with the need for acute admission. Further analyses revealed that the level of personality functioning fully mediated the positive association between social withdrawal and mental health problems. In contrast, level of personality functioning only partially mediated the positive association between loneliness and mental health problems. (4) Conclusions: Our results suggest that more impairment in personality functioning might lead to poorer mental health when adolescents socially withdraw in the aftermath of the COVID-19 pandemic. Loneliness, social withdrawal, and the level of personality functioning may help identifying essential characteristics of adolescents admitted to acute psychiatric inpatient units and guide the development of specific interventions.

Measuring personality functioning with the 12-item version of the OPD-Structure Questionnaire (OPD-SQS): reliability, factor structure, validity, and measurement invariance in the general population.

The assessment of personality functioning is at the core of current dimensional models of personality disorders. A variety of measures from different clinical and research traditions aim to assess basic psychological capacities regarding the self and others. While some instruments have shown reliability and validity in clinical or other selected samples, much less is known about their performance in the general population. In three samples representative of the German adult population with a total of 7,256 participants, levels of personality functioning were measured with the short 12-item version of the Operationalized Psychodynamic Diagnosis - Structure Questionnaire (OPD-SQS). We addressed questions of factor structure, reliability, validity, factorial invariance, and provide norm values. Confirmatory factor analysis indicated a satisfactory to good model fit. OPD-SQS models were mostly unaffected by variables such as gender, age, or measurement time. As expected, personality functioning was associated with general psychopathology as well as indices of occupational functioning. The OPD-SQS is a viable measure to assess personality functioning in the general population.

Evaluating the Construct Validity of the Norwegian Version of the Level of Personality Functioning Scale – Brief Form 2.0 in a Large Clinical Sample

The Level of Personality Functioning – Brief Form 2.0 (LPFS-BF 2.0) is a 12-item self-report questionnaire developed to gain a quick impression of the severity of personality pathology according to the DSM-5 Alternative Model for Personality Disorders (AMPD). The current study evaluated the construct validity and reliability of the Norwegian version of the LPFS-BF 2.0 in a large clinical sample (N = 1673). Dimensionality was examined using confirmatory factor analysis and bifactor analysis followed by an analysis of distinctiveness of the subscales using the proportional reduction in mean squared error (PRMSE), and the concurrent validity was examined using correlations with self-report questionnaires and clinical interviews assessing PDs according to section II of the DSM-5. Taking the findings of the dimensionality and concurrent validity results together, we found moderate to good support for the use of total scores for the Norwegian version of the LPFS-BF 2.0. We would advise against the use of subscale scores, since the subscales provided only a small amount of reliable unique variance.

Nature and Assessment of Personality Pathology and Diagnosis.

This article demonstrates the contribution of Otto Kernberg's object relations theory of personality pathology to the current understanding of the nature and assessment of personality pathology and diagnosis. The article introduces recent advances in psychiatric nosology and presents differing views on the meaning of the general severity criterion common to all personality pathology (i.e., level of personality functioning as described in criterion A of the Alternative DSM-5 Model for Personality Disorders). Next, the significance of Kernberg's theory to recent nosological advances is discussed, with a focus on two important features: first, a definition of personality that goes beyond signs and symptoms to include structural motivational components, in the domains of self- and interpersonal functioning, that are common to all personality manifestations and that fulfill an intrapsychic, organizing function; second, identity formation and consolidation as the ultimate end point of healthy personality functioning. That these cornerstone features of Kernberg's theory, articulated more than 50 years ago, align with the most up-to-date conceptualization of personality pathology confirms that Kernberg's theory represents an idea whose time has finally come.

Personality functioning and physical health

Objectives: Considering direct and indirect evidence of associations between deficits in personality functioning and high somatic morbidity, our exploratory study determined whether and, if so, which physical illnesses may be associated with impairments in personality functioning. Method: A large sample of diagnostically heterogeneous psychotherapy inpatients (N = 5401) was assessed with the short version of the Structural Questionnaire of the Operationalized Psychodynamic Diagnosis (OPD-SQS) and the Work Ability Index (WAI). In addition, discharge diagnoses were recorded. For a subsample (N = 2582), levels of personality functioning were assessed by their therapists according to the OPD system. Results: While consistent associations were found between personality functioning and neurological, urogenital, dermatological, and musculoskeletal disorders, findings on possible associations with other disorders revealed inconsistencies. The number of diseases as surrogate marker for disease burden was significantly associated with several indicators of personality functioning. Conclusions: Our results suggest associations between impairments in personality functioning and poor physical health. We discuss potential mechanisms as well as clinical implications.

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.

Level of personality functioning and its relationship with core schemas in anxiety and mood disorders

Level of personality functioning and its relationship with core schemas in anxiety and mood disorders

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).

Fulfilling the promise of the LPF: Comment on Morey et al. (2022).

In this commentary, I highlight a perceived reluctance in Morey et al.'s (2022) contribution to fully commit to a definition of the level of personality functioning (LPF), not as the functional consequence of extreme traits, but as an intrapsychic system that drives trait manifestation. I argue that for the LPF to reach its full potential to innovate the assessment and diagnosis of personality pathology beyond mere signs and symptoms, it is essential to define the LPF as a subjective meaning-making system located in biological systems that support the metacognitive capacities necessary for abstracting a sense of self. This view reflects the idea that personality does not simply describe a person (as traits do) but also captures how a person manages their self in relation to others (as LPF does). It implies a definition of personality that includes structural motivational components that fulfill an intrapsychic, organizing function, acknowledging the fact that traits alone are not enough to fully describe personality. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Criterion A: Level of personality functioning in the alternative DSM-5 model for personality disorders.

Criterion A, as represented by Level of Personality Functioning (LPF), offers a means by which to conceptualize the core impairment in self and interpersonal functioning that distinguishes personality disorder (PD) from other forms of psychopathology. One of the most widely cited criticisms of the current Section II in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition categorical diagnostic system is the high level of comorbidity among the categorical PD diagnoses. The Section III alternative Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition model for PDs (AMPD) addresses this problem by assessing the commonalities of the PDs using a single severity continuum, represented in the AMPD by the Level of Personality Functioning Scale (LPFS), which comprises both self and interpersonal pathology. Since its initial introduction, the LPFS has generated an expansive literature base and has also seen significant advancements in its measurement, including both semistructured and self-report methods. Such studies have generally demonstrated that the LPFS can be rated reliably, across both experienced and inexperienced raters, and demonstrates strong validity as evidenced by associations with relevant criterion variables and demonstrations of predictive and clinical utility. This review offers a brief history of the conceptualization and development of Criterion A and the LPFS, describes the major advancements in its measurement, and provides a summary of the status of the empirical literature regarding Criterion A's structure, reliability, and validity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Differences in personality functioning impairment in mood, anxiety, and personality disorders: a cluster analysis

BackgroundThe Alternative DSM-5 Model for Personality Disorders and the latest eleventh version of the International Classification of Diseases implement the level of impairment in self and interpersonal personality functioning (Level of Personality Functioning Scale - LPFS) as a core feature of personality pathology. However, some studies have indicated that personality functioning is also impaired in other mental disorders, but a more thorough exploration is missing. Thus, this study aims to develop profiles of levels of personality functioning in people with personality disorders and some other psychiatric diagnoses as well as without diagnosis.MethodsOne-hundred-forty-nine people participated in the study. They came from three groups – healthy controls (n = 53), people with personality disorders (n = 58), and people with mood and anxiety disorders (n = 38). The LPFS was assessed by the Semi-structured Interview for Personality Functioning DSM-5 (STiP-5.1). An optimal clustering solution using agglomerative hierarchical cluster analysis was generated to represent profiles of personality functioning.ResultsThe two patient groups showed significantly higher levels of personality functioning impairment than healthy controls. People with personality disorders showed higher levels of impairment than the other groups. In addition, the clustering analysis revealed three distinct profiles of personality functioning.ConclusionsThe impairment of personality functioning seems to be useful in the clinical assessment of other than personality disorders as well. As the resulting clustering profiles suggest, LPFS can be seen as an overall indicator of the severity of mental health difficulties and the presence of mental disorders symptoms. The LPFS provides valuable and detailed information about the individual’s mental health and can thus serve as a broad basis for case formulation, treatment and therapy planning, and prognosis.

Study Protocol for an Ecological Momentary Assessment Study: TempRes "Temporal Variability of Risk and Resilience Factors for Suicidal Ideation".

Suicide prevention is an important public mental health issue that can be significantly brought forward by recent advances in psychological research methods and assessment. The project “TempRes” aims to harness the power of Ecological Momentary Assessment (EMA) to investigate the transdiagnostic risk and resilience factors associated with suicidal ideation drawn from the most recent research in suicide prevention and personality assessment. Participants will comprise the general population (planned: N = 100) and a risk group (patients currently in psychosomatic or psychiatric treatment) (planned: N = 50). After a comprehensive baseline assessment, they will complete up to ten short assessments per day over the course of 10 days at roughly equidistant intervals. In detail, the project examines the interplay of biography (previous suicidal behavior, experiences of childhood maltreatment), individual differences (level of personality functioning), and time-varying factors (entrapment, loneliness, mood) with respect to the emergence and fluctuation of suicidal ideation. There are two main research foci: First, the project will provide an operationalization and empirical verification of a core assumption of the integrated motivational-volitional model of suicide (IMV model). It will test whether the interaction of the time-varying predictors entrapment with loneliness (as a motivational moderator) explains reports of suicidal ideation over time. Second, it will be the first to examine personality functioning (a transdiagnostic, psychodynamically grounded conceptualization of vulnerability to psychological crises over the life span) as a time-invariant predictor of suicidal ideation assessed within an intensive longitudinal study design. The main analyses will be built on linear mixed models. The overarching aim of the project is to gain a better understanding of the psychological dynamics underlying suicidal ideation in different populations by bringing together concepts from different theoretical traditions. This will inform prevention efforts geared toward the general public as well as intervention in clinical populations.

Impact of level of personality pathology on affective, behavioral, and thought problems in pregnant women during the coronavirus disease 2019 pandemic.

Among at-risk groups for psychological distress in the context of the Coronavirus Disease 2019 (COVID-19) pandemic, pregnant women might be especially vulnerable. Identifying subgroups of pregnant women at high risk of poor adaptation might optimize clinical screening and intervention, which could, in turn, contribute to mitigating the potentially devastating effects of prenatal stress on mothers and fetus. Level of personality functioning may be a good indicator of who may be more vulnerable to distress in challenging periods like the COVID-19 pandemic, as adults with high levels of personality dysfunction may experience significant difficulties in mentalizing threatening situations. The aims of the present study are (a) to determine the impact of level of personality pathology on affective, behavioral, and thought problems in pregnant women during the COVID-19 pandemic; and (b) to test a model where mentalization of trauma mediates the impact of personality pathology on symptomatology. Data from 1,207 French-Canadian pregnant women recruited through social media during the COVID-19 pandemic were analyzed. Latent profile analysis, using the Criterion A elements of the alternative model for personality disorders (Identity, Self-Direction, Empathy, Intimacy) as latent indicators, yielded four profiles: Healthy, Mild Self-Impairment, Intimacy Impairment, and Personality Disorder. Profiles showed significant associations with diverse indicators of symptomatology. Mediation models showed both direct and indirect (through mentalization of trauma) significant associations between level of personality functioning and affective/behavioral/thought problems. Results have clinical implications on prophylactic measures for at-risk pregnant women, especially in challenging contexts such as the COVID-19 pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Supplemental Material for Criterion A: Level of Personality Functioning in the Alternative DSM–5 Model for Personality Disorders

Supplemental Material for Criterion A: Level of Personality Functioning in the Alternative DSM–5 Model for Personality Disorders