Model Of Personality Pathology Research Articles

Multidimensional assessment of personality disorders using different theoretical models: a comparison of the Young Schema Questionnaire, the SCID-5-AMPD structured diagnostic interview, and the PDS-ICD-11 self-report questionnaire

IntroductionThere has been a recent shift in the conceptualisation of personality disorders in diagnostic systems such as DSM-5 or ICD-11, from a categorical approach towards a dimensional approach reflecting severity in general or severity of dysfunction and related pathological traits. In addition, several psychotherapeutic approaches work with their own model of personality pathology, which similarly capture symptoms of personality disorders and their underlying processes in a more subtle way from multiple aspects, and along different constructs.ObjectivesThe aim of our study was to investigate similarities and differences between conceptualisations of personality disorder and instruments used for evaluation based on the BNO-11 Personality Disorders Severity Questionnaire (PDS-ICD-11), Module I. of the Structured Diagnostic Interview for the DSM-5 Alternative Personality Model (SCID-5-AMPD) measuring level of personality function, and the Young Schema Questionnaire assessing early maladaptive schemas.MethodsHospitalized borderline patients were assessed using the Young Schema Questionnaire, the PDS-ICD-11, and Module I. of the SCID-5-AMPD assessing personality function level. Data are analysed using correlation and linear regression models.Results Only part of the results are shown. The PDS-ICD-11 Severity Index and Self-function Index showed significant (p<0.05) and strong correlations with the Abandonment (r=0.98, r=0.94), Vulnerability to harm and illness (r=0. 92, r=0.98), Insufficient Self-Control (r=0.91, r=0.88) and Negativism/Pessimism (r=0.95, r=0.90) schemas. The mean score and all domains of the SCID-5-AMPD Module I (level of personality function) showed significant strong correlations with the Vulnerability to harm and illness schema (AMPD-Average r=0.87; AMPD-Identity r=0.86, AMPD-Objectivity r=0.81, AMPD-Empathy r=0. 77, AMPD-Intimacy r=0.80, p<0.05); moreover, a strong significant correlation was found between the Abandonment schema and AMPD-Average (r=0.81, p<0.05), AMPD-Identity (r=0.98, p<0.05), and AMPD-Intimacy domains (r=0.77, p<0.05).ConclusionsThe main indicators of measures that operationalise a dimensional approach to personality disorders show distinct patterns of strong overlap with some of the maladaptive schemas but cover only a part of the schema domains. For a careful diagnosis and psychotherapeutic plan, the combined use of these measures can provide in-depth and multifaceted information.Disclosure of InterestNone Declared

The DSM's Reconnection to Psychoanalytic Theory through the Alternative Model for Personality Disorders.

Often believed to have Kraepelinian origins, the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) defines personality disorders using a categorical, hierarchical taxonomic system. This system possesses many long-standing problems for clinical practice, including a large assortment of symptom combinations that contribute to problematic heterogeneity and likely impair diagnostic validity. The DSM diagnostic system was at one time heavily influenced by psychoanalytic theory (Shorter 2005). A desire for greater theoretical neutrality then encouraged a shift away from psychoanalytic theory, resulting in the problematic atheoretical model of personality pathology introduced in DSM-III (1980) and still used today. The Alternative Model for Personality Disorders (AMPD), introduced in DSM-5 (2013), is an attempt to reconcile many of the categorical model's issues and directly parallels primary themes that characterize psychoanalytic models of personality. After a review of the historical development of DSM, three current systems for diagnosing personality pathology-the DSM-5's categorical model (2013), its AMPD (2013), and the Psychodynamic Diagnostic Manual (2nd ed.; Alliance of Psychoanalytic Organizations 2017) are compared. The comparison illustrates how the AMPD brings psychoanalytic theory back into the DSM system and acknowledges the implications of a more psychoanalytic DSM.

Psychopathy as an Emergent Interpersonal Syndrome: What Is the Function of Fearlessness?

Lilienfeld and colleagues (this issue) propose that some personality disorders can be conceptualized as emergent interpersonal syndromes (EIS). An EIS elicits negative interpersonal reactions in others. Further, an EIS results from statistical interactions between symptom dimensions that are uncorrelated. As a prototypical EIS, psychopathy is an interaction between boldness (or fearlessness) and interpersonal antagonism. The authors marshal many threads of research to develop an intriguing idea that suggests the "whole" of psychopathy is more than the sum of its parts. Unfortunately, the authors focus primarily on psychopathy, and fail to provide convincing quantitative data for the statistical interaction that forms the basis for their theory. Also missing from this model of personality pathology is a consideration of what function boldness serves; viewing boldness as a means to accomplish the (maladaptive) rewarding goals that motivate the individual high in antagonism and disinhibition may serve to flesh out this theory and our conceptualization of personality pathology more broadly.

Theories and Treatment of Borderline Personality Disorder: Commentary on Gunderson et al.

Models of personality pathology have been used to guide treatment development for patients with borderline personality disorder. The existing treatments are effective, but mechanisms of change related to the model have not been adequately explored.

Effects of different types of instruction on the Scores of PID-5 profile

IntroductionSection III of 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a hybrid model of personality pathology, in which dimensional personality traits (PTs) are used to derive one of six categorical Personality Disorder (PD) diagnoses. The Personality Inventory for DSM-5 (PID-5) has been developed to assess PTs within this new system.ObjectivesPT is a tendency to feel, perceive, behave, and think in relatively consistent ways across time and situations. PD diagnosis is generally stated if a pattern of maladaptive PTs persists at least 5 years. Nevertheless, the PID-5 instruction does not cover duration of symptoms.AimsWe have explored the effect of two different types of instructions, in which duration of symptoms is or is not explicitly mentioned, on the PID-5 scores. Moreover, we have asked whether the scores differ in psychiatric patients and healthy individuals.MethodsDifferences between original and modified instructions of the Czech PID-5 version have been evaluated in a group of 62 psychiatric patients and 38 healthy controls; each respondent has been administered both instruction types in random sequence. ANOVA mixed design has been used to test the relation between groups and different sequence of administration.ResultsWe have found no consistent differences in PID-5 scores using the different types of instruction described above.ConclusionsIn our sample, PID-5 seems to reflect strong beliefs of a subject regardless of symptoms’ duration and could be reliably used with both types of instruction. The PID-5 represents an appropriate instrument for the assessment of maladaptive PTs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Supplemental Material for Predicting Problematic Alcohol Use With the DSM–5 Alternative Model of Personality Pathology

Supplemental Material for Predicting Problematic Alcohol Use With the DSM–5 Alternative Model of Personality Pathology