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.

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

Section III of the Diagnostic and Statistical Manual of Mental Disorders (5th ed) introduced the alternative model of personality disorders that includes assessing levels of personality functioning Here, we describe the development, preliminary psychometric evaluation and sensitivity to change of a revised brief self-report questionnaire, the Level of Personality Functioning Scale-Brief Form 20 (LPFS-BF 20) Patients (N = 201) referred to a specialized centre for the assessment and treatment of personality disorders completed the LPFS-BF 20, the Brief Symptom Inventory and the Severity Indices of Personality Problems Short Form and were administered the Structured Clinical Interview for DSM-IV Axis I and Axis II Disorders Internal structure and aspects of construct validity were examined A subsample of 39 patients also completed the questionnaires after 3 months of inpatient treatment Confirmatory factor analyses demonstrated better fit for a two-factor solution (interpretable as self-functioning and interpersonal functioning) than for a unidimensional model, though acceptable model fit was evident only after two post hoc modifications The LPFS-BF 20 demonstrated satisfactory internal consistency and promising construct validity Sensitivity to change after 3 months of treatment was high The LPFS-BF 20 constitutes a short, user-friendly instrument that provides a quick impression of the severity of personality pathology © 2018 John Wiley & Sons, Ltd

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The Level of Personality Functioning Scale-Brief Form 2.0: Update of a brief instrument for assessing level of personality functioning.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) presents an alternative model for personality disorders in which severity of personality pathology is evaluated by the Level of Personality Functioning Scale (LPFS). The Structured Interview for the DSM-5 Alternative Model for Personality Disorders, Module I (SCID-5-AMPD I) is a new tool for LPFS assessment, but its interrater reliability (IRR) has not yet been tested. Here we examined the reliability of the Norwegian translation of the SCID-5-AMPD I, applying two different designs: IRR assessment based on ratings of 17 video-recorded SCID-5-AMPD I interviews by five raters; and test-retest IRR based on interviews of 33 patients administered by two different raters within a short interval. For the video-based investigation, intraclass correlation coefficient (ICC) values ranged from .77 to .94 for subdomains, .89 to .95 for domains, and .96 for total LPFS. For the test-retest investigation, ICC ranged from .24 to .72 for subdomains, .59 to .90 for domains, and .75 for total LPFS. The test-retest study revealed questionable reliability estimates for some subdomains. However, overall the level of personality functioning was measured with a sufficient degree of IRR when assessed by the SCID-5-AMPD I.

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Interrater Reliability of the Structured Clinical Interview for the DSM-5 Alternative Model of Personality Disorders Module i: Level of Personality Functioning Scale.

Aim The ICD-11 classification of personality disorders (PDs) has adopted a dimensional approach which includes three levels of severity (mild, moderate and severe) with the option of specifying five trait qualifiers (negative affectivity, detachment, dissociality, disinhibition and anankastia) and one borderline pattern qualifier. This study examined mental health professionals' perceived clinical utility of the ICD-11 PD framework compared with the ICD-10 categorical PD framework. Method A sample of 163 mental health professionals (primarily psychologists, nurses and medical doctors) completed a survey in which they were asked to apply the ICD-10 and ICD-11 PD classifications on one of their patients followed by judgement of their clinical utility. Results The ICD-11 PD framework was generally rated as being slightly more useful than the ICD-10 framework even when accounting for educational background and years of experience. This advantage particularly involved the utility for treatment planning, communicating with patients, comprehensiveness and ease of use. The two frameworks showed no significant differences with respect to utility for communicating with other professionals and describing global personality. Conclusion This study provided initial evidence that mental health professionals perceive the ICD-11 PD classification as slightly more useful for clinical practice than the ICD-10 classification. © 2019 John Wiley & Sons, Ltd.

https://findresearcher.sdu.dk:8443/ws/files/170829008/pmh.1442.pdf

Mental health professionals' perceived clinical utility of the ICD-10 vs. ICD-11 classification of personality disorders.

Empirical controversy remains regarding the representation and diagnosis of personality disorders, as either distinct categories or as a dimensional continuum of psychopathology. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the Personality and Personality Disorders Work Group presented an alternative model of personality disorder (AMPD) that elicits a hybrid diagnosis. This attempt to combat the various limitations associated with primarily categorical or dimensional approaches was met with criticism regarding the AMPD's indeterminate clinical utility. To seek clarity, the current mixed-methods systematic review aimed to determine the clinical utility of the AMPD within a clinical population. An electronic screening of six databases, in addition to the application of explicit exclusion criteria, revealed 20 studies of relevance. Study characteristics and individual assessments of methodological quality were tabulated. The convergent, narrative synthesis of results was largely in support of the AMPD's clinical utility. Future exploration of the AMPD's communicative value between clinicians and their patients' families, the feasibility of the model's application, and the model's ability to translate into treatment modalities is required to both consolidate the current findings and to support a transition to a hybrid diagnosis of personality psychopathology. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A systematic review of the clinical utility of the DSM-5 section III alternative model of personality disorder.

The Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013) Section III Alternative Model for Personality Disorders (AMPD) represents a novel...

Shane Bierma

Papers

It's not that Difficult: An Interrater Reliability Study of the DSM-5 Section III Alternative Model for Personality Disorders.