The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) alternative model for personality disorders (PDs) introduced a new paradigm for the assessment of PDs that includes levels of personality functioning indexing the severity of personality pathology irrespective of diagnosis. In this study, we describe the development and preliminary psychometric evaluation of a newly developed brief self-report questionnaire to assess levels of personality functioning, the Level of Personality Functioning Scale-Brief Form (LPFS-BF; Bender, Morey, & Skodol, 2011). Patients (N = 240) referred to a specialized setting for the assessment and treatment of PDs completed the LPFS-BF, the Brief Symptom Inventory (BSI; Derogatis, 1975), the Severity Indices of Personality Problems (SIPP-118; Verheul et al., 2008), and were administered the Structured Clinical Interview for DSM-IV Axis I Personality Disorders (SCID-I; APA, 1994; First, Spitzer, Gibbon, & Williams, 1997) and the SCID Axis II Personality Disorders (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1996). When constrained to a 2-factor oblique solution, the LPFS-BF yielded a structure that corresponded well to an interpretation of Self- and Interpersonal Functioning scales. The instrument demonstrated fair to satisfactory internal consistency and promising construct validity. The LPFS-BF constitutes a short, user-friendly instrument that provides a quick impression of the severity of personality pathology, specifically oriented to the DSM-5 model. Clearly, more research is needed to test its validity and clinical utility.

BackgroundRecent guidelines concerning the treatment of personality disorders (PDs) recommend diagnosing PDs in adolescents. However, it remains unclear whether these guidelines influence the current opinions and practices of mental health care professionals.MethodsFive hundred sixty-six psychologists completed an online survey concerning PDs in adolescents, of whom 367 professionals reported working with adolescents. The survey contained demographical questions (age, gender, profession, work setting) and specific questions related to PD in adolescence.ResultsAlthough a majority of psychologists working with adolescents acknowledged the existence of PDs in adolescents (57.8%), only a small minority diagnoses PDs in adolescence (8.7%) and offers a treatment specifically aimed at targeting PD pathology (6.5%). Reasons for not diagnosing PDs in adolescence mainly concerned the belief that adolescent personality problems are transient (41.2%) and that the DSM-IV-TR does not allow diagnosing PDs in adolescence (25.9%).ConclusionsAlthough practice guidelines might have influenced clinicians’ opinions about PDs in adolescence, they have had little impact so far on routine clinical practice.

The Severity Indices of Personality Problems (SIPP-118; Verheul et al., 2008) is a self-report questionnaire focusing on core components of (mal)adaptive personality functioning. The SIPP-118 was developed and validated in an adult population. In adult populations, the 16 facets of the SIPP-118 fit into 5 higher order domains: self-control, identity integration, relational capacities, social concordance, and responsibility. In this study we present the 1st psychometric properties of the SIPP-118 in adolescents. We compared the SIPP-118 scores of a patient and a nonpatient sample of adolescents, and compared personality disordered and non-personality disordered adolescents. In addition, the relationship between scores on the SIPP-118 and other clinical instruments (Symptom Checklist-90-Revised; SCL-90-R; Derogatis, 1975; Dimensional Assessment of Personality Pathology-Basic Personality; DAPP-BQ; Livesley & Jackson, 2002) was investigated. The questionnaires were completed by 378 adolescent patients and 389 adolescents in the community. Facets appeared to be homogeneous, as alpha coefficients ranged from .62 to .89, indicating moderate to acceptable reliability. Also, more pathological SIPP-118 scores were found in the patient sample, and more specifically in the personality disordered sample, suggesting that the facet scores of the SIPP-118 can discriminate between various populations (divergent validity). Correlation with other clinical instruments was moderate to high (-.82 to .10). Taken together, the SIPP-118 seems to be a promising instrument measuring personality pathology in adolescents.

BackgroundThe borderline personality disorder (BPD) population is notably heterogeneous, and this has potentially important implications for intervention. Identifying distinct subtypes of patients may represent a first step in identifying which treatments work best for which individuals.MethodsA cluster-analysis on dimensional personality disorder (PD) features, as assessed with the SCID-II, was performed on a sample of carefully screened BPD patients (N = 187) referred for mentalization-based treatment. The optimal cluster solution was determined using multiple indices of fit. The validity of the clusters was explored by investigating their relationship with borderline pathology, symptom severity, interpersonal problems, quality of life, personality functioning, attachment, and trauma history, in addition to demographic and clinical features.ResultsA three-cluster solution was retained, which identified three clusters of BPD patients with distinct profiles. The largest cluster (n = 145) consisted of patients characterized by “core BPD” features, without marked elevations on other PD dimensions. A second “Extravert/externalizing” cluster of patients (n = 27) was characterized by high levels of histrionic, narcissistic, and antisocial features. A third, smaller “Schizotypal/paranoid” cluster (n = 15) consisted of patients with marked schizotypal and paranoid features. Patients in these clusters showed theoretically meaningful differences in terms of demographic and clinical features.ConclusionsThree meaningful subtypes of BPD patients were identified with distinct profiles. Differences were small, even when controlling for severity of PD pathology, suggesting a strong common factor underlying BPD. These results may represent a stepping stone toward research with larger samples aimed at replicating the findings and investigating differential trajectories of change, treatment outcomes, and treatment approaches for these subtypes.Trial registrationThe study was retrospectively registered 16 April 2010 in the Nederlands Trial Register, no. NTR2292.