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 approach to the diagnosis of personality disorder (PD). In this model, PD diagnosis requires evaluation of level of impairment in personality functioning (Criterion A) and characterization by pathological traits (Criterion B). Questions about clinical utility, complexity, and difficulty in learning and using the AMPD have been expressed in recent scholarly literature. We examined the learnability, interrater reliability, and clinical utility of the AMPD using a vignette methodology and graduate student raters. Results showed that student clinicians can learn Criterion A of the AMPD to a high level of interrater reliability and agreement with expert ratings. Interrater reliability of the 25 trait facets of the AMPD varied but showed overall acceptable levels of agreement. Examination of severity indexes of PD impairment showed the level of personality functioning (LPF) added information beyond that of global assessment of functioning (GAF). Clinical utility ratings were generally strong. The satisfactory interrater reliability of components of the AMPD indicates the model, including the LPF, is very learnable.

In this article, we explore the extent to which theory-based research is informing our understanding of high-fidelity simulation use in nursing education. We reviewed the primary literature archived in the Cumulative Index of Nursing and Applied Health Literature (CINAHL) and Proquest Dissertation and Theses for empirical reports using the key terms high-fidelity simulation and nursing from the years 1989 to 2009. Of the articles that matched our inclusion criteria: 45% made no use of theory; 45% made minimal use; and 10% made adequate use. We argue that theory-based research could bring coherence and external validity to this domain.

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The construct composition of the Level of Personality Functioning Scale (LPFS; Criterion A) of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model for personality disorders (American Psychiatric Association, 2013) was examined in a clinical vignette rating study. Multiple indices of level of personality functioning, psychiatric and psychosocial impairment, Criterion B maladaptive personality traits, and conceptually divergent variables (intellectual level, socioeconomic status, and likability) were used to deconstruct the LPFS. Most variables were highly intercorrelated, but partial correlational analyses showed the LPFS possesses meaningful personality construct variance not fully explained by severity of pathological traits, psychiatric and psychosocial impairment, or the conceptually divergent variables. This exploratory study offers initial evidence that the LPFS contains substantive LPF variance beyond PD severity. Results are framed and discussed in terms of the known conceptual and empirical overlap between Criterion A and Criterion B as well as the differing ways a dimension of personality disorder (PD) severity may be interpreted. We propose the LPFS is more than statistical artifact created by empirical covariation but less than a true latent dimension of PD severity. The LPFS may be understood as a methodologically pragmatic but theoretically substantive dimension of PD severity.

The present study sought to examine the interactive effects of an external locus of control and interaction in a negative peer group climate on men’s perpetration of physical aggression and infliction of injury toward their female intimate partners. Participants were 206 heterosexual males recruited from the metro-Atlanta community who completed self-report measures of external locus of control, involvement in a negative peer group climate, and physical aggression and infliction of injury against intimate partners during the past 12 months. Negative peer group climate was conceptualized as a peer group that displays behavior which may instigate aggressive norms, attitudes, and behaviors. Results indicated that men with an external locus of control were more likely to perpetrate physical aggression toward and inflict injury on their intimate partners if they reported high, but not low, involvement in a negative peer group climate. These results extend current research suggesting external locus of control as a risk factor for intimate partner aggression by highlighting the impact of negative peer groups. Implications and future intervention research are discussed.