Criterion A of the AMPD in HiTOP

Abstract

The categorical model of personality disorder classification in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013 ) is highly and fundamentally problematic. Proposed for DSM-5 and provided within Section III (for Emerging Measures and Models) was the Alternative Model of Personality Disorder (AMPD) classification, consisting of Criterion A (self-interpersonal deficits) and Criterion B (maladaptive personality traits). A proposed alternative to the DSM-5 more generally is an empirically based dimensional organization of psychopathology identified as the Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al., 2017 ). HiTOP currently includes, at the highest level, a general factor of psychopathology. Further down are the five domains of detachment, antagonistic externalizing, disinhibited externalizing, thought disorder, and internalizing (along with a provisional sixth somatoform dimension) that align with Criterion B. The purpose of this article is to discuss the potential inclusion and placement of the self-interpersonal deficits of the DSM-5 Section III Criterion A within HiTOP.

Prevalence and structure of self‐other problems in SAPAS screening for personality disorder in a National Sample

“…Our finding of two latent subdomains, resembling components of self‐ and interpersonal dysfunction, is consistent with the ecumenical approach to conceptualizing personality pathology proposed by Bender . Accordingly, this structure supports previous empirical research on the DSM‐5 AMPD framework of self/other functioning . Our finding is particularly consistent with previous research on self‐reported personality dysfunction in Danish psychiatric patients and incarcerated addicts as well as Dutch psychiatric patients .…”

Treatment of personality pathology through the lens of the hierarchical taxonomy of psychopathology: Developing a research agenda

“…disinhibited eternalizing includes substance use disorders and internalizing includes mood and anxiety disorders), and there has been much debate regarding what constitutes general personality functioning vs. personality pathology. 26,40 A discussion of this distinction is beyond the scope of the current work as the literature is equivocal. Additionally, given that research specific to the HiTOP model is sparse, evidence for the HiTOP approach to treatment is extrapolated from existing evidence with related models and therefore should be considered speculative.…”

“…There are a few recent notable HiTOP papers beyond the current issue of Personality and Mental Health that are particularly relevant to the current manuscript. Widiger et al 40 describe the potential role, importance and implications of personality within the HiTOP dimensional model of psychopathology, Hopwood et al 27 focus on specific potential advantages of HiTOP for psychotherapy research and practice, and Ruggero et al 41 outline general issues involved in translating HiTOP to clinical practice. The goal of the current paper is to integrate these three areas to highlight potential psychotherapeutic and pharmacological treatment technique recommendations for personality pathology specifically defined within the HiTOP model.…”

“…High internalizing High internalizing Cognitive processing 33,34 Analysing transference 38,41 Cognitive restructuring 5 Clarification 41 Mentalizing 35,36 Emotional expression 42 Mindfulness 37 Mirroring 38 SSRI 39 TCA 39 Unified protocol 40 Low internalizing Facial emotion recognition 43 Family psychoeducation on emotion reactivity 44…”

Borderline personality disorder level predicts change in depressiveness after short‐term group psychotherapy: A study in a daily psychiatric clinic

“…The DSM‐IV and ICD‐10 took a more medical approach to psychopathology, which suggested that personality disorders were categorical constructs rather than dimensional ones. The authors of the newest versions of DSM‐5 and ICD‐11 began shifting the understanding of personality disorder from classification towards dimensions (Kupfer, First, & Regier, ; Widiger et al, ). For example, now the DSM‐5 proposes an alternative model of personality disorder, which stresses the coexistence of pathological personality traits, and ICD‐11 also underlines that the intensity of symptoms must be considered (Gaebel, Zielasek, & Reed, ).…”