Expanding the Role of Levels of Personality Functioning in Personality Disorder Taxonomy: Commentary on “Criterion A of the AMPD in HiTOP”

Meehan, Kevin B.; Siefert, Caleb J.; Sexton, James E.; Huprich, Steven K.

doi:10.1080/00223891.2018.1551228

Cited by 22 publications

(20 citation statements)

References 47 publications

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“…An important question with regard to the AMPD is whether impairments in personality functioning (criterion A) and maladaptive personality traits (criterion B) provide distinct or overlapping information (for a conceptual discussion, see [108•, [299][300][301][302]). From a semantic perspective, criterion A and criterion B share the focus on describing socially undesirable characteristics [302], and differences seem to be mostly due to theoretical traditions and level of inference [303].…”

Section: Empirical Overlap Between Severity and Maladaptive Traitsmentioning

confidence: 99%

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

Zimmermann

Kerber

Kappelmann

et al. 2019

Curr Psychiatry Rep

254

212

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Purpose of Review 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. Recent Findings 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. Summary The AMPD has stimulated extensive research with promising findings. We highlight open questions and provide recommendations for future research.

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Section: Empirical Overlap Between Severity and Maladaptive Traitsmentioning

confidence: 99%

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

Zimmermann

Kerber

Kappelmann

et al. 2019

Curr Psychiatry Rep

254

212

View full text Add to dashboard Cite

show abstract

“…By combining a gradient of severity (Criterion A) with a "stylistic" element (Criterion B), AMPD-based profiles might be able to generate qualitatively distinct profiles distributed along a severity continuum, which other approaches (e.g., based on DSM Section II criteria) could not readily achieve. As a secondary objective, the use of the four Criterion A elements and the seven Criterion B BPD facets as latent indicators should allow (a) contributing to the current debate [25][26][27] regarding the unidimensional versus multidimensional nature of Criterion A, by determining whether the four Criterion A elements are independently useful to uncover conceptually and clinically meaningful profiles of BPD patients; and (b) contributing to ongoing efforts [23,24] aiming to identify which Criterion B facets are the most relevant in the description of BPD.…”

Section: The Present Studymentioning

confidence: 99%

Latent profiles of patients with borderline pathology based on the alternative DSM-5 model for personality disorders

Gamache

Savard

Leclerc

et al. 2021

bord personal disord emot dysregul

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Background There have been multiple attempts to try to parse out heterogeneity within borderline pathology by identifying patient subtypes; thus far, these works have yielded few consistent results. Recent developments in the operationalization of borderline pathology may provide new opportunities to identify clinically and conceptually meaningful subgroups of patients. The Alternative DSM-5 Model for Personality Disorders (AMPD) offers a categorical-dimensional operationalization of Borderline personality disorder (BPD) that has yet to be tested for identification of patient subgroups. The purpose of the present study is to test whether the combination of the Criterion A elements (pertaining to level of severity) and the seven pathological facets from Criterion B that define BPD in the AMPD can yield meaningful patient profiles. Methods A total of 211 outpatients from a specialized PD treatment program (133 women, Mage = 33.66, SD = 10.97) were selected based on the presence of at least moderate borderline pathology according to cutoffs recently proposed for the Borderline Symptom List-23. Valid Criterion A (Self and Interpersonal Functioning Scale) and B (Personality Inventory for DSM-5 Faceted Brief Form) self-reports were administered to measure elements and facets that define BPD in the AMPD model; these variables were used as indicators in a latent profile analysis (LPA). Results The optimal solution generated by LPA yielded four distinct profiles: (a) Borderline traits; (b) Moderate pathology with Impulsivity; (c) Moderate pathology with Identity problems and Depressivity; and (d) Severe pathology. Clinically meaningful distinctions emerged among profiles on AMPD indicators and external variables relevant to PD, especially aggression and impulsivity. Conclusions Profiles reflected both the “severity” and “style” components imbedded within Criterion A and B of the AMPD, as they were mainly distinguished by a continuum of severity but also by some meaningful qualitative differences that may have important clinical implications for treatment planning and contracting. Results also suggest that the four Criterion A elements have independent value to identify important differences in patients with borderline pathology. They also highlight that some Criterion B facets that define BPD in the AMPD may be especially important to identify subgroups of patients, mainly Impulsivity and Depressivity.

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“…As works on the AMPD have continuously accumulated since its initial introduction in the DSM-5 [20], various conceptual and/or clinical arguments have emerged with respect to both Criterion A and Criterion B. For instance, there is an ongoing debate regarding the very nature of Criterion A and its conceptualization (see, e.g., [25][26][27][28][29]). Its four elements are believed to be closely interrelated, with dysfunction within one element being likely to impact functioning in others [22]; in consequence, some AMPD scholars have been adamant [26,30] that Criterion A should be conceptualized as a single core dimension.…”

Section: Introductionmentioning

confidence: 99%

Latent Profiles of Patients with Borderline Pathology Based on the Alternative DSM-5 Model for Personality Disorders

Gamache

Savard

Leclerc

et al. 2020

Preprint

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Background There have been multiple attempts to try to parse out heterogeneity within borderline pathology by identifying patient subtypes; thus far, these works have yielded few consistent results. Recent developments in the operationalization of borderline pathology may provide new opportunities to identify clinically and conceptually meaningful subgroups of patients. The Alternative DSM-5 Model for Personality Disorders (AMPD) offers a categorical-dimensional operationalization of Borderline personality disorder (BPD) that has yet to be tested for identification of patient subgroups. The purpose of the present study is to test whether the combination of the Criterion A elements (pertaining to level of severity) and the seven pathological traits from Criterion B that define BPD in the AMPD can yield meaningful patient profiles. Methods A total of 211 outpatients from a specialized PD treatment program (133 women, Mage = 33.66, SD = 10.97) were selected based on the presence of at least moderate borderline pathology according to cutoffs recently proposed for the Borderline Symptom List-23. Valid Criterion A (Self and Interpersonal Functioning Scale) and B (Personality Inventory for DSM-5-Short Form) self-reports were administered to measure elements and traits that define BPD in the AMPD model; these variables were used as indicators in a Latent profile analysis (LPA). Results The optimal solution generated by LPA yielded four distinct profiles: (a) Borderline traits; (b) Low borderline pathology with Impulsivity; (c) Moderate borderline pathology with Identity problems and Depressivity; and (d) Severe borderline pathology. Clinically meaningful distinctions emerged between profiles on AMPD indicators and external variables relevant to PD, especially aggression and impulsivity. Conclusions Profiles reflected both the “severity” and “style” components imbedded within Criterion A and B of the AMPD, as they were mainly distinguished by a continuum of severity but also by some meaningful qualitative differences that may have important clinical implications for treatment planning and contracting. Results also suggest that the four Criterion A elements have independent value to identify important differences in patients with borderline pathology. They also highlight that some Criterion B traits that define BPD in the AMPD may be especially important to identify subgroups of patients, mainly Impulsivity and Depressivity.

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Expanding the Role of Levels of Personality Functioning in Personality Disorder Taxonomy: Commentary on “Criterion A of the AMPD in HiTOP”

Cited by 22 publications

References 47 publications

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

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

Latent profiles of patients with borderline pathology based on the alternative DSM-5 model for personality disorders

Latent Profiles of Patients with Borderline Pathology Based on the Alternative DSM-5 Model for Personality Disorders

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