Level of personality functioning as a predictor of psychosocial functioning—Concurrent validity of criterion A.

Abstract

The Alternative Model for Personality Disorders (AMPD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM), fifth edition (DSM-5), defines personality functioning by assessment of impairment in Identity and Self-direction (Self-component) and in Empathy and Intimacy (Interpersonal). These four domains constitute the Level of Personality Functioning Scale (LPFS), a trans-diagnostic measure of PD severity. The association between the LPFS and psychosocial impairment based on other previously established psychosocial functioning instruments has not been reported. A total of 317 individuals, including a representative clinical sample of 282 patients (192 with a PD diagnosis), was evaluated with the Structured Clinical Interview for the DSM-5 AMPD (SCID-5-AMPD) Module I. Self-reported impairment was measured by the Work and Social Adjustment Scale (WSAS) and social and occupational impairment was assessed by the functioning score of Global Assessment of Functioning scale (GAF-F). WSAS and GAF-F both correlated significantly with mean LPFS scores and the sum of DSM-IV PD criteria. For both measures, the mean LPFS was a stronger predictor for psychosocial impairment than the sum of DSM-IV PD criteria. Within the LPFS, the Self component was a better predictor than the Interpersonal component for both WSAS and GAF-F. For the four domains the results diverged, with Identity as the strongest predictor by far for WSAS. Empathy was the only significant predictor for impairment evaluated by GAF-F, but its contribution to variance was not substantial.

Levels of Structural Integration Mediate the Impact of Metacognition on Functioning in Non-affective Psychosis: Adding a Psychodynamic Perspective to the Metacognitive Approach

“…It is also worthwhile to mention that psychic structure as measured with the OPD-LSIA refers to level of personality functioning (Zimmermann et al, 2012), that has been additionally considered in recent development of diagnostic systems (DSM-5; American Psychiatric Association, 2013). However, research on how this might relate to other established measures of more general psychosocial functioning (Buer et al, 2019) or the concept of mentalizing (Zettl et al, 2019) emerges only now.…”

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

“…Other empirical results appear to support the unidimensionality claim. Indeed, very high intercorrelations between the four elements within Criterion A self-reports have been documented (see McCabe et al [34]); furthermore, general severity appears to be a valid index that represents a strong predictor of current or future adjustment [35][36], can account for the comorbidity among Section II PD diagnoses [8], and appears to be sensitive to change [37]. Nonetheless, other researchers in the eld have expressed their dissatisfaction with the simpli cation of Criterion A to a single core dimension and have challenged this notion, claiming that Criterion A elements have a meaningful independent value.…”

Subjective experience of the origin and development of avoidant personality disorder

“…In addition, nine participants from the research project, “An Examination of the DSM‐5 Level of Personality Functioning Scale in a Representative Clinical Sample” (Buer Christensen et al, 2020; Buer Christensen et al, 2019; Buer Christensen et al, 2018), who had agreed to be contacted at a later stage for additional research purposes, were approached by the first author (A). They received written information about the research via their therapists.…”