Personality Constructs and Paradigms in the AlternativeDSM-5Model of Personality Disorder

Abstract

The DSM-5 Section III alternative model for personality disorders (AMPD) is a personality disorder (PD) nosology based on severity of personality dysfunction and pathological traits. We examined the degree to which the personality constructs identified by McAdams and Pals (2006; dispositional traits, characteristic adaptations, narrative identity) and the paradigms of personality assessment described by Wiggins (2003; psychodynamic, interpersonal, personological, multivariate, empirical) are represented within the AMPD. Nine raters expert with the AMPD and personality evaluated elements of Criterion A and the 25 trait facets of Criterion B for presence of type and degree of personality constructs and paradigms, as well as level of inference. Criterion B showed higher rater agreement compared to Criterion A. Criteria A and B reflect different configurations of construct, paradigm, and level of inference. The characteristic adaptation construct and interpersonal paradigm were strongly reflected in both Criteria A and B. The psychodynamic and personological paradigms and the narrative identity construct were highly correlated, and the multivariate, empirical, and dispositional traits variables were highly correlated. Results illustrate differential conceptual emphases as well as areas of overlap with Criteria A and B. This characterization highlights that PD nosology rests on personality theory and suggests implications for integrative PD assessment.

Using Interpersonal Dimensions of Personality and Personality Pathology to Examine Momentary and Idiographic Patterns of Alliance Rupture

“…Importantly, Mulay et al (2018) recently reported that, of the major paradigms of personality assessment, interpersonal theory was relatively unique in sharing common ground with both the A and B criteria of the AMPD. Like Criterion B, the interpersonal circumplex model can be used to delineate how people differ from one another, on average, that speaks to the likelihood and type of personality disorder symptoms (Wilson et al, 2017).…”

Borderline personality disorder diagnosis in a new key

“…This observation recalls the conceptual heritage of the LPFS, which drew heavily from psychodynamic research traditions, as well as social-cognitive developmental theory [46]. Relatedly, Mulay, Cain, Waugh, et al [47] found that knowledgeable raters considered the elements of Criterion A to reflect greater psychodynamic (and personological) personality paradigms relative to Criterion B, which was seen as more reflective of the multivariate and empirical paradigms. It may be that greater familiarity or comfort with psychodynamic thinking sensitizes clinicians to more differentiated (or at least more severe) LPFS judgments of psychopathology.…”

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

“…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]. However, if one of the two components lacks incremental validity, one could argue that their separate assessment is uneconomic and the classification system lacks parsimony.…”