1
|
Fuller EK, Gatner DT, Douglas KS. Concurrent, Convergent, and Discriminant Validity of the DSM-5 Section III Psychopathy Specifier. Assessment 2022:10731911221124344. [PMID: 36124389 PMCID: PMC10363948 DOI: 10.1177/10731911221124344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Section III of the fifth iteration of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes an alternative model of personality disorder diagnosis that conceptualizes antisocial personality disorder as an interpersonal, rather than behavioral, construct. However, the diagnostic specifier for psychopathy has been met with recent controversy due to its conceptual and empirical overlap with triarchic boldness, which has been debated as a necessary and sufficient domain of psychopathy. This study examined the concurrent, convergent, and discriminant validity of the specifier using canonical correlation analysis in samples of undergraduate students (N = 224) and community adults with prior criminal involvement (N = 306). Findings highlight the specifier as a multidimensional construct with divergent associations across its three facets. There was limited validity evidence for two of the three facets, raising concerns regarding the clinical utility of the psychopathy specifier.
Collapse
Affiliation(s)
- Erin K Fuller
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Dylan T Gatner
- Simon Fraser University, Burnaby, British Columbia, Canada.,British Columbia Mental Health and Substance Use Services, Vancouver, Canada
| | - Kevin S Douglas
- Simon Fraser University, Burnaby, British Columbia, Canada.,Helse Bergen Sikkerhet Kompetansesenter, Norway.,Oslo University Hospital, Norway
| |
Collapse
|
2
|
Zimmermann J, Kerber A, Rek K, Hopwood CJ, Krueger RF. A Brief but Comprehensive Review of Research on the Alternative DSM-5 Model for Personality Disorders. Curr Psychiatry Rep 2019; 21:92. [PMID: 31410586 DOI: 10.1007/s11920-019-1079-z] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
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. The AMPD has stimulated extensive research with promising findings. We highlight open questions and provide recommendations for future research.
Collapse
Affiliation(s)
- Johannes Zimmermann
- Department of Psychology, University of Kassel, Holländische Str. 36-38, 34127, Kassel, Germany.
| | | | - Katharina Rek
- Max-Planck-Institut für Psychiatrie, Munich, Germany
| | | | | |
Collapse
|
3
|
Mulay AL, Waugh MH, Fillauer JP, Bender DS, Bram A, Cain NM, Caligor E, Forbes MK, Goodrich LB, Kamphuis JH, Keeley JW, Krueger RF, Kurtz JE, Jacobsson P, Lewis KC, Rossi GMP, Ridenour JM, Roche M, Sellbom M, Sharp C, Skodol AE. Borderline personality disorder diagnosis in a new key. Borderline Personal Disord Emot Dysregul 2019; 6:18. [PMID: 31827801 PMCID: PMC6886204 DOI: 10.1186/s40479-019-0116-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Conceptualizations of personality disorders (PD) are increasingly moving towards dimensional approaches. The definition and assessment of borderline personality disorder (BPD) in regard to changes in nosology are of great importance to theory and practice as well as consumers. We studied empirical connections between the traditional DSM-5 diagnostic criteria for BPD and Criteria A and B of the Alternative Model for Personality Disorders (AMPD). METHOD Raters of varied professional backgrounds possessing substantial knowledge of PDs (N = 20) characterized BPD criteria with the four domains of the Level of Personality Functioning Scale (LPFS) and 25 pathological personality trait facets. Mean AMPD values of each BPD criterion were used to support a nosological cross-walk of the individual BPD criteria and study various combinations of BPD criteria in their AMPD translation. The grand mean AMPD profile generated from the experts was compared to published BPD prototypes that used AMPD trait ratings and the DSM-5-III hybrid categorical-dimensional algorithm for BPD. Divergent comparisons with DSM-5-III algorithms for other PDs and other published PD prototypes were also examined. RESULTS Inter-rater reliability analyses showed generally robust agreement. The AMPD profile for BPD criteria rated by individual BPD criteria was not isomorphic with whole-person ratings of BPD, although they were highly correlated. Various AMPD profiles for BPD were generated from theoretically relevant but differing configurations of BPD criteria. These AMPD profiles were highly correlated and showed meaningful divergence from non-BPD DSM-5-III algorithms and other PD prototypes. CONCLUSIONS Results show that traditional DSM BPD diagnosis reflects a common core of PD severity, largely composed of LPFS and the pathological traits of anxiousness, depressively, emotional lability, and impulsivity. Results confirm the traditional DSM criterion-based BPD diagnosis can be reliably cross-walked with the full AMPD scheme, and both approaches share substantial construct overlap. This relative equivalence suggests the vast clinical and research literatures associated with BPD may be brought forward with DSM-5-III diagnosis of BPD.
Collapse
Affiliation(s)
- Abby L Mulay
- 1Medical University of South Carolina, 29C Leinbach Drive, Charleston, SC 29407 USA
| | - Mark H Waugh
- 2Oak Ridge National Laboratory (ORNL) & University of Tennessee Knoxville, Knoxville, TN 37996 USA
| | | | - Donna S Bender
- 4Tulane University, 6823 St. Charles Ave., Bldg. 92, New Orleans, LA 70118 USA
| | | | - Nicole M Cain
- 6Rutgers University, Graduate School of Applied and Professional Psychology, 152 Frelinghuysen Rd, Piscataway, NJ 08854-8020 USA
| | - Eve Caligor
- 7Columbia University, 1501 Riverside Drive, New York, NY 10032 USA
| | - Miriam K Forbes
- 8Macquarie University, Balaclava Rd., Macquarie Park, NSW 2109 Australia
| | | | - Jan H Kamphuis
- 10University of Amsterdam (UvA), Nieuwe Achtergracht, 129B, 1001 NK Amsterdam, Netherlands
| | - Jared W Keeley
- 11Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA 23284-2018 USA
| | - Robert F Krueger
- 12University of Minnesota, 101 Pleasant St SE, Minneapolis, MN 55455 USA
| | - John E Kurtz
- 13Villanova University, 800 Lancaster Avenue, Villanova, PA 19085 USA
| | - Peter Jacobsson
- 14Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Katie C Lewis
- 15Austen Riggs Center, 25 Main Street, P.O. Box 962, Stockbridge, MA 01262 USA
| | - Gina M P Rossi
- 16Department of Psychology, Personality and Psychopathology Research group Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jeremy M Ridenour
- 15Austen Riggs Center, 25 Main Street, P.O. Box 962, Stockbridge, MA 01262 USA
| | - Michael Roche
- 17Penn State Altoona, 3000 Ivyside Park, Altoona, PA 16601 USA
| | - Martin Sellbom
- 18University of Otago, PO Box 56, Dunedin, 9054 New Zealand
| | - Carla Sharp
- 19University of Houston, 3695 Cullen Boulevard Room 126, Houston, TX 77204-5022 USA
| | - Andrew E Skodol
- 20University of Arizona, 1501 N. Campbell Avenue, PO Box 245017, Tucson, AZ 85724 USA
| |
Collapse
|