A Psychometric Analysis of the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I (SCID-5-AMPD-I):Level of Personality Functioning Scale

The current study aims to examine the psychometric properties of the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders Module I (SCID-5-AMPD-I) assessing the Level of Personality Functioning Scale (LPFS) in a heterogeneous sample of 282 nonpsychotic patients. Latent variable models were used to investigate the dimensionality of the LPFS. The results indicate that the LPFS, as assessed by the SCID-5-AMPD-I, can be considered as a unidimensional construct that can be measured reliably across a wide range of the latent trait. Threshold parameters for the 12 indicators of the LPFS increased gradually over the latent scale, indicating that the five LPFS levels were ordered as predicted by the model. In general, the increase of threshold parameters was relatively small for the shift from Level 2 to Level 3. A better distinction among the different severity levels might be obtained by fine-tuning the interview guidelines or the Level 2 indicators themselves

Personality functioning in patients with avoidant personality disorder and social phobia

Avoidant personality disorder (APD) and social phobia (SP) are closely related, such that they are suggested to represent different severity levels of one social anxiety disorder. This cross-sectional study aimed to compare patients with APD to patients with SP, with particular focus on personality dysfunction. Ninety-one adult patients were examined by diagnostic interviews and self-report measures, including the Index of Self-Esteem and the Severity Indices of Personality Problems. Patients were categorized in three groups; SP without APD (n = 20), APD without SP (n = 15), and APD with SP (n = 56). Compared to patients with SP without APD, patients with APD reported more symptom disorders, psychosocial problems, criteria of personality disorders, and personality dysfunction regarding self-esteem, identity and relational problems. These results indicate that APD involves more severe and broader areas of personality dysfunction than SP, supporting the conceptualization of APD as a personality disorder as proposed for DSM-5

DSM-IV diagnostic criteria for AvPD.

<p>DSM-IV diagnostic criteria for AvPD.</p

Attachment style in Avoidant personality disorder (AvPD, n = 70) and Social phobia (SP, n = 20).

<p>Distribution of the AvPD and SP groups in the two dimensional, four categorical parental style model according to the Parental Bonding Instrument (PBI). ORIGO is defined as the cut-off scores, se text. AvPD: Avoidant personality disorder, SP: Social phobia, M: Mother, F: Father</p

Socio-demographic and clinical characteristics of patients with AvPD^a (n = 71) and SP^b (n = 20).

<p>Data are presented as mean (SD) unless otherwise noted.</p><p>^a The AvPD group comprised patients with AvPD with and without co-occurring SP.</p><p>^b The SP group comprised patients with SP without AvPD.</p><p>Socio-demographic and clinical characteristics of patients with AvPD<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122846#t002fn002" target="_blank">^a</a> (n = 71) and SP<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122846#t002fn003" target="_blank">^b</a> (n = 20).</p

Clinical Characteristics of Patients with AvPD^a (<i>n</i> = 71) and SP^b (<i>n</i> = 20).

<p>^a The AvPD group comprised patients with AvPD with and without co-occurring SP.</p><p>^bThe SP group comprised patients with SP without AvPD.</p><p>^<i>c</i>Score range: 5 (no) to 25 (extreme),</p><p>^<i>d</i>Score range: 1 (none or minimal) to 4 (severe to extreme)</p><p>^<i>e</i>Mdn = Median; I-R = Interquartile Range,</p><p>^<i>f</i><i>r²</i> = (z /√N) <i>²</i></p><p>Clinical Characteristics of Patients with AvPD<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122846#t003fn001" target="_blank">^a</a> (<i>n</i> = 71) and SP<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122846#t003fn002" target="_blank">^b</a> (<i>n</i> = 20).</p

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

The alternative model for personality disorders (AMPD) in the Diagnostic and Statistical Manual of Mental Disorders, 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, a trans-diagnostic measure of PD severity. The association between the Level of Personality Functioning Scale 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 personality disorder [PD] diagnosis), was evaluated with the Structured Clinical Interview for the DSM-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 the 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. (PsycINFO Database Record (c) 2020 APA, all rights reserved).This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]