Towards a new perspective on personality disorder classification:The alternative model for personality disorders in clinical practice

The Alternative Model for Personality Disorders (AMPD) constitutes a new and radically different PD classification system. It is a shift towards dimensionality, describing underlying impairments and traits. The research base of the AMPD model has been growing extensively. Research on validity and clinical utility of the model however is still scarce. This thesis aims to address this gap in the research base and focusses on the validity and utility of the AMPD model in clinical practice. The first part of this thesis describes the evaluation of several instruments for assessing Criterion A and the impact of using the model on case-identification of PDs. The second part of this thesis focuses on implementation and clinical utility of the model. The third part of this thesis focuses on a comparison of the AMPD model to the traditional Section II PD model in terms of predictive validity and clinical utility. The present thesis provided largely favorable psychometric results for both self-report and clinician-rated interview methods for assessing the AMPD. Compared to the Section II PD assessment, the AMPD assessment, in particular the LPFS is a promising tool for detecting PD early. Furthermore, compared to the Section II PD model, the LPFS may be superior in capturing vulnerabilities of patients that are predictive of general malfunctioning. With regard to utility of assessment, the present thesis provides a first insight into what makes PD assessment useful for patients: feeling less stigmatized, providing insight, enhancing hope and motivation for treatment, collaboration, and transparency

Towards a new perspective on personality disorder classification:The alternative model for personality disorders in clinical practice

The Alternative Model for Personality Disorders (AMPD) constitutes a new and radically different PD classification system. It is a shift towards dimensionality, describing underlying impairments and traits. The research base of the AMPD model has been growing extensively. Research on validity and clinical utility of the model however is still scarce. This thesis aims to address this gap in the research base and focusses on the validity and utility of the AMPD model in clinical practice. The first part of this thesis describes the evaluation of several instruments for assessing Criterion A and the impact of using the model on case-identification of PDs. The second part of this thesis focuses on implementation and clinical utility of the model. The third part of this thesis focuses on a comparison of the AMPD model to the traditional Section II PD model in terms of predictive validity and clinical utility. The present thesis provided largely favorable psychometric results for both self-report and clinician-rated interview methods for assessing the AMPD. Compared to the Section II PD assessment, the AMPD assessment, in particular the LPFS is a promising tool for detecting PD early. Furthermore, compared to the Section II PD model, the LPFS may be superior in capturing vulnerabilities of patients that are predictive of general malfunctioning. With regard to utility of assessment, the present thesis provides a first insight into what makes PD assessment useful for patients: feeling less stigmatized, providing insight, enhancing hope and motivation for treatment, collaboration, and transparency

Assessing DSM-5-oriented level of personality functioning:Development and psychometric evaluation of the Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1)

The alternative model for personality disorders (AMPD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) features a Level of Personality Functioning Scale, measuring intrinsic personality processes that include identity, self-direction, empathy, and intimacy. This study describes the development and psychometric evaluation of a semistructured interview schedule for the multi-item assessment of the level of personality functioning, the Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1). Eighty patients and 18 community subjects completed the STiP-5.1. Patients additionally completed the Brief Symptom Inventory, the Severity Indices of Personality Problems, and the Structured Clinical Interview for DSM-IV Axis I and Axis II Personality Disorders. Good interrater reliability was observed in subsamples of patients (n = 40) and nonpatients (n = 18). Associations between the interview scores and conceptually relevant external measures consistently supported the construct validity of the instrument. The STiP-5.1 thus offers a brief, relatively user-friendly instrument with generally favorable psychometric properties for the assessment of level of personality functioning of the DSM-5 AMPD. (PsycINFO Database Recor

Towards a new perspective on personality disorder classification:The alternative model for personality disorders in clinical practice

The Alternative Model for Personality Disorders (AMPD) constitutes a new and radically different PD classification system. It is a shift towards dimensionality, describing underlying impairments and traits. The research base of the AMPD model has been growing extensively. Research on validity and clinical utility of the model however is still scarce. This thesis aims to address this gap in the research base and focusses on the validity and utility of the AMPD model in clinical practice. The first part of this thesis describes the evaluation of several instruments for assessing Criterion A and the impact of using the model on case-identification of PDs. The second part of this thesis focuses on implementation and clinical utility of the model. The third part of this thesis focuses on a comparison of the AMPD model to the traditional Section II PD model in terms of predictive validity and clinical utility. The present thesis provided largely favorable psychometric results for both self-report and clinician-rated interview methods for assessing the AMPD. Compared to the Section II PD assessment, the AMPD assessment, in particular the LPFS is a promising tool for detecting PD early. Furthermore, compared to the Section II PD model, the LPFS may be superior in capturing vulnerabilities of patients that are predictive of general malfunctioning. With regard to utility of assessment, the present thesis provides a first insight into what makes PD assessment useful for patients: feeling less stigmatized, providing insight, enhancing hope and motivation for treatment, collaboration, and transparency

The Level of Personality Functioning Scale‐Brief Form 2.0: Update of a brief instrument for assessing level of personality functioning

Section III of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) introduced the alternative model of personality disorders that includes assessing levels of personality functioning. Here, we describe the development, preliminary psychometric evaluation and sensitivity to change of a revised brief self-report questionnaire, the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0). Patients (N = 201) referred to a specialized centre for the assessment and treatment of personality disorders completed the LPFS-BF 2.0, the Brief Symptom Inventory and the Severity Indices of Personality Problems Short Form and were administered the Structured Clinical Interview for DSM-IV Axis I and Axis II Disorders. Internal structure and aspects of construct validity were examined. A subsample of 39 patients also completed the questionnaires after 3 months of inpatient treatment. Confirmatory factor analyses demonstrated better fit for a two-factor solution (interpretable as self-functioning and interpersonal functioning) than for a unidimensional model, though acceptable model fit was evident only after two post hoc modifications. The LPFS-BF 2.0 demonstrated satisfactory internal consistency and promising construct validity. Sensitivity to change after 3 months of treatment was high. The LPFS-BF 2.0 constitutes a short, user-friendly instrument that provides a quick impression of the severity of personality pathology