Search Results (10)

Background: Arabic-speaking populations lack a brief, psychometrically evaluated instrument for assessing maladaptive personality traits within the DSM-5 Alternative Model for Personality Disorders (AMPD). Objective: To translate the Personality Inventory for DSM-5—Brief Form (PID-5-BF) into Standard Arabic and evaluate its content validity, reliability, and factor structure in a Saudi community sample. Methods: The PID-5-BF was translated through a multistep forward–backward procedure with expert panel review. Twenty-five pilot participants rated item clarity and simplicity. The final Arabic version was administered to 328 Saudi adults, and 52 verified pairs completed it twice over a mean interval of 16.1 days. Confirmatory factor analysis (CFA) tested the a priori five-factor model. Principal axis factoring with Promax rotation and Horn’s parallel analysis were used to examine factor retention. Reliability indices included Cronbach’s alpha and intraclass correlation coefficients [ICC(2,1), absolute agreement]. Results: Content validity was excellent (S-CVI/Ave = 0.93 for clarity; 0.94 for simplicity). CFA showed an acceptable RMSEA (0.068, 90% CI 0.062–0.075) but incremental fit below thresholds (CFI = 0.84; TLI = 0.82; SRMR = 0.12). Parallel analysis retained four factors. Domain alphas ranged from 0.70 to 0.78 (total = 0.89), and domain ICCs were 0.74 to 0.85 (total = 0.88). Antagonism items showed 50–58% floor effects. Conclusions: The standard-Arabic PID-5-BF shows acceptable content validity, internal consistency, and temporal stability, with partial structural support. Further work using ordinal estimation, measurement invariance testing, and external validity assessment is needed before routine clinical adoption. Full article

Recent revisions of personality disorder (PD) classifications have moved from categorical diagnoses toward dimensional models, raising renewed questions about the nosological status and clinical utility of borderline personality disorder (BPD). This narrative review traces the development of the borderline construct from early descriptions of patients positioned between neurosis and psychosis, through its theoretical consolidation within the concept of borderline personality organization, to the operationalization of BPD in DSM-III and subsequent diagnostic revisions. A central section summarizes contemporary controversies regarding the validity and utility of BPD features. Arguments for abandoning the diagnosis emphasize the absence of a distinct borderline factor in factor analytic studies, the tendency of the construct to capture fluctuating symptoms and patterns of behaviour rather than stable maladaptive personality traits, the stigmatizing and non-selective use of the label, and the lack of disorder-specific treatment approaches. In contrast, converging evidence supports the view that core borderline symptoms frequently function as markers of general PD pathology and of the severity of impairments in self and interpersonal functioning. The paper integrates the concept of the borderline level of personality functioning, conceptualizing borderline pathology as a dynamic dimension of dysfunction with potential transient regressions, and links this concept to the Level of Personality Functioning (LPF, Criterion A) within the DSM 5 Alternative Model for Personality Disorders (AMPD). Retaining borderline pathology as a dimension may support contemporary PD assessment by offering a clinically recognizable marker of overall dysfunction, a guide for rating severity, an indicator of personality structure and need for psychotherapy, without disrupting continuity with an extensive clinical and research tradition. Full article

Introduction: Personality disorders are enduring, maladaptive patterns that impair social and vocational functioning. The DSM-5 Alternative Model for Personality Disorders (AMPD) distinguishes Criterion A (personality functioning: identity, self-direction, empathy, intimacy) from Criterion B (maladaptive trait domains: negative affectivity, detachment, antagonism, disinhibition, psychoticism). We frame this study within Criterion B, supporting the use of a dimensional approach that complements (rather than replaces) normative models like the Five-Factor Model (FFM) and addresses cross-cultural gaps amid Saudi Arabia’s rapid sociocultural change such as the reforms associated with Vision 2030. Given Saudi Arabia’s collectivist orientation and evolving sociocultural norms under Vision 2030, the dimensional approach of the AMPD Criterion B offers a culturally sensitive lens for capturing personality pathology beyond Western-centric diagnostic models. Aim: We aimed to examine how PID-5-BF maladaptive trait domains vary across key sociodemographic factors in Saudi adults. Subjects and Methods: This was a quantitative, cross-sectional analytical study conducted among Saudi adults using the PID-5-BF Convenience sampling was performed via the dissemination of an online survey; we aimed for 377 participants and obtained 343 completed responses (~91% of the target sample). For trait assessment, we used the PID-5-BF; analyses compared domains across sociodemographic groups. Results: Females showed a higher negative affect; participants ≤ 30 years exhibited higher psychoticism than those >40; and single individuals reported lower detachment and psychoticism than their married peers. Conclusions: Gender, age, and marital status are associated with differences in maladaptive trait expression, supporting the need for culturally tailored screening and interventions in Saudi mental health services. These findings should be interpreted with caution given the fact that WhatsApp-based convenience sampling was used, which may bias the results as the respondents were more likely to live in urban areas, be educated, and be technologically proficient. Full article

Objective: Genetic and environmental factors influence the expression of personality pathology and subsequent treatment efforts. This study associates genetics with a contemporary nosology of personality pathology represented in the Alternative Model for Personality Disorders (AMPD). We hypothesized traits from Criterion B of the AMPD would differ between genotypes of the catechol-O-methyltransferase (COMT) polymorphism (rs4680/Val158Met variation), given this genetic marker’s role in the metabolism of dopamine and norepinephrine, especially in the prefrontal cortex. Methods: The Personality Inventory for DSM-V (PID-5) was used to quantify personality traits, and the Genomind platform was used to identify the genotypes of the Val158Met COMT polymorphism in 84 psychiatric outpatients. Results: One of the five Criterion B personality domains and three of the twenty-five traits were significantly different among genotypes. Met/Met carriers had significantly higher pathological scores on the broad domain of negative affect and specific traits of perceptual dysregulation and separation insecurity, while the Val/Val carriers had significantly higher scores on the restricted affectivity trait. The COMT Val158Met polymorphism’s association with personality pathology was sexually dimorphic, with the two domains and nine traits significantly different across genotypes in males, but no differences were found in females. A substantial improvement in the regression of domains/traits score when gene–sex interactions were included further confirmed the dimorphism, e.g., the R-squared (adjusted) for the psychoticism improved from 0.03 (p = 0.15) to 0.19 (p < 0.001). Conclusions: Findings offer preliminary support for a link, potentially dimorphic across sexes, between the COMT Val158Met polymorphism and personality pathology as represented by the AMPD. Full article

Attachment styles and defense mechanisms are widely recognized as central components in personality development. However, few empirical studies have examined their combined contribution to maladaptive personality traits within the dimensional framework of the DSM-5 Alternative Model for Personality Disorders (AMPD). This study investigated the extent to which adult attachment styles and defense mechanisms predict the five AMPD maladaptive personality domains: negative affectivity, detachment, antagonism, disinhibition, and psychoticism. Data were collected from a community sample of 400 adults (190 males, 47.5%), aged 18 to 69 years (M = 36.96; SD = 11.59). Hierarchical multiple regression analyses were conducted for each maladaptive personality domain to examine the predictive roles of attachment styles and defense mechanisms. Our findings indicate that each maladaptive personality domain is associated with specific configurations of attachment styles and defense mechanisms. In conclusion, the findings suggest the relevance of assessing adult attachment styles and defensive functioning in clinical contexts in order to deepen the understanding of the individuals’ personality profiles. Full article

Background/Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, often persisting into adolescence and adulthood, with significant impacts on social, academic, and occupational functioning. Emerging research highlights the role of personality traits in ADHD, suggesting their influence on symptom presentation, functional impairments, and treatment adherence. This study aims to investigate maladaptive personality domains and traits in adolescents with ADHD using the Alternative Model of Personality Disorders (AMPD) framework and the Personality Inventory for DSM-5 Short Form (PID-5-SF), with a particular focus on the differences among same-sex peers and differences from typically developing peers. Methods: This study included 30 ADHD and 25 TD adolescents aged 11–17 (12.6 ± 2.1 vs. 14.9 ± 1.7; p < 0.001), recruited at IRCCS Centro Neurolesi “Bonino Pulejo”. Participants underwent clinical assessments, cognitive evaluation, and standardized rating scales, with maladaptive personality traits measured using the PID-5-SF. Chi-squared and Mann–Whitney U tests were used to compare the two groups, as appropriate. Results: ADHD adolescents showed significantly higher scores than TD peers in restricted affectivity (p = 0.007), distractibility (p = 0.001), impulsivity (p = 0.049), irresponsibility (p = 0.036), hostility (p = 0.046), perseveration (p = 0.010), submissiveness (p = 0.023), and risk-taking (p = 0.032). Among personality domains, disinhibition was significantly higher in the ADHD group (p = 0.002), while detachment approached significance. Female ADHD participants scored higher than TD females in restricted affectivity, distractibility, and risk-taking. Conclusions: These findings suggest that maladaptive personality traits play a key role in ADHD during adolescence, highlighting the need for tailored interventions. Integrating personality assessment into clinical practice may enhance diagnostic accuracy and support more effective, individualized treatment strategies. Full article

Background/Objectives: In the new conceptualization of personality disorders (PD) in ICD-11 and Diagnostic and Statistical Manual 5 Alternative Model of Personality Disorders (DSM-5 AMPD), identity development in terms of impaired personality functioning plays a central role in diagnostic guidelines and determining PD severity. On the one hand, there is a temporary identity crisis while keeping an integrated sense of identity and, on the other hand, there is pathological identity diffusion, which is associated with a high risk of a current or emerging PD. The latter is characteristic not only of borderline PD but of all personality disorders and should be detected as early as possible to prevent chronic illness and critical life courses. Maternal psychopathology is linked to several areas of child psychopathology (e.g., eating disorders, depression). In the current study, its potential to predict a child’s impaired identity development is investigated. Methods: A total of 101 mothers were asked about their health status 2 weeks after the birth of their child and when their child was 6 weeks, 4 months, 14 months and 5.5 years of age. Specifically, physical and psychological symptoms were assessed with SCL-90-R. In addition, their children were assessed in young adulthood regarding their identity development with the AIDA (Assessment of Identity Development in Adolescence) questionnaire. Linear regression models were used to investigate the amount of explanation of children’s identity diffusion by maternal symptom burden. Results: Maternal psychopathology significantly predicted identity diffusion at all time points with small effect sizes, while after 14 months, the explanation model showed a medium effect size. Conclusions: The present data suggest a relevant influence of maternal psychopathological symptoms on their children’s identity development in terms of functioning that has not yet been empirically shown in a longitudinal study. This finding highlights the importance of including further factors (particularly on the part of the child) in longitudinal studies and of investigating this clinically highly relevant relationship in greater depth. Full article

To investigate if the Personality Disorder (PD) severity concept (Criterion A) of the ICD-11 and DSM-5 AMPD is applicable to children and adolescents, following the ICD-11 lifespan perspective of mental disorders, age-specific and informant-adapted assessment tools are needed. The LoPF-Q 6-18 PR (Levels of Personality Functioning Questionnaire Parent Rating) was developed to assess Impaired Personality Functioning (IPF) in children aged 6–18 in parent-reported form. It is based on the established self-report questionnaire LoPF-Q 12-18. Psychometric properties were investigated in a German-speaking clinical and school sample containing 599 subjects. The final 36-item version of LoPF-Q 6-18 PR showed good scale reliabilities with 0.96 for the total scale IPF and 0.90-0.87 for the domain scales Identity, Self-direction, Empathy, and Intimacy/Attachment and an acceptable model fit in a hierarchical CFA with CFI = 0.936, RMSEA = 0.078, and SRMR = 0.068. The total score discriminated significantly and with large effect sizes between the school population and (a) adolescent PD patients (d = 2.7 standard deviations) and (b) the younger patients (6–11-year-olds) with internalizing and externalizing disorders (d = 2.2 standard deviations). Informant agreement between parent and self-report was good at 0.47. Good construct validity can be assumed given sound covariation with related measures of psychopathology (CBCL 4-18, STiP-5.1, OPD-CA2-SQ PR) and maladaptive traits (PID5BF+ M CA IRF) in line with theory and matching the result patterns obtained in older samples in self-report. The results suggest that parent-reported assessments of IPF and maladaptive traits are equivalent to self-reported measures for Criterion A and B. Assessing IPF as early as age six might be a valuable step to foster early detection of PD, or maladaptive personality development, respectively individuals at risk. Full article

Although numerous studies have explored latent profiles using the Five-Factor Model (FFM) of normative personality, no studies have investigated how broad personality traits (i.e., FFM) and pathological personality traits using the alternative model of personality disorder (AMPD) may combine for latent personality profiles. The present study recruited outpatients (N = 201) who completed the Big Five Aspects Scales (BFAS), Personality Inventory for DSM-5 (PID-5), Structured Clinical Interview for DSM-IV (SCID-I/P), gambling and alcohol use measures, and the Weschler Intelligence subtests. When FFM and AMPD measures were combined, latent profile analyses revealed four profiles, Internalizing-Thought disorder, Externalizing, Average-Detached, and Adaptive. Detachment and openness to experience were the most and least essential traits for profile distinction, respectively. No associations between group membership and cognitive ability measures were found. Internalizing-Thought disorder membership was linked with a current mood and anxiety disorder diagnosis. Externalizing profile membership was associated with younger age, problematic gambling, alcohol use, and a current substance use disorder diagnosis. The four FFM–AMPD profiles overlapped with the four FFM-only and three AMPD-only profiles. Overall, the FFM–AMPD profiles appeared to have better convergent and discriminant validity with DSM-relevant psychopathology. Full article

Background: Personality disorders show strong comorbidities with alcohol-use disorder (AUD), and several personality traits have been found to be more frequent in people with AUD. This study analyzes which personality facets of those proposed in the Alternative Model of Personality Disorder (AMPD) of DSM-5 are associated with the diagnostic criteria of AUD. Methods: The sample was composed of 742 participants randomly selected from the Spanish population, and 243 patients attending mental health services. All participants were of legal age and signed an informed consent form. The instruments were administered to the community sample in an online format, and a psychologist conducted individual face-to-face interviews with the patients. AMPD facets were assessed through the Personality Inventory of DSM-5 Short-Form, and the AUD criteria through the Substance Dependence Severity Scale. A network analysis was applied to identify the personality facets mostly associated with the AUD criteria. Results: The network analysis showed the existence of three communities, grouping the AUD criteria, externalizing spectrum facets, and internalizing spectrum facets, respectively. Risk taking, callousness, and irresponsibility facets showed the strongest association with the AUD criteria, bridging externalizing personality traits with AUD criteria. Conclusions: The facets of risk taking, callousness, and irresponsibility should be accurately assessed in patients with AUD to differentiate between a possible primary personality disorder and a syndrome induced by alcohol addiction. Full article