The DSM-5 Alternative Model for Personality Disorders introduced a dimensional perspective on personality disorders and their assessment by measuring personality functioning in the following domains: Identity, Self-Direction, Empathy, and Intimacy. This study provides a replication of the psychometric evaluation of the Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1) within a mixed clinical sample and a community sample. The sample consisted of 188 adults: 86 participants from the general population and 102 people from a mixed clinical sample. All participants completed the STiP-5.1 and Level of Personality Functioning Scale-Brief Form (LPFS-BF 2.0). Results showed good internal consistency (McDonald's ω = 0.89-0.94) and promising convergent validity (correlations with LPFS-BF 2.0 above 0.6) of the STiP-5.1. Its scores differentiated participants within the community sample from those in the mixed clinical sample with large effect sizes (rrb = 0.77-0.88). Moreover, the impairment in personality functioning was more pronounced in people with personality disorders than in other psychiatric disorders (medium effect size, rrb = 0.46-0.57), supporting the notion of a continuum of personality functioning impairment. The STiP-5.1 therefore offers an instrument with satisfactory psychometric properties for the assessment of personality functioning both for research and clinical practice.

Clinical Research of Mental Disorders National Institute of Mental Health Klecany Czech Republic

Department of Psychology University of New York Prague Prague Czech Republic

Faculty of Education Charles University Prague Czech Republic

Viersprong Institute for Studies on Personality Disorders Halsteren The Netherlands

Zobrazit více v PubMed

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). VA.

Bach, B., & Anderson, J. L. (2020). Patient-reported ICD-11 personality disorder severity and DSM-5 level of personality functioning. Journal of Personality Disorders, 34, 231-249. https://doi.org/10.1521/pedi_2018_32_393

Bach, B., & First, M. B. (2018). Application of the ICD-11 classification of personality disorders. BMC Psychiatry, 18, 351.

Bach, B., & Hutsebaut, J. (2018). Level of Personality Functioning Scale-Brief Form 2.0: Utility in capturing personality problems in psychiatric outpatients and incarcerated addicts. Journal of Personality Assessment, 100(6), 1-11.

Bangash, A. (2020). Personality disorders in later life: Epidemiology, presentation and management. BJPsych Advances, 26, 208-218.

Beatson, J., Broadbear, J. H., Sivakumaran, H., George, K., Kotler, E., Moss, F., & Rao, S. (2016). Missed diagnosis: The emerging crisis of borderline personality disorder in older people. The Australian and New Zealand Journal of Psychiatry, 50, 1139-1145.

Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893-897.

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the BDI-II. Psychological Corporation.

Bender, D. S., Morey, L. C., & Skodol, A. E. (2011). Toward a model for assessing level of personality functioning in DSM-5, part I: A review of theory and methods. Journal of Personality Assessment, 93, 332-346.

Bender DS, Skodol AE, First MB, Oldham JM, American Psychiatric Association. (2018). SCID-5-AMPD: Structured Clinical Interview for the DSM-5® Alternative Model for Personality Disorders. Module I.

Buer, T., Paap, M. C. S., Arnesen, M., Koritzinsky, K., Nysaeter, T.-E., Eikenaes, I., Germans Selvik, S., Walther, K., Torgersen, S., Bender, D. S., Skodol, A. E., Kvarstein, E., Pedersen, G., & Hummelen, B. (2018). Interrater reliability of the structured clinical interview for the DSM-5 alternative model of personality disorders module I: Level of personality functioning scale. Journal of Personality Assessment, 100, 630-641.

Di Pierro, R., Gargiulo, I., Poggi, A., Madeddu, F., & Preti, E. (2020). The level of personality functioning scale applied to clinical material from the structured interview of personality organization (STIPO): Utility in Detecting Personality Pathology. Journal of Personality Disorders, 34, 1-15.

Doering, S., Blüml, V., Parth, K., Feichtinger, K., Gruber, M., Aigner, M., Rössler-Schülein, H., Freidl, M., & Wininger, A. (2018). Personality functioning in anxiety disorders. BMC Psychiatry, 18, 294.

Eaton, N. R., Keyes, K. M., Krueger, R. F., Balsis, S., Skodol, A. E., Markon, K. E., Grant, B. F., & Hasin, D. S. (2012). An invariant dimensional liability model of gender differences in mental disorder prevalence: Evidence from a national sample. Journal of Abnormal Psychology, 121, 282-288.

First, M. B., Gaebel, W., Maj, M., Stein, D. J., Kogan, C. S., Saunders, J. B., Poznyak, V. B., Gureje, O., Lewis-Fernández, R., Maercker, A., Brewin, C. R., Cloitre, M., Claudino, A., Pike, K. M., Baird, G., Skuse, D., Krueger, R. B., Briken, P., Burke, J. D., … Reed, G. M. (2021). An organization- and category-level comparison of diagnostic requirements for mental disorders in ICD-11 and DSM-5. World Psychiatry, 20, 34-51.

Garcia, D. J., Skadberg, R. M., Schmidt, M., Bierma, S., Shorter, R. L., & Waugh, M. H. (2018). It's not that difficult: An interrater reliability study of the DSM-5 section III alternative model for personality disorders. Journal of Personality Assessment, 100, 612-620.

Gutiérrez, F., Vall, G., Peri, J., Bailles, E., Ferraz, L., Gárriz, M., & Caseras, X. (2012). Personality disorder features through the life course. Journal of Personality Disorders, 26, 763-774.

Hopwood, C. J., Kotov, R., Krueger, R. F., Watson, D., Widiger, T. A., Althoff, R. R., Ansell, E. B., Bach, B., Bagby, R. M., Blais, M. A., Bornovalova, M. A., Chmielewski, M., Cicero, D. C., Conway, C., De Clerq, B., De Fruyt, F., Docherty, A. R., Eaton, N. R., Edens, J. F., … Zimmermann, J. (2018). The time has come for dimensional personality disorder diagnosis. Personality and Mental Health, 12, 82-86.

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1-55.

Huprich, S. K. (2020). Personality disorders in the ICD-11: Opportunities and challenges for advancing the diagnosis of personality pathology. Current Psychiatry Reports, 22, 40.

Huprich, S. K., Nelson, S. M., Meehan, K. B., Siefert, C. J., Haggerty, G., Sexton, J., Dauphin, V. B., Macaluso, M., Jackson, J., Zackula, R., & Baade, L. (2018). Introduction of the DSM-5 levels of personality functioning questionnaire. Personal Disorders, 9, 553-563.

Hutsebaut, J., Feenstra, D. J., & Kamphuis, J. H. (2016). Development and Preliminary psychometric evaluation of a brief self-report questionnaire for the assessment of the DSM-5 level of personality functioning scale: The LPFS Brief Form (LPFS-BF). Personality Disorders, 7, 192-197.

Hutsebaut, J., Kamphuis, J. H., Feenstra, D. J., Weekers, L. C., & De Saeger, H. (2017). 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). Personality Disorders, Theory, Research, and Treatment, 8, 94-101.

Matsunaga, M. (2010). How to factor-analyze your data right: Do's don'ts, and how-to's. International Journal of Psychological Research, 3, 98-111.

Morey, L. C. (2017). Development and initial evaluation of a self-report form of the DSM-5 level of personality functioning scale. Psychological Assessment, 29, 1302-1308.

Newton-Howes, G., Clark, L. A., & Chanen, A. (2015). Personality disorder across the life course. The Lancet, 385, 727-734.

Olajide, K., Munjiza, J., Moran, P., O'Connell, L., Newton-Howes, G., Bassett, P., Akintomide, G., Ng, N., Tyrer, P., Mulder, R., & Crawford, M. J. (2018). Development and psychometric properties of the standardized assessment of severity of personality disorder (SASPD). Journal of Personality Disorders, 32, 44-56.

Preti, E., Di Pierro, R., Costantini, G., Benzi, I. M. A., De Panfilis, C., & Madeddu, F. (2018). Using the structured interview of personality organization for DSM-5 level of personality functioning rating performed by inexperienced raters. Journal of Personality Assessment, 100, 621-629.

Schwartz, S. J., Hardy, S. A., Zamboanga, B. L., Meca, A., Waterman, A. S., Picariello, S., Luyckx, K., Crocetti, E., Kim, S. Y., Brittian, A. S., Roberts, S. E., Krauss Whitbourne, S., Ritchie, R. A., Brown, E. J., & Forthun, L. F. (2015). Identity in young adulthood: Links with mental health and risky behavior. Journal of Applied Developmental Psychology, 36, 39-52.

Stern, B. L., Caligor, E., Clarkin, J. F., Critchfield, K. L., Horz, S., MacCornack, V., Lenzenweger, M. F., & Kernberg, O. F. (2010). Structured interview of personality organization (STIPO): Preliminary psychometrics in a clinical sample. Journal of Personality Assessment, 92, 35-44.

Tyrer, P., & Howard, R. (2020). Late-onset personality disorder: A condition still steeped in ignorance. BJPsych Advances, 26, 219-220.

Tyrer, P., Mulder, R., Kim, Y.-R., & Crawford, M. J. (2019). The development of the ICD-11 classification of personality disorders: An amalgam of science, pragmatism, and Politics. Annual Review of Clinical Psychology, 15, 481-502.

Videler, A. C., Hutsebaut, J., Schulkens, J. E. M., Sobczak, S., & van Alphen, S. P. J. (2019). A life span perspective on borderline personality disorder. Current Psychiatry Reports, 21, 51.

Weekers, L. C., Hutsebaut, J., Bach, B., & Kamphuis, J. H. (2020). Scripting the DSM-5 alternative model for personality disorders assessment procedure: A clinically feasible multi-informant multi-method approach. Personality and Mental Health, 14, 304-318.

Weekers, L. C., Hutsebaut, J., & Kamphuis, J. H. (2019). The level of personality functioning scale-brief form 2.0: Update of a brief instrument for assessing level of personality functioning. Personality and Mental Health, 13, 3-14.

World Health Organization. (2018). ICD-11: International statistical classification of diseases and related health problems. World Health Organization.

Zachar, P., & Kendler, K. S. (2017). The philosophy of nosology. Annual Review of Clinical Psychology, 13, 49-71.

Zettl, M., Taubner, S., Hutsebaut, J., & Volkert, J. (2019). Psychometrische Evaluation der deutschen Version des Semistrukturierten Interviews zur Erfassung der DSM-5 Persönlichkeitsfunktionen (STiP-5.1). Psychotherapie, Psychosomatik, Medizinische, 69, 499-504.

Zimmermann, J., Benecke, C., Bender, D. S., Skodol, A. E., Schauenburg, H., Cierpka, M., & Leising, D. (2014). Assessing DSM-5 level of personality functioning from videotaped clinical interviews: A pilot study with untrained and clinically inexperienced students. Journal of Personality Assessment, 96, 397-409.

Zimmermann, J., Kerber, A., Rek, K., Hopwood, C. J., & Krueger, R. F. A. (2019). Brief but comprehensive review of research on the alternative DSM-5 model for personality disorders. Current Psychiatry Reports, 21, 92.

Self-Reported Personality Functioning in Patients With Substance Use Disorders: Similarities and Specifics With Respect to the Czech Community Sample

Differences in personality functioning impairment in mood, anxiety, and personality disorders: a cluster analysis