DSM-5 AMPD Maladaptive Personality Traits: One-Year Temporal Stability and Associations With Therapeutic Processes and Outcomes.

OBJECTIVE

The DSM-5 Alternative Model for Personality Disorders (AMPD) includes two main criteria, impairments in personality functioning (Criterion A) and the presence of maladaptive personality traits (Criterion B). The Personality Inventory for DSM-5 (PID-5) is the primary operationalization of the maladaptive trait framework characterized in Criterion B. This study sought to examine the temporal stability of the PID-5 across 1-year, as well as its concurrent and longitudinal associations with clinically relevant external criteria. We hypothesized the PID-5 would exhibit a high degree of rank-order stability over time, as well as positive associations with putatively negative clinical processes and negative associations with adaptive processes. Negative affectivity was expected to display a markedly consistent pattern of associations, and antagonism was expected to exhibit a more attenuated pattern.

METHODS

Participants with heightened borderline personality features completed the PID-5 and measures of emotional, cognitive, and behavioral processes, as well as psychiatric symptomology, at baseline (N = 107; M = 30.94, SD = 7.33; 51% women) and 1-year follow-up (N = 72). Rank-order stability (Pearson's r) and mean-level changes (Cohen's d) for the PID-5 domains and facets were calculated, along with bivariate correlations with outcomes.

RESULTS

Results suggest high stability in terms of rank-order (median Pearson's r correlation of 0.74 for domains and 0.70 for facets), but small to moderate mean-level Cohen's d changes were common (Mdn = -0.56 for domains). Prospective associations with clinical criteria suggest domains and facets are predictive of important therapeutic change processes and outcomes in theoretically expected ways. Negative affectivity exhibited a consistent pattern of associations with outcomes (14/19 correlations > 0.30), and antagonism demonstrated the most attenuated pattern of associations (5/19 correlations > 0.30).

CONCLUSION

Findings generally support the stability of AMPD maladaptive traits and provide further evidence for the model's clinical utility.