Revising the trait model of the alternative model of personality disorders: Comment on Clark and Watson's structural review.

In their review of examination of the self-report Personality Inventory for Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5; PID-5) factor structure and joint factor analysis of this instrument with other self-report measures of personality and psychopathology, Clark and Watson (2022) make argument for a set of modifications to the DSM-5 alternative model of personality disorders (AMPD)-the AMPD-5.1. In this commentary we offer opinion that their proposed modifications to the AMPD are problematic. In particular, we express concern that their modifications are based solely on research that uses a single instrument to measure the model and that this instrument employs a self-report measure methodology. We argue further that this method of assessment is vulnerable to response bias which could potentially alter the substantive structure of the model. We suggest that any proposed revised model should also be informed by other forms of measurement (e.g., informant report and structured interviews). In addition, we also argue that the best approach to delineating the universe of pathological personality traits should also include clinician input. Such input would maximize the clinical utility of any revised model. We believe that to propose a modified model that is based on self-report only and does not include other sources of information is presumptive and premature. At best, we think that Clark and Watson (2022) have only provided suggestions for a revision and expansion of the Personality Inventory for DSM-5 (i.e., the PID-5.1). (PsycInfo Database Record (c) 2022 APA, all rights reserved).