The DSM-5 Maladaptive Trait Model for Personality Disorders

Abstract The classification of personality disorders (PDs) is integral to clinical science and practice and has been of interest to nosological researchers for decades. The work has revealed various shortcomings of traditional diagnostic approaches, largely stemming from the fact that personality features and psychopathological symptoms do not tend to cluster into distinct categories but rather are better understood along continuous dimensions. The Alternative Model for Personality Disorders (AMPD) reflects this dimensionality, conceiving of PDs as clinically significant difficulties in personality functioning (Criterion A) as expressed in continuous, maladaptive personality traits (Criterion B). The Personality Inventory for DSM-5 (PID-5) is the primary tool for assessing Criterion B, and, since its initial publication in 2012, has garnered considerable empirical attention. This chapter reviews the evidence for the reliability, validity, and clinical utility of the DSM-5 Maladaptive Trait Model (Criterion B), in effect analyzing the extent to which it addresses diagnostic shortcomings. The authors aim to place the Trait Model in the broader context of clinical science by exploring its coverage of traditional PD syndromes and its relations with the Five Factor Model (FFM) of personality, psychopathology more generally, and the Level of Personality Functioning Scale (Criterion A).