Level of Personality Functioning as a Predictor of Psychosocial Functioning-Concurrent Validity of Criterion A

• Published in: Personality disorders 2020-03, Vol.11 (2), p.79-90
• Main Authors: Buer Christensen, Tore, Eikenaes, Ingeborg, Hummelen, Benjamin, Pedersen, Geir, Nysæter, Tor-Erik, Bender, Donna S., Skodol, Andrew E., Selvik, Sara Germans
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Concurrent Validity; Diagnostic and Statistical Manual; Diagnostic and Statistical Manual of Mental Disorders; Empathy; Female; Human; Humans; Inpatient; Interview, Psychological; Intimacy; Male; Mental Disorders; Mental Models; Middle Aged; Norway; Outpatient; Personality; Personality Assessment; Personality Disorders; Personality Disorders - diagnosis; Personality Processes; Psychiatric Status Rating Scales; Psychometrics; Psychosocial Factors; Psychosocial Functioning; Reproducibility of Results; Self Report; Social Functioning; Young Adult
• ISSN: 1949-2715; 1949-2723
• DOI: 10.1037/per0000352

The alternative model for personality disorders (AMPD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), defines personality functioning by assessment of impairment in Identity and Self-direction (Self component) and in Empathy and Intimacy (Interpersonal). These four domains constitute the Level of Personality Functioning Scale, a trans-diagnostic measure of PD severity. The association between the Level of Personality Functioning Scale and psychosocial impairment based on other previously established psychosocial functioning instruments has not been reported. A total of 317 individuals, including a representative clinical sample of 282 patients (192 with a personality disorder [PD] diagnosis), was evaluated with the Structured Clinical Interview for the DSM-5 AMPD Module I. Self-reported impairment was measured by the Work and Social Adjustment Scale (WSAS), and social and occupational impairment was assessed by the functioning score of the Global Assessment of Functioning scale (GAF-F). WSAS and GAF-F both correlated significantly with mean LPFS scores and the sum of DSM-IV PD criteria. For both measures, the mean LPFS was a stronger predictor for psychosocial impairment than the sum of DSM-IV PD criteria. Within the LPFS, the Self component was a better predictor than the Interpersonal component for both WSAS and GAF-F. For the four domains, the results diverged, with Identity as the strongest predictor by far for WSAS. Empathy was the only significant predictor for impairment evaluated by GAF-F, but its contribution to variance was not substantial.