The Trait Model of the DSM–5 Alternative Model of Personality Disorder (AMPD): A Structural Review

Abstract

Publication of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (American Psychiatric Association, 2013), which included an alternative model of personality disorders (AMPD), was followed by an explosion of publications on the new model. The large majority of these publications focused on the AMPD’s Criterion B, which consists of 25 trait facets arranged in 5 broad domains that bear strong similarity to the established five-factor model (FFM) of personality. The operationalization of AMPD traits that has received the most research attention is its self-report measure, the Personality Inventory for Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (PID-5; Krueger et al., 2012). Much of this literature concerns its internal structure and relations with FFM measures. Many of these studies report that a number of the facets appear to be (a) interstitial (cross-loading on 2 or more factors), (b) placed in the wrong domain (i.e., considered by the AMPD to be a facet of a different domain from the one on which it typically loads), or (c) both. Clarifying the structural location of measures is fundamental in understanding their nomological net—and, thereby, the constructs they assess. Therefore, this review focuses on the PID-5 structure in the context of the broader domain of personality, especially the FFM, and primarily examines (1) which facets are interstitial and (2) the best domain(s) in which to place each facet. Also considered are important PD constructs—including multiple facets and one domain—that the AMPD does not include. The review ends with a set of recommendations for AMPD-5.1 and PID-5.1.