Evaluating the DSM–5 Section III Personality Disorder Impairment Criteria

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Abstract

The majority of research on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM–5) Section III alternative model for personality disorders (PDs) has addressed the dimensional traits proposed in Criterion B, while limited research has evaluated Section III functional impairment criteria. The current study evaluated Section III impairment specific to the 6 personality disorder diagnoses included in the Section III model in a sample of 347 undergraduates. We evaluated the factor structure of disorder-specific impairment; their associations with other measures of impairment, Section III traits, and Section II PD symptoms; as well as the incremental utility of impairment above and beyond traits in predicting Section II PD symptoms. Factor analyses indicated limited support for the 2 domain and 4 subfacet levels of impairment, but showed some support for disorder-specific impairment. Furthermore, disorder-specific impairment was associated with other measures of functional impairment, Section II PD symptoms, and Section III traits with a generally good degree of convergence. However, these findings showed a lack of discriminant validity, suggesting a lack of utility in measuring disorder-specific impairment, as opposed to more broadly evaluating an individual’s level of functional impairment. Finally, impairment only added incremental utility to traits in predicting Section II Avoidant PD. By and large, these findings suggested mixed support for disorder-specific impairment as presented in Criterion A and raised additional questions regarding the utility of impairment when paired with dimensional personality traits.

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