DSM-5 Level of Personality Functioning: Refocusing Personality Disorder on What It Means to Be Human

Literature Cited

1. Anderson JL, Sellbom M. 2018. Evaluating the DSM-5 Section III personality disorder impairment criteria. Personal. Disord. 9:51–61
   [Google Scholar]
2. APA (Am. Psychiatr. Assoc.) 2013. Diagnostic and Statistical Manual of Mental Disorders Arlington, VA: Am. Psychiatr. Publ. , 5th ed..
3. Azim HF, Piper WE, Segal PM, Nixon GW, Duncan SC 1991. The Quality of Object Relations Scale. Bull. Menninger Clin. 55:323–43
   [Google Scholar]
4. Bach B, Anderson JL. 2020. Patient-reported ICD-11 personality disorder severity and DSM-5 Level of Personality Functioning. J. Personal. Disord. 34:231–49
   [Google Scholar]
5. Bach B, Hutsebaut J. 2018. Level of Personality Functioning Scale–Brief Form 2.0: utility in capturing personality problems in psychiatric outpatients and incarcerated addicts. J. Personal. Assess. 100:660–70
   [Google Scholar]
6. Bastiaansen L, De Fruyt F, Rossi G, Schotte C, Hofmans J 2013. Personality disorder dysfunction versus traits: structural and conceptual issues. Personal. Disord. 4:293–303
   [Google Scholar]
7. Bender DS, Morey LC, Skodol AE 2011. Toward a model for assessing level of personality functioning in DSM-5, part I: a review of theory and methods. J. Personal. Assess. 93:332–46Summary of the original intention behind the meaning of LPF as intended by the DSM-5 work group.
   [Google Scholar]
8. Bender DS, Skodol AE. 2007. Borderline personality as a self-other representational disturbance. J. Personal. Disord. 21:500–17
   [Google Scholar]
9. Bender DS, Skodol AE, First MB, Oldham JM 2018. Module I: Structured Clinical Interview for the Level of Personality Functioning Scale. Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders (SCID-5-AMPD) MB First, AE Skodol, DS Bender, JM Oldham Arlington, VA: Am. Psychiatr. Assoc. Publ.
   [Google Scholar]
10. Berghuis H, Kamphuis JH, Verheul R 2012. Core features of personality disorder: differentiating general personality dysfunctioning from personality traits. J. Personal. Disord. 26:704–16
    [Google Scholar]
11. Berghuis H, Kamphuis JH, Verheul R 2014. Specific personality traits and general personality dysfunction as predictors of the presence and severity of personality disorders in a clinical sample. J. Personal. Assess. 96:410–16
    [Google Scholar]
12. Bers SA, Blatt SJ, Sayward HK, Johnston RS 1993. Normal and pathological aspects of self-descriptions and their change over long-term treatment. Psychoanal. Psychol. 10:17–37
    [Google Scholar]
13. Berzonsky MD. 2011. A social-cognitive perspective on identity construction. Handbook of Identity Theory and Research: Structures and Processes SJ Schwartz, K Luyckx, VL Vignoles 55–75 New York: Springer
    [Google Scholar]
14. Blatt SJ, Lerner H. 1983. The psychological assessment of object representation. J. Personal. Assess. 47:7–28
    [Google Scholar]
15. Bo S, Bach B, Mortensen EL, Simonsen E 2016. Reliability and hierarchical structure of DSM-5 pathological traits in a Danish mixed sample. J. Personal. Disord. 30:112–29
    [Google Scholar]
16. Buer Christensen T, Eikenaes I, Hummelen B, Pedersen G, Nysaeter TE et al. 2020. Level of personality functioning as a predictor of psychosocial functioning—concurrent validity of criterion A. Personal. Disord. 11:79–90First validation of the interview-based DSM-5 LPF measure, SCID-5-AMPD Module I.
    [Google Scholar]
17. Buer Christensen TB, Paap MCS, Arnesen M, Koritzinsky K, Nysaeter TE et al. 2018. Interrater reliability of the structured clinical interview for the DSM-5 Alternative Model of Personality Disorders Module I: Level of Personality Functioning Scale. J. Personal. Assess. 100:630–41
    [Google Scholar]
18. Busmann M, Wrege J, Meyer AH, Ritzler F, Schmidlin M et al. 2019. Alternative Model of Personality Disorders (DSM-5) predicts dropout in inpatient psychotherapy for patients with personality disorder. Front. Psychol. 10:952
    [Google Scholar]
19. Caspi A, Houts RM, Belsky DW, Goldman-Mellor SJ, Harrington H et al. 2014. The p factor: one general psychopathology factor in the structure of psychiatric disorders. ? Clin. Psychol. Sci. 2:119–37
    [Google Scholar]
20. Chanen AM, Berk M, Thompson K 2016. Integrating early intervention for borderline personality disorder and mood disorders. Harvard Rev. Psychiatry 24:330–41
    [Google Scholar]
21. Clark LA. 2007. Assessment and diagnosis of personality disorder: perennial issues and an emerging reconceptualization. Annu. Rev. Psychol. 58:227–57
    [Google Scholar]
22. Clark LA, Nuzum H, Ro E 2017. Manifestations of personality impairment severity: comorbidity, course/prognosis, psychosocial dysfunction, and ‘borderline’ personality features. Curr. Opin. Psychol. 21:117–21
    [Google Scholar]
23. Clark LA, Ro E. 2014. Three-pronged assessment and diagnosis of personality disorder and its consequences: personality functioning, pathological traits, and psychosocial disability. Personal. Disord. 5:55–69
    [Google Scholar]
24. Clarkin JF, Caligor E, Stern B, Kernberg OF 2004. Structured Interview of Personality Organization (STIPO) New York: Weill Med. Coll., Cornell Univ.
25. Creswell KG, Bachrach RL, Wright AG, Pinto A, Ansell E 2016. Predicting problematic alcohol use with the DSM-5 alternative model of personality pathology. Personal. Disord. 7:103–11
    [Google Scholar]
26. De Clercq B, Decuyper M, De Caluwé E 2014. Developmental manifestations of borderline personality pathology from an age-specific dimensional personality disorder trait framework. Handbook of Borderline Personality Disorder in Children and Adolescents C Sharp, JL Tackett 81–94 New York: Springer
    [Google Scholar]
27. DeFife JA, Goldberg M, Westen D 2015. Dimensional assessment of self- and interpersonal functioning in adolescents: implications for DSM-5’s general definition of personality disorder. J. Personal. Disord. 29:248–60
    [Google Scholar]
28. Dereboy F, Dereboy C, Eskin M 2018. Validation of the DSM-5 Alternative Model Personality Disorder diagnoses in Turkey, Part 1: LEAD validity and reliability of the personality functioning ratings. J. Personal. Assess. 100:603–11
    [Google Scholar]
29. Erikson EH. 1968. Identity: Youth and Crisis Oxford, UK: Norton & Co.
30. Erikson EH. 1977. Childhood and Society London: Paladin Grafton
31. Few LR, Miller JD, Rothbaum AO, Meller S, Maples J et al. 2013. Examination of the Section III DSM-5 diagnostic system for personality disorders in an outpatient clinical sample. J. Abnorm. Psychol. 122:1057–69
    [Google Scholar]
32. Fonagy P, Bateman A. 2009. Mentalization-based treatment for borderline personality disorder. Essentials of Personality Disorders J Oldham, AE Skodol, DS Bender 209–33 Washington, DC: Am. Psychiatr. Publ.
    [Google Scholar]
33. Fossati A, Borroni S, Somma A, Markon KE, Krueger RF 2017. Testing relationships between DSM-5 Section III maladaptive traits and measures of self and interpersonal impairment in Italian community dwelling adults. Personal. Disord. 8:275–80
    [Google Scholar]
34. Freud S. 1923. The Ego and the Id London: Hogarth
35. Gamache D, Savard C, Leclerc P, Cote A 2019. Introducing a short self-report for the assessment of DSM-5 level of personality functioning for personality disorders: the Self and Interpersonal Functioning Scale. Personal. Disord. 10:438–47
    [Google Scholar]
36. Garcia DJ, Skadberg RM, Schmidt M, Bierma S, Shorter RL, Waugh MH 2018. It's not that difficult: an interrater reliability study of the DSM-5 Section III Alternative Model for Personality Disorders. J. Personal. Assess. 100:612–20
    [Google Scholar]
37. Goth K, Birkholzer M, Schmeck K 2018. Assessment of personality functioning in adolescents with the LoPF-Q 12–18 self-report questionnaire. J. Personal. Assess. 100:680–90
    [Google Scholar]
38. Haslam N. 2003. Categorical versus dimensional models of mental disorder: the taxometric evidence. Aust. N.Z. J. Psychiatry 37:696–704
    [Google Scholar]
39. Hentschel AG, Pukrop R. 2014. The essential features of personality disorder in DSM-5: the relationship between criteria A and B. J. Nerv. Ment. Dis. 202:412–18
    [Google Scholar]
40. Hopwood CJ, Good EW, Morey LC 2018. Validity of the DSM-5 Levels of Personality Functioning Scale–Self Report. J. Personal. Assess. 100:650–59
    [Google Scholar]
41. Hopwood CJ, Malone JC, Ansell EB, Sanislow CA, Gill CM et al. 2011. Personality assessment in DSM-5: empirical support for rating severity, style, and traits. J. Personal. Disord. 25:305–20
    [Google Scholar]
42. Huprich SK, Auerbach JS, Porcerelli JH, Bupp LL 2016. Sidney Blatt's object relations inventory: contributions and future directions. J. Personal. Assess. 98:30–43
    [Google Scholar]
43. Huprich SK, Nelson SM, Meehan KB, Siefert CJ, Haggerty G et al. 2018. Introduction of the DSM-5 Levels of Personality Functioning Questionnaire. Personal. Disord. 9:553–63
    [Google Scholar]
44. Hutsebaut J, Feenstra DJ, Kamphuis JH 2016. Development and preliminary psychometric evaluation of a brief self-report questionnaire for the assessment of the DSM-5 Level of Personality Functioning Scale: the LPFS Brief Form (LPFS-BF). Personal. Disord. 7:192–97
    [Google Scholar]
45. Hutsebaut J, Kamphuis JH, Feenstra DJ, Weekers LC, De Saeger H 2017. Assessing DSM-5-oriented level of personality functioning: development and psychometric evaluation of the Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1). Personal. Disord. 8:94–101
    [Google Scholar]
46. James W. 1963. 1892. The self. Psychology176–216 New York: Fawcett
    [Google Scholar]
47. Kampe L, Zimmermann J, Bender D, Caligor E, Borowski AL et al. 2018. Comparison of the structured DSM-5 clinical interview for the Level of Personality Functioning Scale with the Structured Interview of Personality Organization. J. Personal. Assess. 100:642–49
    [Google Scholar]
48. Kernberg OF. 1967. Borderline personality organization. J. Am. Psychoanal. Assoc. 15:641–85
    [Google Scholar]
49. Kernberg OF. 1984. Severe Personality Disorders: Psychotherapeutic Strategies New Haven, CT: Yale Univ. Press
50. Kernberg OF, Caligor E. 2005. A psychoanalytic theory of personality disorders. Major Theories of Personality Disorder MF Lenzenweger, JF Clarkin 114–56 New York: Guilford
    [Google Scholar]
51. Kotelnikova Y, Nuzum H, Ro E, Clark L 2019. Conceptual and measurement challenges in dimensional personality disorder research Paper presented at the International Society for the Study of Personality Disorders (ISSPD) 2019 Congress Vancouver, Can: Oct 15–18
52. Kotov R, Krueger RF, Watson D, Achenbach TM, Althoff RR et al. 2017. The Hierarchical Taxonomy of Psychopathology (HiTOP): a dimensional alternative to traditional nosologies. J. Abnorm. Psychol. 126:454–77
    [Google Scholar]
53. Koudys JW, Traynor JM, Rodrigo AH, Carcone D, Ruocco AC 2019. The NIMH Research Domain Criteria (RDoC) initiative and its implications for research on personality disorder. Curr. Psychiatry Rep. 21:37
    [Google Scholar]
54. Krueger RF, Derringer J, Markon KE, Watson D, Skodol AE 2012. Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychol. Med. 42:1879–90
    [Google Scholar]
55. Krueger RF, Kotov R, Watson D, Forbes MK, Eaton NR et al. 2018. Progress in achieving quantitative classification of psychopathology. World Psychiatry 17:282–93
    [Google Scholar]
56. Lenzenweger MF, Clarkin JF, Kernberg OF, Foelsch PA 2001. The Inventory of Personality Organization: psychometric properties, factorial composition, and criterion relations with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample. Psychol. Assess. 13:577–91
    [Google Scholar]
57. Lind M, Vanwoerden S, Penner F, Sharp C 2019. Inpatient adolescents with borderline personality disorder features: identity diffusion and narrative incoherence. Personal. Disord. 10:389–93
    [Google Scholar]
58. Lind M, Vanwoerden S, Penner F, Sharp C 2020. Narrative coherence in adolescence: relations with attachment, mentalization, and psychopathology. J. Personal. Assess. 102:380–89
    [Google Scholar]
59. Lingiardi V, McWilliams N, eds. 2017. Psychodynamic Diagnostic Manual (PDM-2) New York: Guilford
60. Livesley J. 2003. Practical Management of Personality Disorders New York: Guilford
61. Livesley J. 2010. General Assessment of Personality Disorder Port Huron, MI: Sigma Assess. Syst.
62. Livesley J. 2011. Commentary: tentative steps in the right direction. Personal. Ment. Health 5:263–70
    [Google Scholar]
63. Livesley WJ, Schroeder ML, Jackson DN, Jang KL 1994. Categorical distinctions in the study of personality disorder: implications for classification. J. Abnorm. Psychol. 103:6–17
    [Google Scholar]
64. Loevinger J. 1957. Objective tests as instruments of psychological theory. Psychol. Rep. 3:635–94
    [Google Scholar]
65. Marcia JE. 1966. Development and validation of ego-identity status. J. Personal. Soc. Psychol. 3:551–58
    [Google Scholar]
66. Masterson JF. 1988. The Search for the Real Self: Unmasking the Personality Disorders of Our Age New York: Free Press
67. McAdams DP. 2008. Personal narratives and the life story. Handbook of Personality: Theory and Research JR Robins, L Pervin, 242–62 New York: Guilford
    [Google Scholar]
68. McAdams DP. 2015. The Art and Science of Personality Development. New York: Guilford
    [Google Scholar]
69. Mead GH 1934. Mind, Self and Society. Chicago: Univ. Chicago Press
    [Google Scholar]
70. Morey LC. 2017. Development and initial evaluation of a self-report form of the DSM-5 Level of Personality Functioning Scale. Psychol. Assess. 29:1302–8First validation of the self-report DSM-5 LPF measure, LPFS.
    [Google Scholar]
71. Morey LC. 2018. Application of the DSM-5 Level of Personality Functioning Scale by lay raters. J. Personal. Disord. 32:709–20
    [Google Scholar]
72. Morey LC. 2019a. Interdiagnostician reliability of the DSM-5 Section II and Section III Alternative Model criteria for borderline personality disorder. J. Personal. Disord. 33:721–35
    [Google Scholar]
73. Morey LC. 2019b. Thoughts on the assessment of the DSM-5 alternative model for personality disorders: comment on Sleep et al. 2019. Psychol. Assess. 31:1192–99
    [Google Scholar]
74. Morey LC, Bender DS, Skodol AE 2013a. Validating the proposed Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, severity indicator for personality disorder. J. Nerv. Ment. Dis. 201:729–35
    [Google Scholar]
75. Morey LC, Benson KT, Busch AJ, Skodol AE 2015. Personality disorders in DSM-5: emerging research on the alternative model. Curr. Psychiatry Rep. 17:558
    [Google Scholar]
76. Morey LC, Berghuis H, Bender DS, Verheul R, Krueger RF, Skodol AE 2011. Toward a model for assessing level of personality functioning in DSM-5, Part II: empirical articulation of a core dimension of personality pathology. J. Personal. Assess. 93:347–53Summary of the original intention behind the meaning of LPF as intended by the DSM-5 work group.
    [Google Scholar]
77. Morey LC, Krueger RF, Skodol AE 2013b. The hierarchical structure of clinician ratings of proposed DSM-5 pathological personality traits. J. Abnorm. Psychol. 122:836–41
    [Google Scholar]
78. Nelson SM, Huprich SK, Meehan KB, Siefert C, Haggerty G et al. 2018. Convergent and discriminant validity and utility of the DSM-5 Levels of Personality Functioning Questionnaire (DLOPFQ): associations with medical health care provider ratings and measures of physical health. J. Personal. Assess. 100:671–79
    [Google Scholar]
79. Olajide K, Munjiza J, Moran P, O'Connell L, Newton-Howes G et al. 2018. Development and psychometric properties of the Standardized Assessment of Severity of Personality Disorder (SASPD). J. Personal. Disord. 32:44–56
    [Google Scholar]
80. OPD Task Force 2001. Operationalized Psychodynamic Diagnostics (OPD): Foundations and Practical Handbook Toronto: Hogrefe
81. OPD Task Force 2008. Operationalized Psychodynamic Diagnosis OPD-2: Manual of Diagnosis and Treatment Planning Toronto: Hogrefe
82. Parker G, Both L, Olley A, Hadzi-Pavlovic D, Irvine P, Jacobs G 2002. Defining disordered personality functioning. J. Personal. Disord. 16:503–22
    [Google Scholar]
83. Parker G, Hadzi-Pavlovic D, Both L, Kumar S, Wilhelm K, Olley A 2004. Measuring disordered personality functioning: to love and to work reprised. Acta Psychiatr. Scand. 110:230–39
    [Google Scholar]
84. Pfeifer JH, Blakemore SJ. 2012. Adolescent social cognitive and affective neuroscience: past, present, and future. Soc. Cogn. Affect. Neurosci. 7:1–10
    [Google Scholar]
85. Preti E, Di Pierro R, Costantini G, Benzi IMA, De Panfilis C, Madeddu F 2018. Using the Structured Interview of Personality Organization for DSM-5 Level of Personality Functioning rating performed by inexperienced raters. J. Personal. Assess. 100:621–29
    [Google Scholar]
86. Reed GM. 2018. Progress in developing a classification of personality disorders for ICD-11. World Psychiatry 17:227–29
    [Google Scholar]
87. Roche MJ. 2018. Examining the alternative model for personality disorder in daily life: evidence for incremental validity. Personal. Disord. 9:574–83
    [Google Scholar]
88. Roche MJ, Jacobson NC, Phillips JJ 2018. Expanding the validity of the Level of Personality Functioning Scale observer report and self-report versions across psychodynamic and interpersonal paradigms. J. Personal. Assess. 100:571–80
    [Google Scholar]
89. Rosen K. 2016. Social and Emotional Development: Attachment Relationships and the Emerging Self London: Macmillan Educ. UK
90. Rossi G, Debast I, van Alphen SPJ 2017. Measuring personality functioning in older adults: construct validity of the Severity Indices of Personality Functioning–Short Form (SIPP-SF). Aging Ment. Health 21:703–11
    [Google Scholar]
91. Russ E, Shedler J, Bradley R, Westen D 2008. Refining the construct of narcissistic personality disorder: diagnostic criteria and subtypes. Am. J. Psychiatry 165:1473–81
    [Google Scholar]
92. Rutter M, Sroufe LA. 2000. Developmental psychopathology: concepts and challenges. Dev. Psychopathol. 12:265–96
    [Google Scholar]
93. Samuel D, Widiger T. 2007. Describing Ted Bundy's personality and working towards DSM-V. Indep. Pract. 27:20–22
    [Google Scholar]
94. Scott C, Medeiros M. 2020. Personality and political careers: What personality types are likely to run for office and get elected. ? Personal. Ind. Differ. 152:109600
    [Google Scholar]
95. Sharp C. 2016a. Bridging the gap: the assessment and treatment of adolescent personality disorder in routine clinical care. Arch. Dis. Child. 102:103–8
    [Google Scholar]
96. Sharp C. 2016b. Current trends in BPD research as indicative of a broader sea-change in psychiatric nosology. Personal. Disord. 7:334–43
    [Google Scholar]
97. Sharp C. 2018. Calling for a unified redefinition of “borderlineness”: commentary on Gunderson et al. J. Personal. Disord. 32:168–74
    [Google Scholar]
98. Sharp C. 2020a. Adolescent personality pathology and the Alternative Model for Personality Disorders: self development as nexus. Psychopathology 53:198–204
    [Google Scholar]
99. Sharp C. 2020b. Putting the person back into person(ality) disorder. Oxford Handbook of Personality Disorders T Widiger Oxford, UK: Oxford Univ. Press. , 2nd ed.. In press
    [Google Scholar]
100. Sharp C. 2020c. What's in a name? The importance of adolescent personality pathology for adaptive psychosocial function. J. Am. Acad. Child Adolesc. Psychiatry 59:1130–32
     [Google Scholar]
101. Sharp C, Hernandez J. 2021. Mindreading and psychopathology in middle childhood and adolescence. Theory of Mind in Middle Childhood and Adolescence: Integrating Multiple Perspectives S Lecce, RT Devine London: Taylor & Francis
     [Google Scholar]
102. Sharp C, Kalpakci A. 2015. If it looks like a duck and quacks like a duck: evaluating the validity of borderline personality disorder in adolescents. Scand. J. Child Adolesc. Psychol. Psychiatry 3:49–62
     [Google Scholar]
103. Sharp C, Kerr S, Chanen A 2020. Prevention and early identification and prevention of personality pathology: an AMPD informed model of clinical staging. The American Psychiatric Publishing Textbook of Personality Disorders J Oldham, AE Skodol, DS Bender 285–337 Washington, DC: Am. Psychiatr. Publ. , 2nd ed..
     [Google Scholar]
104. Sharp C, Kim S. 2015. Recent advances in the developmental aspects of borderline personality disorder. Curr. Psychiatry Rep. 17:556
     [Google Scholar]
105. Sharp C, Wall K. 2017. Personality pathology grows up: adolescence as a sensitive period. Curr. Opin. Psychol. 21:111–16
     [Google Scholar]
106. Sharp C, Wall K. 2018. Maladaptive interpersonal signatures as “re-descriptions” of Criterion B. Eur. J. Personal. 32:582–83
     [Google Scholar]
107. Sharp C, Wright AGC, Fowler JC, Frueh BC, Allen JG et al. 2015. The structure of personality pathology: both general (‘g’) and specific (‘s’) factors. ? J. Abnorm. Psychol. 124:387–98First paper to suggest overlap between BPD and the general severity criterion, LPF.
     [Google Scholar]
108. Siefert CJ, Sexton J, Meehan K, Nelson S, Haggerty G et al. 2020. Development of a short form for the DSM-5 Levels of Personality Functioning questionnaire. J. Personal. Assess. 102:516–26
     [Google Scholar]
109. Skodol AE. 2018. Impact of personality pathology on psychosocial functioning. Curr. Opin. Psychol. 21:33–38
     [Google Scholar]
110. Sleep CE, Lynam DR, Widiger TA, Crowe ML, Miller JD 2019. An evaluation of DSM-5 Section III personality disorder Criterion A (impairment) in accounting for psychopathology. Psychol. Assess. 31:1181–91
     [Google Scholar]
111. Thylstrup B, Simonsen S, Nemery C, Simonsen E, Noll JF et al. 2016. Assessment of personality-related levels of functioning: a pilot study of clinical assessment of the DSM-5 level of personality functioning based on a semi-structured interview. BMC Psychiatry 16:298
     [Google Scholar]
112. Tyrer P, Johnson T. 1996. Establishing the severity of personality disorder. Am. J. Psychiatry 153:1593–97
     [Google Scholar]
113. Tyrer P, Mulder R, Kim YR, Crawford MJ 2019. The development of the ICD-11 classification of personality disorders: an amalgam of science, pragmatism, and politics. Annu. Rev. Clin. Psychol. 15:481–502
     [Google Scholar]
114. Tyrer P, Reed GM, Crawford MJ 2015. Classification, assessment, prevalence, and effect of personality disorder. Lancet 385:717–26
     [Google Scholar]
115. Verbeke L, De Caluwe E, De Clercq B 2017. A five-factor model of developmental personality pathology precursors. Personal. Disord. 8:130–39
     [Google Scholar]
116. Verheul R, Andrea H, Berghout CC, Dolan C, Busschbach JJ et al. 2008. Severity Indices of Personality Problems (SIPP-118): development, factor structure, reliability, and validity. Psychol. Assess. 20:23–34
     [Google Scholar]
117. Wakefield JC. 1992. The concept of mental disorder: on the boundary between biological facts and social values. Am. Psychol. 47:373–88
     [Google Scholar]
118. Wakefield JC. 2008. The perils of dimensionalization: challenges in distinguishing negative traits from personality disorders. Psychiatr. Clin. N. Am. 31:3379–93
     [Google Scholar]
119. Weekers LC, Hutsebaut J, Kamphuis JH 2019. The Level of Personality Functioning Scale-Brief Form 2.0: update of a brief instrument for assessing level of personality functioning. Personal. Ment. Health 13:3–14
     [Google Scholar]
120. Westen D, Shedler J. 1999a. Revising and assessing axis II, Part I: developing a clinically and empirically valid assessment method. Am. J. Psychiatry 156:258–72
     [Google Scholar]
121. Westen D, Shedler J. 1999b. Revising and assessing axis II, Part II: toward an empirically based and clinically useful classification of personality disorders. Am. J. Psychiatry 156:273–85
     [Google Scholar]
122. Westen D, Shedler J, Bradley R 2006. A prototype approach to personality disorder diagnosis. Am. J. Psychiatry 163:846–56
     [Google Scholar]
123. Whitbourne SK. 2002. Identity processes in adulthood: theoretical and methodological challenges. Identity 2:29–45
     [Google Scholar]
124. WHO (World Health Organ.) 2001. ICF: International Classification of Functioning, Disability, and Health Geneva, Switz: WHO
125. Widiger TA, Bach B, Chmielewski M, Clark LA, DeYoung C et al. 2019. Criterion A of the AMPD in HiTOP. J. Personal. Assess. 101:345–55Describes how HiTOP, a purely trait-based model of psychopathology, challenges the value of LPF.
     [Google Scholar]
126. Widiger TA, Simonsen E, Krueger R, Livesley WJ, Verheul R 2005. Personality disorder research agenda for the DSM-V. J. Personal. Disord. 19:315–38
     [Google Scholar]
127. Widiger TA, Trull TJ. 2007. Plate tectonics in the classification of personality disorder: shifting to a dimensional model. Am. Psychol. 62:71–83
     [Google Scholar]
128. Williams TF, Scalco MD, Simms LJ 2018. The construct validity of general and specific dimensions of personality pathology. Psychol. Med. 48:834–48
     [Google Scholar]
129. Wright AGC, Hopwood CJ, Skodol AE, Morey LC 2016. Longitudinal validation of general and specific structural features of personality pathology. J. Abnorm. Psychol. 125:1120–34
     [Google Scholar]
130. Zanarini MC, Frankenburg FR, Reich DB, Fitzmaurice G 2012. Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study. Am. J. Psychiatry 169:476–83
     [Google Scholar]
131. Zettl M, Taubner S, Hutsebaut J, Volkert J 2019. [Psychometric evaluation of the German version of the Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1)]. Psychother. Psychosom. Med. Psychol. 69:499–504 In German )
     [Google Scholar]
132. Zettl M, Volkert J, Vogele C, Herpertz SC, Kubera KM, Taubner S 2020. Mentalization and criterion A of the alternative model for personality disorders: results from a clinical and nonclinical sample. Personal. Disord. 11:191–201
     [Google Scholar]
133. Zimmermann J, Benecke C, Bender DS, Skodol AE, Schauenburg H et al. 2014. Assessing DSM-5 level of personality functioning from videotaped clinical interviews: a pilot study with untrained and clinically inexperienced students. J. Personal. Assess. 96:397–409
     [Google Scholar]
134. Zimmermann J, Bohnke JR, Eschstruth R, Mathews A, Wenzel K, Leising D 2015. The latent structure of personality functioning: investigating Criterion A from the alternative model for personality disorders in DSM-5. J. Abnorm. Psychol. 124:532–48
     [Google Scholar]