Different Routes to the Same Destination? Comparing DSM-5 Section II- and AMPD-Defined Borderline Personality Disorder

Borderline personality disorder (BPD) is a heterogeneous condition characterized by dysfunction across several domains. Section II of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires that patients meet at least five out of nine symptoms to meet criteria for a categorical (yes/no) diagnosis of BPD. The Alternative Model of Personality Disorders (AMPD) in Section III of the DSM-5, however, requires that patients demonstrate deficits in self and/or interpersonal functioning (i.e., Criterion A) and elevated levels of certain facets of negative affectivity as well as antagonism and/or disinhibition (i.e., Criterion B). Pretreatment data from an ongoing clinical trial were collected on N = 97 participants, including their scores on the BPD module of the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD), the self-report version of the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD-SR), the Level of Personality Functioning-Brief Form 2.0 (LPFS-BF 2.0), the Five Factor Borderline Inventory-Short Form (FFBI-SF), the Quality of Life, Enjoyment, and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), and the Work and Social Adjustment Scale (WSAS). These data were used to determine whether Section III BPD diagnosis has incremental validity over Section II BPD diagnosis in predicting quality of life and functional impairment, among other aims.