The DSM-5 alternative model for personality disorders and psychotic symptoms: A two-sample study in help-seeking adolescents.
Publisher DOI
PubMed ID
42424939
Abstract
Background And Hypothesis
While the link between positive psychotic symptoms (PPS) and categorical personality disorder (PD) is well established, it remains unclear if it extends to the dimensional PD approach. This study examined whether PPS are associated with (1) personality functioning impairment (PFI) and (2) maladaptive personality traits (MPT) as defined by the DSM-5 Alternative Model for Personality Disorders (AMPD), controlling for concurrent psychiatric diagnoses, in two distinct clinical adolescent samples.Study Design
Adolescents aged 12-17 years were recruited from a specialized outpatient clinic for early PD intervention (N = 432; "at-risk for PD sample") and general inpatient units (N = 317; "general psychiatric sample"). PFI and MPTs were assessed using the STiP-5.1 and the PID-5-BF. PPS were measured with the PQ-B and the SCID-5 hallucination and delusion items. Multiple and nested linear regression models tested whether PFI and MPTs explained variance in PPS beyond concurrent psychiatric diagnoses.Study Results
PFI was positively associated with PSS and explained variance beyond psychiatric diagnoses in both samples. In the general psychiatric sample, in which hallucinations and delusions were analyzed separately, PFI was associated with both symptom domains. Adding MPTs significantly improved the explanation of PPS variance in both samples, diminishing the unique contribution of PFI.Conclusions
The findings extend the PD-PPS link to the dimensional AMPD framework, with both PFI and MPTs showing positive associations with PPS beyond psychiatric diagnoses. Longitudinal research is needed to examine whether improvements in PFI and MPTs lead to a reduction of PPS over time.
While the link between positive psychotic symptoms (PPS) and categorical personality disorder (PD) is well established, it remains unclear if it extends to the dimensional PD approach. This study examined whether PPS are associated with (1) personality functioning impairment (PFI) and (2) maladaptive personality traits (MPT) as defined by the DSM-5 Alternative Model for Personality Disorders (AMPD), controlling for concurrent psychiatric diagnoses, in two distinct clinical adolescent samples.Study Design
Adolescents aged 12-17 years were recruited from a specialized outpatient clinic for early PD intervention (N = 432; "at-risk for PD sample") and general inpatient units (N = 317; "general psychiatric sample"). PFI and MPTs were assessed using the STiP-5.1 and the PID-5-BF. PPS were measured with the PQ-B and the SCID-5 hallucination and delusion items. Multiple and nested linear regression models tested whether PFI and MPTs explained variance in PPS beyond concurrent psychiatric diagnoses.Study Results
PFI was positively associated with PSS and explained variance beyond psychiatric diagnoses in both samples. In the general psychiatric sample, in which hallucinations and delusions were analyzed separately, PFI was associated with both symptom domains. Adding MPTs significantly improved the explanation of PPS variance in both samples, diminishing the unique contribution of PFI.Conclusions
The findings extend the PD-PPS link to the dimensional AMPD framework, with both PFI and MPTs showing positive associations with PPS beyond psychiatric diagnoses. Longitudinal research is needed to examine whether improvements in PFI and MPTs lead to a reduction of PPS over time.
Date Issued
2026-07-08
Publication Type
Article
Subject(s)
Subjects
AMPD
•
Adolescence
•
Dimensional
•
Personality functioning
•
Personality traits
•
Psychosis
Language(s)
en
Author(s)
Kaeser, Janko M | |
Wegmueller, Gian | |
Journal
Schizophrenia Research
Publisher
Elsevier
ISSN
1573-2509
0920-9964
Access(Rights)
open.access