Personality Disorders: Theory, Research, and Treatment, Vol 17(2), Mar 2026, 117-127; doi:10.1037/per0000750
The alternative model for personality disorders (AMPD) constitutes a major shift in conceptualizing personality pathology and has gained considerable attention among both clinicians and personality pathology researchers. The AMPD has two core components: personality dysfunction (Criterion A) and maladaptive traits (Criterion B). As measures of these components are strongly correlated in self-report, cross-sectional data, some researchers question Criterion A’s necessity. We used both self- and interviewer-reported methods to enhance understanding of these AMPD components through principal factors analysis (PFA) and bifactor analysis. Further, we investigated these factors’ associations with psychopathology (e.g., mood and anxiety disorder symptoms, criteria for substance use disorders) and psychosocial functioning dimensions (e.g., life satisfaction, interpersonal and occupational problems, daily functioning), again using both self-reported and interviewer-rated measures of these constructs. Six hundred community adults, half each either screened-in as at-risk for personality pathology or currently in outpatient therapy, participated in the study. In both the PFA and bifactor analyses, a distress-and-pathology factor emerged (e.g., negative affectivity, poor self-dysfunction) along with two primarily interpersonal factors: antagonism–disinhibition and detachment. A key difference between the PFA and bifactor analyses was that the interpersonal factors emerged without distress in the bifactor analysis because of the extraction of a general factor and reflected distinct self versus interviewer perspectives. The distress-and-pathology factor consistently displayed meaningful associations with psychopathology symptoms, personality pathology, and psychosocial functioning, whereas the two interpersonal factors were more specifically associated with personality pathology. We discuss the findings’ implications for conceptualizing personality pathology and its treatment. (PsycInfo Database Record (c) 2026 APA, all rights reserved)