Criterion A of the Alternative Model of Personality Disorders: Structure and Validity in a Community Sample

The alternative model of personality disorders were designed to represent the presence of personality dysfunction (Criterion A) and pathological personality traits (Criterion B). Much of the empirical attention toward this model has been directed toward testing the performance of Criterion B. However, the development of the Levels of Personality Functioning Scale-Self-Report (LPFS-SR) has sparked a growing amount of interest and debate around Criterion A. Specifically, there is significant disagreement in the research examining the validity of the LPFS-SR, with ongoing discrepancies regarding the measure's underlying structure and measurement of Criterion A. The present study aimed to compare four models (one-factor, four-factor, higher order, and bifactor models) in a sample of 416 adults (49.5% women, 63.5% White) to better understand the structure of the LPFS-SR. This study also built on existing efforts to establish convergent and divergent validity of the LPFS-SR by examining how criteria are related to independent measures of both self and interpersonal pathology. The results from the present study supported a bifactor model. Additionally, the four subscales of the LPFS-SR each captured unique variance above and beyond the general factor. Structural equation models predicting identity disturbance and interpersonal traits demonstrated that while the strongest relationships were found between the general factor and the scales, some support was found for the convergent and discriminant validity of the four factors. This work advances our understanding of the LPFS-SR and provides support for the LPFS-SR as a valid marker of personality pathology in clinical and research settings.