The Alternative Model of Personality Disorder (AMPD) and the International Classification of Diseases, 11th edition's personality disorder nosologies reflect a shift from categorical to dimensional diagnosis. However, minimal research has investigated clinician perceptions and attitudes surrounding the diagnoses that dimensional models produce. The current study aimed to (a) investigate and directly compare the clinical utility of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, with the dimensional AMPD, from the perspective of clinicians, and (b) determine how these different diagnostic systems, and their variations in the portrayal of the same PD symptomology, may affect clinician-rated stigma. A sample of 89 psychologists read a series of case vignettes, with each vignette exhibiting a different variation of personality difficulties and accompanying diagnostic information. Clinicians answered a series of questions regarding clinical utility, their treatment recommendations, and stigma after each case vignette. A series of general linear models, post hoc analyses, and chi-squared tests were utilized. The AMPD was neither inferior nor superior to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, categorical model in terms of clinician-perceived clinical utility and stigma attitudes. Diagnostic information more broadly, regardless of the diagnostic system, was more clinically useful than a description-only, formulaic approach to conceptualizing personality difficulties. The absence of diagnostic information was associated with higher stigma among clinicians. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
There is a substantial literature on the associations between personality disorder (PD) and sleep dysfunction, but the majority of studies have focused on borderline PD. Studies that have taken a broader perspective have indicated that associations between PD and sleep problems are diffuse. The current study examined associations between the International Classification of Diseases, 11th revision (ICD-11) PD (severity and traits) with a diverse set of sleep problems as well as the role of adverse childhood experiences (ACEs) and executive functioning in explaining the overlap between PD and sleep dysfunction. Participants were 503 individuals with mental health histories recruited via Prolific Academic from six English-speaking countries and completed a battery of self-report questionnaires targeting the constructs of interest. The results show that ICD-11 PD severity and negative affectivity were both distinctly associated with insomnia severity and presleep arousal. To a lesser degree, disinhibition was primarily associated with an eveningness chronotype and daytime sleepiness. Although both ACEs and executive dysfunction explained the overlap of the PD constructs with insomnia severity and presleep arousal, the latter was associated with a much larger effect size. The findings indicate that a dimensional PD model such as the one included in ICD-11 can be useful in elucidating how PD is related to sleep problems, and this overlap should also signal to clinicians to assess for and intervene with sleep problems in clients with PDs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Paranoia, the unfounded belief and mistrust about other people's intentions as threatening, and social anxiety, the intense worry and fear regarding social interactions, share a number of phenomenological features. Furthermore, both can be conceptualized as traits ranging from mild or subclinical to severe clinical expressions. However, few studies have examined how these trait-level vulnerabilities differentially map onto individuals' daily experiences. The present study used experience sampling methodology to disentangle the overlap and differentiation of trait-level social anxiety and paranoia in daily life. A total of 238 young adults were prompted 8 times daily for 1 week to complete experience sampling methodology questionnaires that assessed affect, cognitive appraisals, suspicious thoughts, activities, and social behaviors. As hypothesized, paranoia and social anxiety were both independently associated with negative affect and negative self- and other-related appraisals. However, after controlling for shared variance, only paranoia was uniquely associated with anger, intense feelings, and threat-related suspicious thoughts, whereas only social anxiety was uniquely associated with feeling not cared for, preference to be alone while with others, and among participants who were alone, interpreting being alone as due to others' dislike. Cross-level interactions further showed that only social anxiety exacerbated the inverse association between momentary reports of feeling close to others and the preference to be alone. Overall, these findings suggest that although paranoia and social anxiety are closely intertwined in daily life, they may reflect partially distinct interpersonal processing: paranoia involving heightened threat detection and suspiciousness, and social anxiety involving heightened sensitivity to rejection and unease. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Scholarly debate continues regarding whether borderline personality disorder (BPD) represents a distinct categorical disorder or primarily reflects elevated levels of personality functioning (LPFs) as conceptualized in the Diagnostic and Statistical Manual of Mental Disorders, fifth ed., Alternative Model of Personality Disorders. The present study examined the overlap between measures of LPF and BPD by analyzing archival data from 289 adults receiving community-based mental health treatment. Participants completed both clinician-rated and self-report measures assessing BPD symptoms, LPF, and relevant psychopathology and personality constructs. Results indicated substantial overlap between measures of BPD and LPF, with confirmatory factor analyses and bifactor modeling supporting a dominant general factor that accounted for most shared variance between the 2 constructs. Concurrently, BPD retained modest yet consistent unique variance, primarily associated with externalizing domains. Together, these findings indicate that BPD largely reflects LPF with some stylistic features remaining unique that are likely artifacts of the behavioral focus of BPD in the Diagnostic and Statistical Manual of Mental Disorders, fifth ed. This observation suggests that resources currently directed toward BPD-specific frameworks may be more effectively invested in dimensional models targeting general personality impairment, with benefits extending across broader personality pathology. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
