The Alternative Model of Personality Disorder Is Inadequate for Capturing Obsessive-Compulsive Personality Disorder

The alternative model of personality disorder (AMPD) included in Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) reconceptualized personality pathology in terms of pathological traits and impairments in functioning. For example, the construct of obsessive-compulsive personality disorder (OCPD) was reconceptualized via the traits of rigid perfectionism as well as at least 2 of perseveration, intimacy avoidance, and restricted affectivity. We review the literature to summarize how effectively the legacy construct of OCPD is captured by the AMPD. We conclude that although the trait of rigid perfectionism is highly related to scores on OCPD measures, the AMPD as a whole fails to adequately account for the broader features of the legacy OCPD construct. Specifically, the AMPD trait model lacks a number of traits, such as workaholism, excessive deliberation, and moral scrupulousness, which are necessary for a fulsome dimensional trait system. These limitations in the inclusion of important traits stem from the AMPD's development process that left out crucial content. We outline how the AMPD could be improved in its ability to account for problems of overcontrolled behavior.