A Systematic Review of the Clinical Utility of the DSM-5 Section III Alternative Model of Personality Disorder

Empirical controversy remains regarding the representation and diagnosis of personality disorders, as either distinct categories or as a dimensional continuum of psychopathology. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the Personality and Personality Disorders Work Group presented an alternative model of personality disorder (AMPD) that elicits a hybrid diagnosis. This attempt to combat the various limitations associated with primarily categorical or dimensional approaches was met with criticism regarding the AMPD's indeterminate clinical utility. To seek clarity, the current mixed-methods systematic review aimed to determine the clinical utility of the AMPD within a clinical population. An electronic screening of six databases, in addition to the application of explicit exclusion criteria, revealed 20 studies of relevance. Study characteristics and individual assessments of methodological quality were tabulated. The convergent, narrative synthesis of results was largely in support of the AMPD's clinical utility. Future exploration of the AMPD's communicative value between clinicians and their patients' families, the feasibility of the model's application, and the model's ability to translate into treatment modalities is required to both consolidate the current findings and to support a transition to a hybrid diagnosis of personality psychopathology.