The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Alternative Model Conceptualization of Borderline Personality Disorder: A Review of the Evidence

In the 10 years following the publishing of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), studies have accumulated testing the validity and utility of the alternative model for personality disorders (AMPD) in the context of borderline personality disorder (BPD). In this article, we review the studies that have tested how well the AMPD conceptualization of BPD captures the traditional (DSM-5, Section II) conceptualization of BPD. Although we note that studies that measure the full conceptualization of the AMPD-BPD are limited compared with studies focusing on a single aspect of the AMPD, studies reviewed suggest that the AMPD conceptualization of BPD largely overlaps with Section II, is associated with a similar range of external constructs, and can be measured with similar levels of interrater reliability. This evidence is promising in terms of the goal of the AMPD developers to not lose relevant and clinically meaningful information associated with traditional conceptualizations of BPD. However, further applied research is needed to understand how the AMPD may improve upon our existing categorical conceptualization of BPD.