Prototype Models of Personality Disorders: Prototype Convergence and Association With Pathological Traits

The goal of this study was to evaluate whether personality disorder prototypes derived from three different models have similar pathological trait profiles within the Alternative Model of Personality Disorders (AMPD). Trainee clinicians (N = 329) rated a patient they were currently treating using the Shedler-Westen Assessment Procedure, the DSM-5 hybrid model prototype match (modified from the original prototype DSM-5 proposal) and the Psychodynamic Diagnostic Manual prototype match. Correlations among each PD prototype model with the DSM-5 traits were assessed. Theoretically similar prototypes across the SWAP-II, DSM-5 hybrid model and PDM were correlated with several traits across models, ranging from small-to-large effect sizes. Similar prototypes also appeared to display similar trait profiles with some exceptions. Results suggest that the SWAP-II, DSM-5 and PDM prototype models tend to assess similar constructs overall, even though the methods are theoretically distinct. Implications of these findings for PD diagnosis are discussed.