Empirical convergence between Kernberg's model of personality organization and the alternative DSM‐5 model for personality disorders

Both Kernberg's model of personality organization and the alternative model for personality disorders (AMPD) in the Diagnostic and Statistical Manual of Mental Disorders-5th edition provide a multidimensional framework for assessing personality pathology, while having a dual focus on general and specific personality pathology. The present study was the first to investigate the empirical convergence between measures of personality organization and the AMPD (personality functioning and pathological personality traits), considering general and specific personality pathology. A mixed clinical sample completed self-reports for personality organization, personality functioning and pathological personality traits, as well as an interview for personality organization. Two bifactor models with three specific exploratory factors were estimated, comprising a self-report model based on domain scores using exploratory factor analysis (n = 336) and a multi-method model predominantly based on subdomain scores applying exploratory structural equation modelling (n = 277). Both bifactor models yielded strong general factors with high loadings of the personality organization domains identity and primitive defences, as well as the personality functioning domains. The specific factors suggest convergence between other-directed aggression (personality organization), restricted moral functioning (personality organization) and antagonism (pathological personality traits), between diminished reality testing (personality organization) and psychoticism (pathological personality traits) and between maladaptive object relations (personality organization), impaired interpersonal functioning (personality functioning) and detachment (pathological personality traits). It can be concluded that measures of personality organization and the AMPD strongly converge regarding both general and specific personality pathology. Kernberg's model of personality organization may serve as a valuable complement to the AMPD, guiding forthcoming research and the clinical assessment of personality pathology.