Exploring the Relationship between the DSM-5 Levels of Personality Functioning Scale and Psychopathy in a Clinical Sample of Patients with Antisocial Personality Disorder

Abstract

ABSTRACT Background: The DSM-5 alternative model of personality disorders (AMPD) provides a new paradigm for diagnosing personality disorders (PD) in which a PD diagnosis is based on levels of personality functioning (Criterion A) and pathological personality traits (Criterion B). AMPD has retained six specific PDs, including antisocial PD (ASPD). In order to capture the construct of psychopathy, a psychopathy specifier is included. There is a need for studies examining the validity of the new model with respect to ASPD and psychopathy. Objective: The main focus of this thesis is to explore whether the impairment in personality functioning (i.e., Level of Personality Functioning Scale, LPFS) is capable to capture the construct of psychopathy and its severity by comparing the LPFS with the Psychopathy Checklist: Screening Version (PCL:SV). The psychopathy specifier is also explored. Methods: The subsample is drawn from a larger sample of patients participating in the Norwegian multicentre study on the DSM-5 AMPD. Among these patients, 30 patients met the ASPD criteria and were recruited from a substance abuse clinic in the south of Norway that serve prison inmates. All patients were assessed by the SCID-II, PCL:SV, LPFS and a self-report questionnaire (i.e., the Personality Inventory for DSM-5; PID-5). Pearsons r correlation coefficient was used in assessing the relationship between variables. Results: We discovered a negative correlation between the LPFS and psychopathy. The LPFS has a negative association with the general psychopathy factor (F1) of the PCL. As expected, two out of three traits in the psychopathy specifier were significantly or almost significantly negatively correlated with the F1 factor. The antisocial factor (F2) presents no significant association to any of the traits in the psychopathy specifier. Conclusion: Our findings suggest that patients with the highest scores on the PCL:SV are not captured within the LPFS construct. It seems that the LPFS is designed to capture patients who need treatment and not to detect psychopaths who generally have little psychological problems. However, the psychopathy specifier shows promising results and may be a step forward in the construction of a measure that may be able to detect psychopaths.