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Personality dysfunction according to the DSM-5 Alternative Model of Personality Disorders (AMPD) predicts suicide attempts in clinical high-risk adolescents.

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Τίτλος: Personality dysfunction according to the DSM-5 Alternative Model of Personality Disorders (AMPD) predicts suicide attempts in clinical high-risk adolescents.
Συγγραφείς: Zippert LK; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany; Graduate School for Health Sciences, University of Bern, Bern, Switzerland., Hertel C; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland., Sele S; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland., Reichl C; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland., Cavelti M; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland., Koenig J; Clinic and Polyclinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany., Kaess M; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany. Electronic address: michael.kaess@upd.ch.
Πηγή: Journal of affective disorders [J Affect Disord] 2026 Aug 15; Vol. 407, pp. 121811. Date of Electronic Publication: 2026 Apr 15.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Netherlands NLM ID: 7906073 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2517 (Electronic) Linking ISSN: 01650327 NLM ISO Abbreviation: J Affect Disord Subsets: MEDLINE
Imprint Name(s): Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press.
Ιατρικοί όροι (MeSH): Suicide, Attempted*/psychology , Suicide, Attempted*/statistics & numerical data , Personality Disorders*/psychology , Personality Disorders*/diagnosis , Diagnostic and Statistical Manual of Mental Disorders*, Depression/psychology ; Self-Injurious Behavior/psychology ; Humans ; Female ; Adolescent ; Child ; Male ; Bayes Theorem ; Risk-Taking ; Models, Psychological ; Longitudinal Studies
Περίληψη: Background: Both personality traits and personality disorders have been linked to suicide risk in youth. The DSM-5 Alternative Model of Personality Disorders (AMPD) allows dimensional assessment of personality pathology, which may enhance prediction of suicide attempts. A recent study found that personality dysfunction (Criterion A of the AMPD) is associated with past suicide attempts in adolescents. Building on this, the present study aimed to investigate the longitudinal relationship between AMPD personality pathology and suicide attempts in adolescents.
Methods: Data were drawn from a consecutive clinical cohort study including adolescent patients aged 12 to 18 years (N = 252, 85% female) engaging in risk-taking and self-harming behaviors. Personality dysfunction, maladaptive personality traits, suicide attempts, and depression severity were assessed using standardized interviews and questionnaires at baseline and at two annual follow-ups. 66% of participants completed any follow-up. A Bayesian Structural Equation Modeling framework was used for data analysis.
Results: Personality dysfunction predicted suicide attempts over the two-year follow-up (β = 0.38, 95% CI [0.01; 0.73], p = .046). Adding maladaptive personality traits did not add predictive value, while depression severity emerged as a slightly stronger predictor. The effect of personality dysfunction remained stable after accounting for these variables.
Conclusions: These findings highlight the value of assessing personality dysfunction in adolescent suicide risk evaluation. Within the AMPD framework, personality dysfunction may be more important than maladaptive traits in predicting suicide attempts. However, analyzing distinct personality functioning domains or maladaptive traits may provide further insight into suicide attempt prediction.
(Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Adolescence; Bayesian Structural Equation Modeling; Dimensional personality model; Personality disorder; Suicidal behavior
Entry Date(s): Date Created: 20260417 Date Completed: 20260715 Latest Revision: 20260715
Update Code: 20260715
DOI: 10.1016/j.jad.2026.121811
PMID: 41997375
Βάση Δεδομένων: MEDLINE
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  Data: Personality dysfunction according to the DSM-5 Alternative Model of Personality Disorders (AMPD) predicts suicide attempts in clinical high-risk adolescents.
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  Data: <searchLink fieldCode="AU" term="%22Zippert+LK%22">Zippert LK</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Hertel+C%22">Hertel C</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Sele+S%22">Sele S</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Reichl+C%22">Reichl C</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Cavelti+M%22">Cavelti M</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Koenig+J%22">Koenig J</searchLink>; Clinic and Polyclinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.<br /><searchLink fieldCode="AU" term="%22Kaess+M%22">Kaess M</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany. Electronic address: michael.kaess@upd.ch.
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  Data: Background: Both personality traits and personality disorders have been linked to suicide risk in youth. The DSM-5 Alternative Model of Personality Disorders (AMPD) allows dimensional assessment of personality pathology, which may enhance prediction of suicide attempts. A recent study found that personality dysfunction (Criterion A of the AMPD) is associated with past suicide attempts in adolescents. Building on this, the present study aimed to investigate the longitudinal relationship between AMPD personality pathology and suicide attempts in adolescents.<br />Methods: Data were drawn from a consecutive clinical cohort study including adolescent patients aged 12 to 18 years (N = 252, 85% female) engaging in risk-taking and self-harming behaviors. Personality dysfunction, maladaptive personality traits, suicide attempts, and depression severity were assessed using standardized interviews and questionnaires at baseline and at two annual follow-ups. 66% of participants completed any follow-up. A Bayesian Structural Equation Modeling framework was used for data analysis.<br />Results: Personality dysfunction predicted suicide attempts over the two-year follow-up (β = 0.38, 95% CI [0.01; 0.73], p = .046). Adding maladaptive personality traits did not add predictive value, while depression severity emerged as a slightly stronger predictor. The effect of personality dysfunction remained stable after accounting for these variables.<br />Conclusions: These findings highlight the value of assessing personality dysfunction in adolescent suicide risk evaluation. Within the AMPD framework, personality dysfunction may be more important than maladaptive traits in predicting suicide attempts. However, analyzing distinct personality functioning domains or maladaptive traits may provide further insight into suicide attempt prediction.<br /> (Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved.)
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