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The DSM-5 alternative model for personality disorders and psychotic symptoms: A two-sample study in help-seeking adolescents.

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Τίτλος: The DSM-5 alternative model for personality disorders and psychotic symptoms: A two-sample study in help-seeking adolescents.
Συγγραφείς: Kaeser JM; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland., Wegmueller G; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland., Lerch S; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland., Michel C; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland., Burkhardt E; 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., Berger T; Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland., Kaess M; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany., Cavelti M; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. Electronic address: marialuisa.cavelti@unibe.ch.
Πηγή: Schizophrenia research [Schizophr Res] 2026 Oct; Vol. 296, pp. 102-110. Date of Electronic Publication: 2026 Jul 09.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Science Publisher B. V Country of Publication: Netherlands NLM ID: 8804207 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2509 (Electronic) Linking ISSN: 09209964 NLM ISO Abbreviation: Schizophr Res Subsets: MEDLINE
Imprint Name(s): Original Publication: Amsterdam : Elsevier Science Publisher B. V., c1988-
Ιατρικοί όροι (MeSH): Personality Disorders*/diagnosis , Personality Disorders*/epidemiology , Personality Disorders*/physiopathology , Psychotic Disorders*/diagnosis , Psychotic Disorders*/epidemiology , Psychotic Disorders*/physiopathology , Diagnostic and Statistical Manual of Mental Disorders* , Patient Acceptance of Health Care*, Humans ; Adolescent ; Female ; Male ; Child ; Psychiatric Status Rating Scales ; Hallucinations ; Models, Psychological
Περίληψη: Background and Hypothesis: While the link between positive psychotic symptoms (PPS) and categorical personality disorder (PD) is well established, it remains unclear if it extends to the dimensional PD approach. This study examined whether PPS are associated with (1) personality functioning impairment (PFI) and (2) maladaptive personality traits (MPT) as defined by the DSM-5 Alternative Model for Personality Disorders (AMPD), controlling for concurrent psychiatric diagnoses, in two distinct clinical adolescent samples.
Study Design: Adolescents aged 12-17 years were recruited from a specialized outpatient clinic for early PD intervention (N = 432; "at-risk for PD sample") and general inpatient units (N = 317; "general psychiatric sample"). PFI and MPTs were assessed using the STiP-5.1 and the PID-5-BF. PPS were measured with the PQ-B and the SCID-5 hallucination and delusion items. Multiple and nested linear regression models tested whether PFI and MPTs explained variance in PPS beyond concurrent psychiatric diagnoses.
Study Results: PFI was positively associated with PSS and explained variance beyond psychiatric diagnoses in both samples. In the general psychiatric sample, in which hallucinations and delusions were analyzed separately, PFI was associated with both symptom domains. Adding MPTs significantly improved the explanation of PPS variance in both samples, diminishing the unique contribution of PFI.
Conclusions: The findings extend the PD-PPS link to the dimensional AMPD framework, with both PFI and MPTs showing positive associations with PPS beyond psychiatric diagnoses. Longitudinal research is needed to examine whether improvements in PFI and MPTs lead to a reduction of PPS over time.
(Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Marialuisa Cavelti reports financial support was provided by Swiss National Science Foundation. If there are other authors, they 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: AMPD; Adolescence; Dimensional; Personality functioning; Personality traits; Psychosis
Entry Date(s): Date Created: 20260709 Date Completed: 20260907 Latest Revision: 20260907
Update Code: 20260908
DOI: 10.1016/j.schres.2026.07.006
PMID: 42424939
Βάση Δεδομένων: MEDLINE
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  Data: The DSM-5 alternative model for personality disorders and psychotic symptoms: A two-sample study in help-seeking adolescents.
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  Data: <searchLink fieldCode="AU" term="%22Kaeser+JM%22">Kaeser JM</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Wegmueller+G%22">Wegmueller G</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Lerch+S%22">Lerch S</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Michel+C%22">Michel C</searchLink>; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.<br /><searchLink fieldCode="AU" term="%22Burkhardt+E%22">Burkhardt E</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="%22Berger+T%22">Berger T</searchLink>; Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.<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; Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.<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. Electronic address: marialuisa.cavelti@unibe.ch.
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  Data: Background and Hypothesis: While the link between positive psychotic symptoms (PPS) and categorical personality disorder (PD) is well established, it remains unclear if it extends to the dimensional PD approach. This study examined whether PPS are associated with (1) personality functioning impairment (PFI) and (2) maladaptive personality traits (MPT) as defined by the DSM-5 Alternative Model for Personality Disorders (AMPD), controlling for concurrent psychiatric diagnoses, in two distinct clinical adolescent samples.<br />Study Design: Adolescents aged 12-17 years were recruited from a specialized outpatient clinic for early PD intervention (N = 432; "at-risk for PD sample") and general inpatient units (N = 317; "general psychiatric sample"). PFI and MPTs were assessed using the STiP-5.1 and the PID-5-BF. PPS were measured with the PQ-B and the SCID-5 hallucination and delusion items. Multiple and nested linear regression models tested whether PFI and MPTs explained variance in PPS beyond concurrent psychiatric diagnoses.<br />Study Results: PFI was positively associated with PSS and explained variance beyond psychiatric diagnoses in both samples. In the general psychiatric sample, in which hallucinations and delusions were analyzed separately, PFI was associated with both symptom domains. Adding MPTs significantly improved the explanation of PPS variance in both samples, diminishing the unique contribution of PFI.<br />Conclusions: The findings extend the PD-PPS link to the dimensional AMPD framework, with both PFI and MPTs showing positive associations with PPS beyond psychiatric diagnoses. Longitudinal research is needed to examine whether improvements in PFI and MPTs lead to a reduction of PPS over time.<br /> (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.)
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  Data: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Marialuisa Cavelti reports financial support was provided by Swiss National Science Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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