The Levels of Personality Functioning Questionnaire 12-18 (LoPF-Q 12-18) is the only self-report measure informed by the Level of Personality Functioning (Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM-5; American Psychiatric Association, 2013]) Alternative Model of Personality Disorders developed for adolescents. The present investigation includes two studies evaluating the English LoPF-Q 12-18. In Study 1, single-factor and bifactor structures (unidimensional severity criterion and four specific factors: identity, self-direction, empathy, intimacy) were evaluated in an ethnically diverse community sample (N = 453; age 10–18; 57% female). Study 2 used a community control (n = 298; age 10–18; 54.4% female) and clinical sample (n = 94; age 11–18; 58.5% female) to examine reliability, validity, and clinical utility. Study 1 results supported the bifactor model, with a robust general factor and little multidimensionality caused by the group factors, suggesting an essentially unidimensional structure. Study 2 revealed good internal consistency and construct validity and provided clinical cut-offs, supporting the use of the LoPF-Q 12-18 total score in research and clinical applications.
American Educational Research Association, American Psycho-logical Association, & National Council on Measurement in Education. (Eds.). (2014). Standards for educational and psychological testing. American Educational Research Association.
2.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.).
3.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
4.
AndersonJ. L.SellbomM.SalekinR. T. (2018). Utility of the Personality Inventory for DSM-5 Brief Form (PID-5-BF) in the measurement of maladaptive personality and psychopathology. Assessment, 25(5), 596–607. https://doi.org/10.1177/1073191116676889
5.
BachB.HutsebautJ. (2018). Level of Personality Functioning Scale–Brief Form 2.0: Utility in capturing personality problems in psychiatric outpatients and incarcerated addicts. Journal of Personality Assessment, 100(6), 660–670. https://doi.org/10.1080/00223891.2018.1428984
6.
BachB.Maples-KellerJ. L.BoS.SimonsenE. (2016). The alternative DSM–5 personality disorder traits criterion: A comparative examination of three self-report forms in a Danish population. Personality Disorders: Theory, Research, and Treatment, 7(2), 124–135. https://doi.org/10.1037/per0000162
7.
BarkauskienėR.SkabeikytėG. (2020). Culture-adapted version Lithuanian of the self-report questionnaire LoPF-Q 12-18 (Levels of Personality Functioning Questionnaire; authors Goth & Schmeck) - Short manual. Academic-Tests.
8.
BlitonC. F.RocheM. J.PincusA. L.DueberD. (2021). Examining the structure and validity of self-report measures of DSM-5 Alternative Model for Personality Disorders criterion A. Journal of Personality Disorders, 36, Article 531. https://doi.org/10.1521/pedi_2021_35_531
9.
BrowneM. W.CudeckR. (1993). Alternative ways of assessing model fit. In BollenK. A.LongJ. S. (Eds.), Testing struclural equalion riiodels (pp. 136–162). Sage.
10.
Buer ChristensenT.EikenaesI.HummelenB.PedersenG.NysæterT.-E.BenderD. S.SkodolA. E.SelvikS. G. (2020). Level of personality functioning as a predictor of psychosocial functioning: Concurrent validity of criterion A. Personality Disorders: Theory, Research, and Treatment, 11(2), 79–90. https://doi.org/10.1037/per0000352
11.
BusmannM.WregeJ.MeyerA. H.RitzlerF.SchmidlinM.LangU. E.GaabJ.WalterM.EulerS. (2019). Alternative Model of Personality Disorders (DSM-5) predicts dropout in inpatient psychotherapy for patients with personality disorder. Frontiers in Psychology, 10, Article 952. https://doi.org/10.3389/fpsyg.2019.00952
12.
ChanenA. M.BerkM.ThompsonK. (2016). Integrating early intervention for borderline personality disorder and mood disorders. Harv Rev Psychiatry, 24(5), 330–341. https://doi.org/10.1097/HRP.0000000000000105
13.
ClarkL. A. (2007). Assessment and diagnosis of personality disorder: Perennial issues and an emerging reconceptualization. Annual Review of Psychology, 58, 227–257. https://doi.org/10.1146/annurev.psych.57.102904.190200
14.
ClarkL. A.NuzumH.RoE. (2018). Manifestations of personality impairment severity: Comorbidity, course/prognosis, psychosocial dysfunction, and “borderline” personality features. Current Opinion in Psychology, 21, 117–121. https://doi.org/10.1016/j.copsyc.2017.12.004
15.
CohenP.CrawfordT. N.JohnsonJ. G.KasenS. (2005). The children in the community study of developmental course of personality disorder. Journal of Personality Disorders, 19(5), 466–486. https://doi.org/10.1521/pedi.2005.19.5.466
16.
CosgunS.GothK.CakirogluS. (2021). Levels of Personality Functioning Questionnaire (LoPF-Q) 12–18 Turkish Version: Reliability, validity, factor structure and relationship with comorbid psychopathology in a Turkish adolescent sample. Journal of Psychopathology and Behavioral Assessment, 43, 620–631. https://doi.org/10.1007/s10862-021-09867-2
17.
CrickN. R.Murray–CloseD.WoodsK. (2005). Borderline personality features in childhood: A short-term longitudinal study. Development and Psychopathology, 17(4), 1051–1070. https://doi.org/10.1017/S0954579405050492
18.
ErcegovicN.ParadzikL.Boricevic MarsanicV.MarcinkoD. (2018). Nonsuicidal self-injury and identity development in adolescents. Socijalna Psihijatrija, 46(4), 457–470.
19.
FanX.ThompsonB.WangL. (1999). Effects of sample size, estimation methods, and model specification on structural equation modeling fit indexes. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 56–83. https://doi.org/10.1080/10705519909540119
20.
FewL. R.MillerJ. D.RothbaumA. O.MellerS.MaplesJ.TerryD. P.CollinsB.MacKillopJ. (2013). Examination of the Section III DSM-5 diagnostic system for personality disorders in an outpatient clinical sample. Journal of Abnormal Psychology, 122(4), 1057–1069. https://doi.org/10.1037/a0034878
21.
FossatiA.KruegerR. F.MarkonK. E.BorroniS.MaffeiC.SommaA. (2015). The DSM-5 Alternative Model of Personality Disorders from the perspective of adult attachment: A study in community-dwelling adults. The Journal of Nervous and Mental Disease, 203(4), 252–258. https://doi.org/10.1097/NMD.0000000000000274
22.
FossatiA.SommaA.BorroniS.MarkonK. E.KruegerR. F. (2017). The Personality Inventory for DSM-5 Brief Form: Evidence for reliability and construct validity in a sample of community-dwelling Italian adolescents. Assessment, 24(5), 615–631. https://doi.org/10.1177/1073191115621793
23.
GamacheD.SavardC.LeclercP.CôtéA. (2019). Introducing a short self-report for the assessment of DSM–5 level of personality functioning for personality disorders: The Self and Interpersonal Functioning Scale. Personality Disorders: Theory, Research, and Treatment, 10(5), 438–447. https://doi.org/10.1037/per0000335
24.
GanderM.BuchheimA.BockA.SteppanM.SeveckeK.GothK. (2020). Unresolved attachment mediates the relationship between childhood trauma and impaired personality functioning in adolescence. Journal of Personality Disorders, 34(Supplement B), 84–103.
25.
GorsuchR. L. (1983). Factor analysis (2nd ed.). Lawrence Erlbaum Associates.
26.
GothK.BirkhölzerM.SchmeckK. (2018a). Assessment of Personality Functioning in Adolescents with the LoPF–Q 12–18 Self-Report Questionnaire. Journal of Personality Assessment, 100(6), 680–690. https://doi.org/10.1080/00223891.2018.1489258
27.
GothK.BirkhölzerM.SchmeckK. (2018b). LoPF-Q 12-18 (Levels of Personality Functioning Questionnaire) German version: A self-report questionnaire for measuring personality functioning in adolescence—Short description. Academic-Tests.
28.
GothK.SchmeckK. (2018). AIDA (Assessment of Identity Development in Adolescence)German Version: A self-report questionnaire for measuring identity development in adolescence - Short manual. Academic-Tests.
29.
HaC.BalderasJ. C.ZanariniM. C.OldhamJ.SharpC. (2014). Psychiatric comorbidity in hospitalized adolescents with borderline personality disorder. Journal of Clinical Psychiatry, 75(5), e457–e464. https://doi.org/10.4088/JCP.13m08696
30.
HancockG. R.MuellerR. O. (2001). Rethinking construct reliability within latent variable systems. In CudeckR.du ToitS.SörbomD. (Eds.), Structural equation modeling: Present and future—A Festschrift in honor of Karl Jöreskog (pp. 195–216). Scientific Software International.
31.
HopwoodC. J.GoodE. W.MoreyL. C. (2018). Validity of the DSM–5 levels of personality functioning scale–self report. Journal of Personality Assessment, 100(6), 650–659.
32.
HuL.BentlerP. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
33.
HutsebautJ.FeenstraD. J.KamphuisJ. H. (2016). Development and Preliminary Psychometric Evaluation of a Brief Self-Report Questionnaire for the Assessment of the DSM–5 level of Personality Functioning Scale: The LPFS Brief Form (LPFS-BF). Personality Disorders: Theory, Research, and Treatment, 7(2), 192–197. https://doi.org/10.1037/per0000159
34.
HutsebautJ.KamphuisJ. H.FeenstraD. J.WeekersL. C.De SaegerH. (2017). Assessing DSM–5-oriented level of personality functioning: Development and psychometric evaluation of the Semi-Structured Interview for Personality Functioning DSM–5 (STiP-5.1). Personality Disorders: Theory, Research, and Treatment, 8(1), 94–101. https://doi.org/10.1037/per0000197
35.
KassinM.De CastroF.ArangoI.GothK. (2013). Psychometric properties of a culture-adapted Spanish version of AIDA (Assessment of Identity Development in Adolescence) in Mexico. Child and Adolescent Psychiatry and Mental Health, 7(1), Article 25. https://doi.org/10.1186/1753-2000-7-25
36.
KassinM.HackradtJ. (2019). Culture-adapted version Spanish Mexico of the self-report questionnaire LoPF-Q12-18 (Levels of Personality Functioning Questionnaire; authors Goth & Schmeck) - Short manual. Academic-Tests.
37.
KruegerR. F.KotovR.WatsonD.ForbesM. K.EatonN. R.RuggeroC. J.SimmsL. J.WidigerT. A.AchenbachT. M.BachB.BagbyR. M.BornovalovaM. A.CarpenterW. T.ChmielewskiM.CiceroD. C.ClarkL. A.ConwayC.DeClercqB.DeYoungC. G.ZimmermannJ. (2018). Progress in achieving quantitative classification of psychopathology. World Psychiatry, 17(3), 282–293. https://doi.org/10.1002/wps.20566
38.
LindM.VanwoerdenS.PennerF.SharpC. (2019). Inpatient adolescents with borderline personality disorder features: Identity diffusion and narrative incoherence. Personality Disorders: Theory, Research, and Treatment, 10(4), 389–393. https://doi.org/10.1037/per0000338
39.
McAdamsD. P. (2015). The art and science of personality development. Guilford Press.
40.
MoreyL. C. (2017). Development and initial evaluation of a self-report form of the DSM–5 Level of Personality Functioning Scale. Psychological Assessment, 29(10), 1302.
41.
MoreyL. C.BenderD. S.SkodolA. E. (2013). Validating the proposed diagnostic and statistical manual of mental disorders, 5th Edition, severity indicator for personality disorder. Journal of Nervous & Mental Disease, 201(9), 729–735. https://doi.org/10.1097/NMD.0b013e3182a20ea8
42.
MoreyL. C.BerghuisH.BenderD. S.VerheulR.KruegerR. F.SkodolA. E. (2011). Toward a model for assessing level of personality functioning in DSM–5, part II: Empirical articulation of a core dimension of personality pathology. Journal of Personality Assessment, 93(4), 347–353. https://doi.org/10.1080/00223891.2011.577853.
43.
MuthénB. O.KaplanD.HollisM. (1987). On structural equation modeling with data that are not missing completely at random. Psychometrika, 52, 431–462. http://dx.doi.org/10.1007/BF0229436.
44.
MuthénL. K.MuthénB. O. (2017). Mplus: Statistical Analysis with Latent Variables: User’s Guide (Version 8). Los Angeles, CA: Authors.
45.
RagelienėT.JustickisV. (2016). Interrelations of adolescent’s identity development, differentiation of self and parenting style. Psichologija, 53, 24–43.
46.
ReiseS. P.ScheinesR.WidamanK. F.HavilandM. G. (2013). Multidimensionality and structural coefficient bias in structural equation modeling: A bifactor perspective. Educational and Psychological Measurement, 73, 5–26. http://dx.doi.org/10.1177/001316441244983.
47.
RodriguezA.ReiseS. P.HavilandM. G. (2016). Applying bifactor statistical indices in the evaluation of psychological measures. Journal of Personality Assessment, 98(3), 223–237. https://doi.org/10.1080/00223891.2015.1089249
48.
SharpC. (2020). Adolescent personality pathology and the Alternative Model for Personality Disorders: Self development as nexus. Psychopathology, 53(3), 198–204.
49.
SharpC.FonagyP. (2015). Practitioner Review: Borderline personality disorder in adolescence–recent conceptualization, intervention, and implications for clinical practice. Journal of Child Psychology and Psychiatry, 56(12), 1266–1288.
50.
SharpC.KerrS.ChanenA. (2021). Early identification and prevention of personality pathology: An AMPD informed model of clinical staging. In SkodolA.OldhamJ. (Eds.), The American Psychiatric Association textbook of personality disorders (pp. 285–337). American Psychiatric Association.
51.
SharpC.MillerJ. (2022). Ten-year retrospective on the DSM–5 Alternative Model of Personality Disorder: Seeing the forest for the trees. Personality Disorders: Theory, Research and Treatment, 13(4), 301–304.
52.
SharpC.SteinbergL.TempleJ.NewlinE. (2014). An 11-item measure to assess borderline traits in adolescents: Refinement of the BPFSC using IRT. Personality Disorders: Theory, Research, and Treatment, 5(1), 70–78. https://doi.org/10.1037/per0000057
53.
SharpC.VanwoerdenS. (2018). Culture-adapted version English USA of the self-report questionnaire LoPF-Q 12-18 (Levels of Personality Functioning Questionnaire; authors Goth & Schmeck)—Short manual. Academic-tests.
54.
SharpC.VanwoerdenS.SchmeckK.BirkhölzerM.GothK. (2021). An evaluation of age-group latent mean differences in maladaptive identity in adolescence. Frontiers in Psychiatry, 12, Article 730415. https://doi.org/10.3389/fpsyt.2021.730415
55.
SharpC.WallK. (2017). Personality pathology grows up: Adolescence as a sensitive period. Current Opinion in Psychology, 21, 111–116. https://doi.org/10.1016/j.copsyc.2017.11.010
56.
SharpC.WallK. (2021). DSM-5 level of personality functioning: Refocusing personality disorder on what it means to be human. Annual Review of Clinical Psychology, 17(1), 313–317. https://doi.org/10.1146/annurev-clinpsy-081219-105402
57.
SharpC.WrightA. G. C.FowlerJ. C.FruehB. C.AllenJ. G.OldhamJ.ClarkL. A. (2015). The structure of personality pathology: Both general (“g”) and specific (“s”) factors?Journal of Abnormal Psychology, 124(2), 387–398. https://doi.org/10.1037/abn0000033
58.
ShiD.LeeT.Maydeu-OlivaresA. (2019). Understanding the model size effect on SEM fit indices. Educational and Psychological Measurement, 79(2), 310–334. https://doi.org/10.1177/0013164418783530
59.
SiefertC. J.SextonJ.MeehanK.NelsonS.HaggertyG.DauphinB.HuprichS. (2020). Development of a short form for the DSM–5 levels of Personality Functioning Questionnaire. Journal of Personality Assessment, 102(4), 516–526. https://doi.org/10.1080/00223891.2019.1594842.
60.
SleepC. E.LynamD. R.WidigerT. A.CroweM. L.MillerJ. D. (2019). An evaluation of DSM–5 Section III personality disorder Criterion A (impairment) in accounting for psychopathology. Psychological Assessment, 31(10), 1181–1191. https://doi.org/10.1037/pas0000620
61.
TardivoL. S. P. C.MiuraP.AlhanatM. (2016). Family violence against children and adolescents in Brazil and relations with identity development. Acta Psychopathologica, 2(4), Article 35. https://doi.org/10.4172/2469-6676.100061
62.
VanwoerdenS.GareyL.FergusonT.TempleJ. R.SharpC. (2019). Borderline Personality Features Scale for Children-11: Measurement invariance over time and across gender in a community sample of adolescents. Psychological Assessment, 31(1), 114–119.
63.
WeekersL. C.HutsebautJ.KamphuisJ. H. (2019). The Level of Personality Functioning Scale-Brief Form 2.0—Update of a brief instrument for assessing level of personality functioning: The Level of Personality Functioning Scale—Brief Form 2.0. Personality and Mental Health, 13(1), 3–14. https://doi.org/10.1002/pmh.1434
64.
WeekersL. C.VerhoeffS. C. E.KamphuisJ. H.HutsebautJ. (2020). Assessing Criterion A in adolescents using the Semistructured Interview for Personality Functioning DSM–5. Personality Disorders: Theory, Research, and Treatment, 12, 312–319. https://doi.org/10.1037/per0000454
65.
WrightA. G. C.HopwoodC. J.SkodolA. E.MoreyL. C. (2016). Longitudinal validation of general and specific structural features of personality pathology. Journal of Abnormal Psychology, 125(8), 1120–1134. https://doi.org/10.1037/abn0000165
66.
WrightA. G. C.ZalewskiM.HallquistM. N.HipwellA. E.SteppS. D. (2016). Developmental trajectories of borderline personality disorder symptoms and psychosocial functioning in adolescence. Journal of Personality Disorders, 30(3), 351–372. https://doi.org/10.1521/pedi_2015_29_200
67.
ZanariniM. C.HorwoodJ.WolkeD.WaylenA.FitzmauriceG.GrantB. F. (2011). Prevalence of DSM-IV borderline personality disorder in two community samples: 6,330 English 11-year-olds and 34,653 American adults. Journal of Personality Disorders, 25(5), 607–619. https://doi.org/10.1521/pedi.2011.25.5.607
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
