Episode
The DSM's New Model of Personality Disorders: The Good, The Bad, and What's Missing
- Podcast
- Heal NPD
- Published
- May 26, 2026
- Duration seconds
- 3519
- Processing state
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Summary
This episode continues the Heal NPD Seminar Series with Dr. Mark Ettensohn, joined by his associates Deanna Young, Psy.D., and Danté Spencer, Ph.D. In this session, the group examines the Alternative DSM-5 Model for Personality Disorders (AMPD), a dimensional framework introduced in Section III of the DSM-5 and retained in DSM-5-TR. The model was developed in response to longstanding limitations of the traditional categorical system, including diagnostic overlap, heterogeneity within disorders, and the absence of a clear framework for assessing severity. The discussion focuses on the two core components of the model. The first, Level of Personality Functioning (Criterion A), assesses impairments in identity, self-direction, empathy, and intimacy. This portion of the model reflects a structural approach to personality and aligns with psychodynamic and developmental perspectives on personality organization. The second component, Criterion B, introduces a trait-based system organized around five domains: negative affectivity, detachment, antagonism, disinhibition, and psychoticism. These traits are derived from dimensional personality research and represent an effort to describe maladaptive personality features in a standardized way. The group explores the strengths of this combined model, as well as its limitations. Particular attention is given to the tension between structural and trait-based approaches, and to the question of whether personality pathology can be adequately captured through trait descriptions alone. Using narcissistic personality disorder as a focal example, the discussion examines how the model emphasizes grandiosity and attention-seeking traits while underrepresenting vulnerability, shame, and fluctuations in self-state. The conversation highlights t…