Leslie C Morey

Texas A&M University | TAMU · Department of Psychology

This study examined whether reductions in the severity of personality disorders (PD) mainly reflect changes in personality traits or rather an alleviation of a demoralized state involving nonspecific unpleasant affect. We used 4 years of longitudinal data from the Collaborative Longitudinal Personality Disorders Study, in which patients (N = 419) c...

The Level of Personality Functioning Scale–Self-Report (LPFS-SR) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. The current study aimed 1) to examine the internal consistency of the Portuguese version of the LPFS-SR in a community sample and a clinical sample, 2) to compare non-clinical participants (N = 282,...

Introduction Originally published in the United States of America in 1991, the Personality Assessment Inventory (PAI) has been translated and adapted to a growing number of countries, but Portugal had yet to study its adequacy to the Portuguese population. Methods The current study aimed to investigate the Portuguese normative data, the predictive...

The goal of this study was to compare the predictive validity of the alternative model for personality disorders (AMPD) versus the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Section II categorical model regarding clinician judgments about mental health outcomes. To do so, we instructed a national sample of 136 ment...

In this study, we explored the temporal stability of the Personality Assessment Inventory (PAI), which has not been comprehensively reexamined since it was first published. Our three specific aims were to determine the utility of PAI indicators of basic protocol validity (inconsistent responses [ICN] and highly unusual/unlikely responses [INF]) in...

Attention Deficit Hyperactivity Disorder is a relatively common and often disabling disorder in adults. However, feigning ADHD symptomatology is both easy and potentially common. We explored the most effective strategies for A) identifying individuals who had been diagnosed with ADHD based on existing PAI symptom indicators, and B), discriminating...

We tested the predictive validity of personality disorder (PD) indicators at different levels of aggregation, ranging from general PD severity to PD syndrome scales to individual PD criteria. We compared the predictive validity of models on these levels based on interview data on all 78 DSM-IV PD criteria, by using 19 outcome scales in three differ...

One barrier to fully understanding and treating the interpersonal difficulties associated with a variety of psychiatric disorders is a current lack of suitable methodology, which aligns with contemporary interpersonal theory and offers a comprehensive assessment of interpersonal judgment. Specifically, no standardized behavioral interpersonal asses...

Background Identity disturbances are a common feature of personality pathology and BPD. The Self-Reference Effect paradigm is a method used to measure the impact of self-relevant processing on encoding/memory, whereby self-relevant information is typically advantaged in cognitive processes. We postulated that difficulties with identity might impede...

Criterion A, as represented by Level of Personality Functioning (LPF), offers a means by which to conceptualize the core impairment in self and interpersonal functioning that distinguishes personality disorder (PD) from other forms of psychopathology. One of the most widely cited criticisms of the current Section II in Diagnostic and Statistical Ma...

Mental disorder is widespread in correctional settings, as is the potential for suicide and self-harm among detained individuals. The ability of the Personality Assessment Screener (PAS) to identify potential mental health problems has been the focus of recent research in corrections, but few studies have examined the prediction of crisis events re...

Background Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD...

Aim: This study examined psychometric properties of the Polish adaptation of a Self-Report Form of the DSM-5 Level of Personality Functioning Scale (LPFS-SR). It is a scale designed to measure general impairment, jointly with a detailed assessment of distinguished components of personality functioning characterized in terms of disturbances in self...

Past psychiatric diagnoses are central to patient case formulation and prognosis. Recently, alternative classification models such as the Hierarchical Taxonomy of Psychopathology (HiTOP) proposed to assess traits to predict clinically relevant outcomes. In the current study, we directly compared personality traits and past diagnoses as predictors o...

s Psychopathy is an important construct for research and applied usage in forensic context. Rigorous assessment with suitable instruments is imperative for the evolution of research on etiology, risk assessment, prevention, and intervention. Since the construction of the Hare Psychopathic Scale and consequently revised versions, that are consider a...

Structural models of personality traits, particularly the five-factor model (FFM), continue to inform ongoing debates regarding what personality attributes and trait domains are central to psychopathy. A growing body of literature has linked the constructs of the triarchic model of psychopathy (boldness, meanness, disinhibition) to the FFM. Recentl...

The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical-based classification of psychopathology. Detachment is one of the six spectra in the current HiTOP working model. The aim of this study was to develop preliminary scales for the HiTOP Detachment spectrum that can be used in the next phase of developing a comprehensive measure of H...

The Personality Assessment Inventory (PAI) is a multiscale, standardized self-administered questionnaire designed to provide a comprehensive assessment of client personality and psychopathology. The measure demonstrates widespread use in clinical, research, and training settings, with practical applications across several assessment specialties, in...

Two of the most widely used self-report measures of impulsivity are the UPPS-P Impulsive Behavior Scale and its shortened version, the SUPPS-P, which currently are limited by their inability to detect careless and/or random responding. The present study develops and cross-validates an inconsistency scale for use with the UPPS-P and SUPPS-P in order...

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is ge...

Importance Borderline personality disorder (BPD) has been identified as a strong risk factor for suicidal behavior, including suicide attempts. Delineating specific features that increase risk could inform interventions. Objective To examine factors associated with prospectively observed suicide attempts among participants in the Collaborative Lon...

Differential diagnosis of autism spectrum disorder (ASD) among intellectually-able adults often presents a clinical challenge, particularly when individuals present in crisis without diagnostic history. The Personality Assessment Inventory (PAI) is a multiscale personality and psychopathology instrument utilized across clinical settings, but to dat...

We critique Roy et al.'s (2020; this issue) approach to characterizing the item-level factor structure of the three scales of the Triarchic Psychopathy Measure (TriPM), in light of the manner in which the TriPM scales were developed, the purposes they were designed to serve, and the growing body of evidence supporting their construct validity. We f...

The Levels of Personality Functioning Scale—Self-Report (LPFS-SR) is a freely available self-report instrument that corresponds directly in content to the DSM-5 Alternative Model of Personality Disorders (AMPD) Criterion A, which assesses global pathology of personality functioning. The present study translated the LPFS-SR into Persian and examined...

Objective: The DSM-5 Alternative Model of Personality Disorders distinguishes core personality dysfunction common to all personality pathology from maladaptive traits that are specific variants of disorder. Previous research shows convergence between maladaptive and normal range trait domains as well as substantial correlations between maladaptive...

Objective The DSM‐5 Alternative Model of Personality Disorders distinguishes core personality dysfunction common to all personality pathology from maladaptive traits that are specific variants of disorder. Previous research shows convergence between maladaptive and normal range trait domains as well as substantial correlations between maladaptive t...

This chapter describes the emergence of dimensional models for the classification and diagnosis of personality pathology. Broad personality traits underlie the meta-structure of psychopathology in general and describe the myriad manifestations of personality disorders (PDs) specifically. Domains of personality functioning distinguish personality st...

Much of the research on identifying feigning in psychological assessment has focused on adults with less attention to adolescents. The purpose of the present study is to expand the limited literature on detecting feigning in adolescents using the Personality Assessment Inventory – Adolescent. The study included 114 nonclinical adolescents (ages 15...

This study examined the ability of several Personality Assessment Inventory (PAI) validity indicators to detect feigning of post-traumatic stress disorder (PTSD). Participants included 491 individuals recruited through Amazon Mechanical Turk (MTURK): 44 participants were asked to feign PTSD, 25 participants carried a diagnosis of PTSD and demonstra...

Objective: Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alte...

Converging lines of evidence suggest that personality pathology comprises shared and unique impairments. We leveraged a large clinical sample ( N = 505) and a person-centered statistical approach, ipsative change analysis, to decompose individuals’ multidimensional profiles at two time points into a metric that captures change in the elevation of t...

Sleep, Lynam, Widiger, Crowe, and Miller (2019) discuss a number of concerns previously raised with respect to the distinction between impairment and trait in the Alternative Model of Personality Disorders (AMPD). In particular, they cite issues of overlap between the 2 as raising concerns about parsimony of representation. In this response, I brie...

In a recent article, Sleep, Lynam, Widiger, Crowe, and Miller (2019) examined various properties of measures of Criterion A and Criterion B of the Alternative Model for Personality Disorders presented in DSM-5. This commentary discusses the suitability of certain indicators of factor structure, discriminant validity, and incremental validity as eva...

Although the Personality Assessment Screener (PAS; Morey, 1997) has garnered substantial research interest, the measure's temporal stability and sensitivity to change have remained largely uninvestigated. The present study employs a dynamic approach to investigating the convergent and discriminant validity of the PAS by examining relationships betw...

The categorical model of personality disorder classification in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013) is highly and fundamentally problematic. Proposed for DSM–5 and provided within Section III (for Emerging Measures and Models) was the...

Objective: This study extends upon the investigation of the influence of response format on the convergence between performance-based and self-report assessments of similar mental health constructs, to further examine the role of method variance in poor heteromethod convergence. Methods: An online sample of 455 participants (57% male; mean age =...

The present study was intended to assess the reliability of clinician judgments, with a particular interest in how such judgments vary by the gender of the case vignette and clinician. A national sample of 123 mental health professionals (57.7% male) provided clinical judgments on 12 case vignettes primarily representing personality pathology; two...

The authors asked 361 personality disorder experts to rank order their preferences for a categorical, dimensional, or mixed/hybrid approach to personality disorder diagnosis in manuals such as the DSM and ICD. Respondents reported a general preference for the mixed/hybrid approach over a purely dimensional approach, and a clear preference against a...

This study examined the interdiagnostician reliability and potential gender bias of the DSM-IV/DSM-5 Section II and DSM-5 Alternative Model definitions of borderline personality disorder. A national sample of 123 mental health professionals provided diagnostic judgments on 12 case vignettes selected to represent a range of personality pathology. Tw...

Converging lines of evidence suggest that personality pathology is comprised of shared and unique impairments. The current study leveraged a large clinical sample (N=505) and a person-centered statistical approach, ipsative change analysis, to decompose individuals’ multidimensional profiles at two time points into a metric which captures change in...

Objective This study presents an examination of the influence of response format on convergence between performance‐based and self‐report assessments of similar mental health constructs, to determine if such method variance might account for prior findings of lack of relationship. Methods An online sample of 455 participants (57% male; average age...

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is ge...

The Continuous Assessment of Interpersonal Dynamics (CAID) is a method in which trained observers continuously code the dominance and warmth of individuals who interact with one another in dyads. This method has significant promise for assessing dynamic interpersonal processes. The purpose of this study was to examine the impact of individual sex,...

Questionnaire items and scoring instructions for the Level of Personality Functioning Scale - Self Report questionnaire from Morey, L.C. (2017). Development and initial evaluation of a self-report form of the DSM-5 Level of Personality Functioning Scale. Psychological Assessment, 29, 1302-1308. DOI: 10.1037/pas0000450.supp

Borderline personality disorder (PD) has historically been cast as an unabating condition. Longitudinal data, however, support a more variable time course marked by remission and relapse. In the present study, we tested the possibility that borderline PD has both stable (i.e., consistently present across time and situation, as modern diagnostic sys...

This study set out to create measures of the five personality disorder trait domains outlined in Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychiatric Association, 2013) from the Personality Assessment Inventory items (Morey, 2007). Rasch rating scale model analyses and classical test theory a...

As the research literature on the Personality Assessment Inventory (PAI; Morey, 1991) has expanded, several supplemental indicators have been introduced to aid in the interpretation of PAI results for the purpose of addressing particular assessment questions, such as protocol validity or treatment-related considerations. However, many of these indi...

Examines impacts of familiarity, conflict, and sex on continuously assessed behavior in dyadic interactions using the Continuous Assessment of Interpersonal Dynamics across several samples. Establishes norms and basic psychometrics for CAID while also informing factors that influence interpersonal behavior.

The categorical model of personality disorder classification in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psyc...

As online data collection services such as Amazon’s Mechanical Turk (MTurk) gain popularity, the quality and representativeness of such data sources have gained research attention. To date, the majority of existing studies have compared MTurk workers with undergraduate samples, localized community samples, or other Internet-based samples, and thus,...

In this study we examined the structure, reliability, and validity of the Levels of Personality Functioning Scale–Self Report (LPFS–SR) in 3 large community samples. The LPFS–SR is a questionnaire with content that corresponds directly to the DSM–5 alternative model of personality disorders, Criterion A. We found that the LPFS–SR was highly reliabl...

This study examined the cross-cultural comparability of the Personality Assessment Inventory (PAI: Morey, 1991) in Vietnam, employing a sample of 128 nonclinical Vietnamese native speakers and 53 bilingual Vietnamese/English speakers. The Vietnamese version demonstrated comparable internal consistency to that obtained in the original PAI US standar...

Attention Deficit Hyperactivity Disorder (ADHD) is a diagnosis of particular significance for college students, as when present it can significantly compromise academic achievement. However, because high-stakes decisions may be riding on the outcome of an ADHD evaluation (such as access to educational accommodations or stimulant medication), the di...

Validation of the Levels of Personality Functioning Scale - Self-Report. Results suggest that the measure has a robust single dimension and that it correlates in a very general manner with a wide range of maladaptive personality variables, consistent with its purpose as a measure of non-specific personality pathology.

One concern that has been expressed with the Alternative Model for Personality Disorders (AMPD) presented in DSM-5 is that the description of characteristic impairments in personality function uses concepts requiring considerable experience and clinical inference to apply. To examine this question, the individual indicators included in the AMPD's L...

Against the background of a dearth of studies examining the properties of the scale scores of the Personality Assessment Inventory–Adolescent (PAI–A; Morey, 2007), this study was conducted to evaluate evidence of construct validity for the Anxiety (ANX) and Depression (DEP) scales of the PAI–A. Convergent and discriminant validity of the ANX and DE...

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) Section III Alternative Model for Personality Disorders (AMPD; APA, 2013) represents an innovative system for simultaneous psychiatric classification and psychological assessment of personality disorders (PD). The AMPD combines major paradigms of personality assessment...

The reliability and validity of traditional taxonomies are limited by arbitrary boundaries between psychopathology and normality, often unclear boundaries between disorders, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. These taxonomies went beyond evidence available on the structure of psychopathology...

Questionnaire items and scoring instructions for the Level of Personality Functioning Scale - Self Report questionnaire from Morey, L.C. (2017). Development and initial evaluation of a self-report form of the DSM-5 Level of Personality Functioning Scale. Psychological Assessment, 29, 1302-1308.

The DSM-5 presents an Alternative Model for Personality Disorder (AMPD) recommending the assessment of impairments in core personality functions as well as clinically relevant personality traits. Although a self-report assessment instrument has been provided corresponding to the trait model proposed in the AMPD, no comparable instrument provides a...

A substantial amount of research has examined the developmental trajectory of antisocial behavior and, in particular, the relationship between antisocial behavior and maladaptive personality traits. However, research typically has not controlled for previous behavior (e.g., past violence) when examining the utility of personality measures, such as...

Theorists have long argued that personality disorder (PD) is best understood in terms of general impairments shared across the disorders as well as more specific instantiations of pathology. A model based on this theoretical structure was proposed as part of the DSM–5 revision process. However, only recently has this structure been subjected to for...

Individuals with a personality disorder (PD) tend to experience more negative life events (NLEs) than positive life events (PLEs). In community samples, the Five Factor Model of personality (FFM) predicts both positive and negative life events. The present research examined whether FFM normal personality traits were associated with positive and neg...

Section III of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013) contains an alternative model for the diagnosis of personality disorder involving the assessment of 25 traits and a global level of overall personality functioning. There is hope that this model will be increasingly use...

In an initial investigation by Morey and Ochoa (1989), adherence to DSM-III personality disorder diagnostic criteria was examined as an agreement rate between clinician (global) diagnoses and diagnoses algorithmically generated from DSM-III criteria rules. Morey and Ochoa (1989) findings suggested significant clinician-criterion diagnostic incongru...

Background: Beginning with DSM-III, the inclusion of a "personality" axis was designed to encourage awareness of personality disorders and the treatment-related implications of individual differences, but since that time there is little accumulated evidence that the personality disorder categories provide substantial treatment-related guidance. Th...

The present study is the first to investigate the Personality Assessment Screener, a brief self-report measure of risk for emotional and behavioral dysfunction, in relation to the informant report version of this instrument, the Personality Assessment Screener-Other. Among a sample of undergraduate roommate dyads (N = 174), self-report and informan...

This case illustrates the utility of incorporating therapeutic assessment in a triage context that typically involves a focus on gathering information. A man referred to our clinic by a local mental health center was seen by our assessment team for a triage that includes the administration of a single psychological test, the Personality Assessment...

A number of studies have evaluated the possibility of bias in the diagnostic criteria in borderline personality disorder as an explanation of gender differences in prevalence. Previous studies have used both regression and latent trait approaches but the results have been inconsistent. The current study extended prior investigations in testing diff...

The DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DS...

Although originally developed to estimate the probability of winning percentage when two teams from the same league are matched, the log5 formula suggested by Bill James has often been applied to evaluate probabilities of events resulting from specific batter/pitcher matchups in baseball. However, this odds-ratio based formula may have biases of es...

A Young Attorney Presents for Outpatient Treatment of Depression Ms.Bisa32-year-oldsingleCaucasianwomanwhowasreferred byafriend’spsychiatristformentalhealthtreatmentforthe first time after a 4-month period of depression. She reported persistent feelings of “emptiness” and “worthlessness,” increased sleeping with difficulty getting out of bed, impai...

Research on borderline personality disorder (BPD) has consistently found that those with the disorder often experience volatile interpersonal interactions, and several areas of research have been dedicated to the understanding of the mechanisms behind these interpersonal struggles. One of the most common theories is that the emotional dysregulation...

The literature on the prevalence of borderline personality disorder (BPD) across gender reveals multiple trends. A number of studies indicate that women have a higher prevalence. Others indicate no difference, and a few even reveal that men have a higher prevalence. Yet existing studies are plagued by sampling biases, use mainly self-reported infor...

Objective: This report examines the relationship of DSM-IV borderline personality disorder (BPD) to anxiety disorders using data on the reciprocal effects of improvement or worsening of BPD and anxiety disorders over the course of 10 years. Method: We reliably and prospectively assessed borderline patients (n = 164) with DSM-IV-defined co-occurr...

The current categorical classification of personality disorders, originally introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), has been found to suffer from numerous shortcomings that hamper its usefulness for research and for clinical application. The Personality and Personality Disorders Work Group for DSM-5 was ch...

The Personality Assessment Inventory ( PAI ) is a multiscale personality inventory that measures a variety of constructs relevant to clinical diagnosis and decision making. The PAI is a questionnaire that has 344 self‐reported items arranged into 22 full scales, with various subscales and supplemental indices available to refine interpretation. Fir...

Past research has established strong psychometric properties of several indicators of response distortion on the Personality Assessment Inventory (PAI). However, to date, it has been unclear whether the response distortion indicators of the adolescent version of the PAI (PAI-A) operate in an equally valid manner. The current study sought to examine...

Objective: To examine the relationship of borderline personality disorder (BPD) to mood disorders by using data from the Collaborative Longitudinal Personality Disorders Study on the reciprocal interactions of BPD with both depressive and bipolar disorders over the course of 10 years. Method: The study included 223 BPD patients with DSM-IV-defin...

This study compared the perceived clinical utility of DSM-IV-TR personality disorder diagnoses (retained in DSM-5) with the alternative model presented in DSM-5 Section III, using a national sample of clinicians applying both systems to their own patients. A sample of 337 mental health clinicians (26% psychiatrists, 63% psychologists, and 11% other...

Background: Many treatments for Borderline Personality Disorder (BPD) are based upon the hypothesis that gross distortion in perceptions and attributions related to self and others represent a core mechanism for the enduring difficulties displayed by such patients. However, available experimental evidence of such distortions provides equivocal res...

Although score reliability is a sample-dependent characteristic, researchers often only report reliability estimates from previous studies as justification for employing particular questionnaires in their research. The present study followed reliability generalization procedures to determine the mean score reliability of the Eating Disorder Invento...

An alternative model for the diagnosis of personality disorders (PDs), based on assessments of impairments in personality functioning and of pathological personality traits, was intended for the official classification in the Diagnostic and Statistical Manual for Mental Disorders-Fifth Edition (DSM-5), but was instead placed in Section III, "Emergi...

Presents a rejoinder to comments by Silk (see record 2013-45025-005) and Zimmerman (see record 2013-45025-006) on the original article by Skodol et al. (see record 2013-45025-004) regarding personality disorders in the DSM-5. Here, Skodol et al. comment that many of the early decisions made by the Diagnostic and Statistical Manual of Mental Disorde...

Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously establishe...

The authors sought to determine whether a 5-point global rating of personality dysfunction on the Level of Personality Functioning Scale proposed as a severity index for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), would be related to DSM-IV personality disorder diagnosis as well as to other key clinical judgments. Da...

The validity of various indicators of response distortion on the Personality Assessment Inventory-Adolescent (PAI-A; Morey, 2007a) and its potential usefulness to detect malingering were evaluated by having 17- and 18-year-old students complete the PAI-A attempting to simulate Attention-Deficit/Hyperactivity Disorder (ADHD) under coached or noncoac...