772 Alternative DSM-5 Model for Personality Disorders
Self- and Interpersonal  Functioning 
Dimensional Definition
Generalized severity may be the most import ant single predictor of concurrent and pro-
spective dysfunction in assessing personalit y psychopathology. Pers onality disorders are
optimally characterized by a generalized pers onality severity continuum with additional
specification of stylistic elem ents, derived from personalit y disorder symptom constella-
tions and personality traits. At the same time , the core of personality psychopathology is
impairment in ideas and feelin gs regarding self and interper sonal relationships; this no-
tion is consistent with multiple theories of personality disorder and their research bases. The
components of the Level of Personality Func tioning Scale—identity, self-direction, empa-
thy, and intimacy (see Table 1)—are particularly  central in describing a personality func-
tioning continuum.
Mental representations of the self and interpersonal relationships are reciprocally in-
fluential and inextricably tied , affect the nature of interaction with mental health pro-
fessionals, and can have a significant impact  on both treatment efficacy and outcome,
underscoring the importance of assessing an individual’s characteristic self-concept as
well as views of other people and relationships. Although the degree of disturbance in the
self and interpersonal functioning is continuous ly distributed, it is useful to consider the
level of impairment in functioning for clinical characterization and for treatment planning
and prognosis.
Rating Level of Pers onality Functioning
To use the Level of Personality Functioning Sc ale (LPFS), the clinician selects the level that
most closely captures  the individual’s current overall  level of impairment in personality func-
tioning. The rating is necessary for the diagnosi s of a personality disord er (moderate or greater