Table 1 DSM-5 Level of Personality Functioning Scale (APA, 2013; p. 775–777)
From: The role of identity in the DSM-5 classification of personality disorders
Self | Interpersonal | |||
|---|---|---|---|---|
Level | Identity | Self-direction | Empathy | Intimacy |
0 Little or no im-pairment | - Has ongoing awareness of a unique self; maintains role-appropriate boundaries- … | - Sets and aspires to reasonable goals based on a realistic assessment of personal capacities- … | - Is capable of accurately understanding others’ experiences and motivations in most situations- … | - Maintains multiple satisfying and enduring relationships in personal and community life- … |
1 Some impairment | - Has relatively intact sense of self, with some decrease in clarity of boundaries when strong emotions and mental distress are experienced- … | - Is excessively goal-directed, somewhat goal-inhibited, or conflicted about goals.- … | - Is somewhat compromised in ability to appreciate and understand others’ experiences; may tend to see others as having unreasonable expectations or a wish for control.- … | - Is able to establish enduring relationships in personal and community life, with some limitations on degree of depth and satisfaction.- … |
2 Moderate impairment | - Depends excessively on others for identity definition, with compromised boundary delineation.- … | - Goals are more often a means of gaining external approval than self-generated, and thus may lack coherence and/or stability.- … | - Is hyperattuned to the experience of others, but only with respect to perceived relevance to self.- … | - Is capable of forming and desires to form relationships in personal and community life, but connections may be largely superficial.- … |
3 Severe impairment | - Has a weak sense of autonomy/agency; experience of a lack of identity, or emptiness. Boundary definition is poor or rigid: may show overidentification with others, overemphasis on independence from others, or vacillation between these.- … | - Has difficulty establishing and/or achieving personal goals.- … | - Ability to consider and understand the thoughts, feelings and behavior of other people is significantly limited; may discern very specific aspects of others’ experience, particularly vulnerabilities and suffering.- … | - Has some desire to form relationships in community and personal life is present, but capacity for positive and enduring connections is significantly impaired.- … |
4 Extreme impairment | - Experience of a unique self and sense of agency / autonomy are virtually absent, or are organized around perceived external persecution. Boundaries with others are confused or lacking.- … | - Has poor differentiation of thoughts from actions, so goal-setting ability is severely compromised, with unrealistic or incoherent goals.- … | - Has pronounced inability to consider and understand others’ experience and motivation.- … | - Desire for affiliation is limited because of profound disinterest or expectation of harm. Engagement with others is detached, disorganized or consistently negative.- … |