Reference
Guide | Reference

46  Personality Functioning (Dimensional)

46.1 Summary

  • A dimensional construct describing stability of self-functioning and quality of interpersonal functioning.

46.2 Core Construct

  • Consistency of identity, self-direction, empathy, and intimacy over time.

46.3 Subdimensions

  • Self: identity and self-direction.
  • Interpersonal: empathy and intimacy.

46.4 Severity Anchors (0-4)

  • 0: Stable self and relationships; flexible functioning.
  • 1: Mild instability or relational strain.
  • 2: Moderate instability with recurring impairment.
  • 3: Severe instability with chronic impairment.
  • 4: Extreme dysfunction with high risk or incapacity.

46.5 Time-Course Patterns

  • Chronic and longstanding.
  • Fluctuates with stress and relational context.

46.6 Functional Impact

  • Work/school: conflict, inconsistency, instability.
  • Relationships: intense, unstable, or avoidant patterns.
  • Self-care: impulsive or self-damaging behavior.

46.7 Developmental Expression

  • Adolescence: identity instability and relational volatility.
  • Adulthood: entrenched patterns.
  • Late life: isolation or rigidity.

46.8 Cultural / Context Notes

  • Norms for identity and relationships vary by culture.
  • Context can mask or amplify impairment.

46.9 Differential and Rule-Outs

  • Trauma-related dysregulation.
  • Mood episodes with interpersonal effects.
  • Substance-driven impulsivity.

46.10 Measurement Prompts

  • Brief personality functioning screening.
  • Collateral reports when available.

46.11 Treatment-Relevant Correlates (non-prescriptive)

  • Higher severity predicts broader impairment and risk.

46.13 Documentation Snippet (1-2 lines)

  • “Marked instability in identity and relationships; Personality Functioning 3; chronic course.”