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Given the heterogeneity of BPD symptomatology and the current shift toward dimensional assessments of personality disorders, this study investigates whether dimensional measures according to the DSM-5\u2019s Alternative Model for Personality Disorders (AMPD) may serve as additional markers of treatment outcome and dropout. Eighty-five participants with BPD were recruited from a naturalistic inpatient DBT program. Associations between BPD symptoms (Borderline Symptom List, Borderline Personality Disorder Severity Index), personality functioning (Level of Personality Functioning Scale \u2013 Brief Form 2.0), and dysfunctional personality traits (Personality Inventory for DSM-5 and ICD-11 \u2013 Brief Form Plus) were examined at baseline, as well as their sensitivity to change after DBT. At baseline, both personality functioning and dysfunctional personality traits, except antagonism, were associated with BPD symptoms (all\n                    <jats:italic>r<\/jats:italic>\n                    \u2009\u2265\u20090.4). After 10 weeks of DBT, parallel improvements were observed in personality functioning and dysfunctional personality traits, with significant reductions in negative affectivity and detachment. Elevated baseline levels of negative affectivity and psychoticism were associated with less BPD symptom change. DBT dropout was linked to higher impairment in negative affectivity and anankastia at admission. Personality functioning showed greater sensitivity to change throughout DBT compared to dysfunctional personality traits. These findings emphasize how AMPD may yield benefits beyond categorical BPD diagnoses, potentially contributing to more personalized and effective treatment planning and preventing dropouts.\n                  <\/jats:p>","DOI":"10.1007\/s00406-026-02215-z","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T13:27:43Z","timestamp":1778246863000},"page":"2159-2172","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes of borderline symptoms, personality functioning, and dysfunctional personality traits after dialectical-behavioral therapy in borderline personality disorder"],"prefix":"10.1007","volume":"276","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4273-3432","authenticated-orcid":false,"given":"Julia I.","family":"Kunz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Zwick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Boll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Meinhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrina","family":"H\u00fcttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Grigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Musil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Goerigk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Jobst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Padberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias A.","family":"Reinhard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"2215_CR1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders: DSM-5","author":"American Psychiatric Association","year":"2013","unstructured":"American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. 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He has received speaker\u2019s honoraria from Mag&More GmbH and the neuroCare Group. His lab has received support with equipment from neuroConn GmbH, Ilmenau, Germany, and Mag&More GmbH and Brainsway Inc., Jerusalem, Israel. RM has received financial research support from the EU (H2020 No. 754740) and served as PI in clinical trials from Abide Therapeutics, B\u00f6hringer-Ingelheim, Emalex Biosciences, Lundbeck GmbH, Nuvelution TS Pharma Inc., Oryzon, Otsuka Pharmaceuticals and Therapix Biosciences. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was part of an ongoing naturalistic study of the Department of Psychiatry and Psychotherapy of the LMU University Hospital, LMU Munich, Germany (German Clinical Trial Register ID: DRKS00019821) which was approved by the local ethics committee of the Faculty of Medicine, LMU Munich (EK-No. 713\u2009\u2212\u200915). The study was designed in accordance with the Declaration of Helsinki of 1964 as well as its subsequent amendments. All methods followed the German Psychological Society\u2019s ethical guidelines, a German adaptation of the \u201cEthical Principles of Psychologists and Code of Conduct\u201d of the American Psychiatric Association.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All participants gave written informed consent.","order":3,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All participants gave written informed consent regarding publishing.","order":4,"name":"Ethics","label":"Consent to Publish","group":{"name":"EthicsHeading","label":"Declarations"}}]}}