The ICD-11 Classification of Personality Disorders and the DSM-5 Alternative Model of Personality Disorders (AMPD) operate with trait domains that contribute to the individual expression of personality disturbance (i.e., negative affectivity, detachment, dissociality, disinhibition, anankastia, and psychoticism). To date, these trait frameworks have not been investigated sufficiently in Middle Eastern cultures. Thus, the present study explored the structure of the ICD-11 and AMPD personality disorder (PD) trait domains in a large mixed sample from the Kurdistan zone of Iran. The ICD-11 and AMPD trait domains were operationalized using empirically supported algorithms for the Personality Inventory for DSM-5 (PID-5). The PID-5 was administered to a large mixed sample (N = 3,196) composed of 2,678 community and 518 clinical participants. Structural validity was investigated using Exploratory Factor Analysis (EFA), whereas differential construct validity was explored by comparing clinical and community scores. Model fit and the expected factor structure were deemed appropriate for the ICD-11 trait model, but less adequate for the DSM-5 trait model (i.e., disinhibition did not emerge as a separate factor). All domain and facet scores showed significant differences between clinical and community subsamples with moderate to large effects, mostly for disinhibition and dissociality/antagonism while least for anankastia. The findings of the present study may suggest that the ICD-11 trait model is more cross-culturally fitting than the DSM-5 AMPD trait model, at least with respect to a large mixed sample from the region of Kurdistan. Accordingly, there is evidence for using PID-5 data for WHO ICD-11 purposes in this part of the World.

Objective To explore the relationship between temperament and character traits in Cloninger’s psychobiological theory and mental disorders. Methods: A systematic literature search was conducted of five international databases for all articles published in English between January 1990 and April 2019 (PROSPERO-CRD42019133214). Owing to heterogeneity, pooled estimates of correlations for personality disorders and standardized mean differences for case–control studies related to other mental disorders were calculated using the random-effects method. Results The pooled effect sizes obtained from 149 studies showed that high harm avoidance (related to 22/24 diagnostic categories), low self-directedness (21/23), low cooperativeness (17/23), high self-transcendence (14/23), low reward dependence (11/24), high novelty-seeking (10/24), low novelty-seeking (7/24), high persistence (2/23), low persistence (2/23) and high reward dependence (2/24) were related to psychopathology. Conclusions All traits provided unique psychobiological tools for differential diagnosis of mental disorders. However, high harm avoidance and low self-directedness played a canonical role in psychopathology. Despite the study limitations, additional studies are warranted to evaluate the differential diagnoses suggested by the present model.

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 the psychometrics of the translated measure in a sample of 471 college students and 142 hospitalized patients with a diagnosed personality disorder (PD). Results indicate that the Persian translation of the LPFS-SR is highly internally consistent and concurrently valid with related indicators of personality pathology. Additionally, the LPFS-SR significantly discriminated between the college sample and clinical sample, while also demonstrating considerable incremental validity over the Structured Clinical Interview for DSM-IV-TR Axis II Personality Questionnaire (SCID-II-PQ) in the prediction of personality disorder diagnosis. The majority of indices supported a unidimensional structure for the LPFS-SR. Six items showed negative item-total correlations and may necessitate refinement in order to capture pathology-related content more adequately for Iranian culture. Overall, the findings of the present study support the use of the Persian translation of the LPFS-SR.

The current classification of personality disorder in ICD-11 includes a description of personality functioning, derived from a number of theoretical paradigms, but most notably consistent with the psychodynamic approach. Concurrently, an object-relations model of personality functioning in a dimensional assessment of severity is provided in the Structured Interview of Personality Organization-Revised (STIPO-R). To date, there are no published measures of International Classification of Diseases-11 (ICD-11) personality severity, though the construct is very comparable to the concepts assessed in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) levels of personality functioning concept, which is measured by the Level of Personality Functioning Scale-Self-Report (LPFS-SR). This study examined the validity of ICD-11 personality functioning, as measured by the LPFS-SR, by evaluating its associations with the STIPO-R in Kurdistan region. The samples included 231 University students and 419 inpatient participants across four hospitals (267 with a diagnosed personality disorder). All the components of LPFS-SR and STIPO-R were positively and significantly intercorrelated. The components of each measure discriminated PD and non-PD patients from a University, non-clinical group adequately. Despite slightly better performance of the STIPO-R in this discrimination, the measures had a high congruence in predicting personality dysfunction. Overall, the findings of the present study support the validity of ICD-11 construct for evaluating personality functioning.

BackgroundThe present study was conducted to determine the differential profile of social anxiety disorder (SAD) and avoidant personality disorder (APD) based on dimensional diagnosis in criterion B of the DSM-5 Alternative Model for Personality Disorders (DSM-5-AMPD) in a college sample.MethodsSamples of this cross-sectional study included 320 (23.08 ± 2.66 years; 57% female) college students in western Iran during February 2015 to December 2017. Liebowitz-social anxiety scale, PID-5, SCID-II, SCID-II-SQ and diagnostic interview for SAD were the tools. The data were analysed using Pearson correlation and multiple linear regression analysis.ResultsForty-three and 38 participants met criteria for SAD alone and APD, respectively. Five main domains of PID-5 could explain 29% and 54% of the variance of SAD and APD, respectively. Facets of negative affect, detachment, antagonism, disinhibition, and psychoticism could explain 25% versus 43%, 26% versus 54%, 7% versus 27%, 21% versus 41%, 13% versus 30% of the variance of SAD and APD, respectively.ConclusionSAD and APD probably refer to two distinct mental states having prominent anxiety, emotional instability, and interpersonal pattern of avoidance and detachment of challenge. SAD is a simple form of mental disturbances with anxiety in its core features; although, APD is possibly referring to more complicated psychopathology.

Background: The main aim of this study was to determine whether childhood sexual abuse (CSA) is reflected in the pathological traits of the alternative model of personality disorders (AMPD) in section-III of DSM-5 and Cloninger’s temperament and character profiles. Methods: The Persian versions of Personality Inventory for DSM-5 (PID-5), Temperament and Character Inventory (TCI-125), and Structured Clinical Inventory for DSM-IV-TR-Axis II-Screening Questionnaire (SCID-II-SQ) were administered to 43 Iranian college students who reported a history of CSA and 390 participants who did not. Bivariate Pearson correlations and general linear model repeated measures (GLMRM) were used to compare results. Results: Bivariate correlations indicated that both the PID-5 and TCI-125 were significantly associated with their relevant personality disorders. Profile analysis showed that the pathological trait domains of the PID-5, except for negative affectivity, were significantly greater in those with an experience of CSA. Of the seven dimensions of TCI-125, novelty seeking and persistence were higher in those with an experience of CSA, but reward dependence, self-directedness, and cooperativeness were lower. Conclusions: These results confirmed a correlation between CSA and personality dysfunction. The pattern of dysfunction was complex and somewhat different from the two facet measures used.

Background The Personality Inventory for DSM-5 (PID-5) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) are tools designed for personality dispositions for mental health symptoms. The present study was conducted to compare these models in terms of their relative sensitivity to the symptoms of personality disorders (PDs) and non-personality disorders (NPDs). Methods Subjects in this cross-sectional study were 1232 (805 female; 63.5%) community samples in western Iran. Data were collected using the PID-5, the TEMPS-A, the Symptom Checklist-90 (SCL-90-R), and the Personality Diagnostic Questionnaire (PDQ-4). Correlations and Regression models were used to examine associations between traits and symptoms. Results Maladaptive traits assessed by the PID-5 were more strongly associated with PD symptoms, whereas affective temperaments measured by the TEMPS-A were more strongly associated with NPD symptoms. Conclusion The present findings highlighted the practical utility of both the PID-5 and TEMPS-A indicating risk for psychopathology, but also suggest a distinction between PDs and NPDs in terms of underlying personality dispositions.

The systematic review aims to identify four personality temperament models related to somatoform disorder with the main focus on the meta-analysis of temperaments and characters in Cloninger's theory. The literature search was performed on PubMed (Medline), Scopus, Web of Science, Cochrane, and ProQuest for all articles published in English from January 1990 to April 2019. Due to heterogeneity, pooled estimates of the standard mean difference between cases and controls were calculated using the random-effects model. Based on our inclusion criteria, 14 studies were identified, 7 of which were included in the meta-analysis. The results show that there is a significant difference between cases and controls with regard to harm avoidance (HA) ( z = 5.322, P < 0.001), self-directedness ( z = −4.719, P < 0.001), and self-transcendence ( z = 2.848, P = 0.004). Compared to controls, HA and self-transcendence were higher and self-directedness was lower in cases. With regard to other subscales, there was no difference between the two groups ( P > 0.05). The publication bias was not seen ( P > 0.05 for Egger statistics). Up to now, very few studies have been focused on the relationship between personality temperament models and somatoform disorder. Among the components of the Cloninger's model, the poor self-directedness along with the abnormally high self-transcendence and HA is the personality component related to the somatoform disorder. Thus, Cloninger's model may potentially draw a personality profile for vulnerability to somatoform disorder. Given the limited number of studies available, future studies may challenge the results of the present study.