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.

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.

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.

The antisocial and violent behaviors of cult‐like religious groups (CRGs) and the maladaptive social consequences of their activities suggest clinical or character pathology and invite diagnostic and dynamic formulations of their members' personalities. The current study utilized secondary reports in the commercial media about CRG members, combined with the lived experience method of two of the authors. The resulting core characteristics of CRG members were then classified following the alternative DSM‐5 alternative model for personality disorders. The overall clinical picture is then discussed in terms of the shared psychodynamic sources that undergird the behaviors of the antisocial‐obsessive‐compulsive personality disorders. By tracing the personality characteristics into their unconscious sadomasochistic conflicts, these insights shed light on the paradoxical frequent co‐occurrence of antisocial and obsessive‐compulsive characteristics among extremists, in contrast to the patient population at large.

Objectives Intensive short‐term dynamic psychotherapy (ISTDP) requires the technique of challenge to defenses when treating resistant patients. As the technique of challenge is difficult for some therapists to practice, it leads us to question whether challenge can be replaced by clarification of defenses without losing treatment effectiveness. This study compared ISTDP with two different technical emphases while treating social anxiety disorder (SAD). Method Forty‐two subjects with DSM‐5 SAD were randomly assigned to either a waitlist control, 10 sessions of ISTDP with the use of challenge or 10 sessions of ISTDP without the use of challenge. Results ISTDP led to significant, sustained symptom reduction on the Liebowitz Social Anxiety Scale (LSAS‐SR) compared with the control group. There were no significant outcome differences between standard ISTDP and ISTDP where challenge was restricted. Conclusion ISTDP is efficacious for SAD. ISTDP may be effective for SAD without the use of challenge elements.

This research examined the efficacy of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of social anxiety disorder (SAD) and compared the therapeutic outcomes of ISTDP when feeling focus or defense work is emphasized. A three-group randomized design with 6-month follow-up was used. Forty-one subjects were selected among volunteer college students diagnosed with SAD. They were assigned randomly into three groups; 14 cases to feeling-focused ISTDP (FF-ISTDP) group, 14 cases to defense-focused ISTDP (DF-ISTDP) group, and 13 cases to a control group. All subjects were evaluated at pretest, posttest, and six-month follow-up through clinical interviewing using DSM-5 criteria for SAD along with the Liebowitz Social Anxiety Scale. Each experimental group had a course of 8 to 10 sessions of ISTDP treatment. Analysis of variance showed that ISTDP is an effective treatment for SAD compared with a control group. No outcome differences were found between FF-ISTDP and DF-ISTDP in treating SAD.

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