Clinical Implications of ICD-11 for Diagnosing and Treating Personality Disorders

Bach, Bo; Mulder, Roger

doi:10.1007/s11920-022-01364-x

Cited by 7 publications

(12 citation statements)

References 96 publications

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“…The convergent validity of the PID5BF+M was investigated by means of correlations with NEO-FFI. In line with previous studies, the AMPD and ICD-11 trait domains were significantly associated with corresponding FFM domain scores: negative affectivity with neuroticism (r = 49), detachment with reversed extraversion (r = −60), antagonism with reversed agreeableness (r = −34), disinhibition with reversed conscientiousness (r = −47), and anankastia with conscientiousness (r = 26; Al-Dajani et al, 2016;Bach & Mulder, 2022b).…”

Section: Alignment With Big Five Personality Traitssupporting

confidence: 90%

“…Likewise, the World Health Organization's (WHO) International Classification of Diseases 11th revision (ICD-11) classification of PD is based on global severity of personality dysfunction, which may be further characterized by five stylistic trait domain specifiers (i.e., negative affectivity, detachment, dissociality, disinhibition, and anankastia) along with an optional "borderline pattern specifier" (World Health Organization [WHO], 2022). A large body of research on the AMPD and the ICD-11 trait models have already yielded an emerging foundation for informing clinical assessment and treatment planning (Bach & Mulder, 2022a, 2022bBach & Tracy, 2022;Tracy et al, 2021;Zimmermann et al, 2019).…”

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confidence: 99%

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Evaluation of a 36-item measure of ICD-11 and DSM-5 personality disorder trait domains and facets in Russian inpatients.

Zinchuk¹,

Kustov²,

Bach³

et al. 2023

Psychological Assessment

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The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) and International Classification of Diseases 11th revision (ICD-11) have introduced a new dimensional approach to personality disorder (PD) classification that relies on the global level of PD severity and individual expressions of personality dysfunction in terms of specified trait domains (i.e., negative affectivity, detachment, antagonism, disinhibition, anankastia, and psychoticism). This study sought to evaluate the psychometric qualities of the DSM-5 and ICD-11 trait domains and facets in 570 Russian psychiatric inpatients using the Modified 36-Item Personality Inventory for DSM-5 and ICD-11 Brief Form Plus-Modified (PID5BF+M). The expected six-factor structure of the DSM-5 and ICD-11 trait domains was replicated using exploratory factor analysis. The six domain scores showed expected convergence with normal five-factor model scores, and the 18 subfacets showed acceptable scale reliability. Our findings overall support the psychometric properties of the six PID5BF+M domain scores and 18 subfacet scores covering both the ICD-11 and the DSM-5 trait models. Consequently, clinicians and researchers in Russian-speaking mental health services are now able to perform a combined and facet-level assessment of the DSM-5 and ICD-11 trait models in a feasible and psychometrically sound manner. Public Significance StatementThis study shows that the combined six domains and 18 primary subfacets of the DSM-5 and International Classification of Diseases 11th revision trait models can be measured in Russian mental health care in a psychometrically sound manner using a 36-item patient-reported instrument: Personality Inventory for DSM-5 and ICD-11 Brief Form Plus-Modified (PID5BF+M).

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Section: Alignment With Big Five Personality Traitssupporting

confidence: 90%

mentioning

confidence: 99%

Evaluation of a 36-item measure of ICD-11 and DSM-5 personality disorder trait domains and facets in Russian inpatients.

Zinchuk¹,

Kustov²,

Bach³

et al. 2023

Psychological Assessment

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“…In terms of personality functioning, emerging evidence suggests the use of severity- and trait-informed treatment methods. In addition, the different facets described by the AMPD or ICD-11, may help clinicians to identify individual problems across domains (e.g., identity, self-reflection, emotion regulation, and interpersonal security), resulting in more tailor-made treatments [ 78 ]. Combined with trauma-informed practices, such interventions could help maltreated children and adolescents to develop more adaptive self-concepts, self-direction, and emotion regulation capacities, which, in turn, could potentially mitigate psychopathological outcomes.…”

Section: Discussionmentioning

confidence: 99%

Personality functioning and the pathogenic effect of childhood maltreatment in a high-risk sample

d’Huart

Hutsebaut

Schmid

et al. 2022

Child Adolesc Psychiatry Ment Health

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Background While the psychopathological sequalae of childhood maltreatment are widely acknowledged, less is known about the underlying pathways by which childhood maltreatment might lead to an increased risk for mental health problems. Recent studies indicated that impaired personality functioning might mediate this relationship. The aim of the present paper was to extend the current literature by investigating the mediating effect of impaired personality functioning between different types of childhood maltreatment and self-reported mental health problems in a high-risk sample. Methods Overall, 173 young adults (mean age = of 26.61 years; SD = 3.27) with a history of residential child welfare and juvenile justice placements in Switzerland were included in the current study. The Childhood Trauma Questionnaire (CTQ-SF), Semi-structured Interview for Personality Functioning DSM-5 (STiP-5.1) and the self-report questionnaires of the Achenbach System of Empirically Based Assessment scales (ASEBA) were used. Mediation analyses were conducted through structural equation modeling. Results Overall, 76.3% (N = 132) participants indicated at least one type of childhood maltreatment, with emotional neglect being most commonly reported (60.7%). A total of 30.6% (N = 53) participants self-reported mental health problems. Emotional abuse (r = 0.34; p < .001) and neglect (r = 0.28; p < .001) were found to be most strongly associated with mental health problems. In addition, impaired personality functioning was fond to be a significant mediator for overall childhood maltreatment (β = 0.089; p = 0.008) and emotional neglect (β = 0.077; p = 0.016). Finally, impaired self-functioning was found to be a significant mediator when both self-functioning and interpersonal functioning were included as potential mediators in the relationship between overall childhood maltreatment (β1 = 0.177, p1 = 0.007) and emotional neglect (β1 = 0.173, p1 = 0.003). Conclusion Emotional neglect may be particularly important in the context of childhood maltreatment, personality functioning, and mental health problems and, therefore, should not be overlooked next to the more “obvious” forms of childhood maltreatment. Combining interventions designed for personality functioning with trauma-informed practices in standard mental health services might counteract the psychopathological outcomes of maltreated children and adolescents.

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“…Other recent measures include the ICD-11 Personality Disorder Severity Scale (PDS-ICD-11; 17 ), Clark et al scales ( 18 ), and PF scale of the Integrative Dimensional Personality Inventory for ICD-11 (IDPI-11; 19 ). Unlike criterion A of the DSM-5 AMPD, these measures have a unifactorial nature since self and interpersonal functioning are defined in a more interconnected way and linked to real-life consequences at moderate to severe levels, such as self-harm or harm to others and the reality test ( 20 ).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of severity measures of ICD-11 and DSM-5 personality disorder: clarifying the clinical landscape with the most up-to-date evidence

Hualparuca-Olivera

Caycho‐Rodríguez

2023

Front. Psychiatry

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With the implementation of new dimensional models of personality disorder (PD) in the DSM-5 and ICD-11, several investigators have developed and evaluated the psychometric properties of measures of severity. The diagnostic accuracy of these measures, an important cross-cultural metric that falls between validity and clinical utility, remains unclear. This study aimed to analyze and synthesize the diagnostic performance of the measures designed for both models. For this purpose, searches were carried out using three databases: Scopus, PubMed, and Web of Science. Studies that presented sensitivity and specificity parameters for cut-off points were selected. There were no restrictions on the age and gender of the participants nor on the reference standard used or the settings. Study quality and synthesis were assessed using QUADAS-2 and MetaDTA software, respectively. Twelve studies were eligible covering self-reported and clinician-rated measures based on the ICD-11 and DSM-5 PD severity models. A total of 66.7% of the studies showed a risk of bias in more than 2 domains. The 10th and 12th studies provided additional metrics, resulting in a total of 21 studies for evidence synthesis. Adequate overall sensitivity and specificity (Se = 0.84, Sp = 0.69) of these measures were obtained; however, the cross-cultural performance of specific cut-off points could not be assessed due to the paucity of studies on the same measure. Evidence suggests that patient selection processes should mainly be improved (avoid case–control design), use adequate reference standards, and avoid only reporting metrics for the optimal cut-off point.

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Clinical Implications of ICD-11 for Diagnosing and Treating Personality Disorders

Cited by 7 publications

References 96 publications

Evaluation of a 36-item measure of ICD-11 and DSM-5 personality disorder trait domains and facets in Russian inpatients.

Evaluation of a 36-item measure of ICD-11 and DSM-5 personality disorder trait domains and facets in Russian inpatients.

Personality functioning and the pathogenic effect of childhood maltreatment in a high-risk sample

Diagnostic accuracy of severity measures of ICD-11 and DSM-5 personality disorder: clarifying the clinical landscape with the most up-to-date evidence

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