Evaluating the assessment of the ICD-11 personality disorder diagnostic system.

Abstract

Proposed for the ICD-11 is a dimensional model of personality disorder that, if approved, would be a paradigm shift in the conceptualization of personality disorder. The proposal consists of a general severity rating, 5 maladaptive personality trait domains, and a borderline pattern qualifier. The general severity rating can be assessed by the Standardized Assessment of Severity of Personality Disorder (SASPD), the trait domains by the Personality Inventory for ICD-11 (PiCD), and the borderline pattern by the Borderline Pattern Scale (BPS), which is developed in the present study. To date, no study has examined the relations among all 3 components, due in part to the absence of direct measures for each component (until recently). The current study develops and provides initial validation evidence for the BPS, and examines the relations among the BPS, SASPD, and PiCD. Also considered is their relationship with the 5-factor model of general personality as well as with 2 other measures of personality disorder severity (including the DSM–5 Level of Personality Functioning Scale [LPFS]). Further, an alternative trait-based coding of the DSM–5 LPFS is examined (modeled after the ICD-11 SASPD), suggesting that its coverage of diverse maladaptivity may not be because it assesses the core of personality disorder, but rather because it has items specific to the different domains of personality.

The Personality Inventory for ICD-11: Investigating Reliability, Structural and Concurrent Validity, and Method Variance

“…The internal consistency reliability estimates for the PiCD domains were adequate (see Table 1); all coefficient categorical omega values were greater than .75, suggesting that more than 75% of the variance in observed PiCD domain scores can be accounted for by their respective latent variable (i.e., in unidimensional measurement models). In comparison to the reliability estimates in previous studies using the PiCD (i.e., Crego & Widiger, 2019;Oltmanns & Widiger, 2018;Oltmanns & Widiger, 2019a;Oltmanns & Widiger, 2019b) our coefficient alpha values were somewhat lower. Specifically, the mean coefficient alpha value for the PiCD domains in the current study was .78, whereas the mean coefficient alpha value across the previous studies was .87.…”

A psychometric evaluation of the Standardized Assessment of Severity of Personality Disorder (SASPD) in nonclinical and clinical German samples.

“…Since convergent validity denotes the strength of association between two measures that are supposed to assess the same underlying construct, it requires very high intercorrelations (e.g., > .70). However, in line with previous research (e.g., Oltmanns & Widiger, 2019), SASPD scores were only moderately correlated (r ̅ = .56) with scores of other proxy PD severity measures (i.e., IPO-16, OPD-SQS, PID-5 SF), indicating relatively low convergence (see Table 3). One of the largest associations was observed between SASPD and PID-5 SF total scores.…”

A Brief but Comprehensive Review of Research on the Alternative DSM-5 Model for Personality Disorders

“…However, several questions remain unanswered and should be addressed in future research. First, although the PD chapter in ICD-11 conceptually shares many features with the AMPD, studies are needed that investigate their communalities and differences empirically, and directly compare their clinical utility (for recently published studies addressing this issue, see [38,128,129]). Second, the vast majority (i.e., 94%) of studies on the AMPD are based on a monomethod approach (see Fig.…”

“…), and incremental validity (i.e., Do test scores provide unique information when predicting outcomes?). Note that we will not cover research on the ICD-11 proposal in this regard, because relevant studies were often based on archival data using earlier measures [124][125][126], and studies using measures that were explicitly designed for the ICD-11 PD chapter are still scarce [25,37,38,52,[127][128][129][130].…”