Development of a Short and ICD-11 Compatible Measure for DSM-5 Maladaptive Personality Traits Using Ant Colony Optimization Algorithms.

André Kerber,Johannes Zimmermann,Aidan G C Wright,Steffen Müller,Robert F Krueger,Rosa Maria Rühling,Martin Schultze,Christine Knaevelsrud,Carsten Spitzer

doi:10.1177/1073191120971848

Abstract

While Diagnostic and Statistical Manual of Mental Disorders–Fifth edition (DSM-5) Section III and ICD-11 (International Classification of Diseases 11th–Revision) both allow for dimensional assessment of personality pathology, the models differ in the definition of maladaptive traits. In this study, we pursued the goal of developing a short and reliable assessment for maladaptive traits, which is compatible with both models, using the item pool of the Personality Inventory for DSM-5 (PID-5). To this aim, we applied ant colony optimization algorithms in English- and German-speaking samples comprising a total N of 2,927. This procedure yielded a 34-item measure with a hierarchical latent structure including six maladaptive trait domains and 17 trait facets, the “Personality Inventory for DSM-5, Brief Form Plus” (PID5BF+). While latent structure, reliability, and criterion validity were ascertained in the original and in two separate validation samples (n = 849, n = 493) and the measure was able to discriminate personality disorders from other diagnoses in a clinical subsample, results suggest further modifications for capturing ICD-11 Anankastia.

Highlights

The classification and diagnosis of personality disorders (PD) is shifting away from categorical models toward a dimensional approach (Krueger & Markon, 2014; Mulder & Tyrer, 2018; Tyrer et al, 2018)
In the Diagnostic and Statistical Manual of Mental Disorders–Fifth edition (DSM-5) Section III (American Psychiatric Association, 2013a), a dimensional Alternative Model for Personality Disorders (AMPD) has been added as an optional, “emerging model,” whereas in the ICD-11 (International Classification of Diseases 11th–Revision; World Health Organization, 2018) PD categories will be completely replaced by a dimensional model (Tyrer et al, 2018)
In anticipation of these findings, Bach et al (2017) constructed a “cross-walk” between DSM-5 trait facets and ICD-11 trait domains using exploratory factor analysis of Personality Inventory for DSM-5 (PID-5) facet scores, suggesting that the missing ICD-11 trait domain Anankastia could be assessed by the DSM-5 trait facets “rigid perfectionism” and “perseveration.” Based on their findings, they developed an algorithm for the operationalization of the ICD-11 trait domains using a selection of 16 PID-5 facet scales

Summary

Introduction

The classification and diagnosis of personality disorders (PD) is shifting away from categorical models toward a dimensional approach (Krueger & Markon, 2014; Mulder & Tyrer, 2018; Tyrer et al, 2018). In the Diagnostic and Statistical Manual of Mental Disorders–Fifth edition (DSM-5) Section III (American Psychiatric Association, 2013a), a dimensional Alternative Model for Personality Disorders (AMPD) has been added as an optional, “emerging model,” whereas in the ICD-11 (International Classification of Diseases 11th–Revision; World Health Organization, 2018) PD categories will be completely replaced by a dimensional model (Tyrer et al, 2018) This shift was motivated by notable limitations of categorical models including high comorbidity and low specificity of PD diagnoses, overreliance on “PD not otherwise specified,” and a generally poor match to the empirical covariation of PD criteria (Hengartner et al, 2018; Widiger & Trull, 2007). The resulting measurement model is not backward-compatible with the DSM-5 trait model

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