Abstract
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.
Highlights
A paradigm shift has occurred in response to 30 years of demonstrated shortcomings of the categorical conceptualization of personality disorders (PD) [1, 2]
Only little research has been dedicated to these new trait models in non-Western cultures, and only few international studies have focused on the ICD-11 PD approach, despite the fact that this framework must be used for coding purposes by all WHO-member countries
The present study aimed to investigate and compare the psychometric features of the DSM-5 Alternative Model for Personality Disorders (AMPD) and ICD-11 trait domain operationalizations including their empirical suitability for the cultural setting of the Kurdistan region
Summary
A paradigm shift has occurred in response to 30 years of demonstrated shortcomings of the categorical conceptualization of personality disorders (PD) [1, 2]. Given the overlap between ICD-11 and AMPD trait models and the need for more focus on WHO’s international ICD-11 approach, Bach and colleagues [26] developed an algorithm that involved 16 designated PID-5 facets to assess the five proposed ICD-11 trait domains This PID-5 operationalization of ICD-11 trait domains has subsequently been supported in several studies [21, 27, 28]. Sellbom et al [29] updated Bach et al.’s [26] ICD-11 scoring algorithm by adding the PID-5 trait facets of Suspiciousness and Attention Seeking to account for more nuances of Negative Affectivity and Dissociality This revised 18-facet scoring algorithm was validated (i.e., structural and criterion validity) using a large Canadian psychiatric inpatient sample. We evaluated the expected five-factor structures and the ability of AMPD and ICD-11 trait domains to distinguish between clinical and non-clinical groups
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