Abstract
The ICD-11 Classification of Personality Disorders delineates five trait domain qualifiers (i.e., negative affectivity, detachment, dissociality, disinhibition, and anankastia), whereas the DSM-5 Alternative Model of Personality Disorders also delineates a separate domain of psychoticism. These six combined traits not only characterize individual stylistic features, but also the severity of their maladaptive expressions. It was, therefore, the aim of this study to investigate the utility of ICD-11 and DSM-5 trait domains to differentiate patients with personality disorders (PD) from patients with other mental disorders (non-PD). The Personality Inventory for DSM-5 Brief Form Plus (PID5BF+M) was administered to a sample of patients diagnosed with a personality disorder (N = 124, Mage = 42.21, 42.7% females) along with a sample of patients diagnosed with other mental disorders (N = 335, Mage = 44.83, 46.6% females). Group differences were explored using the independent sample t test or the Mann–Whitney U test for independent samples, and discriminant factor analysis was used to maximize group differences for each trait domain and facet score. The PD group showed significantly higher scores for the total PID5BF+M composite score, for the trait domains of negative affectivity, antagonism/dissociality, and disinhibition and for the trait facets of emotional lability, manipulativeness, deceitfulness, and impulsivity. The trait domains of disinhibition, negative affectivity, and antagonism/dissociality as well as the trait facets of impulsivity, deceitfulness, emotional lability, and manipulativeness were the best discriminators between PD and non-PD patients. The global PID5BF+M composite score was also one of the best discriminators supporting its potential as a global severity index for detecting personality dysfunction. Finally, high scores in three or more of the 18 PID5BF+M facets suggested the possible presence of a PD diagnosis. Despite some limitations, our findings suggest that the ICD-11 and DSM-5 traits have the potential to specifically describe the stylistic features that characterize individuals with PD, including the severity of their maladaptive expressions.
Highlights
There is broad consensus within the scientific community as to the supremacy of dimensional classification models over categorical models in the diagnosis of personality disorders (PD) [1, 2]
The current study sought to investigate the utility of the PID5BF+M in differentiating patients with PD from other psychiatric patients
A dimensional approach to identifying PD based on severity is proposed by several authors [3, 24, 25], and PD severity is the real differentiator between PD and non-PD in the ICD-11 [9]
Summary
There is broad consensus within the scientific community as to the supremacy of dimensional classification models over categorical models in the diagnosis of personality disorders (PD) [1, 2]. Style indicates the likely expression of the pathology and gears the clinician toward the most appropriate type of intervention [3, 6, 8] Reflecting this trend, the recently released ICD-11 Classification of Personality Disorders [9] and the DSM-5 Alternative Model of Personality Disorders (AMPD) [10] consider impairments in self and interpersonal functioning as the core feature of PD and delineate levels of dysfunction. To better capture the features of the ICD-11 domain of anankastia, Bach et al [14] developed a modified version of the PID5BF+, the PID5BF+M, in which the perseveration facet, which contributes to the negative affectivity domain, was excluded and the orderliness, rigidity, and perfectionism sub-facets of the original rigid perfectionism facet were added These three new anankastia facets are in keeping with the initial 37-facet version of the DSM-5 trait model that included the compulsivity domain [15]. The use of the PID5BF+ as a proxy of severity is supported in a comparative study by Zimmermann et al [22], which found the total PID5BF+ score to align well with a number of PD severity measures
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