The utility of ICD-11 and DSM-5 traits for differentiating patients with personality disorders from other clinical groups

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, M age = 42.21, 42.7% females) along with a sample of patients diagnosed with other mental disorders (N = 335, M age = 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.

Description

Copyright © 2021 Pires, Henriques-Calado, Sousa Ferreira, Bach, Paulino, Gama Marques, Ribeiro Moreira, Grácio and Gonçalves. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Keywords

ICD-11 classification of personality disorders DSM-5 alternative model for personality disorders Personality disorders Severity Personality traits PID5BF+M