ICD-11 Personality Disorders: Utility and Implications of the New Model

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.655548 ◽

2021 ◽

Vol 12 ◽

Author(s):

Roger T. Mulder

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Reliability And Validity ◽

General Description ◽

New Model ◽

Normal Personality ◽

Major Predictor ◽

Normal Clinical Practice ◽

Severe Patient

The ICD-11 classification of personality disorders represents a paradigm shift in diagnosis. This was felt necessary because previous personality disorder classifications had major problems. These included unnecessary complexity, inconsistency with data on normal personality traits, and minimal consideration of severity despite this being shown to be the major predictor of outcome. The ICD-11 classification abolishes all categories of personality disorder except for a general description of personality disorder. This diagnosis can be further specified as “mild,” “moderate,” or “severe.” Patient behavior can be described using one or more of five personality trait domains; negative affectivity, dissociality, anankastia, detachment, and disinhibition. Clinicians may also specify a borderline pattern qualifier. The ICD-11 shows considerable alignment with the DSM-5 Alternative Model for Personality Disorders. Early evidence around the reliability and validity of the new model appear promising, although at present there is still limited specific evidence due to the model being so recently finalized. However, for the model to be successful, it needs to be embraced by clinicians and used widely in normal clinical practice.

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Personality disorders

Oxford Handbook of Psychiatry ◽

10.1093/med/9780199693887.003.0013 ◽

2013 ◽

pp. 489-510

Keyword(s):

Personality Disorder ◽

Mental Disorders ◽

Personality Disorders ◽

Normal Personality ◽

General Aspects ◽

Severe Personality Disorder

The concept of personality disorder ‘Normal’ personality Classification of personality disorder Psychopathy and ‘severe’ personality disorder Aetiology of personality disorder Epidemiology of personality disorder Relationship between personality disorder and other mental disorders Assessment of personality disorder Management of personality disorder 1: general aspects Management of personality disorder 2: specific treatments...

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ICD-11 and DSM-5 personality trait domains capture categorical personality disorders: Finding a common ground

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867417727867 ◽

2017 ◽

Vol 52 (5) ◽

pp. 425-434 ◽

Cited By ~ 18

Author(s):

Bo Bach ◽

Martin Sellbom ◽

Mathias Skjernov ◽

Erik Simonsen

Keyword(s):

Personality Disorder ◽

Mental Disorders ◽

Personality Disorders ◽

International Classification Of Diseases ◽

International Classification ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Classification Of Diseases ◽

Domain Models

Objective: The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Method: Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Results: Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive–compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. Conclusion: These preliminary findings suggest that little information is ‘lost’ in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain ‘cross walk’ is provided in the article.

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Diagnosis and classification of personality disorders

New Oxford Textbook of Psychiatry ◽

10.1093/med/9780199696758.003.0109 ◽

2012 ◽

pp. 855-860

Author(s):

James Reich ◽

Giovanni de Girolamo

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Assessment Methods ◽

Icd 10 ◽

Diagnosis And Classification ◽

Dsm Iv ◽

Similarities And Differences ◽

Different Cultures

There has been considerable interest in the study of personality and personality disorder (PD) since early times and in many different cultures. This chapter covers definitions of personality disorders, ICD and DSM classifications of personality disorders, similarities and differences between ICD-10 and DSM-IV, recent changes in the conceptualization of DSM personality disorders, categorical versus dimensional styles of classification, and assessment methods for personality disorders.

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The Typology of Personality Disorders — Diagnostic Problems and Their Relevance for Suicidal Behavior

Crisis ◽

10.1027/0227-5910.17.2.55 ◽

1996 ◽

Vol 17 (2) ◽

pp. 55-58 ◽

Cited By ~ 18

Author(s):

Thomas Bronisch

Keyword(s):

Personality Disorders ◽

Suicidal Behavior ◽

Reliability And Validity ◽

International Classification Of Diseases ◽

Classification Systems ◽

Psychological Autopsy ◽

Diagnostic And Statistical Manual ◽

Classification Of Diseases ◽

Methodological Problems

Personality disorders (PD) play an important role in clinical psychiatry. The typologies of personality disorders (PDs) found in different classification systems, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD), are quite congruent. There are many methodological problems with reliability and validity of the diagnosis of PD. However, having a typology seems to be very helpful. Recent psychological autopsy studies reported that about one third of suicide victims met the criteria for a PD. Antisocial PD, borderline PD, narcissistic PD, and depressive PD in particular were often clinically associated with suicidal behavior.

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Threading a pathway through the forest of mood and personality disorders

BJPsych Advances ◽

10.1192/bja.2019.63 ◽

2019 ◽

Vol 26 (1) ◽

pp. 58-60

Author(s):

Peter Tyrer

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Personality Disorders ◽

Borderline Personality ◽

The Will

SUMMARYThe classification of mood and personality disorders has become unnecessarily complicated. It has become bogged down by well-meaning but unhelpful subcategories that puzzle the will of clinicians to make useful judgements. The answer is to think of bipolar, depressive and personality disorders as each constituting a spectrum of severity and not to be too preoccupied with individual labels. It would also be useful to avoid the diagnostic chimera of borderline personality disorder, a condition that defies proper classification.

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Classification of Personality Disorder

The British Journal of Psychiatry ◽

10.1192/bjp.135.2.163 ◽

1979 ◽

Vol 135 (2) ◽

pp. 163-167 ◽

Cited By ~ 196

Author(s):

Peter Tyrer ◽

John Alexander

Keyword(s):

Cluster Analysis ◽

Factor Analysis ◽

Personality Disorder ◽

Personality Disorders ◽

Psychiatric Patients ◽

Interview Schedule ◽

Personality Variables ◽

Current Classification ◽

Personality Disordered

SummaryAn interview schedule was used to record the personality traits of 130 psychiatric patients, 65 with a primary clinical diagnosis of personality disorder and 65 with other diagnoses. The results were analysed by factor analysis and three types of cluster analysis. Factor analysis showed a similar structure of personality variables in both groups of patients, supporting the notion that personality disorders differ only in degree from the personalities of other psychiatric patients. Cluster analysis revealed five discrete categories; sociopathic, passive-dependent, anankastic, schizoid and a non-personality-disordered group. Of all the personality-disordered patients 63 per cent fell into the passive-dependent or sociopathic category. The results suggest that the current classification of personality disorder could be simplified.

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Personality Disorder According to the ICD 9 and DSM III and Their Value in Court Reporting

Medicine Science and the Law ◽

10.1177/002580248602600206 ◽

1986 ◽

Vol 26 (2) ◽

pp. 113-124 ◽

Cited By ~ 3

Author(s):

J. J. Gayford ◽

H. N. K. Jungalwalla

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Forensic Psychiatry ◽

Critical Evaluation ◽

Historical Background ◽

Court Reporting ◽

Personality Typology

The historical background to classification of personality is briefly reviewed. A more detailed comparative account is given of the ICD 9 (1978) and the DSM III (1980) typological classifications of personality disorders. Their value in court reporting is discussed. A critical evaluation is made of personality typology. The conclusion is that in spite of certain defects they are a useful method of transmitting information and of making prognostications in forensic psychiatry.

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Personality disorders

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738018769685 ◽

2018 ◽

Vol 11 (7) ◽

pp. 357-361

Author(s):

Roberta Camilleri

Keyword(s):

Personality Disorder ◽

Personality Disorders

Personality disorders are complex to both identify and manage. All humans have a unique personality. Personality is what distinguishes us from each other and shapes our thoughts, emotions and behaviour. Personality disorders may be diagnosed when behaviour differs from expected norms, and abnormal traits in behaviour are persistent, pervasive and problematic. This article will provide an overview of the classification of personality disorders and the factors that contribute to their development. It will then consider dissocial personality disorder, the personality disorder encountered most often by GPs, in more detail. Finally, the benefits of countertransference are considered in an overview of the interaction between GPs and patients with a personality disorder.

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Childhood antecedents of personality disorder: An alternative perspective

Development and Psychopathology ◽

10.1017/s095457940900042x ◽

2009 ◽

Vol 21 (3) ◽

pp. 771-791 ◽

Cited By ~ 50

Author(s):

Thomas A. Widiger ◽

Barbara De Clercq ◽

Filip De Fruyt

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Factor Model ◽

Five Factor Model ◽

Personality Structure ◽

Childhood And Adolescence ◽

Adult Personality ◽

Dsm Iv ◽

Childhood Antecedents

AbstractOne of the fundamental limitations of theDiagnostic and Statistical Manual of Mental Disorders—Fourth Edition, Text Revision(DSM-IV-TR) categorical model of personality disorder classification has been the lack of a strong scientific foundation, including an understanding of childhood antecedents. TheDSM-IV-TRpersonality disorders, however, do appear to be well understood as maladaptive variants of the domains and facets of the general personality structure as conceptualized within the five-factor model (FFM). Integrating the classification of personality disorder with the FFM brings to an understanding of the personality disorders a considerable body of scientific research on childhood antecedents. The temperaments and traits of childhood do appear to be antecedent to the FFM of adult personality structure, and these temperament and traits of childhood and adolescence are the likely antecedents for adult personality disorder, providing further support for the conceptualization of the adult personality disorders as maladaptive variants of the domains and facets of the FFM. Conceptualizing personality disorders in terms of the FFM thereby provides a basis for integrating the classification of abnormal and normal personality functioning across the life span.

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