International Assessment of DSM-5 and ICD-11 Personality Disorder Traits: Toward a Common Nosology in DSM-5.1

Abstract

Introduction: The DSM-5 Alternative Model of Personality Disorders (AMPD) and the ICD-11 Classification of Personality Disorders (PD) are largely commensurate, and when combined, they delineate six trait domains: Negative Affectivity, Detachment, Antagonism/Dissociality, Disinhibition, Anankastia, and Psychoticism. Objective: The present study evaluated the international validity of a brief 36-item patient-report measure that portrays all six domains simultaneously including 18 primary subfacets. Methods: We developed and employed a modified version of the Personality Inventory for DSM-5 - Brief Form Plus (PID5BF+). The expected 6-factor structure of facets was initially investigated in samples from Denmark (n = 584), Germany (n = 1,271), and the U.S. (n = 605), and was subsequently replicated in samples from Italy, France, Switzerland, Belgium, Norway, Portugal, Spain, Poland, Czech Republic, U.S., and Brazil (both patient- and community samples were used). Associations with interview-rated DSM-5 PD categories were also investigated. Results: Findings generally supported the empirical soundness and international robustness of the six domains including meaningful associations with familiar interview-rated PD types. Conclusions: The modified PID5BF+ may be employed internationally by clinicians and researchers for brief and reliable assessment of the six combined DSM-5 and ICD-11 domains, including 18 primary subfacets. This six-domain framework may inform a future nosology for DSM-5.1 that is more reasonably aligned with the authoritative ICD-11 codes than the current DSM-5 AMPD model. The 36-item modified PID5BF+ scoring key is provided in supplemental Appendix A.