SPA 2023 - ICD-11 model and instruments for dimensional assessment of personality disorder (1.5 CEs)

Abstract

Abundant critiques of the categorical approach to personality disorders (PDs) resulted in the launch of the Alternative Model for PDs (AMPD) in DSM-5’s Section III for emerging measures and models. Despite weak empirical support for categorical PD diagnoses, a categorical-dimensional hybrid approach was taken to soften the transition to a fully-dimensional model. The two core criteria of this dimensional model are impairment in terms of personality functioning and maladaptive trait domains and facets. Since their introduction, the AMPD model and AMPD measures have been well established empirically. In 2022, the ICD-11 model for PDs was published and clearly advocated a dimensional approach, completely overhauling the use of types (i.e., categories). The ICD-11 model, similar to the AMPD, conceptualizes PD by level of severity and maladaptive traits. In ICD-11, severity (mild-moderate-severe) is conditional for making a PD diagnosis while trait levels of Negative Affectivity, Detachment, Dissociality, Disinhibition, and Anankastia (and a Borderline pattern) are applied to portray stylistic differences in PD expression. Empirical evidence about the ICD-11 model and ICD-11 measures has begun to accumulate, but is limited compared to the amount of AMPD research (likely due to the former’s more recent release). In aim of facilitating ICD-11 research, this symposium will introduce attendees to the ICD-11 model and several ICD-11 compatible instruments, with discussions focused on the ICD-11 as a framework for the dimensional assessment of personality and PDs. Gina Rossi (Chair) will discuss the age-neutrality of multiple ICD-11 measures originally developed using younger adult populations (SASPD, PiCD, BPS) and present research on whether these instruments accurately assess personality disorders in older adults. Joshua Oltmanns will address self-other agreement and the validity of an informant version of the PiCD (the IPiC), specifically in older adults. Martin Sellbom will then present on the development and validation of the PDS-ICD-11, a recently developed scale designed to adhere to the current guidelines for assessing personality impairment using the ICD-11 severity level approach. Finally, Adam Natoli (co-Chair) will present a study of the incremental validity of defense mechanisms and discuss evidence pertaining to whether defense mechanisms should be included in the ICD-11 model of PDs. This symposium will conclude with Aaron Pincus, serving as discussant, offering an integrative conclusion about the utility of the ICD-11 model, potential value of ICD-11 compatible measures for PD assessment, and how ICD-11 research can evolve to address pertinent assessment and clinical implications for the PD field.

Chair

Gina Rossi | Vrije Universiteit Brussel

Discussant

Aaron Pincus | Pennsylvania State University - University Park

Goals & Objectives

1. Describe the ICD-11 model and several ICD-11 compatible instruments.
2. Describe how the ICD-11 can be a framework for the dimensional assessment of personality and PDs.