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. 2021 Aug;15(3):223-236.
doi: 10.1002/pmh.1510. Epub 2021 May 17.

Development and initial evaluation of the ICD-11 personality disorder severity scale: PDS-ICD-11

Bo Bach  1 , Tiffany A Brown  2 , Roger T Mulder  3 , Giles Newton-Howes  4 , Erik Simonsen  1   5 , Martin Sellbom  2
Affiliations

Development and initial evaluation of the ICD-11 personality disorder severity scale: PDS-ICD-11

Bo Bach et al. Personal Ment Health. 2021 Aug.

Abstract

Aim: No measure has formally been developed to assess the published ICD-11 model of Personality Disorder (PD) severity. We therefore set out to develop and evaluate the 14-item Personality Disorder Severity ICD-11 (PDS-ICD-11) scale.

Method: A representative U.S. community sample (N = 428; 50.9% women) and a New Zealand mental health sample (N = 87; 61.5% women) completed the PDS-ICD-11 scale along with a series of established PD and impairment measures.

Results: Item response theory supported the unidimensionality of PDS-ICD-11 (median item loading of 0.68) and indicated that a PDS-ICD-11 score of 17.5 may serve as a benchmark for pronounced dysfunction. Correlation and regression analyses supported both criterion validity and incremental validity in predicting impairment and PD symptoms. The PDS-ICD-11 was particularly associated with measures of Level of Personality Functioning Scale (LPFS), Global PD severity, and Borderline PD symptom score. A comparison between clinical individuals diagnosed with an ICD-11 PD vs. no PD supported diagnostic validity.

Conclusion: This initial construction study suggests that the PDS-ICD-11 constitutes a promising instrument that provides a quick impression of the severity of personality dysfunction according to the official ICD-11 PD guidelines. Clearly, more research is needed to corroborate its validity and utility. The PDS-ICD-11 scale is provided as online supporting information.

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References

REFERENCES

    1. Bach, B., & Anderson, J. L. (2020). Patient-reported ICD-11 personality disorder severity and DSM-5 level of personality functioning. Journal of Personality Disorders, 34(2), 231-249. https://doi.org/10.1521/pedi_2018_32_393
    1. Bach, B., & First, M. B. (2018). Application of the ICD-11 classification of personality disorders. BMC Psychiatry, 18(1), 351. https://doi.org/10.1186/s12888-018-1908-3
    1. Bach, B., & Hutsebaut, J. (2018). Level of personality functioning scale-brief form 2.0: Utility in capturing personality problems in psychiatric outpatients and incarcerated addicts. Journal of Personality Assessment, 100(6), 660-670. https://doi.org/10.1080/00223891.2018.1428984
    1. Bach, B., & Simonsen, S. (2021). How does level of personality functioning inform clinical management and treatment? Implications for ICD-11 classification of personality disorder severity. Current Opinion in Psychiatry, 34(1), 54-63. https://doi.org/10.1097/YCO.0000000000000658
    1. Bach, B., Sellbom, M., Kongerslev, M. T., Simonsen, E., Krueger, R. F., & Mulder, R. T. (2017). Deriving ICD-11 personality disorder domains from dsm-5 traits: Initial attempt to harmonize two diagnostic systems. Acta Psychiatrica Scandinavica, 136(1), 108-117. https://doi.org/10.1111/acps.12748

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