The International Classification of Diseases, 11th Edition (ICD-11) has reconceptualized personality disorders (PD), and measures are therefore being developed to aid the assessment of ICD-11 PD. The ...present study examined the validity of the recently developed self-report inventory the Personality Disorder Severity for ICD-11 (PDS-ICD-11), and its utility in differentiating across ICD-11 PD severity levels in a community mental health sample (n = 232). We examined the associations between the PDS-ICD-11 with various clinician ratings, self-report questionnaires, and informant-report measures of dimensional personality impairment and traditional Diagnostic and Statistical Manual of Mental Disorders, fifth edition PDs. Further, we examined mean group differences in PDS-ICD-11 scores between levels of ICD-11 PD clinician diagnosis. The PDS-ICD-11 exhibited moderate-to-large associations with all clinician ratings, and more variable associations with self-report and informant-report measures. PDS-ICD-11 mean scores were significantly different across all levels of ICD-11 PD clinician-rated diagnostic levels. These findings provide additional promising evidence for the validity and utility of the PDS-ICD-11 for the assessment of ICD-11 PD in community mental health patients.
Public Significance Statement
ICD-11 personality disorder is a new diagnosis, which requires valid assessment measures. The PDS-ICD-11 is an efficacious brief screening tool for researchers and clinicians interested in ICD-11 personality disorder. The present study provides support for validity and utility of this new measure.
Objectives:
The International Classification of Diseases, 11th edition includes a new personality disorder diagnosis, in light of growing concerns of the categorical personality disorder diagnoses. ...The purpose of the current study was to examine the reliability and validity of the severity dimension of the new International Classification of Diseases, 11th edition diagnosis, through multi-method assessment.
Method:
In a community mental health sample (n = 311), we examined the interrater reliability of the severity diagnosis and evaluated the diagnosis against self-report measures of dimensional personality pathology and psychopathology constructs and traditional categorical and informant-report measures.
Results:
Intraclass correlations indicated ‘excellent’ reliability of the diagnostic ratings. Large associations were observed between the International Classification of Diseases, 11th edition clinician diagnosis and overall impairment measures. Generally, the International Classification of Diseases, 11th edition clinician diagnosis exhibited largest associations with measures of internalising dysfunction, and more variable associations with interpersonal and externalising impairment. The International Classification of Diseases, 11th edition clinician diagnosis showed a large association with borderline personality disorder symptom scores and moderate associations with Paranoid, Schizoid and Avoidant personality disorder scores. Similar patterns emerged of the associations between the International Classification of Diseases, 11th edition personality disorder diagnosis with self-report and informant-report measures, although the associations were larger with self-report measures.
Conclusion:
These findings provide promising initial evidence for the reliability and validity of the new International Classification of Diseases, 11th edition personality disorder diagnosis, indicating that the new conceptualisation of personality disorders may address issues within the categorical model.
The International Classification of Diseases, 11th Edition (ICD-11) includes a new personality disorder (PD) severity diagnosis that may be further characterized using up to five trait domain ...specifiers. Most of the previous studies have investigated the ICD-11 trait domains using self-report measures. The present study aimed to validate ICD-11 PD trait domains using a multimethod design in a community mental health sample (n = 336). We conducted two confirmatory factor analyses to examine the factor structure of the ICD-11 PD trait model, utilizing clinician-rating, self-report, and informant-report measures. Finally, we examined associations between clinician-rated, self-reported, and informant-reported ICD-11 trait domains with external criteria, specifically traditional PD symptoms and the five-factor model of normal personality. All clinician-rated, self-reported, and informant-reported domain scores loaded meaningfully on their expected factors when controlling for nontrivial method factors. Generally, the trait domains exhibited meaningful associations with conceptually relevant external criteria, although the anankastia domain exhibited more variability in its pattern of correlations across methods. Overall, the ICD-11 trait domain model shows promising reliability and validity, indicating good progress within the field of PD assessment toward a more useful PD operationalization.
Public Significance Statement
The International Classification of Diseases, 11th Edition, has a new diagnostic system for personality disorder, which includes dimensional personality traits. Further validation of this system is necessary to ensure that it works well in practice. The present study provides support for validity of the International Classification of Diseases, 11th Edition personality trait model.
Historically, male presentations of eating disorders (EDs) have been perceived as rare and atypical – a perception that has resulted in the systematic underrepresentation of males in ED research. ...This underrepresentation has profoundly impacted clinical practice with male patients, in which i) stigmatization and treatment non-engagement are more likely, ii) a distinct array of medical complexities are faced, and iii) symptom presentations differ markedly from female presentations. Further, the marginalization of males from ED research has hindered the assessment and clinical management of these presentations. This critical review provides an overview of the history of male EDs and synthesizes current evidence relating to the unique characteristics of male presentations across the diagnostic spectrum of disordered eating. Further, the emerging body of evidence relating to muscularity-oriented eating is synthesized in relation to the existing nosological framework of EDs. The impact of marginalizing male ED patients is discussed, in light of findings from epidemiological studies suggesting that clinicians will be increasingly likely to see males with ED in their practices. It is suggested that changes to current conceptualizations of ED pathology that better accommodation male ED presentations are needed.
•Male EDs are systematically overlooked in ED research.•Male ED presentations differ significantly from female ED presentations.•Muscularity-oriented disordered eating has emerged as an ED phenotype in males.•Current ED classification schemes do not accommodate muscularity-oriented disordered eating.•The marginalization of male ED patients remains an ongoing concern.
Purpose of Review
There is growing recognition that eating disorder (ED) symptoms, particularly those of a muscularity-oriented nature, are more common in men than previously understood. The purpose ...of the current review is to describe contemporary directions and implications of research on traditional and muscularity-oriented ED symptoms among males.
Recent Findings
Evidence indicates that ED symptoms occur in a substantial minority of men. Importantly, recent research has focused on muscularity-oriented body image and disordered eating in males, demonstrating the prevalence, correlates, and consequences of maladaptive muscularity-oriented attitudes and behaviors. A growing number of assessments are available to measure these constructs in males, and preliminary treatment considerations have begun to be addressed in the literature.
Summary
Research on male EDs and body image is increasingly focusing on muscularity-oriented manifestations. Continued empirical work will be critical to improve our understanding of the onset, maintenance, and treatment of muscularity-oriented disordered eating in males.
Objective
The current study examined associations between Minnesota Multiphasic Personality Inventory‐3 (MMPI‐3) scales and self‐reported DSM‐5 Section II personality disorder (PD) symptoms. A priori ...hypotheses were generated for which MMPI‐3 scales would be most highly associated with each PD.
Methods
We used a large sample (n = 489) of university students, who completed the MMPI‐3 and two established self‐report measures of personality disorders.
Results
The results were generally consistent with theoretical expectations and previous research utilizing the MMPI‐2‐RF. Specifically, most hypothesized MMPI‐3 scales exhibited meaningful associations with relevant PD variables, although there were some notable exceptions. The regression models revealed significant predictors for each PD which were generally consistent with expectations and previous research.
Conclusions
Overall, the MMPI‐3 appears well situated to cover a range of DSM‐5 Section II PD‐related psychopathology, and three of the new MMPI‐3 scales appear to have added utility for assessing personality pathology.
The current study aimed to examine the associations between Minnesota Multiphasic Personality Inventory-3 (MMPI-3) scales and the dimensional personality traits contained within the ICD-11 ...Personality Disorder diagnosis and DSM-5 Alternative Model for Personality Disorders (AMPD) models. The sample consisted of 489 undergraduate students, with dimensional personality traits operationalized via the Comprehensive Assessment of Traits relevant to Personality Disorder (CAT-PD). A priori hypotheses were generated for which MMPI-3 scales would be most associated with each personality trait domain, as well as individual CAT-PD scales. Zero-order correlations and regression analyses were used to examine associations between a set of hypothesized MMPI-3 scale scores and CAT-PD scale scores. The results showed a pattern of meaningful correlations supporting the majority of hypotheses. Moreover, most hypothesized scales also incremented one another in regression models predicting hypothesized PD scale scores. These findings indicate that the MMPI-3 is well situated to aid clinicians in the assessment of personality trait dysfunction from a dimensional perspective.
Cognitive behavioral therapy for Avoidant Restrictive Food Intake Disorder (ARFID; CBT-AR) is an emerging treatment for ARFID. However, this treatment modality has yet to be examined among older ...adults (e.g., older than 50 years) or with adults presenting with feeding tubes. To inform future versions of CBT-AR, we present the results of a singular case study (G) of an older male with the sensory sensitivity phenotype of ARFID who presented for treatment with a gastrostomy tube.
G was a 71-year-old male who completed eight sessions of CBT-AR in a doctoral training clinic. ARFID symptom severity and comorbid eating pathology changes were examined pre- and post-treatment.
Posttreatment, G reported significant decreases in ARFID symptom severity and no longer met diagnostic criteria for ARFID. Furthermore, throughout treatment, G reported significant increases in his oral food consumption (vs. calories being pushed through the feeding tube), solid food consumption, and the feeding tube was ultimately removed.
This study provides proof of concept that CBT-AR is potentially effective for older adults and/or those presenting for treatment with feeding tubes. Validation of patient efforts and severity of ARFID symptoms emerged as core to treatment success and should be emphasized when training clinicians in CBT-AR.
Cognitive behavior therapy for ARFID (CBT-AR) is the leading treatment for this disorder; however, it has yet to be tested among older adults or those with feeding tubes. This single-patient case study demonstrates that CBT-AR may be efficacious in reducing ARFID symptom severity among older adults with a feeding tube.
Purpose of Review
This review summarized trends and key findings from empirical studies conducted between 2011 and 2017 regarding eating disorders and disordered weight and shape control behaviors ...among lesbian, gay, bisexual, and other sexual minority (i.e., non-heterosexual) populations.
Recent Findings
Recent research has examined disparities through sociocultural and minority stress approaches. Sexual minorities continue to demonstrate higher rates of disordered eating; disparities are more pronounced among males. Emerging data indicates elevated risk for disordered eating pathology among sexual minorities who are transgender or ethnic minorities. Dissonance-based eating disorder prevention programs may hold promise for sexual minority males.
Summary
Continued research must examine the intersections of sexual orientation, gender, and ethnic identities, given emergent data that eating disorder risk may be most prominent among specific subgroups. More research is needed within sexual minorities across the lifespan. There is still a lack of eating disorder treatment and prevention studies for sexual minorities.
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