Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T15:32:42.123Z Has data issue: false hasContentIssue false

19 - Using DSM-5 and ICD-11 Personality Traits in Clinical Treatment

from Part V - Treatment

Published online by Cambridge University Press:  24 February 2020

By
Bo Bach  and
Jennifer Presnall-Shvorin
Edited by
Carl W. Lejuez  and
Kim L. Gratz
Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
Get access

Summary

The DSM-5 Alternative Model of Personality Disorders (AMPD) and the ICD-11 Classification of Personality Disorders allow clinicians to describe trait domains that contribute to the unique expression of personality dysfunction. Both diagnostic systems deliniate trait domain features of negative affectivity, detachment, antagonism/dissociality, disinhibition, and anankastia/compulsivity, which may inform clinicians about how to manage treatment. This chapter specifically describes how the DSM-5 and ICD-11 trait domains may be useful for establishing a favorable treatment alliance, doing therapeutic assessment, increasing the patient’s self-knowledge, providing psychoeducation, planning realistic treatment goals, and matching therapy to the patient’s personality. A key message of this chapter is that practitioners should not treat traits per se but the maladaptive expressions of traits.

Keywords

personality disordersTraitsICD-11DSM-5Alternative Model of Personaity Disorderstrait qualifierstreatment planningtherapytherapeutic assessment
Type
Chapter
Information
The Cambridge Handbook of Personality Disorders , pp. 450 - 467
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Al-Dajani, N., Gralnick, T. M., & Bagby, R. M. (2016). A psychometric review of the Personality Inventory for DSM-5 (PID-5): Current status and future directions. Journal of Personality Assessment, 98(1), 62–81.CrossRefGoogle ScholarPubMed
Allport, G. W. (1961). Pattern and Growth in Personality. New York: Holt, Rinehart & Winston.Google Scholar
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
Anderson, J. L., Sellbom, M., Bagby, R. M., Quilty, L. C., Veltri, C. O. C., Markon, K. E., & Krueger, R. F. (2013). On the convergence between PSY-5 domains and PID-5 domains and facets: Implications for assessment of DSM-5 personality traits. Assessment, 20(3), 286–294.Google Scholar
Arntz, A. (2012). Schema Therapy for Cluster C Personality Disorders. In van Vreeswijk, M., Broersen, J., & Nadort, M. (Eds.),The Wiley-Blackwell Handbook of Schema Therapy: Theory, Research, and Practice (pp. 397–414). Malden, MA: Wiley-Blackwell.Google Scholar
Bach, B., Anderson, J., & Simonsen, E. (2017). Continuity between interview-rated personality disorders and self-reported DSM-5 traits in a Danish psychiatric sample. Personality Disorders: Theory, Research, and Treatment, 8(3), 261–267.Google Scholar
Bach, B., & Bernstein, D. P. (2019). Schema therapy conceptualization of personality functioning and traits in ICD-11 and DSM-5. Current Opinion in Psychiatry, 32(1), 38–49.CrossRefGoogle ScholarPubMed
Bach, B., & First, M. B. (2018). Application of the ICD-11 classification of personality disorders. BMC Psychiatry, 18(1), 351.Google Scholar
Bach, B., & Fjeldsted, R. (2017). The role of DSM-5 borderline personality symptomatology and traits in the link between childhood trauma and suicidal risk in psychiatric patients. Borderline Personality Disorder and Emotion Dysregulation, 4(1), 12. http://doi.org/10.1186/s40479–017-0063-7CrossRefGoogle ScholarPubMed
Bach, B., Markon, K., Simonsen, E., & Krueger, R. F. (2015). Clinical utility of the DSM-5 Alternative Model of Personality Disorders. Journal of Psychiatric Practice, 21(1), 3–25.CrossRefGoogle ScholarPubMed
Bach, B., Sellbom, M., Bo, S., & Simonsen, E. (2016). Utility of DSM-5 section III personality traits in differentiating borderline personality disorder from comparison groups. European Psychiatry, 37(9), 22–27.CrossRefGoogle ScholarPubMed
Bach, B., Sellbom, M., Kongerslev, M., Simonsen, E., Krueger, R. F., & Mulder, R. (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.Google Scholar
Bach, B., Sellbom, M., Skjernov, M., & Simonsen, E. (2018). ICD-11 and DSM-5 personality trait domains capture categorical personality disorders: Finding a common ground. Australian & New Zealand Journal of Psychiatry, 52(5), 425–434.Google Scholar
Bagby, R. M., Gralnick, T. M., Al-Dajani, N., & Uliaszek, A. A. (2016). The role of the Five-Factor Model in personality assessment and treatment planning. Clinical Psychology: Science and Practice, 23(4), 365–381.Google Scholar
Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., & Ehrenreich-May, J. T. (2011). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide. New York: Oxford University Press.Google Scholar
Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K. (2014). The nature, diagnosis, and treatment of neuroticism. Clinical Psychological Science, 2(3), 344–365.Google Scholar
Bastiaens, T., Claes, L., Smits, D., De Clercq, B., De Fruyt, F., Rossi, G., … De Hert, M. (2016). The construct validity of the Dutch Personality Inventory for DSM-5 Personality Disorders (PID-5) in a clinical sample. Assessment, 23(1), 42–51.Google Scholar
Bateman, A., & Fonagy, P. (2016). Mentalization Based Treatment for Personality Disorders: A Practical Guide. New York: Oxford University Press.Google Scholar
Beck, A. T. (1983). Cognitive therapy of depression: New perspectives. In Clayton, P. J. and Barrett, J. E. (Eds.), Treatment of Depression: Old Controversies and New Approaches (pp. 265–290). New York: Raven.Google Scholar
Beck, A. T., Davis, D. D., & Freeman, A. (2015). Cognitive Therapy of Personality Disorders (3rd ed.). New York: Guilford Press.Google Scholar
Behary, W. T., & Dieckman, E. (2012). Schema therapy for narcissism: The art of empathic confrontation, limit-setting, and leverage. In Campbell, W. K. & Miller, J. D. (Eds.), The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings, and Treatments. New York: John Wiley & Sons.Google Scholar
Bernstein, D. P., Arntz, A., & de Vos, M. (2007). Schema focused therapy in forensic settings: Theoretical model and recommendations for best clinical practice. International Journal of Forensic Mental Health, 6(2), 169–183.CrossRefGoogle Scholar
Brown, J. (1999). Bowen family systems theory and practice: Illustration and critique. Australian and New Zealand Journal of Family Therapy, 20(2), 94–103.Google Scholar
Cattell, R. B. (1943). The description of personality: Basic traits resolved into clusters. Journal of Abnormal and Social Psychology, 38(4), 476–506.Google Scholar
Chmielewski, M., Bagby, R. M., Markon, K., Ring, A. J., & Ryder, A. G. (2014). Openness to experience, intellect, schizotypal personality disorder, and psychoticism: Resolving the controversy. Journal of Personality Disorders, 28(4), 483–499.Google Scholar
Clark, L. A. (1993). SNAP, Schedule for Nonadaptive and Adaptive Personality: Manual for Administration, Scoring, and Interpretation. Minneapolis: University of Minnesota Press.Google Scholar
Clark, L. A., Vanderbleek, E., Shapiro, J., Nuzum, H., Allen, X., Daly, E., … Ro, E. (2015). The brave new world of personality disorder-trait specified: Effects of additional definitions on coverage, prevalence, and comorbidity. Psychopathology Review, 2(1), 52–82.CrossRefGoogle ScholarPubMed
Clarkin, J. F., Yeomans, F. E., & Kernberg, O. F. (2006). Psychotherapy for Borderline Personality: Focusing on Object Relations. Washington, DC: American Psychiatric Publishing.Google Scholar
Costa, P. T., & McCrae, R. R. (1992). Normal personality assessment in clinical practice: The NEO Personality Inventory. Psychological Assessment, 4(1), 5–13.Google Scholar
Dimidjian, S., & Linehan, M. M. (2008). Mindfulness practice. In O’Donohue, W. T. (Ed.), Cognitive Behavior Therapy: Applying Empirically Supported Techniques in Your Practice (2nd ed., pp. 327–336). Hoboken, NJ: John Wiley & Sons.Google Scholar
Drake, M. M., Morris, D. M., & Davis, T. J. (2017). Neuroticism’s susceptibility to distress: Moderated with mindfulness. Personality and Individual Differences, 106, 248–252.CrossRefGoogle Scholar
Eysenck, H. J. (1947). Dimensions of Personality. London: Routledge & Kegan Paul.Google Scholar
Fischer, C. T., & Finn, S. E. (2008). Developing the life meaning of psychological test data: Collaborative and therapeutic approaches. In Archer, R. P. & Smith, S. R. (Eds.), Personality Assessment (pp. 379–404). New York: Routledge.Google Scholar
Fossati, A., Krueger, R. F., Markon, K. E., Borroni, S., Maffei, C., & Somma, A. (2015). The DSM-5 Alternative Model of Personality Disorders from the perspective of adult attachment. Journal of Nervous and Mental Disease, 203(4), 252–258.CrossRefGoogle ScholarPubMed
Gabbard, G. O., & Newman, C. F. (2007). Psychotherapy of obsessive-compulsive personality disorder. In Gabbard, G. O., Beck, J., & Holmes, J. (Eds.), Oxford Textbook of Psychotherapy (pp. 329–338). New York: Oxford University Press.Google Scholar
Gartstein, M. A., Putnam, S. P., Aron, E. N., & Rothbart, M. K. (2016). Temperament and personality. In Maltzman, S. (Ed.), The Oxford Handbook of Treatment Processes and Outcomes in Psychology: A Multidisciplinary, Biopsychosocial Approach (pp. 11–41). New York: Oxford University Press.Google Scholar
Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6–41.Google Scholar
Gore, W. L., & Widiger, T. A. (2013). The DSM-5 dimensional trait model and five-factor models of general personality. Journal of Abnormal Psychology, 122(3), 816–821.Google Scholar
Granieri, A., La Marca, L., Mannino, G., Giunta, S., Guglielmucci, F., & Schimmenti, A. (2017). The relationship between defense patterns and DSM-5 maladaptive personality domains. Frontiers in Psychology, 1–12. http://doi.org/10.3389/fpsyg.2017.01926CrossRefGoogle Scholar
Harkness, A. R., & Lilienfeld, S. O. (1997). Individual differences science for treatment planning: Personality traits. Psychological Assessment, 9(4), 349–360.CrossRefGoogle Scholar
Harkness, A. R., & McNulty, J. L. (2006). An overview of personality: The MMPI-2 Personality Psychopathology Five (PSY-5) Scales. In Butcher, J. N. (Ed.), MMPI-2: A Practitioner’s Guide (pp. 73–97). Washington, DC: American Psychological Association.Google Scholar
Hayes, S. (2004). Acceptance and commitment therapy and the new behavior therapies: Mindfulness, acceptance, and relationship. In Hayes, S. C., Follette, V. M., & Linehan, M. M. (Eds.), Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition (pp. 1–29). New York: Guilford Press.Google Scholar
Henderson, A. R. (2013). The impact of social cognition training on recovery from psychosis. Current Opinion in Psychiatry, 26(5), 429–432.Google Scholar
Hopwood, C. J., Schade, N., Krueger, R. F., Wright, A. G. C., & Markon, K. E. (2013). Connecting DSM-5 personality traits and pathological beliefs: Toward a unifying model. Journal of Psychopathology and Behavioral Assessment, 35(2), 162–172.Google Scholar
Hopwood, C. J., & Thomas, K. M. (2014). Schema therapy is an effective treatment for avoidant, dependent and obsessive-compulsive personality disorders. Evidence Based Mental Health, 17(3), 90–91.Google Scholar
Korzekwa, M. I., Dell, P. F., & Pain, C. (2009). Dissociation and borderline personality disorder: An update for clinicians. Current Psychiatry Reports, 11(1), 82–88.CrossRefGoogle ScholarPubMed
Kotov, R., Gamez, W., Schmidt, F., & Watson, D. (2010). Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychological Bulletin, 136(5), 768–821.CrossRefGoogle ScholarPubMed
Krueger, R. F., Derringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42(9), 1879–1890.Google Scholar
Kulkarni, J. (2017). Complex PTSD: A better description for borderline personality disorder? Australasian Psychiatry, 25(4), 333–335.CrossRefGoogle ScholarPubMed
Leising, D., & Zimmermann, J. (2011). An integrative conceptual framework for assessing personality and personality pathology. Review of General Psychology, 15(4), 317–330.Google Scholar
Lejuez, C. W., Hopko, D. R., Acierno, R., Daughters, S. B., & Pagoto, S. L. (2011). Ten year revision of the brief behavioral activation treatment for depression: Revised treatment manual. Behavior Modification, 35(2), 111–161.CrossRefGoogle ScholarPubMed
Linehan, M. M., & Dexter-Mazza, E. T. (2008). Dialectical behavior therapy for borderline personality disorder. In Barlow, D. H. (Ed.), Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual (4th ed., pp. 365–420). New York: Guilford Press.Google Scholar
Livesley, W. J. (2003). Practical Management of Personality Disorder. New York: Guilford Press.Google Scholar
Lotfi, M., Bach, B., Amini, M., & Simonsen, E. (2018). Structure of DSM-5 and ICD-11 personality domains in Iranian community sample. Personality and Mental Health. http://doi.org/10.1002/pmh.1409CrossRefGoogle Scholar
Lynam, D. R., & Widiger, T. A. (2001). Using the Five-Factor Model to represent the DSM-IV personality disorders: An expert consensus approach. Journal of Abnormal Psychology, 110(3), 401–412.Google Scholar
Lynch, T. R., Hempel, R. J., & Dunkley, C. (2015). Radically open-dialectical behavior therapy for disorders of over-control: Signaling matters. American Journal of Psychotherapy, 69 (2), 141–162.Google Scholar
Markon, K. E., Quilty, L. C., Bagby, R. M., & Krueger, R. F. (2013). The development and psychometric properties of an informant-report form of the Personality Inventory for DSM-5 (PID-5). Assessment, 20(3), 370–383.CrossRefGoogle ScholarPubMed
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438–450.Google Scholar
McCrae, R. R., & Costa, P. T. (1995). Trait explanations in personality psychology. European Journal of Personality, 9(4), 231–252.Google Scholar
Miller, J. D., Sleep, C., & Lynam, D. R. (2018). DSM-5 alternative model of personality disorder: Testing the trait perspective captured in Criterion B. Current Opinion in Psychology, 21, 50–54Google Scholar
Miller, T. W., & Kraus, R. F. (2007). Modified dialectical behavior therapy and problem solving for obsessive-compulsive personality disorder. Journal of Contemporary Psychotherapy, 37(2), 79–85.Google Scholar
Millon, T., Grossman, S., Millon, C., Meagher, S., & Ramnath, R. (2004). Personality Disorders in Modern Life (2nd ed.). Hoboken, NJ: John Wiley & Sons.Google Scholar
Morey, L. C., Benson, K. T., & Skodol, A. E. (2016). Relating DSM-5 section III personality traits to section II personality disorder diagnoses. Psychological Medicine, 46(3), 647–655.Google Scholar
Morey, L. C., Krueger, R. F., & Skodol, A. E. (2013). The hierarchical structure of clinician ratings of proposed DSM-5 pathological personality traits. Journal of Abnormal Psychology, 122(3), 836–841.Google Scholar
Oltmanns, T. F., Gleason, M. E. J., Klonsky, E. D., & Turkheimer, E. (2005). Meta-perception for pathological personality traits: Do we know when others think that we are difficult? Consciousness and Cognition, 14(4), 739–751.Google Scholar
Oltmanns, J. R., & Widiger, T. A. (2018). A self-report measure for the ICD-11 dimensional trait model proposal: The Personality Inventory for ICD-11. Psychological Assessment, 30(2), 154–169.Google Scholar
Phillips, M. R. (2009). Is distress a symptom of mental disorders, a marker of impairment, both or neither? World Psychiatry, 8(2), 91–92.Google Scholar
Pires, R., Sousa Ferreira, A., & Gonçalves, B. (2017). The factor structure of the Portuguese version of the personality inventory for DSM-5 (PID-5). European Psychiatry, 41, S259.Google Scholar
Presnall, J. R. (2013). Disorders of personality: Clinical treatment from a Five-Factor Model perspective. In Widiger, T. A. & Costa, P. T. (Eds.), Personality Disorders and the Five-Factor Model of Personality (3rd ed., pp. 409–432). Washington, DC: American Psychological Association.Google Scholar
Renton, J. C., & Mankiewiecz, P. D. (2015). Paranoid, schizotypal, and schizoid personality disorder. In Beck, A. T., Davis, D. D., & Freeman, A. (Eds.), Cognitive Therapy of Personality Disorders (pp. 244–275). New York: Guilford Press.Google Scholar
Roberts, B. W., Hill, P. L., & Davis, J. P. (2017). How to change conscientiousness: The sociogenomic trait intervention model. Personality Disorders: Theory, Research, and Treatment, 8(3), 199–205.Google Scholar
Roberts, B. W., Kuncel, N. R., Shiner, R., Caspi, A., & Goldberg, L. R. (2007). The power of personality: The comparative validity of personality traits, socioeconomic status, and cognitive ability for predicting important life outcomes. Perspectives on Psychological Science, 2(4), 313–345.Google Scholar
Roberts, B. W., Luo, J., Briley, D. A., Chow, P. I., Su, R., & Hill, P. L. (2017). A systematic review of personality trait change through intervention. Psychological Bulletin, 143(2), 117–141.CrossRefGoogle ScholarPubMed
Ronningstam, E. (2010). Narcissistic personality disorder: A current review. Current Psychiatry Reports, 12(1), 68–75.Google Scholar
Safren, S. A. (2006). Cognitive-behavioral approaches to ADHD treatment in adulthood. Journal of Clinical Psychiatry, 67(8), 46–50.Google Scholar
Salekin, R. T. (2002). Psychopathy and therapeutic pessimism: Clinical lore or clinical reality? Clinical Psychology Review, 22(1), 79–122.Google Scholar
Sauer-Zavala, S., Bentley, K. H., & Wilner, J. G. (2016). Transdiagnostic treatment of borderline personality disorder and comorbid disorders: A clinical replication series. Journal of Personality Disorders, 30(1), 35–51.Google Scholar
Schmidt, N. B., Joiner, T. E. Jr., Young, J. E., & Telch, M. J. (1995). The schema questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Cognitive Therapy and Research, 19(3), 295–321.CrossRefGoogle Scholar
Sellbom, M., Bach, B., & Huxley, E. (2018). Related personality disorders located within an elaborated externalizing psychopathology spectrum. In Lochman, J. E. & Matthys, W. (Eds.), The Wiley Handbook of Disruptive and Impulse-Control Disorders (pp. 103–124). Chichester: John Wiley & Sons.Google Scholar
Simon, K. M. (2015). Obsessive-compulsive personality disorder. In Beck, A. T., Davis, D. D., & Freeman, A. (Eds.), Cognitive Therapy of Personality Disorders (3rd ed., pp. 203–222). New York: Guilford Press.Google Scholar
Skodol, A. E., First, M. B., Bender, D. S., & Oldham, J. M. (2018). Module II: Structured clinical interview for personality traits. In First, M. B., Skodol, A. E., Bender, D. S., & Oldham, J. M. (Eds.), Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders (SCID-AMPD). Arlington, VA: American Psychiatric Association.Google Scholar
Smith, T. E., & Samuel, D. B. (2017). A multi-method examination of the links between ADHD and personality disorder. Journal of Personality Disorders, 31(1), 26–48.CrossRefGoogle ScholarPubMed
Stern, B. L., Diamond, D., & Yeomans, F. E. (2017). Transference-focused psychotherapy (TFP) for narcissistic personality: Engaging patients in the early treatment process. Psychoanalytic Psychology, 34(4), 381–396.Google Scholar
Thimm, J. C. (2010). Personality and early maladaptive schemas: A five-factor model perspective. Journal of Behavior Therapy and Experimental Psychiatry, 41(4), 373–380.CrossRefGoogle ScholarPubMed
Tyrer, P. (2002). Nidotherapy: A new approach to the treatment of personality disorder. Acta Psychiatrica Scandinavica, 105(6), 469–471.Google Scholar
Wachtel, P. L. (1973). Psychodynamics, behavior therapy, and the implacable experimenter: An inquiry into the consistency of personality. Journal of Abnormal Psychology, 82(2), 324–334.Google Scholar
Widiger, T. A., & Clark, L. A. (2000). Toward DSM-V and the classification of psychopathology. Psychological Bulletin, 126(6), 946–963.CrossRefGoogle ScholarPubMed
Widiger, T. A., & Costa, P. T. (Eds.) (2013). Personality Disorders and the Five-Factor Model of Personality (3rd ed.). Washington, DC: American Psychological Association.Google Scholar
Widiger, T. A., & Simonsen, E. (2005). Alternative dimensional models of personality disorder: Finding a common ground. Journal of Personality Disorders, 19(2), 110–130.Google Scholar
Widiger, T. A., & Trull, T. J. (1992). Personality and psychopathology: An application of the Five-Factor Model. Journal of Personality, 60(2), 363–393.Google Scholar
World Health Organization. (2019). ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders. Geneva: World Health Organization.Google Scholar
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema Therapy: A Practitioner’s Guide. New York: Guilford Press.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×