From categories to traits: assessing personality dysfunction in ICD-11 and the DSM-5 alternative model for personality disorders

A paradigm shift in the assessment of personality pathology is underway, as diagnosticians move beyond traditional personality disorder categories and assess personality dysfunction using contemporary dimensional frameworks. This article describes the assessment of personality pathology in ICD-11 and the DSM-5 Alternative Model for Personality Disorders (AMPD). Recent findings in this area can be grouped into three domains: reliability, factor structure, and temporal stability of ICD-11 and AMPD constructs, convergence of personality pathology ratings with external indices of psychopathology and adjustment, and clinical utility (e.g., usefulness in rendering clinical decisions, prediction of treatment outcome). Research in this area confirms that level of personality functioning and the presence of one or more pathological personality traits predict an array of clinical outcomes, including symptom disorders (e.g., anxiety, depression), suicide risk, and psychotherapy effectiveness. Findings support the cross-cultural generalizability of these patterns, and the clinical utility of assessing personality functioning and traits in adolescents and adults.