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BackgroundThere is a presumption that pathological narcissism, or narcissistic personality disorder per se, can be considered a precursor to addiction. Although the ICD-11 model does not distinguish specific personality disorders, narcissistic psychopathology should be captured through personality trait qualifiers.ObjectivesTo verify the capacity of the ICD-11 model in the detection of narcissistic psychopathology in patients with addiction; to test its discrimination capacity, convergent validity, and specificity toward the gender and the type of addiction.Materials and methodsTwo samples were employed in the study. Sample 1 (n = 421) consisted of patients with addiction; Sample 2 (n = 567) consisted of general population volunteers. Age range was 18–75 years and a battery of self-assessment questionnaires containing Personality Inventory for DSM-5–Brief Form Plus Modified; Triarchic Psychopathy Measure; Hypersensitive Narcissism Scale; and Level of Personality Functioning Scale-Self-Report was administered by pencil-and-paper method.ResultsThe following was confirmed: (1) capacity of the ICD-11 model in relation to capture narcissistic pathology; (2) the differentiation capacity between the clinical and non-clinical population; (3) gender specificity in relation to grandiose and vulnerable narcissism; (4) the connection between the overall degree of impairment in personality functioning and most of trait qualifiers; (5) certain specifics of patients with addiction in relation to the type of addiction.ConclusionResults support the empirical and clinical relevance of the ICD-11 model in capturing narcissistic pathology in addicted patients. Clinical implications concerning assessment and treatment in addiction settings, and certain limits regarding the Anankastia domain are discussed.

Background: Personality pathology does not have to be a contraindication to a bariatric surgery if a proper pre-surgical assessment is done. Indicating subgroups of patients with their specific needs could help tailor interventions and improve surgical treatment outcomes.Objectives: Using the Alternative DSM-5 model for personality disorders (AMPD) and the ICD-11 model for PDs to detect subgroups of patients with obesity based on a specific constellation of maladaptive personality traits and the level of overall personality impairment.Methods: 272 consecutively consented patients who underwent a standard pre-surgical psychological assessment. The majority were women (58.0%), age range was 22–79 years (M = 48.06, SD = 10.70). Patients’ average body mass index (BMI) was 43.95 kg/m2. All participants were administered the Personality Inventory for DSM-5 (PID-5) from which Level of Personality Functioning Scale-Self Report (LPFS-SR) and Standardized Assessment of Severity of Personality Disorder (SASPD) scores were gained using the “crosswalk” for common metric for self-reported severity of personality disorder. The k-means clustering method was used to define specific subgroups of patients with obesity and replicated for equality testing to the samples of non-clinical respondents and psychiatric patients.Results: The cluster analysis detected specific groups in the sample of patients with obesity, which differed quantitatively from the samples of non-clinical respondents and psychiatric patients. A vast majority of patients with obesity showed above-average values in most of the PID-5 facets compared to the United States representative general community sample. In two out of the three clusters defined, patients demonstrated moderate (> M + 1.5 × SD) to severe (> M + 2.0 × SD) personality psychopathology within the Detachment and Negative Affectivity domains according to PID-5, which in one of the clusters corresponded to the mild overall impairment in both, LPFS-SR (M = 2.18, SD = 0.27) and SASPD (M = 8.44, SD = 2.38). Moreover, higher levels of psychopathology prove to be associated with higher age and use of psychiatric medication.Conclusions: The dimensional DSM-5 and ICD-11 trait models are suitable procedures for defining specific “characters” of patients in a pre-bariatric setting. As such, they help to identify subgroups of patients with obesity who are different from general population and psychiatric patients. Implications for clinical practice and further research are discussed.

Background: Empirical soundness and international robustness of the PID5BF+M, a shortened version of the PID-5 developed for simultaneous evaluation of maladaptive personality traits in the DSM-5 AMPD and ICD-11 models for personality disorders, was recently confirmed in 16 samples from different countries. Because the modified PID5BF+ scale (36 items) was extracted from the complete 220-item PID-5, an independent evaluation of psychometric properties of a stand-alone PID5BF+M is still missing.Objectives: The present study evaluated the validity and reliability of the 36-item PID5BF+M in comparison with the extracted version from the original PID-5. It also assessed associations between the Borderline Pattern qualifier and trait domain qualifiers.Methods: Two non-clinical samples meeting the inclusion criteria were employed in the study. Sample 1 (n = 614) completed the 220-item PID-5; Sample 2 (n = 1,040) completed the independent 36-item PID5BF+M. Participants were from all 14 regions of the Czech Republic. The Borderline Pattern qualifier was evaluated using a shortened IPDEQ screener.Results: The proposed latent structure of the independent PID5BF+M was confirmed, with an exception of the Disinhibition domain. The results confirmed good internal consistency and test-retest reliability of the measure, as well as some support for the measurement invariance of the independent PID5BF+M in comparison with the extracted version from the original PID-5. Significant associations between the Negative affectivity, Disinhibition, and Psychoticism qualifiers and the IPDEQ items for the emotionally unstable personality disorder of both impulsive and borderline types confirmed good predictive validity of the PID5BF+M in pursuing borderline psychopathology within the ICD-11 model.Conclusions: The independent PID5BF+M was found to be a valid and reliable tool for evaluation of the ICD-11 trait model. However, the Disinhibition domain deserves further investigation in clinical samples as well as in international community samples.

Obesity is a metabolic disorder conditioned by several factors with the individual genetic proneness to accumulation of body fat with a positive energetic balance. If such definition describes the essential nature of obesity aptly, the treatment thereof ought to be the realm of somatic medicine and somatically oriented physicians, which is, unfortunately, frequently the case. Yet, not only being a disorder concerning improper body composition, but also a difference in cognitive processes and emotions of the obese, obesity needs to be considered in a more complex manner. The life of the obese consists of periods of strict, starvation diets on one hand and total loss of control and excessive calorie intake. Therefore, the corresponding therapy also needs to be provided in a more complex fashion, i.e. it is not solely the somatic disorder that should be addressed, but also the emotions and cognitions which induce the undesirable behaviour. Generally, it is possible to summarise that cognition and emotions are likely to be anticipated, directed and controlled by affecting the stimuli promoting the erratic attitude. Thanks to the achievements which relate not only to loss of weight, but also to higher self-esteem, more gratifying feelings aroused by the patients self, improvement of both physical and mental conditions and enhancement of the quality of life as a whole, the new behaviour patterns are established, strengthened and sustained on a long-term basis. Several psychotherapeutic attitudes/methods may be used with cognitive-behavioral therapy, existential therapy and, recently, psychodynamic approach. The psychologists role is essential and fundamental in both conservative and the metabolic-bariatric treatment of obesity. The most common character traits of obese patients include predominantly neuroticism, which comprises anxiety, depressions, impulsiveness, anger and hostility. Likewise, obesity is often suffered from by children and adolescents and its treatment relies on, in like manner as with adults, an active change of unsuitable dietary and movement habits with the family of the patient and their motivation of the patient to make the desirable change. It needs to be noted, however, that except for the changes in lifestyle, treatment of psychological difficulties accompanying obesity is a part of psychotherapy of such a group of young and adolescent patients.

Introduction: The DSM-5 Alternative Model of Personality Disorders (AMPD) and the ICD-11 classification of personality disorders (PD) are largely commensurate and, when combined, they delineate 6 trait domains: negative affectivity, detachment, antagonism/dissociality, disinhibition, anankastia, and psychoticism. Objective: The present study evaluated the international validity of a brief 36-item patient-report measure that portrays all 6 domains simultaneously including 18 primary subfacets. Methods: We developed and employed a modified version of the Personality Inventory for DSM-5 – Brief Form Plus (PID5BF+). A total of 16,327 individuals were included, 2,347 of whom were patients. The expected 6-factor structure of facets was initially investigated in samples from Denmark (n = 584), Germany (n = 1,271), and the USA (n = 605) and subsequently replicated in both patient- and community samples from Italy, France, Switzerland, Belgium, Norway, Portugal, Spain, Poland, Czech Republic, the USA, and Brazil. Associations with interview-rated DSM-5 PD categories were also investigated. Results: Findings generally supported the empirical soundness and international robustness of the 6 domains including meaningful associations with familiar interview-rated PD types. Conclusions: The modified PID5BF+ may be employed internationally by clinicians and researchers for brief and reliable assessment of the 6 combined DSM-5 and ICD-11 domains, including 18 primary subfacets. This 6-domain framework may inform a future nosology for DSM-5.1 that is more reasonably aligned with the authoritative ICD-11 codes than the current DSM-5 AMPD model. The 36-item modified PID5BF+ scoring key is provided in online supplementary Appendix A see www.karger.com/doi/10.1159/000507589 (for all online suppl. material).

To date, numerous studies have confirmed empirical relevance of the personality trait model defined in the Alternative DSM-5 Model for Personality Disorders. The supposed single-factor structure of its facets and general domains across various samples, however, has not been researched thoroughly. This study focused on evaluating the hypothesized unidimensional factor structure of the lower-order personality trait facets, as well as the validity of the higher-order domains. The Czech version of the Personality Inventory for DSM-5 (PID-5) was used in a sample of 351 community volunteers and 143 psychiatric patients. The fit of the model for 25 facets could not be replicated with the original PID-5, while a shortened version confirmed the single-factor structure of all facets and their relevance to the five proposed domains. The findings support unidimensional structure of the modified DSM-5 personality trait model and imply discussion of the utility of the proposed PID-5 version. Copyright © 2018 John Wiley & Sons, Ltd.

To date, numerous studies have confirmed empirical relevance of the personality trait model defined in the Alternative DSM-5 Model for Personality Disorders. The supposed single-factor structure of its facets and general domains across various samples, however, has not been researched thoroughly. This study focused on evaluating the hypothesized unidimensional factor structure of the lower-order personality trait facets, as well as the validity of the higher-order domains. The Czech version of the Personality Inventory for DSM-5 (PID-5) was used in a sample of 351 community volunteers and 143 psychiatric patients. The fit of the model for 25 facets could not be replicated with the original PID-5, while a shortened version confirmed the single-factor structure of all facets and their relevance to the five proposed domains. The findings support unidimensional structure of the modified DSM-5 personality trait model and imply discussion of the utility of the proposed PID-5 version. Copyright © 2018 John WileySons, Ltd.

IntroductionSection III of 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a hybrid model of personality pathology, in which dimensional personality traits (PTs) are used to derive one of six categorical Personality Disorder (PD) diagnoses. The Personality Inventory for DSM-5 (PID-5) has been developed to assess PTs within this new system.ObjectivesPT is a tendency to feel, perceive, behave, and think in relatively consistent ways across time and situations. PD diagnosis is generally stated if a pattern of maladaptive PTs persists at least 5 years. Nevertheless, the PID-5 instruction does not cover duration of symptoms.AimsWe have explored the effect of two different types of instructions, in which duration of symptoms is or is not explicitly mentioned, on the PID-5 scores. Moreover, we have asked whether the scores differ in psychiatric patients and healthy individuals.MethodsDifferences between original and modified instructions of the Czech PID-5 version have been evaluated in a group of 62 psychiatric patients and 38 healthy controls; each respondent has been administered both instruction types in random sequence. ANOVA mixed design has been used to test the relation between groups and different sequence of administration.ResultsWe have found no consistent differences in PID-5 scores using the different types of instruction described above.ConclusionsIn our sample, PID-5 seems to reflect strong beliefs of a subject regardless of symptoms’ duration and could be reliably used with both types of instruction. The PID-5 represents an appropriate instrument for the assessment of maladaptive PTs.Disclosure of interestThe authors have not supplied their declaration of competing interest.