ICD-11 Criteria for Prominent Personality Traits or Patterns (6D11)
Trait domain qualifiers may be applied to Personality Disorders or Personality Difficulty to describe the characteristics of the individual’s personality that are most prominent and that contribute to personality disturbance. Trait domains are continuous with normal personality characteristics in individuals who do not have Personality Disorder or Personality Difficulty. Trait domains are not diagnostic categories, but rather represent a set of dimensions that correspond to the underlying structure of personality. As many trait domain qualifiers may be applied as necessary to describe personality functioning. Individuals with more severe personality disturbance tend to have a greater number of prominent trait domains.
6D11.0 Negative Affectivity in Personality Disorder or Personality Difficulty
The core feature of the Negative
Affectivity trait domain is the tendency to experience a broad range of
negative emotions. Common manifestations of Negative Affectivity, not all of
which may be present in a given individual at a given time, include: experiencing
a broad range of negative emotions with a frequency and intensity out of
proportion to the situation; emotional lability and poor emotion regulation;
negativistic attitudes; low self-esteem and self-confidence; and
mistrustfulness.
Coding Note: This category should ONLY be used in combination with a Personality disorder category (Mild, Moderate, or Severe) or Personality difficulty.
6D11.1 Detachment in personality disorder or personality difficulty
The core feature of the Detachment
trait domain is the tendency to maintain interpersonal distance (social
detachment) and emotional distance (emotional detachment). Common
manifestations of Detachment, not all of which may be present in a given
individual at a given time, include: social detachment (avoidance of social
interactions, lack of friendships, and avoidance of intimacy); and emotional
detachment (reserve, aloofness, and limited emotional expression and
experience).
Coding Note: This category should ONLY be used in combination with a Personality disorder category (Mild, Moderate, or Severe) or Personality difficulty.
6D11.2 Dissociality in personality disorder or personality difficulty
The core feature of the
Dissociality trait domain is disregard for the rights and feelings of others,
encompassing both self-centeredness and lack of empathy. Common manifestations
of Dissociality, not all of which may be present in a given individual at a
given time, include: self-centeredness (e.g., sense of entitlement, expectation
of others’ admiration, positive or negative attention-seeking behaviours,
concern with one's own needs, desires and comfort and not those of others); and
lack of empathy (i.e., indifference to whether one’s actions inconvenience hurt
others, which may include being deceptive, manipulative, and exploitative of
others, being mean and physically aggressive, callousness in response to
others' suffering, and ruthlessness in obtaining one’s goals).
Coding Note: This category should ONLY be used in combination with a Personality disorder category (Mild, Moderate, or Severe) or Personality difficulty.
6D11.3 Disinhibition in personality disorder or personality difficulty
The core feature of the
Disinhibition trait domain is the tendency to act rashly based on immediate
external or internal stimuli (i.e., sensations, emotions, thoughts), without
consideration of potential negative consequences. Common manifestations of
Disinhibition, not all of which may be present in a given individual at a given
time, include: impulsivity; distractibility; irresponsibility; recklessness;
and lack of planning.
Coding Note: This category should ONLY be used in combination with a Personality disorder category (Mild, Moderate, or Severe) or Personality difficulty.
6D11.4 Anankastia in personality disorder or personality difficulty
The core feature of the Anankastia
trait domain is a narrow focus on one’s rigid standard of perfection and of
right and wrong, and on controlling one’s own and others’ behaviour and
controlling situations to ensure conformity to these standards. Common
manifestations of Anankastia, not all of which may be present in a given
individual at a given time, include: perfectionism (e.g., concern with social
rules, obligations, and norms of right and wrong, scrupulous attention to
detail, rigid, systematic, day-to-day routines, hyper-scheduling and
planfulness, emphasis on organisation, orderliness, and neatness); and
emotional and behavioural constraint (e.g., rigid control over emotional
expression, stubbornness and inflexibility, risk-avoidance, perseveration, and
deliberativeness).
Coding Note: This category should ONLY be used in combination with a Personality disorder category (Mild, Moderate, or Severe) or Personality difficulty.
6D11.5 Borderline pattern
The Borderline pattern specifier
may be applied to individuals whose pattern of personality disturbance is
characterised by a pervasive pattern of instability of interpersonal
relationships, self-image, and affects, and marked impulsivity, as indicated by
many of the following: Frantic efforts to avoid real or imagined abandonment; A
pattern of unstable and intense interpersonal relationships; Identity
disturbance, manifested in markedly and persistently unstable self-image or
sense of self; A tendency to act rashly in states of high negative affect,
leading to potentially self-damaging behaviours; Recurrent episodes of
self-harm; Emotional instability due to marked reactivity of mood; Chronic
feelings of emptiness; Inappropriate intense anger or difficulty controlling
anger; Transient dissociative symptoms or psychotic-like features in situations
of high affective arousal.
Coding Note: This category should ONLY be used in combination with a Personality disorder category (Mild, Moderate, or Severe) or Personality difficulty.
REFERENCE:
International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.
https://creativecommons.org/licenses/by-nc-nd/3.0/igo/
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