Classification of Personality Disorders and Related Traits According to the ICD-11

Diagnostic Requirements

Personality refers to an individual’s characteristic way of behaving, experiencing life, and of perceiving and interpreting themselves, other people, events, and situations. Personality Disorder is a marked disturbance in personality functioning, which is nearly always associated with considerable personal and social disruption. The central manifestations of Personality Disorder are impairments in functioning of aspects of the self (e.g., identity, self-worth, capacity for self-direction) and/or problems in interpersonal functioning (e.g., developing and maintaining close and mutually satisfying relationships, understanding others’ perspectives, managing conflict in relationships). Impairments in self-functioning and/or interpersonal functioning are manifested in maladaptive (e.g., inflexible or poorly regulated) patterns of cognition, emotional experience, emotional expression, and behaviour.

The following diagnostic requirements for Personality Disorder present a set of Essential Features, all of which must be present to diagnose a Personality Disorder. Once the diagnosis of a Personality Disorder has been established, it should be described in terms of its level of severity: 　

6D10.0 Mild Personality Disorder
6D10.1 Moderate Personality Disorder
6D10.2 Severe Personality Disorder

A category relevant to this grouping is: QE50.7 Personality Difficulty

Personality Difficulty is not classified as a mental disorder, but rather is listed in the grouping of Problems Associated with Interpersonal Interactions in the chapter on Factors Influencing Health Status or Contact with Health Services. Personality Difficulty refers to pronounced personality characteristics that may affect treatment or health services but do not rise to the level of severity to merit a diagnosis of Personality Disorder.

Personality Disorder and Personality Difficulty can be further described using five trait domain specifiers. These trait domains describe the characteristics of the individual’s personality that are most prominent and that contribute to personality disturbance. As many as necessary to describe personality functioning should be applied.

Trait domain specifiers that may be recorded include the following:

6D11.0 Negative Affectivity
6D11.1 Detachment
6D11.2 Dissociality
6D11.3 Disinhibition
6D11.4 Anankastia

More detailed guidance about the personality characteristics reflected in the trait domain specifiers is provided in the respective sections.

Clinicians may also wish to add an additional specifier for ‘Borderline pattern’:

6D11.5 Borderline pattern

The Borderline pattern specifier has been included to enhance the clinical utility of the classification of Personality Disorder. Specifically, use of this specifier may facilitate the identification of individuals who may respond to certain psychotherapeutic treatments.

A complete description of a particular case of Personality Disorder includes the rating of the severity level and the assignment of the applicable trait domain specifiers (e.g., Mild Personality Disorder with Negative Affectivity and Anankastia; Severe Personality Disorder with Dissociality and Disinhibition.) The Borderline pattern specifier is considered optional but, if used, should ideally be used in combination with the trait domain specifiers (e.g., Moderate Personality Disorder with Negative Affectivity, Dissociality, and Disinhibition, Borderline pattern).

Subcategories

ICD-11 Criteria for Personality disorder (6D10)

ICD-11 Criteria for Prominent personality traits or patterns (6D11)

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