The Construct Validity of the ICD-11 Severity of Personality Dysfunction Under Scrutiny of Object-Relations Theory

Amin Nazari; Steven K Huprich; Azad Hemmati; Farzin Rezaei

doi:10.3389/fpsyt.2021.648427

The Construct Validity of the ICD-11 Severity of Personality Dysfunction Under Scrutiny of Object-Relations Theory

Front Psychiatry. 2021 Jul 22:12:648427. doi: 10.3389/fpsyt.2021.648427. eCollection 2021.

Authors

Amin Nazari¹, Steven K Huprich^{2

3}, Azad Hemmati¹, Farzin Rezaei⁴

Affiliations

¹ Department of Psychology, University of Kurdistan, Sanandaj, Iran.
² Department of Psychology, University of Detroit Mercy, Detroit, MI, United States.
³ Department of Psychiatry and Behavioral Sciences, College of Human Medicine, Michigan State University, Lansing, MI, United States.
⁴ Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Abstract

The current classification of personality disorder in ICD-11 includes a description of personality functioning, derived from a number of theoretical paradigms, but most notably consistent with the psychodynamic approach. Concurrently, an object-relations model of personality functioning in a dimensional assessment of severity is provided in the Structured Interview of Personality Organization-Revised (STIPO-R). To date, there are no published measures of International Classification of Diseases-11 (ICD-11) personality severity, though the construct is very comparable to the concepts assessed in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) levels of personality functioning concept, which is measured by the Level of Personality Functioning Scale-Self-Report (LPFS-SR). This study examined the validity of ICD-11 personality functioning, as measured by the LPFS-SR, by evaluating its associations with the STIPO-R in Kurdistan region. The samples included 231 University students and 419 inpatient participants across four hospitals (267 with a diagnosed personality disorder). All the components of LPFS-SR and STIPO-R were positively and significantly intercorrelated. The components of each measure discriminated PD and non-PD patients from a University, non-clinical group adequately. Despite slightly better performance of the STIPO-R in this discrimination, the measures had a high congruence in predicting personality dysfunction. Overall, the findings of the present study support the validity of ICD-11 construct for evaluating personality functioning.

Keywords: ICD-11; LPFS-SR; STIPO-R; object-relations theory; severity of personality dysfunction.