Personality Disorder Severity–ICD-11 Scale and CPTSD ICD-11 Scale: examining possible psychometric properties and diagnostic concept overlap

Background: The new way of categorising ICD-11 Personality Disorder (PD) moved from categorical PD types to a dimension of PD severity. This change has raised a debate regarding the question of whether the new PDS-ICD-11 possibly overlaps with Complex Post-Traumatic Stress Disorder (CPTSD) clusters, specifically the Disturbances in Self-Organization (DSO) cluster. Both disorders, PD and CPTSD, contain self and interpersonal impairment; moreover, as both are trauma-based disorders, it is unclear if different trauma risk factors apply to each. Objective: The current study had two aims: first, to use the new PDS-ICD-11 severity scale (PDS) to assess the psychometric properties of PD in a unique population of male perpetrators of intimate partner violence who suffer from high levels of PD and CPTSD: second, to examine whether exposure to different types of traumatic events and attachment styles would be associated differently with PD and with CPTSD clusters. Method: Participants were 116 males receiving treatment at 18 domestic violence centres. Data were collected using the International Trauma Questionnaire and the PDS-ICD-11 (Hebrew versions). Results: Confirmatory factor analysis supported the factorial validity of PDS-ICD-11, after removing the self-injury symptom. Cumulative childhood trauma and anxiety attachment were associated with PD, PTSD, and DSO, while recent exposure to trauma and avoidance attachment was associated only with DSO. Conclusions: The study supports the psychometric of construct distinction within the new PDS-ICD-11 scale’s definitions of PD and CPTSD. Specifically, it supports the distinctions even where there is similar content of DSO and PD dysfunction of the self and interpersonal impairment. The absence of significant differences in risk factors relating to childhood trauma exposure and psychological injuries support the understanding that all diagnoses shared the same aetiological risk factors.