RESUMEN
While mental health treatments have proven to be effective for a range of mental health problems, there is comparably little research on its effects on personality disorders or difficulty (PD). New dimensional conceptualizations of PD such as the ICD-11 PD model enable the cost- and time-effective dimensional assessment of severity and style of PD. Furthermore, they constitute a promising tool to investigate PD, not only as a treatment endpoint but also as a predictive or influencing factor for mental health treatments. In this study, we investigated the effects in two different mental health treatment settings [online (N = 38); face-to-face and blended [FTF/blended] (N = 35)] on the reduction of maladaptive personality traits as well as the interaction between maladaptive personality patterns and the response on primary endpoints (i.e., mental distress). Results indicate that both treatment settings have comparable within-group effects on the reduction of distress symptoms, while the treatment in the FTF/blended setting seems to have a stronger impact on the reduction of maladaptive traits. Further, reduction of maladaptive trait expressions was a reliable predictor of treatment response in the FTF/blended setting while explaining less variance in the online setting. Beyond the promising findings on the utility of maladaptive trait change as an outcome measure, we discuss possible applications as an information source for treatment decisions.
RESUMEN
PURPOSE OF REVIEW: The International Classification of Diseases-11th edition (ICD-11) is poised to make a dramatic change in the diagnosis of personality disorders by introducing a fully dimensionalized framework. In this paper, the history of this process is reviewed, along with international efforts taken to address some underlying concerns with this transition. Recent studies of this framework are also reviewed. RECENT FINDINGS: Studies have concluded that the ICD-11 proposal is supported; however, there are a number of methodological limitations to these studies, including the utilization of measures that are not directly derived from the ICD-11 description of levels of personality severity and trait domains. There is a clear need for additional studies with measures that directly reflect the ICD-11 description of personality disorders. While there are some potentially positive effects of moving toward the dimensional model, there are a number of concerns remaining about the clinical utility of moving in this way.