Gilbar Ohad
Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel.
Eur J Psychotraumatol. 2025 Dec;16(1):2541472. doi: 10.1080/20008066.2025.2541472. Epub 2025 Sep 4.
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. 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. 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). 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. 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.
国际疾病分类第11版（ICD - 11）中人格障碍（PD）的新分类方式从分类型人格障碍类型转变为了人格障碍严重程度维度。这一变化引发了一场关于新的国际疾病分类第11版人格障碍严重程度量表（PDS - ICD - 11）是否可能与复杂创伤后应激障碍（CPTSD）集群，特别是自我组织障碍（DSO）集群重叠的争论。人格障碍和复杂创伤后应激障碍这两种障碍都包含自我和人际关系受损的情况；此外，由于两者都是基于创伤的障碍，目前尚不清楚不同的创伤风险因素是否分别适用于这两种障碍。本研究有两个目的：第一，使用新的PDS - ICD - 11严重程度量表（PDS）来评估患有高水平人格障碍和复杂创伤后应激障碍的亲密伴侣暴力男性施暴者这一独特群体中人格障碍的心理测量特性；第二，研究接触不同类型的创伤事件和依恋风格是否会与人格障碍和复杂创伤后应激障碍集群产生不同的关联。参与者为116名在18个家庭暴力中心接受治疗的男性。使用国际创伤问卷和PDS - ICD - 11（希伯来语版本）收集数据。在去除自我伤害症状后，验证性因素分析支持了PDS - ICD - 11的因素效度。童年累积创伤和焦虑依恋与人格障碍、创伤后应激障碍和自我组织障碍相关，而近期接触创伤和回避依恋仅与自我组织障碍相关。该研究支持了在新的PDS - ICD - 11量表对人格障碍和复杂创伤后应激障碍的定义内进行构念区分的心理测量。具体而言，即使在自我组织障碍与人格障碍在自我和人际关系受损功能方面存在相似内容的情况下，该研究也支持这种区分。童年创伤暴露和心理伤害相关风险因素不存在显著差异，这支持了所有诊断共享相同病因风险因素的理解。
