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A number of measures and scales have been developed for the ICD-11 personality disorder (PD) diagnosis, including severity and trait dimensions. The present systematic review and meta-analysis sought to evaluate the internal consistency of these measures across different populations and cultures. A systematic search was conducted across four databases where relevant studies were subjected to explicit eligibility criteria resulting in 49 included studies and 370 effect sizes. Study characteristics were tabulated, their methodological quality was evaluated, and findings were synthesized using random effects meta-analysis. Findings overall indicated that measures of ICD-11 PD severity and trait domains have adequate levels of internal consistency (α/ω = 0.82, 95% CI [0.81; 0.83], I 2  = 97.3%). Aspects such as sample, country, language, format, and measured construct were significant sources of variation. Additional meta-analyses revealed that some measures performed better than others for certain dimensions. Internal consistency was overall supported across ICD-11 measures of severity and trait domains. Future research should further investigate the interrater reliability, test-retest reliability and stability, and alignment with interview-based PD diagnoses., (© 2024 The Author(s). Personality and Mental Health Published by John Wiley & Sons Ltd.)

Background: Personality disorder (PD) in ICD-11 is defined primarily by self and interpersonal dysfunction and optionally by other qualifiers. This definition is inseparable from relativism of cultural determinants., Aims: This review aimed to synthesize the relevant aspects of the influence of culture on clinical practice and health management for this condition, aligning them to the ICD-11 PD model., Method: In Scopus, we systematically searched for studies that included the text strings: cultur* | personality AND (disorder* OR patholog*) without any restrictions on publication date or language or other exclusion criteria, up to November 2022., Results: Evidence suggests that cultural variables in ethnic groups (Western and non-Western) such as the individualist/collectivist philosophy, historical/generational trauma, immigration, acculturation, religion, and gender influence the etiology, semiology, epidemiology, evaluation, diagnosis, treatment, and management of health services for ICD-11 PD. We discuss the limitations and propose future lines of research on this topic based on our knowledge and experience. In this review, we provide the scientific community and clinicians with relevant cultural information to guide their practice and propose strategies to manage PD from the ICD-11 model., Conclusions: More research is needed using mixed study methodologies on stigma, the experiences of patients, clinicians, and health agencies, to reduce the care gaps and achieve a culturally comprehensive, inclusive, and competent use of this new model.

In the current diagnostic systems, the International Classification of Diseases-11th rev. (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders-5th ed. (DSM-5), the evaluation and diagnosis of personality disorder (PD) aim at dimensional examination of the severity of its dysfunction and the stylistic features that accompany it. Since their implementation, or even before, several measures have been developed to assess PD severity and traits in both models. Thus, convergent validity metrics have been reported with various PD measures; however, the convergence of the same constructs included in the measures of these two models remains undefined. The objective of the present review was to examine whether there is a sufficient relationship between PD measures of the ICD-11 and DSM-5 AMPD in the general population. For this meta-analytic review, systematic searches were conducted in Web of Science, PubMed, Scopus, and Google Scholar. We included studies that reported Pearson's r correlations without restrictions on language, age, sex, setting, type of sample, or informant of the measures. We excluded associations with anankastia, psychoticism or the borderline pattern because they were not comparable between one dimensional model and the other. We examined the quality of the evidence with the JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies, and performed the random effects meta-analysis with the 'meta' package of the RStudio software. Of the 5,629 results returned by the search, 16 studies were eligible; and showed moderate quality. The risk of bias was manifested by not specifying the details of the sample, the recruitment environment, and the identification and control of confounding factors. Thirteen studies provided two or more correlations resulting in a total of 54 studies for meta-analysis. The overall effect size estimate (correlation) was moderate for the overall model ( r  = 0.62, 95% CI [0.57, 0.67], p  < 0.0001, I 2  = 97.6%). For the subgroup of associations, ICD-11 severity model and DSM-5 AMPD severity model, the correlation was also moderate ( k  = 10, r  = 0.57, 95% CI [0.48; 0.66]; I 2  = 92.9%); as for the subgroup of associations, ICD-11 traits model and DSM-5 AMPD traits model ( k  = 44, r  = 0.63, 95% CI [0.57; 0.69], I 2  = 97.9%). The convergent validity between measures of PD severity and traits between one diagnostic system and another has been demonstrated in this review and they can probably be used interchangeably because they also measure the same constructs. Future research can address the limitations of this study and review the evidence for the discriminant validity of these measures., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hualparuca-Olivera, Caycho-Rodríguez, Torales and Ramos-Campos.)