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Table 5 Trait domain qualifiers that contribute to the expression of personality dysfunction

From: Application of the ICD-11 classification of personality disorders

Trait domain Core definition Specific features
Negative Affectivity A tendency to experience a broad range of negative emotions with a frequency and intensity out of proportion to the situation. Anxiety, anger, worry, fear, vulnerability, hostility, shame, depression, pessimism, guilt, low self-esteem, and mistrustfulness. For example, once upset, such individuals have difficulty regaining their composure and must rely on others or on leaving the situation to calm down.
Detachment A tendency to maintain interpersonal distance (social detachment) and emotional distance (emotional detachment) Social detachment including avoidance of social interactions, lack of friendships, and avoidance of intimacy. Emotional detachment including being reserved, aloofness, and limited emotional expression and experience. For example, such individuals seek out employment that does not involve interactions with others.
Dissociality Disregard for the rights and feelings of others, encompassing both self-centeredness and lack of empathy. Self-centeredness including entitlement, grandiosity, expectation of others’ admiration, and attention-seeking. Lack of empathy including being deceptive, manipulative, exploiting, ruthless, mean, callous, and physically aggressive, while sometimes taking pleasure in others’ suffering. For example, such individuals respond with anger or denigration of others when they are not granted admiration.
Disinhibition A tendency to act rashly based on immediate external or internal stimuli (i.e., sensations, emotions, thoughts), without consideration of potential negative consequences. Impulsivity, distractibility, irresponsibility, recklessness, and lack of planning. For example, such individuals may be engaged in reckless driving, dangerous sports, substance use, gambling, and unplanned sexual activity.
Anankastia A narrow focus on one’s rigid standard of perfection and of right and wrong, and on controlling one’s own and others’ behaviour and controlling situations to ensure conformity to these standards. Perfectionism including concern with rules, norms of right and wrong, details, hyper-scheduling, orderliness, and neatness. Emotional and behavioral constraint including rigid control over emotional expression, stubbornness, risk-avoidance, perseveration, and deliberativeness. For example, such individuals may stubbornly redo the work of others because it does not meet their standards.
  1. Note. Adapted from the ICD-11 Clinical Descriptions and Diagnostic Guidelines for Personality Disorder, which include a more detailed description of the trait domain qualifiers