Psychosocial working conditions, perceived patient safety and their association in emergency medical services workers in Germany - a cross-sectional study.

BACKGROUND: Emergency medical service (EMS) workers face challenging working conditions that are characterized by high stress and a susceptibility to making errors. The objectives of the present study were (a) to characterize the psychosocial working conditions of EMS workers, (b) to describe the perceived quality of patient care they provide and patient safety, and (c) to investigate for the first time among EMS workers associations of psychosocial working conditions with the quality of patient care and patient safety. METHODS: For this cross-sectional study, we carried out an online survey among 393 EMS workers who were members of a professional organization. Working conditions were measured by the Demand-Control-SupportQuestionnaire (DCSQ) and seven self-devised items covering key stressors. Participants reported how often they perceived work stress to affect the patient care they provided and we inquired to what extent they are concerned to have made a major medical error in the last three months. Additionally, we used parts of the Emergency Medical Services - Safety Inventory (EMS-SI) to assess various specific errors and adverse events. We ran descriptive analyses (objective a and b) and multivariable logistic regression (objective c). RESULTS: The most common stressors identified were communication problems (reported by 76.3%), legal insecurity (69.5%), and switching of colleagues (48.9%) or workplaces (44.5%). Overall, 74.0% reported at least one negative safety outcome based on the EMS-SI. Concerns to have made an important error and the perception that patient care is impaired by work stress and were also frequent (17.8% and 12.7%, respectively). Most psychosocial working conditions were associated with the perception that patient care is impaired due to work stress. CONCLUSIONS: Work stress in EMS staff is pronounced and negative safety outcomes or potential errors are perceived to occur frequently. Poor psychosocial working conditions were only consistently associated with perceived impairment of patient care due to work stress. It seems necessary to reduce communication problems and to optimize working processes especially at interfaces between emergency services and other institutions. Legal insecurity could be reduced by clarifying and defining responsibilities. Communication and familiarity between team colleagues could be fostered by more consistent composition of squads.

Public Stigma and Continuum Beliefs Across Personality Disorder Severity Levels.

Stigmatizing attitudes toward persons with personality disorders are common. Preliminary evidence suggests that continuum beliefs (the view that presented symptoms lie on a continuum with normality) are associated with reduced personality disorder stigma. This study aimed to evaluate whether this association holds across the entire spectrum of personality disorder severity and whether greater personality disorder severity is linked to higher stigma. A general population sample (N = 848) completed questions about a vignette depicting mild, moderate, or severe personality disorder severity. Higher continuum beliefs were associated with a lower desire for social distance from persons with mild, moderate, or severe personality disorder. In addition, continuum beliefs were higher, and the desired social distance was lower toward a person with mild than a person with moderate or severe personality disorder. Thus, fostering continuum beliefs might aid in combating personality disorder stigma, including toward severely affected persons who experience strong stigmatization.

The various facets of orthorexic eating behavior: five case reports of individuals with supposed orthorexia nervosa.

BACKGROUND: Orthorexia nervosa, defined as a fixation on eating healthy according to subjective criteria, is recently being discussed as another variant of disordered eating behavior. Further characteristics are rigid adherence to nutritional rules, anxieties and avoidance behavior in the context of eating as well as a focus on health, not on body shape or weight loss, which is supposed to differentiate orthorexic from other disordered eating behavior. Although diagnostic criteria have been suggested, they have rarely been used in case reports published to date. Hence, the aim of this study was to present five individuals with supposed orthorexia nervosa, using preliminary diagnostic criteria to assess their eating behavior. CASE PRESENTATION: The five cases (three females, two males) reveal the great variety of disordered eating behavior. Fear of unhealthy overweight (case A), supposed orthorexic eating behavior as a coping strategy for anorexia nervosa (case B), the exclusive consumption of animal products with a total exclusion of fruits and vegetables (case C), the fixation on exercise and athletic goals (case D) as well as a focus on a vegan diet and unprocessed foods (case E) are facets of orthorexia nervosa with varying degrees of impairment. CONCLUSIONS: It is concluded that orthorexia nervosa manifests itself in very different ways and that more research is needed in order to determine whether it could be a useful additional category of disordered eating behavior.

Perfectionism, perceived stress, and presleep arousal in insomnia: effects on sleep in a daily life study.

STUDY OBJECTIVES: Perfectionism is considered a predisposing and maintaining factor for insomnia disorder. However, previous studies were predominantly based on retrospective self-reports of sleep and have yielded mixed results. Here, we investigated associations between perfectionism, daily stress levels, pre-sleep arousal, and actigraphic and sleep diary-derived sleep in insomnia using an experience sampling design. METHODS: Individuals with insomnia (n = 63) reported their trait perfectionism levels and completed assessments on seven consecutive days. Momentary stress levels were reported on mobile phones at three semirandom time points each day. Presleep arousal levels were rated each morning for the previous night. Sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency were assessed prospectively using actigraphic watches and sleep diaries. RESULTS: Perfectionism dimensions and daily stress levels did not predict self-reported or actigraphic sleep parameters. Higher levels of somatic and cognitive presleep arousal were robustly associated with indicators of poorer same-night sleep. The concern over mistakes and doubts dimension of perfectionism interacted with cognitive presleep arousal in predicting self-reported sleep parameters. In the presence of higher presleep arousal, participants with high concern over mistakes and doubts experienced shorter self-reported total sleep time and lower sleep efficiency (both Ps < .01) than on days with lower cognitive arousal. CONCLUSIONS: Taken together, our results did not indicate an impact of heightened perfectionism levels on sleep in individuals with insomnia, based on prospective sleep assessments. However, our findings provide further evidence for the role of somatic and cognitive presleep arousal, potentially interacting with perfectionism, in the perpetuation of insomnia symptoms. CITATION: Küskens A, Stricker J, Hertrampf LS, Pietrowsky R, Gieselmann A. Perfectionism, perceived stress, and presleep arousal in insomnia: effects on sleep in a daily life study. J Clin Sleep Med. 2024;20(3):433-443.

Enhancing the effectiveness of CBT for patients with unipolar depression by integrating digital interventions into treatment: A pilot randomized controlled trial.

OBJECTIVE: Blended cognitive behavioral therapy (bCBT) combines face-to-face therapy with digital elements, such as digital health apps. This pilot study aimed to explore the effectiveness and safety of a novel bCBT application for treating unipolar depression in adults combined with cognitive behavioral therapy (CBT) compared to CBT alone in routine care. METHODS: Patients (N = 82) were randomly assigned to bCBT (n = 42) or CBT (n = 40) over 12 weeks. bCBT consisted of weekly CBT sessions accompanied by the elona therapy depression module (a bCBT application for unipolar depression) for use between sessions. Standard CBT consisted of weekly CBT sessions. Outcomes (6,12 weeks) were analyzed with linear mixed models. RESULTS: Improvements in depressive symptoms (BDI-II, PHQ-9) were descriptively larger for the bCBT group. Yet, this difference did not reach statistical significance. bCBT was superior to standard CBT in secondary outcome measures of psychological health (d = .50) and generalized anxiety symptoms (d = -.45). In other secondary outcomes (BAI, PSWQ, GSE, WHOQOL-BREF), improvements were descriptively larger for bCBT compared to CBT. CONCLUSION: This pilot study provided preliminary evidence that bCBT might be advantageous in comparison to CBT alone in the treatment of depression, but larger RCTs of the bCBT application are needed.

Associations of continuum beliefs with personality disorder stigma: correlational and experimental evidence.

PURPOSE: A pervasive and deeply entrenched stigma of personality disorders exists. For other mental disorders, a large body of research suggests that continuum beliefs (i.e., the endorsement of continuum perspectives on mental health and psychopathology) stimulate more favorable attitudes toward affected persons. Additionally, mental disorder classification systems increasingly incorporate continuous personality disorder models. Yet, it is unclear how continuum beliefs are related to personality disorder stigma. This study evaluated the link of continuum beliefs with personality disorder stigma based on correlational and experimental data. METHODS: A large general population sample (N = 848) completed self-report measures of continuum beliefs regarding personality disorders, desired social distance, and prejudice toward persons with personality disorders. Additionally, participants were randomly presented with information supporting a continuous or a dichotomous view of personality disorders. RESULTS: Continuum beliefs were associated with lower desired social distance (r = - 0.19) and prejudice (r = - 0.22). Additionally, the brief continuum intervention was associated with increased continuum beliefs (d = 0.99) and decreased desired social distance (d = - 0.14) and prejudice (d = - 0.17). Finally, the intervention effects on desired social distance and prejudice were mediated by continuum beliefs. CONCLUSION: This study suggests that highlighting continuum views on personality disorders in public communication and interventions might reduce personality disorder stigma.

The clinical effects of digital cognitive behavioral therapy for insomnia in a heterogenous study sample: results from a randomized controlled trial.

STUDY OBJECTIVES: Numerous studies worldwide have reported the beneficial effects of digital cognitive behavioral therapy for insomnia (dCBT-I). However, few focus on real-world study samples that reflect people in regular care. To test whether dCBT-I is suitable within German regular care, we designed a randomized controlled trial recruiting a heterogenous insomnia population. METHODS: Participants aged ≥18 who met the criteria for insomnia disorder were randomized to 8-weeks dCBT-I + care-as-usual (CAU) or they were set on a waitlist + CAU. The intervention group was followed-up at 6- and 12-months. The primary outcome was self-reported insomnia severity, assessed with the Insomnia Severity Index (ISI) at 8-weeks post-randomization. A one-way ANCOVA with baseline score as a covariate was fitted to determine group differences. Secondary outcomes included measures of daytime functioning, quality of life, depression, anxiety, dreams, and nightmares. RESULTS: Of the N = 238 participants (67.6% female), age range 19-81 years, n = 118 were randomized to dCBT-I and n = 120 to the control group. At posttreatment, the use of dCBT-I was associated with a large reduction in the ISI (Diffadj = -7.60) in comparison to WLC (d = -2.08). This clinical improvement was also reflected in responder and remission rates. Treatment effects were also observed for daytime functioning, quality of life, symptoms of depression and anxiety (ds = 0.26-1.02) and at long-term follow-up (intervention group only; ds = 0.18-1.65). No effects were found for dream and nightmare frequency. CONCLUSIONS: This study showed that dCBT-I reduces insomnia symptoms and improves daytime functioning in a heterogenous insomnia population in Germany with sustained long-term treatment effects in the intervention group. Our results underscore the potential of digital health applications, their suitability within regular care, and their role in facilitating widespread implementation of CBT-I as a first-line treatment for insomnia.

Multidimensional perfectionism and poor sleep: A meta-analysis of bivariate associations.

The link between perfectionism and poor sleep has been intensively debated, and previous studies on perfectionism-sleep associations have yielded mixed results. Recent research suggests that the two-dimensional perfectionism model, differentiating perfectionistic concerns (centered around concerns over imperfections) and perfectionistic strivings (centered around excessively high personal standards), may reconcile previously inconclusive findings, as both dimensions might be differentially related to sleep. Thus, to clarify the perfectionism-sleep link, this meta-analysis investigated relations of perfectionistic concerns and strivings with two well-established self-report measures of poor sleep. A systematic literature search yielded 55 effect sizes from 15 studies (N = 10,275) for inclusion in this meta-analysis. Perfectionistic concerns correlated positively with the Insomnia Severity Index (r+ = 0.221, 95% CI [0.102, 0.333], p = .004) and the Pittsburgh Sleep Quality Index (r+ = 0.248, 95% CI [0.172, 0.321], p < .001). Perfectionistic strivings correlated positively, albeit less strongly, with the Insomnia Severity Index (r+ = 0.114, 95% CI [0.039, 0.189], p = .010), but not significantly with the Pittsburgh Sleep Quality Index (r+ = 0.028, 95% CI [-0.026, 0.082], p = .247). These meta-analytic findings indicate that perfectionistic concerns are substantially linked to poor sleep, whereas the relation of perfectionistic strivings with sleep is less evident. Although the identified associations were less robust for perfectionistic strivings than for perfectionistic concerns, previously used labels like "positive" or "adaptive" appear inappropriate for perfectionistic strivings in the context of sleep.

Nightmare distress is related to traumatic childhood experiences, critical life events and emotional appraisal of a dream rather than to its content.

Nightmares are a substantial burden for sleep quality. Previous studies have shown that traumatic experiences can increase the probability of nightmares, and also waking-life distress can enhance this effect. There is evidence that the intensity of negative dream emotions is more responsible for rating a dream as a nightmare than threatening dream contents. However, there is still a lack of research concerning effects on nightmare distress. We hypothesise that traumatic childhood experiences (such as emotional abuse, obtained by the Childhood Trauma Questionnaire), critical life events (obtained by the Social Readjustment Rating Scale) and threatening dream contents are associated with nightmare distress. A sample of N = 103 participants kept a dream diary over 28 consecutive days. About 60% of the sample were frequent nightmare dreamers. The participants recorded their violent dream contents and dream emotions in their diary. To predict nightmare distress, regression models were constructed; nightmare distress was measured with the Nightmare Distress Questionnaire. Results showed that emotional abuse in childhood and critical life events predicted nightmare distress. Moreover, violent dream contents were associated with nightmare distress but, after we controlled for nightmare frequency and the intensity of negative dream emotions, the significant impact of violent dream contents decreased. The results suggest that the emotional appraisal of a dream has a substantial influence on nightmares in addition to traumatic childhood experiences and critical life events.

A consensus document on definition and diagnostic criteria for orthorexia nervosa.

PURPOSE: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with "correct" eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. METHODS: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A-Definition, Clinical Aspects, Duration; B-Consequences; C-Onset; D-Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. RESULTS: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. CONCLUSIONS: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel. LEVEL OF EVIDENCE: Level V: opinions of expert committees.

Six-month stability and predictive validity of the personality inventory for ICD-11.

BACKGROUND: The International Classification of Diseases 11th Revision (ICD-11) personality disorder model comprises, among other elements, five maladaptive personality trait domains (negative affectivity, detachment, dissociality, disinhibition, anankastia). Recently, the personality inventory for ICD-11 (PiCD) has emerged as one of the most widely used measures of these ICD-11 personality trait domains. METHODS: The current study contributed to the validation of the PiCD validation by exploring its stability and predictive links with psychological distress over 6 months in a sample of 206 German community adults. RESULTS: The PiCD trait domain scales displayed strong differential (all r ≥ .80) and absolute stability (all |d| ≤ .09). Additionally, PiCD negative affectivity predicted depression, anxiety, and stress, and PiCD detachment predicted depression over 6 months beyond baseline. CONCLUSION: In sum, this study demonstrated the stability of the PiCD trait domain scores, supporting their utility for capturing relatively stable traits as described in the ICD-11. Additionally, we provided the first evidence for the predictive validity of some of the PiCD trait domain scores.

No elevated levels of orthorexic eating behavior in a sample of adults with allergies and food intolerances.

PURPOSE: To compare orthorexic eating behavior in a sample of adults with and without self-reported allergies and food intolerances. METHODS: N = 52 individuals with and n = 102 individuals without self-reported allergies and food intolerances (80% with medical diagnosis; in total 74.6% female, 23.7% male; age: M = 28.13, SD = 11.96 years) completed an online survey with the Düsseldorf Orthorexia Scale and answered several questions regarding their allergies/intolerances. RESULTS: The groups did not differ in their orthorexic eating behavior. In the sample of individuals with allergies/intolerances, orthorexic eating behavior correlated with the perceived severity of the allergic symptoms and the number of consequences that the allergies had for eating behavior. CONCLUSIONS: In line with previous findings, orthorexic eating behavior does not seem to be elevated in individuals with allergies/intolerances. However, focusing on a healthy diet despite adverse food reactions and experiencing a number of allergy-related consequences for one's eating behavior might be associated with orthorexic eating behavior. LEVEL OF EVIDENCE: III, case-control analytic study.

An exploratory study of associations between the ICD-11 personality disorder model and eating pathology.

BACKGROUND: Recently, the International Classification of Diseases 11th Revision (ICD-11) has introduced a paradigm shift in personality disorder conceptualization. The novel ICD-11 personality disorder model comprises a dimensional assessment of personality dysfunction and five maladaptive personality trait domains. Maladaptive personality plays a central role in eating pathology. Yet, relations between the ICD-11 personality disorder model and eating pathology are, to date, unclear. Thus, this study aimed to explore the bivariate, incremental, and interactive associations of the ICD-11 personality disorder model components with eating pathology domains. METHODS: A predominantly female (85%) sample of 888 German-speaking community adults completed validated self-report measures of personality dysfunction, the ICD-11 personality trait domains, and five eating pathology domains (drive for thinness, bulimia, body dissatisfaction, orthorexia, binge eating). Bivariate and hierarchical regressions models were used to investigate bivariate, incremental, and interactive relations between the ICD-11 personality disorder model components and eating pathology. RESULTS: Personality dysfunction and the ICD-11 personality trait domains showed statistically significant bivariate relations with eating pathology. Additionally, personality dysfunction and most ICD-11 personality trait domains displayed incremental links with eating pathology. Finally, the relations of the ICD-11 personality trait domains with eating pathology were largely independent of the severity of personality dysfunction. CONCLUSIONS: This study indicated that all ICD-11 personality disorder model components are uniquely linked to eating pathology. Beyond maladaptive personality trait domains, the strong and incremental relations of personality dysfunction with eating pathology have potential implications for theory building. Further research using longitudinal designs is needed to evaluate causal links between the ICD-11 personality disorder model components and eating pathology.

The International Classification of Diseases 11th Revision (ICD-11) contains a novel personality disorder model. We explored how this model's components (i.e., personality dysfunction, five maladaptive personality traits) relate to eating pathology. The model components were significantly and complementarily related to a drive for thinness, bulimia, body dissatisfaction, orthorexia, and binge eating. Hence, the ICD-11 personality disorder model may potentially prove helpful in better understanding individual differences in eating pathology.

Alignment of the personality inventory for ICD-11 with the five-factor model of personality.

A central innovation in the International Classification of Diseases 11th Revision (ICD-11) is a dimensional personality disorder model differentiating five personality trait domains. The Personality Inventory for ICD-11 (PiCD) is a frequently used measure to assess these components of the ICD-11 personality disorder model. Conceptually, the ICD-11 personality trait domains correspond to trait domains from the five-factor model (FFM) of personality. However, empirically, it is unclear how the PiCD scales align with the FFM. In this questionnaire study with 480 German community adults, we assessed the joint factor structure of the PiCD trait domain scales and the FFM personality facets (assessed with the Big Five Inventory-2 [BFI-2]). A principal axis factor analysis revealed a joint five-factorial structure. The PiCD trait domain scales and the BFI-2 facet scales of the respectively corresponding FFM trait domains were almost perfectly aligned, including a bipolar anankastia-disinhibition factor along the conscientiousness dimension. Facets of openness to experience formed a fifth factor, separate from the PiCD scales. Together, these findings demonstrate structural correspondences of the PiCD trait domain scales and the respective BFI-2 facet scales, mirroring conceptual analogies between the ICD-11 and FFM personality models. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Continuity or compensation? - A hypothesis testing study concerning two types of dreamers' Aggressive Behaviors in Nightmares.

Being the aggressor in dreams has been investigated relatively sparsely. On the one hand, these kinds of nightmares may represent continuity of aggression in waking-life, but on the other hand, being the aggressor in dreams may compensate failing (suppressed) aggression from waking-life. Two subtypes of aggressor nightmares should thus be distinguished: Those in which the dreamer is the primary aggressor and those, in which the dreamer reacts with aggression to a threatening event. We hypothesized that nightmares in which the aggressive event was caused by the dream-self may be related to waking-life aggression according to the continuity hypothesis, while in nightmares, in which the aggressive event by the dream-self was the response to threats caused by other dream-characters, the dream-self may be reacting in self-defense. Thus, participants who dreamt that the aggressive act was initiated by the dream-self should be more aggressive in waking-life (supporting continuity) than those who dreamt that the offending act was initiated by other dream characters, and the dream-self was only reacting (supporting compensation). Waking-life aggression was obtained with the Buss and Perry Aggression Questionnaire. Results showed that dreamers who dreamt that their dream-self initiated the aggressive act were more aggressive in waking-life than those who dreamt that other dream characters had initiated the aggressive act. Nightmares with aggression done by the dream-self thus support the continuity hypothesis of dreaming while aggressor nightmare with reactive aggression of the dream-self support the compensatory hypothesis of dreaming.

The Impact of the Implementation of Preventive Measures Due to COVID-19 on Work Design and Early Childhood Professionals' Well-Being-A Qualitative Study.

The reopening of child-care programs during COVID-19 demanded comprehensive preventive measures. Research to date has overlooked this reopening process as well as early childhood professionals' (ECPs) implementation efforts and resulting changes in their work practices and well-being. As a result, this study sought insights into (1) the practical implementation of measures, (2) perceptions and evaluations of measures, (3) changes in work characteristics, and (4) its impact on well-being. Qualitative interviews were conducted with German child-care managers (N = 27) between June and August 2020. The semi-structured interviews were audio-recorded, transcribed, and content-analyzed using MAXQDA. ECPs, through a combination of high effort and engagement, ensured the feasibility of most preventive measures. This included practices which were perceived to be unreasonable or ones which were stricter than practices required for the public. This exacerbated the critical work characteristics (e.g., high workload, overtime, and multitasking) from pre-pandemic scenarios and led to new work demands (e.g., changes in work content and social interactions). ECPs maintained intensive work demands and consequently suffered from broad strain outcomes (e.g., worry, exhaustion, anger, fear of infection, and reduced psychological sense of community). This study highlights the adverse psychosocial work environment of ECPs despite the necessity of ensuring health and safety at work.

No perfect sleep! A systematic review of the link between multidimensional perfectionism and sleep disturbance.

The view that perfectionists are prone to experiencing sleep disturbance is widely held. Yet, almost three decades of empirical research have yielded conflicting results. Whereas some researchers viewed perfectionism as a risk factor for sleep disturbance, others spoke of "adaptive" or "positive" forms of perfectionism in the context of sleep. The multidimensional conceptualisation of perfectionism may resolve this disagreement. Thus, this systematic review aimed to clarify the perfectionism-sleep disturbance link using the widely accepted two-dimensional perfectionism model, differentiating perfectionistic concerns (defined by worries over imperfections) and perfectionistic strivings (defined by excessively high personal standards). A systematic literature search returned 24 relevant empirical studies. Perfectionistic concerns were robustly linked to sleep disturbance. Perfectionistic strivings displayed comparatively small and inconsistent relations with sleep disturbance. Finally, cross-sectional mediation studies suggested that psychological distress and dysfunctional cognitive processes might underlie the perfectionistic concerns-sleep disturbance link. These findings show that considering perfectionistic concerns in explaining, predicting, and treating sleep disturbance may be a promising approach. In contrast, perfectionistic strivings appeared neither universally adaptive nor maladaptive. We identified several critical gaps in the empirical literature and point towards future research directions, highlighting the need for more longitudinal studies.

Incremental validity of the ICD-11 personality disorder model for explaining psychological distress.

Many persons with personality disorder experience psychological distress. The International Classification of Diseases, 11th Revision (ICD-11) contains a dimensional personality disorder model that comprises personality dysfunctioning, 5 maladaptive personality trait domains, and a borderline pattern qualifier. Research on the relations between the ICD-11 personality disorder model and psychological distress is sparse. Particularly, it is unclear whether personality dysfunctioning on the one side and the more specific personality traits in ICD-11 on the other side incrementally predict psychological distress. In addition, the incremental validity of the components of the ICD-11 personality disorder model beyond the five-factor model of normal-range personality as a widely accepted personality framework has not been established. In this study, we assessed the relations between self-report measures of the ICD-11 personality disorder model and psychological distress in 2 community samples (NSample 1 = 203, NSample 2 = 226). Except anankastia, all ICD-11 personality trait domains assessed with the Personality Inventory for ICD-11 and the borderline pattern qualifier assessed with the Borderline Pattern Scale were strongly related to psychological distress. In hierarchical regressions, the personality traits in ICD-11 incrementally predicted psychological distress beyond personality dysfunctioning, and vice versa. In addition, the components of the ICD-11 personality disorder model were substantially related to psychological distress beyond the corresponding normal-range Big Five personality traits. Our results demonstrate the criterion-related and incremental validity of self-report instruments assessing the ICD-11 personality disorder model, which supports their utility for screening and assessment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).