Young children intuitively organize numbers on straight, horizontal lines from left to right before the onset of formal instruction.

The number line estimation task is frequently used to measure children's numerical magnitude understanding. It is unclear whether the resulting straight, horizontal, left-to-right-oriented estimate patterns indicate task constraints or children's intuitive number-space mapping. Three- to six-year-old children (N = 72, Mage = 4.89, 56% girls, 94% German citizenship) were asked to explain the meaning of numbers to a teddy by laying out a rope and attaching cards showing non-symbolic numerosities (dots) to it. Most children intuitively created straight, horizontal, and left-to-right-oriented representations. Characteristics of the line correlated with age, mathematical competencies, and home numeracy. This demonstrates the usefulness of the number line estimation task for assessing how children intuitively map numbers onto space.

Enhancing self-esteem in adults with body dysmorphic symptoms: experimental testing and initial evaluation of a brief internet-based training.

BACKGROUND: Low self-esteem is an important factor associated with body dysmorphic concerns. In treatment, self-esteem cannot always be adequately addressed. Internet-based interventions offer a low-threshold and cost-efficient possibility for treating body dysmorphic disorder (BDD). AIMS: For this reason, we conducted two studies to explore the effectiveness of an internet-based intervention targeting improving self-esteem in adults with BDD symptoms. METHOD: The first study investigated the differential effects of a 1-week self-esteem training compared with a 1-week attention-focus training. Two hundred twenty adults with elevated body dysmorphic symptoms were randomly assigned to one of the two trainings. Our second study (n = 58 adults with body dysmorphic symptoms) evaluated an extended 2-week stand-alone self-esteem training. RESULTS: In the first study, self-esteem in different domains (appearance, performance and social), self-focused attention, and BDD symptom severity improved in both groups. Other-focused attention only increased in the attention training group. Participants' overall adherence was high. In the second study we observed significant improvements in self-esteem, BDD symptom severity, and other secondary outcomes, with additional improvements in most outcomes in the second week. Adherence was again high. CONCLUSIONS: Together, these findings show that a brief internet-based intervention may be a highly accepted and effective way of improving self-esteem in people suffering from BDD symptoms.

The number line estimation task is a valid tool for assessing mathematical achievement: A population-level study with 6484 Luxembourgish ninth-graders.

The number line estimation task is an often-used measure of numerical magnitude understanding. The task also correlates substantially with broader measures of mathematical achievement. This raises the question of whether the task would be a useful component of mathematical achievement tests and instruments to diagnose dyscalculia or mathematical giftedness and whether a stand-alone version of the task can serve as a short screener for mathematical achievement. Previous studies on the relation between number line estimation accuracy and broader mathematical achievement were limited in that they used relatively small nonrepresentative samples and usually did not account for potentially confounding variables. To close this research gap, we report findings from a population-level study with nearly all Luxembourgish ninth-graders (N = 6484). We used multilevel regressions to test how a standardized mathematical achievement test relates to the accuracy in number line estimation on bounded number lines with whole numbers and fractions. We also investigated how these relations were moderated by classroom characteristics, person characteristics, and trial characteristics. Mathematical achievement and number line estimation accuracy were associated even after controlling for potentially confounding variables. Subpopulations of students showed meaningful differences in estimation accuracy, which can serve as benchmarks in future studies. Compared with the number line estimation task with whole numbers, the number line estimation task with fractions was more strongly related to mathematical achievement in students across the entire mathematical achievement spectrum. These results show that the number line estimation task is a valid and useful tool for diagnosing and monitoring mathematical achievement.

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.

Heart Rate Variability, Autonomic Reactivity, and Emotion Regulation during Sadness Induction in Somatic Symptom Disorder.

BACKGROUND: Preliminary evidence suggests altered heart rate variability (HRV) and impaired emotion regulation (ER) in somatic symptom disorder (SSD). Moreover, HRV can be considered an index of ER. Yet, to date, research on HRV and emotional reactivity in SSD is scarce and findings are inconsistent. Thus, this study aimed to examine ER differences, HRV at rest, and in response to emotion induction in persons with SSD compared to controls. METHODS: The sample comprised 44 persons with SSD (DSM-5; 79.5% female, Mage = 45.7, SD = 14.7) and 41 persons without SSD (non-SSD; 78% female, Mage = 44.2, SD = 14.7). We assessed the participants' somatic symptom severity, ER, and control variables (e.g., depressive symptoms). Frequency and time domain HRV by ECG and subjective emotional states were measured at rest, under sadness induction, and during recovery periods. We evaluated baseline between-group differences with t-tests, and HRV and emotional reactivity and recovery with repeated measures ANOVAs. RESULTS: We found no significant differences in resting state HRV between persons with and without SSD. Regarding reactivity and recovery, SSD group showed lower reactivity in SDNN (standard deviation of NN interval) than non-SSD group. Moreover, SSD group reported more maladaptive ER techniques (e.g. rumination) and a higher effort to regulate their emotions during the experiment than non-SSD group. CONCLUSIONS: The study indicated impaired ER in persons with SSD. This finding showed more clearly in self-report than in HRV. Further research on HRV reactivity including tasks evoking other negative emotions in persons with SSD is required.

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.

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.

No transfer effect of a fraction number line game on fraction understanding or fraction arithmetic: A randomized controlled trial.

Fractions are hard to understand for students. According to Siegler's integrated theory, magnitude understanding is central to numerical development. Whole-number magnitude understanding can be improved by serious games that include practicing mapping numbers onto number lines or similar one-dimensional visuospatial representations. These games were effective even when they did not include direct instruction on whole numbers. Previous studies have also evaluated whether similar number line estimation (NLE) interventions improve fraction learning. We contribute to this literature by evaluating how the catch-the-monster game with fractions affects NLE, magnitude understanding, and arithmetic with fractions in a randomized controlled pretest-intervention-posttest design. The game included NLE with feedback but no direct instruction. A sample of 188 fifth- to eighth-graders participated in a fraction number line game condition, a scaffolded fraction number line games condition, or an active control condition. In fifth- and sixth-graders, participation in the intervention improved the trained measure of fraction understanding (NLE on 0-1 line) but left unchanged two untrained measures of fraction understanding (NLE on 0-5 lines and fraction comparison) and a measure of fraction arithmetic. Seventh- and eighth-graders showed no intervention effects. The lack of transfer in fifth- and sixth-graders indicates that gamified NLE interventions can complement but not replace more direct instruction on fraction concepts and fraction arithmetic.

[Digital Options for Treating Mental Disorders during the COVID-19 Pandemic]. / Digitale Verfahren zur Behandlung psychischer Störungen in der COVID-19-Pandemie.

The COVID-19 pandemic and its consequences, such as contact restrictions, pose new challenges to psychiatric-psychotherapeutic care in many parts of the world. This article provides an overview of digital methods for treating mental disorders under pandemic conditions and for reducing pandemic-related psychological distress (e.g., due to social isolation). Current challenges and limitations in the use of digital treatment options and their long-term perspectives in psychiatric-psychotherapeutic care are discussed.

Accuracy of diagnostic classification and clinical utility assessment of ICD-11 compared to ICD-10 in 10 mental disorders: findings from a web-based field study.

In this web-based field study, we compared the diagnostic accuracy and clinical utility of 10 selected mental disorders between the ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) and the ICD-10 CDDG using vignettes in a sample of 928 health professionals from all WHO regions. On average, the ICD-11 CDDG displayed significantly higher diagnostic accuracy (71.9% for ICD-11, 53.2% for ICD-10), higher ease of use, better goodness of fit, higher clarity, and lower time required for diagnosis compared to the ICD-10 CDDG. The advantages of the ICD-11 CDDG were largely limited to new diagnoses in ICD-11. After limiting analyses to diagnoses existing in ICD-11 and ICD-10, the ICD-11 CDDG were only superior in ease of use. The ICD-11 CDDG were not inferior in diagnostic accuracy or clinical utility compared to the ICD-10 CDDG for any of the vignettes. Diagnostic accuracy was consistent across WHO regions and independent of participants' clinical experience. There were no differences between medical doctors and psychologists in diagnostic accuracy, but members of other health professions had greater difficulties in determining correct diagnoses based on the ICD-11 CDDG. In sum, there were no differences in diagnostic accuracy for diagnoses existing in ICD-10 and ICD-11, but the introduction of new diagnoses in ICD-11 has improved the diagnostic classification of some clinical presentations. The favourable clinical utility ratings of the ICD-11 CDDG give reason to expect a positive evaluation by health professionals in the implementation phase of ICD-11. Yet, training in ICD-11 is needed to further enhance the diagnostic accuracy.

Classification and Diagnosis of Schizophrenia or Other Primary Psychotic Disorders: Changes from ICD-10 to ICD-11 and Implementation in Clinical Practice.

From January 2022, the WHO member countries shall start implementing the mortality and morbidity statistics (MMS) version of the eleventh revision of the International Classification of Diseases (ICD-11). Regarding mental, behavioural or neurodevelopmental disorders, there are substantial changes from ICD-10 to ICD-11. The subchapter for schizophrenia or other primary psychotic disorders has changed due to a revised structure, new diagnostic criteria, and the introduction of dimensional elements (i.e., course and symptom qualifiers). The aim of this manuscript is twofold. First, we review changes from ICD-10 to ICD-11 in the classification and diagnosis of schizophrenia or other primary psychotic disorders, including findings from recent field studies. Second, we provide an overview of approaches to the implementation of ICD-11 in clinical practice. Critical elements for transition from ICD-10 to ICD-11 include the use of digital tools, education and training, stakeholder involvement, national adaptations, and continuous evaluation.

Associations of Number Line Estimation With Mathematical Competence: A Meta-analysis.

The number line estimation task is widely used to investigate mathematical learning and development. The present meta-analysis statistically synthesized the extensive evidence on the correlation between number line estimation and broader mathematical competence. Averaged over 263 effect sizes with 10,576 participants with sample mean ages from 4 to 14 years, this correlation was r = .443. The correlation increased with age, mainly because it was higher for fractions than for whole numbers. The correlation remained stable across a wide range of task variants and mathematical competence measures (i.e., counting, arithmetic, school achievement). These findings demonstrate that the task is a robust tool for diagnosing and predicting broader mathematical competence and should be further investigated in developmental and experimental training studies.

Associations of non-symbolic and symbolic numerical magnitude processing with mathematical competence: a meta-analysis.

Many studies have investigated the association between numerical magnitude processing skills, as assessed by the numerical magnitude comparison task, and broader mathematical competence, e.g. counting, arithmetic, or algebra. Most correlations were positive but varied considerably in their strengths. It remains unclear whether and to what extent the strength of these associations differs systematically between non-symbolic and symbolic magnitude comparison tasks and whether age, magnitude comparison measures or mathematical competence measures are additional moderators. We investigated these questions by means of a meta-analysis. The literature search yielded 45 articles reporting 284 effect sizes found with 17,201 participants. Effect sizes were combined by means of a two-level random-effects regression model. The effect size was significantly higher for the symbolic (r = .302, 95% CI [.243, .361]) than for the non-symbolic (r = .241, 95% CI [.198, .284]) magnitude comparison task and decreased very slightly with age. The correlation was higher for solution rates and Weber fractions than for alternative measures of comparison proficiency. It was higher for mathematical competencies that rely more heavily on the processing of magnitudes (i.e. mental arithmetic and early mathematical abilities) than for others. The results support the view that magnitude processing is reliably associated with mathematical competence over the lifespan in a wide range of tasks, measures and mathematical subdomains. The association is stronger for symbolic than for non-symbolic numerical magnitude processing. So symbolic magnitude processing might be a more eligible candidate to be targeted by diagnostic screening instruments and interventions for school-aged children and for adults.

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.

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.

Concurrent and predictive relations of multidimensional perfectionism with test anxiety in secondary school students.

Background and Objectives. Perfectionism is a multidimensional personality trait often viewed as a risk factor for developing test anxiety. A recent meta-analysis showed positive correlations of perfectionism facets with test anxiety dimensions. However, all previous research into the perfectionism-test anxiety relation has been cross-sectional. Thus, it is unclear whether perfectionism facets longitudinally predict test anxiety.Design. In this study, we investigated concurrent and predictive relations of two perfectionism facets with cognitive test anxiety (worry) and affective test anxiety (emotionality) in secondary school students (N = 478, mean age at T1 = 11.95 years). At T1, participants completed self-report measures of text anxiety and perfectionism. Almost five years later, participants again reported their test anxiety levels (T2).Results. Concern over mistakes and doubts correlated positively with current worry and emotionality. Personal standards correlated positively with current worry. Neither concern over mistakes and doubts nor personal standards significantly predicted later test anxiety beyond baseline.Conclusions. Perfectionism and test anxiety share common manifestations. Yet, this study raises the question whether perfectionism truly influences test anxiety development or whether other factors (e.g., construct overlap) may explain the identified cross-sectional correlations. Future research is needed to provide more nuanced insights into perfectionism-test anxiety associations.

Efficacy of a Brief Blended Cognitive Behavioral Therapy Program for the Treatment of Depression and Anxiety in University Students: Uncontrolled Intervention Study.

BACKGROUND: Blended cognitive behavioral therapy (bCBT)-the combination of cognitive behavioral therapy and digital mental health applications-has been increasingly used to treat depression and anxiety disorders. As a resource-efficient treatment approach, bCBT appears promising for addressing the growing need for mental health care services, for example, as an early intervention before the chronification of symptoms. However, further research on the efficacy and feasibility of integrated bCBT interventions is needed. OBJECTIVE: This study aimed to evaluate the efficacy of a novel bCBT program comprising short (25 min), weekly face-to-face therapy sessions combined with a smartphone-based digital health app for treating mild to moderate symptoms of depression or anxiety. METHODS: This prospective uncontrolled trial comprised 2 measurement points (before and after treatment) and 2 intervention groups. We recruited university students with mild to moderate symptoms of depression or anxiety. On the basis of the primary symptoms, participants were assigned to either a depression intervention group (n=67 completers) or an anxiety intervention group (n=33 completers). Participants in each group received 6 weekly individual psychotherapy sessions via videoconference and completed modules tailored to their respective symptoms in the smartphone-based digital health app. RESULTS: The depression group displayed medium to large improvements in the symptoms of depression (Cohen d=-0.70 to -0.90; P<.001). The anxiety group experienced significant improvements in the symptoms of generalized anxiety assessed with the Generalized Anxiety Disorder-7 scale with a large effect size (Cohen d=-0.80; P<.001) but not in symptoms of anxiety assessed with the Beck Anxiety Inventory (Cohen d=-0.35; P=.06). In addition, both groups experienced significant improvements in their perceived self-efficacy (Cohen d=0.50; P<.001 in the depression group and Cohen d=0.71; P<.001 in the anxiety group) and quality of life related to psychological health (Cohen d=0.87; P<.001 in the depression group and Cohen d=0.40; P=.03 in the anxiety group). Work and social adjustment of patients improved significantly in the depression group (Cohen d=-0.49; P<.001) but not in the anxiety group (Cohen d=-0.06; P=.72). Patients' mental health literacy improved in the anxiety group (Cohen d=0.45; P=.02) but not in the depression group (Cohen d=0.21; P=.10). Patient satisfaction with the bCBT program and ratings of the usability of the digital app were high in both treatment groups. CONCLUSIONS: This study provides preliminary evidence for the feasibility and efficacy of a novel brief bCBT intervention. The intervention effects were generalized across a broad spectrum of patient-reported outcomes. Hence, the newly developed bCBT intervention appears promising for treating mild to moderate depression and anxiety in young adults.

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.

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).