Comparison of ICD-10 Diagnostic Guidelines and Research Criteria for Enduring Personality Change after Catastrophic Experience
Abstract
Enduring personality change after catastrophic experience (EPCACE) is a diagnostic category included in the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), as one of the adult personality disorders. Preliminary investigation suggests there is considerable endorsement in principle for this new category amongst experts in the field of intentional human trauma, yet many aspects of the diagnosis remain contentious. EPCACE is described in 2 sets of ICD-10 criteria: the Diagnostic Criteria for Research (DCR) and the Clinical Description and Diagnostic Guidelines (CDDG). Studies have found that the use of the DCR and CDDG for some disorders has created issues related to lack of compatibility and agreement between these 2 versions. This article examines the similarities and differences between the DCR and CDDG for EPCACE. Using background literature to inform our analysis, this article highlights issues related to the stressor criterion, symptom criteria, impairment criterion, criterion related to exclusion of personal vulnerability and early psychiatric history, symptom duration and relationship of post-traumatic-stress disorder with EPCACE. The similarities and differences between the research criteria and diagnostic guidelines of EPCACE are consistent with concerns already identified in the literature for other disorders. This presents a challenge to the way in which diagnostic criteria are conceptualized and stated.
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The EPCACE diagnosis was neither widely taken up by clinicians nor subject to much empirical investigation.
“However, the diagnosis was neither widely taken up by clinicians nor subject to much empirical investigation.”
The description of symptoms of EPCACE was very broad and general, which made clinical application and research difficult.
“Moreover, the description of symptoms of EPCACE was very broad and general, which made clinical application and research difficult 24,25 .”
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Reed, G. M., First, M. B., Billieux, J., Cloitre, M., Briken, P., Achab, S., Brewin, C. R., King, D. L., Kraus, S. W., & Bryant, R. A. (2022) · World Psychiatry · doi:10.1002/wps.20960 · Cited by 182 · see citing works
- Authors
- Beltran, R. O., Silove, D., & Llewellyn, G. M.
- Affiliations
- The University of Sydney (AU)
- Liverpool Hospital (AU)
- Venue
- Psychopathology
- Publisher
- S. Karger AG
- Published
- 2009
- Volume
- 42
- Issue
- 2
- Pages
- 113-118
- ISSN
- 0254-4962 (ISSN-L)
- 1423-033X
- OpenAlex
- W2013448320
- Cited by
- 28
- References
- 41
- Citations by year
- 2025: 2 · 2024: 1 · 2022: 3 · 2021: 6 · 2020: 2 · 2019: 1 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 2
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- ICD-10, diagnostic criteria, research criteria, personality disorders, post-traumatic stress disorder, diagnostic classification, symptom duration
- MeSH terms
- Humans, Life Change Events, Personality Disorders, Research, Stress Disorders, Post-Traumatic, Guidelines as Topic, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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