CS04-03 - New developments in the classification of personality disorders

2011 ◽  
Vol 26 (S2) ◽  
pp. 1780-1780
Author(s):  
E. Simonsen
Keyword(s):  
Personality Disorders ◽  
Psychiatric Patients ◽  
Normal Population ◽  
Scientific Basis ◽  
Personality Pathology ◽  
Clinical Validity ◽  
New Developments ◽  
Functional Deficits ◽  
Dsm Iv

Personality disorders are regarded as being among the more important categories within the DSM-IV diagnostic nomenclature, because they have the unique distinction of being placed on a separate diagnostic axis. However, empirical data have pointed out a number of disadvantages and concerns with the categorical system: excessive co-occurrence, inadequate coverage, heterogeneity within diagnoses, arbitrary and unstable diagnostic boundaries and inadequate scientific basis.Alternative dimensional approaches have been considered. There is a surprising consistency over the number and descriptions of the main factors or dimensions both in normal population and among psychiatric patients, at least the following four: an externalizing factor aggression (antagonism), an internalizing anxious-emotional unstable second factor, an inhibited and constraint third factor and fourth factor of compulsivity and perfectionism. Beside this, severity of functional deficits, a number of trait domains and disturbances of self and identity are considered to be included as additional descriptors of personality pathology. It is proposed that only 5 or 6 of the current categories with highest clinical validity will be kept in the system. The aim is to maximize clinical utility, but the current suggestions seem to be too complex for the average clinician to follow.

scholarly journals Diagnosis and classification of personality disorder: difficulties, their resolution and implications for practice

2010 ◽  
Vol 16 (5) ◽  
pp. 388-396 ◽  
Author(s):  
Jaydip Sarkar ◽  
Conor Duggan
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Integrated Approach ◽  
Personality Pathology ◽  
Icd 10 ◽  
Diagnosis And Classification ◽  
Axis I ◽  
Dsm Iv ◽  
Current Systems

SummaryThere are many difficulties associated with the diagnostic guidelines for personality disorder in the current international classificatory systems such as ICD–10 and DSM–IV. These lead not only to significant overlap with DSM Axis I disorders, resulting in high rates of diagnoses of comorbidities and multiple personality disorders, but also to lack of adequate capture of core personality pathology. The current classifications are also unhelpful in treatment selection, presumably the prime reason for assessing individuals in the first place. In this article we highlight various deficits and inadequacies related to the nosology of the current systems and suggest some strategies for dealing with these. We offer an integrated model of assessing and diagnosing personality disorders. We attempt to demonstrate how using a more integrated approach minimises or even eliminates some of the key problems highlighted in the current systems.

Assessment of Pathological Traits in DSM-5 Personality Disorders By the DAPP-BQ: How Do These Traits Relate to the Six Personality Disorder Types of the Alternative Model?

2019 ◽  
Vol 33 (1) ◽  
pp. 49-70 ◽  
Author(s):  
Han Berghuis ◽  
Theo J. M. Ingenhoven ◽  
Paul T. van der Heijden ◽  
Gina M. P. Rossi ◽  
Chris K. W. Schotte
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Alternative Model ◽  
Psychiatric Patients ◽  
Personality Pathology ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Criterion A ◽  
Dsm Iv ◽  
Dimensional Assessment

The six personality disorder (PD) types in DSM-5 section III are intended to resemble their DSM-IV/DSM-5 section II PD counterparts, but are now described by the level of personality functioning (criterion A) and an assigned trait profile (criterion B). However, concerns have been raised about the validity of these PD types. The present study examined the continuity between the DSM-IV/DSM-5 section II PDs and the corresponding trait profiles of the six DSM-5 section III PDs in a sample of 350 Dutch psychiatric patients. Facets of the Dimensional Assessment of Personality Pathology—Basic Questionnaire (DAPP-BQ) were presumed as representations (proxies) of the DSM-5 section III traits. Correlational patterns between the DAPP-BQ and the six PDs were consistent with previous research between DAPP-BQ and DSM-IV PDs. Moreover, DAPP-BQ proxies were able to predict the six selected PDs. However, the assigned trait profile for each PD didn't fully match the corresponding PD.

scholarly journals Towards a contemporary approach for understanding personality pathology in developmental context: An integrative model

2021 ◽  
pp. 1-10
Author(s):  
Melody R. Altschuler ◽  
Robert F. Krueger
Keyword(s):  
Personality Disorders ◽  
Personality Pathology ◽  
Integrative Model ◽  
Research Domain Criteria ◽  
Developmental Context ◽  
Dimensional Classification ◽  
Developmental Theories ◽  
Underlying Mechanisms ◽  
Research Domain

Abstract Traditional categorical approaches to classifying personality disorders are limited in important ways, leading to a shift in the field to dimensional approaches to conceptualizing personality pathology. Different areas of psychology – personality, developmental, and psychopathology – can be leveraged to understand personality pathology by examining its structure, development, and underlying mechanisms. However, an integrative model that encompasses these distinct lines of inquiry has not yet been proposed. In order to address this gap, we review the latest evidence for dimensional classification of personality disorders based on structural models of maladaptive personality traits, provide an overview of developmental theories of pathological personality, and summarize the Research Domain Criteria (RDoC) initiative, which seeks to understand underlying mechanisms of psychopathology. We conclude by proposing an integrative model of personality pathology development that aims to elucidate the developmental pathways of personality pathology and its underlying mechanisms.

Diagnosis and classification of personality disorders

2012 ◽  
pp. 855-860
Author(s):  
James Reich ◽  
Giovanni de Girolamo
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Assessment Methods ◽  
Icd 10 ◽  
Diagnosis And Classification ◽  
Dsm Iv ◽  
Similarities And Differences ◽  
Different Cultures

There has been considerable interest in the study of personality and personality disorder (PD) since early times and in many different cultures. This chapter covers definitions of personality disorders, ICD and DSM classifications of personality disorders, similarities and differences between ICD-10 and DSM-IV, recent changes in the conceptualization of DSM personality disorders, categorical versus dimensional styles of classification, and assessment methods for personality disorders.

Minimal emotional dysfunctions (MED) in personality disorders

2006 ◽  
Vol 21 (5) ◽  
pp. 325-332 ◽  
Author(s):  
M. Linden
Keyword(s):  
Personality Disorders ◽  
Brain Research ◽  
New Developments ◽  
Future Developments

AbstractThe concept of minimal emotional dysfunctions (MED) refers to traditional psychopathology in order to describe, classify, and understand personality disorders. Emotional dysfunctions encompass disorders of affect predominance, production, expression, experience, modulation, and regulation. MED can explain the dimensional nature of personality disorders, their multidimensionality and problems with categorical classifications. It can stimulate research on the etiology of personality disorders in reference to modern developmental brain research and trauma psychology. It can guide new developments in pharmacotherapy and psychotherapy. It is suggested to focus on MED in future developments of the description and classification of personality disorders.

Classification of Personality Disorder

1979 ◽  
Vol 135 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Peter Tyrer ◽  
John Alexander
Keyword(s):  
Cluster Analysis ◽  
Factor Analysis ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Psychiatric Patients ◽  
Interview Schedule ◽  
Personality Variables ◽  
Current Classification ◽  
Personality Disordered

SummaryAn interview schedule was used to record the personality traits of 130 psychiatric patients, 65 with a primary clinical diagnosis of personality disorder and 65 with other diagnoses. The results were analysed by factor analysis and three types of cluster analysis. Factor analysis showed a similar structure of personality variables in both groups of patients, supporting the notion that personality disorders differ only in degree from the personalities of other psychiatric patients. Cluster analysis revealed five discrete categories; sociopathic, passive-dependent, anankastic, schizoid and a non-personality-disordered group. Of all the personality-disordered patients 63 per cent fell into the passive-dependent or sociopathic category. The results suggest that the current classification of personality disorder could be simplified.

scholarly journals Comparison of alternative models for personality disorders, II: 6-, 8- and 10-year follow-up

2011 ◽  
Vol 42 (8) ◽  
pp. 1705-1713 ◽  
Author(s):  
L. C. Morey ◽  
C. J. Hopwood ◽  
J. C. Markowitz ◽  
J. G. Gunderson ◽  
C. M. Grilo ◽  
...  
Keyword(s):  
Personality Disorders ◽  
Factor Model ◽  
Five Factor Model ◽  
Personality Pathology ◽  
Diagnostic Categories ◽  
Dsm 5 ◽  
Axis I ◽  
Dsm Iv ◽  
Characteristic Features

BackgroundSeveral conceptual models have been considered for the assessment of personality pathology in DSM-5. This study sought to extend our previous findings to compare the long-term predictive validity of three such models: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP), and DSM-IV personality disorders (PDs).MethodAn inception cohort from the Collaborative Longitudinal Personality Disorder Study (CLPS) was followed for 10 years. Baseline data were used to predict long-term outcomes, including functioning, Axis I psychopathology, and medication use.ResultsEach model was significantly valid, predicting a host of important clinical outcomes. Lower-order elements of the FFM system were not more valid than higher-order factors, and DSM-IV diagnostic categories were less valid than dimensional symptom counts. Approaches that integrate normative traits and personality pathology proved to be most predictive, as the SNAP, a system that integrates normal and pathological traits, generally showed the largest validity coefficients overall, and the DSM-IV PD syndromes and FFM traits tended to provide substantial incremental information relative to one another.ConclusionsDSM-5 PD assessment should involve an integration of personality traits with characteristic features of PDs.

Childhood antecedents of personality disorder: An alternative perspective

2009 ◽  
Vol 21 (3) ◽  
pp. 771-791 ◽  
Author(s):  
Thomas A. Widiger ◽  
Barbara De Clercq ◽  
Filip De Fruyt
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Factor Model ◽  
Five Factor Model ◽  
Personality Structure ◽  
Childhood And Adolescence ◽  
Adult Personality ◽  
Dsm Iv ◽  
Childhood Antecedents

AbstractOne of the fundamental limitations of theDiagnostic and Statistical Manual of Mental Disorders—Fourth Edition, Text Revision(DSM-IV-TR) categorical model of personality disorder classification has been the lack of a strong scientific foundation, including an understanding of childhood antecedents. TheDSM-IV-TRpersonality disorders, however, do appear to be well understood as maladaptive variants of the domains and facets of the general personality structure as conceptualized within the five-factor model (FFM). Integrating the classification of personality disorder with the FFM brings to an understanding of the personality disorders a considerable body of scientific research on childhood antecedents. The temperaments and traits of childhood do appear to be antecedent to the FFM of adult personality structure, and these temperament and traits of childhood and adolescence are the likely antecedents for adult personality disorder, providing further support for the conceptualization of the adult personality disorders as maladaptive variants of the domains and facets of the FFM. Conceptualizing personality disorders in terms of the FFM thereby provides a basis for integrating the classification of abnormal and normal personality functioning across the life span.

Assessment of DSM–III–R Personality Disorders by Self-Report Questionnaire: the Role of Informants and a Screening Test for Co-morbid Personality Disorders (STCPD)

1992 ◽  
Vol 161 (3) ◽  
pp. 344-352 ◽  
Author(s):  
J. H. Dowson
Keyword(s):  
Cluster Analysis ◽  
Personality Disorders ◽  
Screening Test ◽  
Psychiatric Patients ◽  
Self Report ◽  
The Mean

A modified version of the revised Personality Diagnostic Questionnaire (PDQ–R), based on DSM–III–R personality disorders (PDs), was completed by 60 psychiatric patients. An informant's version was also completed by 60 relatives or friends nominated by each subject. Discrete DSM–III–R PDs were rare; the mean number of PDs per subject was 4.5. Cluster analysis showed that only antisocial PD was a basis for classification of patients, while most patients formed two groups which were mainly distinguished by quantitative differences related to the total scores of positive PD criteria. A shorter version of the questionnaire can be used as a screening test for co-morbid PDs (STCPD) which can predict the number of co-morbid DSM–III–R PDs. The total scores of positive PD criteria from the STCPD were usually (and significantly) higher than the corresponding scores from informants' questionnaires but when an informant's total score exceeded that of the patient, this indicated a subject's under-reporting.

Dimensional models and neurobiology of personality disorders

1999 ◽  
Vol 11 (1) ◽  
pp. 1-4
Author(s):  
W. van den Brink
Keyword(s):  
Personality Disorders ◽  
Personality Pathology ◽  
Diagnostic Model ◽  
Axis Ii ◽  
Statistical Procedures ◽  
Statistical Studies ◽  
Chronic Disorders ◽  
Theoretical Considerations ◽  
Exclusive Choice

SUMMARYSince the introduction of a separate axis in DSM-III (1980), the validity of the categorical nature of the classification of personality disorders has been seriously questioned. Subsequently, a number of multidimensional alternatives have been proposed based on statistical procedures or theoretical considerations. At the same time, the study of the neurobiological underpinnings of personality and personality disorders has created a better understanding of etiological and pathogenetic processes responsible for these chronic disorders. The findings of these studies corroborate some of the major findings of statistical studies regarding the nature of the frequent comorbidity of axis II disorders. In the discussion, a mixed, two-tier diagnostic model is proposed to serve both scientific and clinical aims without the disadvantages of an exclusive choice for either categorical or dimensional approaches to the classification of personality pathology.

Sign in / Sign up

Export Citation Format

Share Document