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.

scholarly journals ICD-11 Personality Disorders: A Psychodynamic Perspective on Personality Functioning

2021 ◽  
Vol 12 ◽  
Author(s):  
Victor Blüml ◽  
Stephan Doering
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Conceptual Analysis ◽  
Common Ground ◽  
Personality Pathology ◽  
Object Relations Theory ◽  
Personality Functioning ◽  
Dimensional Classification ◽  
Data Points

The new ICD-11 introduces a fully dimensional classification of personality disorders representing a fundamental change in personality disorder diagnosis with major implications for clinical practice and research. The new system centers on the evaluation of the severity of impairment in the areas of self and interpersonal functioning. This focus on personality functioning converges with long-standing psychoanalytic/psychodynamic conceptualizations of personality pathology. In a detailed conceptual analysis and review of existing empirical data, points of convergence and notable differences between major exponents of the psychodynamic tradition—object relations theory as developed by Kernberg et al. and the Operationalized Psychodynamic Diagnosis—and the ICD-11 system are critically discussed. Personality functioning can be considered to be the current “common ground” for the assessment of personality disorders and constitutes a considerable step forward in making personality disorder diagnosis both clinically meaningful and suitable for research purposes.

scholarly journals Kaleidoscope

2014 ◽  
Vol 205 (3) ◽  
pp. 254-255
Author(s):  
Derek K. Tracy ◽  
Dan W. Joyce ◽  
Sukhwinder S. Shergill
Keyword(s):  
Experimental Approach ◽  
Response Selection ◽  
Research Priorities ◽  
Borderline Personality ◽  
Research Domain Criteria ◽  
Case Processing ◽  
Negative Valence ◽  
Underlying Mechanisms ◽  
Golden Gate Bridge ◽  
Research Domain

June 27 this year was the day that funding was approved for San Francisco's Golden Gate Bridge physical suicide deterrent barrier (www.ggbsuicidebarrier.org). This follows over 1400 suicides since the bridge's opening in 1937: a morbid record 46 were in 2013 alone, possibly exacerbated by the global economic crisis. The barrier is in place to prevent the end-point of suicidal behaviour (physically preventing suicide) but how much effort is going into the examination of the external factors that drive such behaviour? Aleman & Denys argue that psychiatry has failed to tackle suicide as a disease entity in its own right, instead relegating the act of deliberately ending one's life to a symptom or consequence of an underlying psychiatric illness. They note that in DSM-5 suicidality is only mentioned as a symptom of borderline personality disorder and mood disorders, despite this presenting as the most prominent psychiatric emergency. They argue for a more experimental approach based on the National Institute of Mental Health's Research Domain Criteria (www.nimh.nih.gov/research-priorities/rdoc/index.shtml) that emphasises the study of psychiatric phenomena with reference to their underlying mechanisms: in this case, processing of negative valence, context and response selection, and mechanisms to regulate arousal.

scholarly journals The role of RDoC in future classification of mental disorders

2020 ◽  
Vol 22 (1) ◽  
pp. 81-85 ◽  
Keyword(s):  
Mental Health ◽  
Affective Behavior ◽  
Research Domain Criteria ◽  
Computational Approaches ◽  
Diagnostic Categories ◽  
Key Features ◽  
Study Designs ◽  
Research Domain

The Research Domain Criteria (RDoC) project constitutes a translational framework for psychopathology research, initiated by the National Institute of Mental Health in an attempt to provide new avenues for research to circumvent problems emerging from the use of symptom-based diagnostic categories in diagnosing disorders. The RDoC alternative is a focus on psychopathology based on dimensions simultaneously defined by observable behavior (including quantitative measures of cognitive or affective behavior) and neurobiological measures. Key features of the RDoC framework include an emphasis on functional dimensions that range from normal to abnormal, integration of multiple measures in study designs (which can foster computational approaches), and high priority on studies of neurodevelopment and environmental influences (and their interaction) that can contribute to advances in understanding the etiology of disorders throughout the lifespan. The paper highlights key implications for ways in which RDoC can contribute to future ideas about classification, as well as some of the considerations involved in translating basic behavioral and neuroscience data to psychopathology.

Current diagnostic criteria

2018 ◽  
Author(s):  
Luis Augusto Rohde ◽  
Christian Kieling ◽  
Giovanni Abrahão Salum
Keyword(s):  
International Classification Of Diseases ◽  
Research Domain Criteria ◽  
Statistical Manual ◽  
Adhd Diagnosis ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
History Of ◽  
Research Domain ◽  
Clinical Category

In this chapter we describe the history of ADHD diagnosis and how it is currently conceptualized in two main classificatory manuals: the Diagnostic and Statistical Manual for the Mental Disorders (DSM) and the International Classification of Diseases (ICD). We also outline differences between DSM and ICD manuals and review discussions in the realm of the 11th edition of the ICD, in its journey to increase clinical utility. Lastly, we discuss the research domain criteria and how this initiative might affect ADHD diagnosis in the future. We conclude by offering a perspective that acknowledges both the limitations of our current classificatory systems, but also points out their paramount importance to clinical practice. ADHD, as currently defined by DSM and ICD, is a well validated clinical category and a useful diagnosis for communication among practitioners, researchers, and for selecting treatments and care for patients.

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.

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 The role of migration processes and cultural factors in the classification of personality disorders

2021 ◽  
pp. 136346152110364
Author(s):  
Ardalan Najjarkakhaki ◽  
Samrad Ghane
Keyword(s):  
Personality Disorders ◽  
Ethnic Minorities ◽  
Historical Trauma ◽  
Cultural Factors ◽  
Cultural Dimensions ◽  
Economic Resources ◽  
Personality Pathology ◽  
Indigenous Populations

Migrants and ethnic minorities are at risk of being under- and overdiagnosed with personality disorders (PDs). A culturally informed approach to the classification of PDs guides clinicians in incorporating migration processes and cultural factors, to arrive at a reliable and valid assessment of personality pathology. In this article, we provide a tentative framework to highlight specific interactions between personality disorders, migration processes, and cultural factors. It is argued that migration processes can merely resemble personality pathology, activate certain (latent) vulnerabilities, and aggravate pre-existing personality pathology. We propose that these migration processes can include manifestations of grief about the loss of pre-migratory psychosocial and economic resources, and the struggle to attain psychosocial and economic resources in the host culture. Moreover, several cultural dimensions are outlined that can either resemble or mask personality pathology. The term “culturally masked personality disorder” is coined, to delineate clinical cases in which cultural factors are overused or misused to rationalize behavioral patterns that are consistently inflexible, distressing, or harmful to the individual and/or significant others, lead to significant impairment, and exceed the relevant cultural norms. Additionally, the role of historical trauma is addressed in the context of potential overdiagnosis of personality disorders in Indigenous persons, and the implications of misdiagnosis in migrants, ethnic minorities, and Indigenous populations are elaborated. Finally, clinical implications are discussed, outlining various diagnostic steps, including an assessment of temperament/character, developmental history, systemic/family dynamics, migration processes, cultural dimensions, and possible historical trauma.

Research Domain Criteria (RDoC): A Perspective to Probe the Biological Background behind Treatment Efficacy in Depression

2021 ◽  
Vol 28 ◽  
Author(s):  
Marco Calabrò ◽  
Chiara Fabbri ◽  
Siegfried Kasper ◽  
Joseph Zohar ◽  
Daniel Souery ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Health Concern ◽  
Research Domain Criteria ◽  
Major Depressive ◽  
Major Health ◽  
Antidepressant Effects ◽  
Research Domain ◽  
Drugbank Database ◽  
Antidepressant Action

Background: Major Depressive Disorder (MDD) and its frequent partial response to antidepressants are a major health concern and therefore an important focus of research. Despite the efforts, MDD pathogenesis and the mechanisms of antidepressant action are only partially understood. In the last few years, the need of rethinking the classification of depressive disorders and psychiatric disorders in general has been suggested, in order to provide a nosology that reflects more closely the biological background associated with disease pathogenesis and its role/significance in treatment. The classification proposed by the National Institute of Mental Health (NIMH), namely the research domain criteria (RDoC), may represent a key framework to guide research in this direction. Methods: A literature search was performed on PubMed and Google Scholar databases in order to retrieve data regarding Antidepressants effects on specific RDoC constructs. Further, the targets of drugs of interest were identified through Drugbank database, and their possible function within RDoC constructs was discussed. Discussion: In this review we summarize and discuss the significance of the results of pre-clinical and clinical studies investigating specific RDoC paradigms relevant to depressive phenotypes and antidepressant effects.

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.

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