Diagnosis and DSM-5: Work in Progress

2012 ◽  
pp. 34-57 ◽  
Author(s):  
Andrew E. Skodol
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Personality Assessment ◽  
Field Testing ◽  
Field Trials ◽  
Assessment Model ◽  
Major Step ◽  
Dsm 5 ◽  
Definition Of ◽  
Assessment And Diagnosis

A new hybrid dimensional-categorical model for personality and personality disorder assessment and diagnosis has been proposed for DSM-5 field testing. The justifications for the proposed modifications in approach to diagnosing personality disorders include lack of specificity in the DSM-IV-TR definition of personality disorder, inadequate representation of personality disorder severity and arbitrary thresholds for diagnosis, excessive comorbidity among personality disorders, limited validity for some existing types, heterogeneity within types, and instability of current personality disorder criteria sets. This chapter reviews the development of the revised personality assessment model, including summaries of literature reviews, experiences in workshops, comments from the field, and published critiques. The next major step in the development of the DSM-5 personality assessment and diagnosis model will be the DSM-5 field trials. Further revisions are anticipated.

Compulsions and Personality Disorders

2019 ◽  
Vol 29 (1) ◽  
pp. 79-97
Author(s):  
Mara Luiza Vieira Ceroni ◽  
Cláudia Abude
Keyword(s):  
Personality Disorder ◽  
Early Diagnosis ◽  
Personality Disorders ◽  
Social Relationships ◽  
Psychological Treatment ◽  
Human Beings ◽  
Dsm 5 ◽  
Schizoid Personality ◽  
Schizoid Personality Disorder ◽  
Prevention And Treatment

This article proposes a reflection on the possible causes and diagnosis of people involved in violent shootings. The policies for prevention of those social tragedies remain somewhat controversial and vaguely addressed, lacking theoretical attention (Rocque & Duwe, 2018). One of the main diagnoses involved in those cases, according to literature, is Schizoid Personality Disorder-SPD with characteristics of detachment, isolation and difficulties of contact with other human beings (DSM-5, 2013). The loss of capacity to establish social relationships and intimacy hamper and may sometimes impede a psychological treatment based on connection possibilities. Juvenile violence statistics increased dramatically in the last 50 years and because of this, early diagnosis is important for the prevention and treatment of these cases. At the same time, further research and case studies are a pressing need (Rocque, 2017). For diagnosed SPD patients, Bioenergetics Analysis stands out in a scenario in which rapprochement and contact are a priority, also as an approach that is open to new care techniques and alternatives investigations in helping people to open their hearts to life and love. If this objective is not achieved, the outcome, according to Lowen (1991) is tragic.

Borderline personality disorder: part 1 – assessment and diagnosis

2020 ◽  
Vol 26 (3) ◽  
pp. 159-172
Author(s):  
Jacqueline Garland ◽  
Stephen Miller
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Clinical Features ◽  
Borderline Personality ◽  
The Core ◽  
Diagnostic Practice ◽  
Assessment And Diagnosis

SUMMARYGeneral adult psychiatrists are largely responsible for the care of patients with personality disorders in community and in-patient settings, and this can be associated with diagnostic and management challenges. In the first of two articles focusing specifically on borderline personality disorder (BPD), we summarise the core clinical features of the disorder and discuss appropriate diagnostic practice.

Personality Disorder Features and Paraphilic Interests Among Undergraduates: Differential Relations and Potential Antecedents

2019 ◽  
Vol 33 (1) ◽  
pp. 22-48 ◽  
Author(s):  
Ashley L. Watts ◽  
Madeline G. Nagel ◽  
Robert D. Latzman ◽  
Scott O. Lilienfeld
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Antisocial Personality Disorder ◽  
Antisocial Personality ◽  
Sexual Sadism ◽  
Base Rates ◽  
Dsm 5 ◽  
Disorder Symptom ◽  
Differential Relations

We examined the relations between: (1) narcissism, psychopathy, DSM-5 personality disorder symptom counts; and (2) paraphilic interests among undergraduates (N = 608). Base rates of paraphilic interests were appreciable. The disinhibition and meanness features of psychopathy and the entitlement and exploitativeness features of narcissism were robustly associated with paraphilic interests, particularly sexual sadism, whereas the boldness features of narcissism and psychopathy were essentially unrelated to these interests. Narcissism and psychopathy features typically manifested the most pronounced relations with paraphilic interests, although antisocial personality disorder features were also strong predictors. By and large, these relations were comparable across gender. Lastly, there was no evidence that erotophilia mediated the relations between the narcissism and psychopathy features and paraphilic interests, most likely because erotophilia was generally unrelated to paraphilic interests. Relative to other dimensions of personality disorders, facets of meanness and disinhibition from psychopathy and entitlement/exploitativeness facets from narcissism were most associated with paraphilic interests.

Relating DSM-5 section III personality traits to section II personality disorder diagnoses

2015 ◽  
Vol 46 (3) ◽  
pp. 647-655 ◽  
Author(s):  
L. C. Morey ◽  
K. T. Benson ◽  
A. E. Skodol
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Personality Disorders ◽  
Alternative Model ◽  
Work Group ◽  
Taxonomic Structure ◽  
Personality Functioning ◽  
Dsm 5 ◽  
Criterion A ◽  
Dsm Iv

BackgroundThe DSM-5 Personality and Personality Disorders Work Group formulated a hybrid dimensional/categorical model that represented personality disorders as combinations of core impairments in personality functioning with specific configurations of problematic personality traits. Specific clusters of traits were selected to serve as indicators for six DSM categorical diagnoses to be retained in this system – antisocial, avoidant, borderline, narcissistic, obsessive–compulsive and schizotypal personality disorders. The goal of the current study was to describe the empirical relationships between the DSM-5 section III pathological traits and DSM-IV/DSM-5 section II personality disorder diagnoses.MethodData were obtained from a sample of 337 clinicians, each of whom rated one of his or her patients on all aspects of the DSM-IV and DSM-5 proposed alternative model. Regression models were constructed to examine trait–disorder relationships, and the incremental validity of core personality dysfunctions (i.e. criterion A features for each disorder) was examined in combination with the specified trait clusters.ResultsFindings suggested that the trait assignments specified by the Work Group tended to be substantially associated with corresponding DSM-IV concepts, and the criterion A features provided additional diagnostic information in all but one instance.ConclusionsAlthough the DSM-5 section III alternative model provided a substantially different taxonomic structure for personality disorders, the associations between this new approach and the traditional personality disorder concepts in DSM-5 section II make it possible to render traditional personality disorder concepts using alternative model traits in combination with core impairments in personality functioning.

Assessment of Personality Disorders and Related Traits: Bridging DSM-IV-TR and DSM-5

2012 ◽  
pp. 107-140 ◽  
Author(s):  
Joshua D. Miller ◽  
Lauren R. Few ◽  
Thomas A. Widiger
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Self Report ◽  
Dsm 5 ◽  
Prototype Matching ◽  
Semistructured Interviews ◽  
Assessment Techniques ◽  
Dsm Iv ◽  
The Many ◽  
Diagnostic Criterion

The assessment of personality disorders and related traits is at an important crossroads with the imminent release of DSM-5. In this chapter we first review assessment techniques and measures as they pertain to the DSM-IV-TR personality disorders and pathological personality traits, focusing in particular on the many self-report inventories and semistructured interviews that have been developed. Second, we discuss the proposed changes to the diagnosis of personality disorder in DSM-5, which are substantial, and their ramifications for the assessment of personality disorder, including the (now abandoned) proposal to replace explicit diagnostic criterion sets with a prototype matching technique, the proposal to delete and/or shift a number of diagnoses from the personality disorders section, the provision of a new dimensional trait model of personality pathology, and the provision of new rating of impairment pertaining to self and interpersonal functioning.

How to choose the best screening instrument for personality disorder for your specific practice

2011 ◽  
Vol 26 (S2) ◽  
pp. 1019-1019
Author(s):  
S. Germans ◽  
G.L. Van Heck ◽  
P.P.G. Hodiamont
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Personality Assessment ◽  
Structured Interview ◽  
Screening Instrument ◽  
Mental Illnesses ◽  
Standardized Assessment ◽  
Short Version ◽  
Specific Practice ◽  
Neo Five Factor Inventory

IntroductionPersonality disorders (PD) are common in psychiatric services and can adversely affect the management and outcome of mental illnesses. Therefore assessment of the personality is an essential part of initial psychiatric examination. To diagnose a PD takes time and competence. A screening instrument in the diagnostic phase can be a solution.AimThe goal of the study was to provide clinicians a powerful screening tool for personality disorders that is ‘quick and dirty’.MethodNine screening instruments were studied in a prospective, observational, test development study with a random sample of Dutch psychiatric outpatients, using the SCID-II as the gold standard. There were three short questionnaires (Standardized Assessment of Personality- Abbreviated Scale (SAPAS), Iowa Personality Disorder Screen (IPDS), Short version of the SCID-II), three longer questionnaires (the SCID-II Personality Questionnaire, the NEO Five-Factor Inventory (NEO-FFI), Inventory of Interpersonal Problems (IIP-PD/C;) one short semi structured interview (Quick Personality Assessment Schedule (PAS-Q.) and two informant interviews (Standardised Assessment of personality (SAP), the Standardized Assessment of Personality- Abbreviated Scale for informants (SAPAS-INF)) involved.ResultsThe three short questionnaires and the semi structured interview were very useful for determining the presence/absence of PD. The other instruments can be used in particular situations for example to determine a specific PD or if the patient is not able to accomplish the test.ConclusionBefore deciding which screening instrument for PD is the best for your practice, you have to consider psychometric values as well as practical circumstances.

Examining the Incremental Utility of DSM-5 Section III Traits and Impairment in Relation to Traditional Personality Disorder Scores in a Female Correctional Sample

2018 ◽  
Vol 32 (6) ◽  
pp. 738-752 ◽  
Author(s):  
Chelsea E. Sleep ◽  
Dustin B. Wygant ◽  
Joshua D. Miller
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Alternative Model ◽  
Female Inmates ◽  
Societal Costs ◽  
Dsm 5 ◽  
Narcissistic Personality ◽  
Categorical Models ◽  
Personality Psychopathology ◽  
Personality Disordered

Personality disorders (PDs) are challenging to assess and are associated with great individual and societal costs. In response to the limitations of categorical models, the DSM-5 included an alternative model (i.e., Section III), which uses impairment (Criterion A) and pathological traits (Criterion B) to diagnose PDs. Although numerous studies have illustrated dimensional trait models' ability to capture personality psychopathology, less attention has been paid to personality impairment. The present investigation sought to examine Criterion A's ability to contribute incrementally to the prediction of antisocial (ASPD), borderline (BPD), and narcissistic personality disorders (NPD), and Interpersonal-Affective (F1) and Impulsive-Antisocial (F2) features of psychopathy. The current study used 200 female inmates and found that impairment contributed to the prediction of BPD, NPD, and psychopathy F1 scores and did not add to the prediction of ASPD and psychopathy F2 scores. Difficulties in distinguishing between personality impairment and personality disordered traits are discussed.

Personality Disorders and Suicide Attempts

2016 ◽  
Vol 33 (S1) ◽  
pp. S506-S506
Author(s):  
O.W. Muquebil Ali Al Shaban Rodriguez ◽  
J.R. López Fernández ◽  
C. Huergo Lora ◽  
S. Ocio León ◽  
M.J. Hernández González ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Suicide Attempts ◽  
Obsessive Compulsive ◽  
Dsm 5 ◽  
Patterns Of Behavior ◽  
Cluster A ◽  
Competing Interest ◽  
Clear Relation ◽  
Clinical Cases

IntroductionThe personality disorders are defined according to the DSM-5 like “an enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's cultures. These patterns develop in adolescence and the beginning of adulthood, and are associated with significant distress or disability”. The personality disorders can be a risk factor for different processes of the psychiatric pathology like suicide. The personality disorders are classified in 3 groups according to the DSM-5:– cluster A (strange subjects): paranoid, schizoid and schizotypal;– cluster B (immature subjects): antisocial, bordeline, histrionic and narcissistic;– cluster C (frightened subjects): avoidant, dependent and obsessive-compulsive.AimsTo describe the influence of personality disorders in suicide attempts.MethodologyExhibition of clinical cases.ResultsIn this case report, we exhibit three clinical cases of suicide attempts which correspond to a type of personality disorder belonging to each of the three big groups of the DSM-5 classification, specifically the paranoid disorder of the cluster A, the disorder borderline of cluster B and the obsessive compulsive of cluster C.ConclusionsThe personality disorders have a clear relation with the suicide attempts, increasing this influence in some of them, especially the borderline personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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