The Schedule for Nonadaptive and Adaptive Personality: A Useful Tool for Diagnosis and Classification of Personality Disorder

Author(s):  
Eunyoe Ro ◽  
Deborah Stringer ◽  
Lee Anna Clark

This chapter discusses new theoretical and research developments related to the Schedule for Adaptive and Nonadaptive Personality-2 (SNAP-2; Clark, Simms, Wu, & Casillas, in press) in the context of the forthcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5), particularly regarding personality disorder (PD). The theoretical underpinnings of dimensional taxonomies of personality traits and PD, and between personality and psychosocial functioning, are considered first. Next, recent SNAP-2 research is reviewed, most notably in the areas of dependency, impulsivity, and schizotypy. In aggregate, the findings suggest that existing SNAP-2 scales cover significant variance in these content domains, but that a SNAP-3 would benefit by increased coverage of each, specifically active/emotional dependency, carefree/-less behavior, and schizotypal disorganization. Information about additional SNAP versions for informant ratings and adolescent personality/PD, respectively, is provided. Finally, the utility of a program of research elucidating relations between personality and functioning is presented.

Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.


Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.


Author(s):  
Timo D. Vloet ◽  
Marcel Romanos

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.


2017 ◽  
Vol 52 (5) ◽  
pp. 425-434 ◽  
Author(s):  
Bo Bach ◽  
Martin Sellbom ◽  
Mathias Skjernov ◽  
Erik Simonsen

Objective: The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Method: Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Results: Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive–compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. Conclusion: These preliminary findings suggest that little information is ‘lost’ in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain ‘cross walk’ is provided in the article.


2020 ◽  
Vol 54 (11) ◽  
pp. 1095-1100
Author(s):  
Roger T Mulder ◽  
L John Horwood ◽  
Peter Tyrer

Objective: The International Classification of Diseases, 11th Revision classification of personality disorder removes all categories of disorder in favour of a single diagnostic spectrum extending from no personality dysfunction to severe personality disorder. Following concerns from some clinicians and Personality Disorder Societies, it was subsequently agreed to include a borderline pattern descriptor as a qualifier of the main diagnosis. We explore the value of this additional descriptor by examining personality data in patients with major depression. Method: We examined personality data obtained using the Structured Clinical Interview for Personality Disorder-II in 606 patients enrolled in five randomised controlled trials of depression. The Structured Clinical Interview for Personality Disorder-II uses the Diagnostic and Statistical Manual of Mental Disorders categorical system, which includes borderline personality disorder. The International Classification of Diseases, 11th Revision classification has five domain traits. Each of the Diagnostic and Statistical Manual of Mental Disorders personality disorder symptoms or behaviours from Structured Clinical Interview for Personality Disorder-II was reordered into the five domains independently by two assessors. The relationship between the two systems was examined by tabular and correlational analysis. Results: The findings showed that the symptoms of borderline personality disorder were associated with greater severity of personality disturbance in the International Classification of Diseases, 11th Revision classification ( p < 0.0001) and were associated primarily with the Negative Affective, Dissocial and Disinhibited domains. There was only a weak association with the other two domains, Anankastia and Detachment. Conclusion: The addition of a borderline pattern descriptor is likely to add little to the International Classification of Diseases, 11th Revision classification of personality disorder. Its features are well represented within the severity/domain structure, which allows for more fine-grained description of the personality features that constitute the borderline concept.


Author(s):  
Manfred Döpfner ◽  
Tobias Banaschewski

Zusammenfassung. Der Beitrag gibt eine kurze Übersicht über die Veränderungen in der Klassifikation von Hyperkinetischen Störungen und Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen nach ICD-11 (International Statistical Classification of Diseases and Related Health Problems). Sowohl in der Bezeichnung als auch in der Binnendifferenzierung lehnt sich ICD-11 erfreulicherweise an das DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) an. Auch die Aufgabe der ICD-10-Kombinationsdiagnose der Hyperkinetischen Störung des Sozialverhaltens zugunsten von Mehrfachdiagnosen ist zu begrüßen. Der Verzicht auf eine exakte Operationalisierung der Kriterien hilft einerseits bei der Einordung von Grenzfällen in der klinischen Praxis, macht es aber auch notwendig, für die Klärung der einzelnen Symptome auf das DSM-5 zurückzugreifen.


Author(s):  
Joel Paris

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), was initially expected to be a radical revision of previous editions. However, there was insufficient evidence to support many of the proposals for changes, and the final product is not that different from DSM-IV. This having seen said, this chapter outlines what changes have been made, and what the future prospects for the classification of mental disorders may be.


2021 ◽  
pp. 338-342
Author(s):  
Brian A. Palmer

A personality disorder (PD) is defined in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.” DSM-5 has revised the PDs to individual disorders. They no longer are reported in Axis II; DSM-5, unlike previous editions, does not use the axis system.


2021 ◽  
pp. 216770262198935
Author(s):  
Thomas A. Widiger

Wilshire, Ward, and Clark (this issue, p. ♦♦♦) critiqued the classification of psychopathology in the Diagnostic and Statistical Manual of Mental Disorders, offering as an alternative a “Cambridge model” that focuses on symptoms rather than syndromes. They compared their model with additional alternatives, such as the Research Domain Criteria, the Hierarchical Taxonomy of Psychopathology, and network analysis. In this commentary, I offer further comparisons, considering as well the five-factor model alternative to the DSM syndromal classification of personality disorder.


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