Personality Disorders in the DSM-5: Proposed Revisions and Critiques

2012 ◽  
Vol 34 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Emily Good

This article discusses the Personality and Personality Disorder Work Group's proposed changes for Personality Disorders in the DSM-5: (a) adoption of a hybrid dimensional-categorical model; (b) utilization of 6 personality disorder types instead of the previous 10 personality disorders; (c) addition of personality traits and facets to define personality disorders; (d) addition of a rating scale for levels of personality functioning; (e) revised diagnostic criteria; and (f) the collapsing of Axes I, II, and III. Also discussed are ways in which the DSM-5 proposals are reactions to criticisms of the DSM-IV-TR (APA, 2000) and criticisms of the proposed changes.

2015 ◽  
Vol 46 (3) ◽  
pp. 647-655 ◽  
Author(s):  
L. C. Morey ◽  
K. T. Benson ◽  
A. E. Skodol

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.


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

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.


2014 ◽  
Author(s):  
Yosefa A. Ehrlich ◽  
Amir Garakani ◽  
Stephanie R Pavlos ◽  
Larry Siever

Personality can be defined as an organizational system of self that shapes the manner in which a person interacts with his or her environment. Personality traits develop in adolescence or early adulthood and are thought to be shaped by early childhood experiences and enduring throughout a lifetime. Personality traits that prevent an individual from being able to function in society or that cause significant distress are diagnosed as personality disorders. A thorough history is needed to rule out other psychiatric and medical disorders. This chapter reviews the diagnostic criteria, differential diagnosis, comorbidity, prevalence, etiology (including genetics and neurobiology), prognosis, and treatment of paranoid, schizoid, schizotypal, borderline, antisocial, narcissistic, histrionic, avoidant, obsessive-compulsive, and dependent personality disorders. A discussion of the relevance of personality disorders to primary care practices and approaches to managing such patients is also included. Tables describe the diagnostic criteria of each personality disorder. Figures illustrate the prevalence of personality disorders in the general and psychiatric populations; schizotypal personality disorder in the community, general population, and clinical population; childhood trauma in individuals with personality disorder; and comorbid disorders in individuals with borderline personality disorder. A model of brain processing in borderline personality disorder is also featured. This chapter contains 5 highly rendered figures, 10 tables, 230 references, and 5 MCQs.


2002 ◽  
Vol 32 (2) ◽  
pp. 219-226 ◽  
Author(s):  
S. FAZEL ◽  
T. HOPE ◽  
I. O’DONNELL ◽  
R. JACOBY

Background. Psychiatric disorders are purported to play a role in the aetiology of violent crime, but evidence for their role in sexual offending is less clear. The authors investigated the prevalence of psychiatric morbidity and personality disorders in elderly incarcerated sex offenders compared with elderly non-sex offenders.Method. One hundred and one sex offenders and 102 non-sex offenders aged over 59 years were interviewed using standardized semi-structured interviews for psychiatric illness (the Geriatric Mental State) and the personality disorder (Structured Clinical Interview for DSM-IV personality disorders). Data on demographic, offence and victim characteristics were collected.Results. Six per cent of the elderly sex offenders had a psychotic illness, 7% a DSM-IV major depressive episode and 33% a personality disorder; and 1% had dementia. These prevalence figures were not different from the elderly non-sex offenders interviewed in this study. Differences emerged at the level of personality traits with sex offenders having more schizoid, obsessive–compulsive, and avoidant traits, and fewer antisocial traits compared with non-sex offenders.Conclusions. Elderly sex offenders and non-sex-offenders have similar prevalence rates of mental illness. However, elderly sex offenders have increased schizoid, obsessive–compulsive, and avoidant personality traits, supporting the view that sex offending in the elderly is associated more with personality factors than mental illness or organic brain disease.


Author(s):  
Joshua D. Miller ◽  
Lauren R. Few ◽  
Thomas A. Widiger

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.


2019 ◽  
pp. 1-20 ◽  
Author(s):  
Antonella Somma ◽  
Robert F. Krueger ◽  
Kristian E. Markon ◽  
Valentina B. M. Alajmo ◽  
Emanuela Arlotta ◽  
...  

In order to assess the relationships between DSM-5 Alternative Model of Personality Disorder (AMPD) maladaptive personality traits and self-reports of aggression, 508 Italian adult participants who met at least one DSM-IV Axis II/DSM-5 Section II personality disorder (PD) diagnosis were administered the Personality Inventory for DSM-5 (PID-5) and the Aggression Questionnaire (AQ). Analysis results showed that multiple regression results, PID-5 Hostility, Callousness, and Risk Taking trait scale scores explained a large amount of variance in AQ Physical Aggression (PA) scores. Moreover, PID-5 Hostility, Callousness, and Risk Taking explained more than 20% of the variance in the AQ Physical Aggression scale scores that was left unexplained by selected continuously scored DSM-IV Axis II/ DSM-5 Section II PDs, whereas SCID-II Paranoid, Narcissistic, Borderline, and Antisocial PDs added only 4% of variance to the amount of variance in AQ Physical Aggression scores that was already explained by the PID-5 trait scale scores.


2012 ◽  
Vol 121 (2) ◽  
pp. 424-432 ◽  
Author(s):  
Christopher J. Hopwood ◽  
Katherine M. Thomas ◽  
Kristian E. Markon ◽  
Aidan G. C. Wright ◽  
Robert F. Krueger

Author(s):  
Suzanne Holroyd

The study of personality disorder (PD) in late life presents conceptual, diagnostic, and methodological difficulties. By definition, PD is considered a group of personality traits that relatively persistent through adulthood. However, the concept of PD persisting throughout the lifespan contradicts widespread clinical belief that they become less severe with ageing. There are difficulties in studying PD in the elderly. One is the instability of the definition of PD over time, making it difficult to relate earlier studies to those using current definitions of PD. In addition, diagnostic criteria are subject to criticism when applied to the elderly, in that they may be ‘age-biased’. Finally, the methodology used to diagnose PD has been highly variable and difficult to interpret between studies. This chapter covers clinical features, diagnosis, epidemiology and aetiology, course and prognosis, and treatment and management.


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