Personality Disorder Types Proposed for DSM-5

University of Arizona College of Medicine and Sunbelt Collaborative, 6340 N. Campbell Ave., Tucson, AZ 85718, USA.
Journal of personality disorders (Impact Factor: 3.08). 04/2011; 25(2):136-69. DOI: 10.1521/pedi.2011.25.2.136
Source: PubMed


The Personality and Personality Disorders Work Group has proposed five specific personality disorder (PD) types for DSM-5, to be rated on a dimension of fit: antisocial/psychopathic, avoidant, borderline, obsessive-compulsive, and schizotypal. Each type is identified by core impairments in personality functioning, pathological personality traits, and common symptomatic behaviors. The other DSM-IV-TR PDs and the large residual category of personality disorder not otherwise specified (PDNOS) will be represented solely by the core impairments combined with specification by individuals' unique sets of personality traits. This proposal has three main features: (1) a reduction in the number of specified types from 10 to 5; (2) description of the types in a narrative format that combines typical deficits in self and interpersonal functioning and particular configurations of traits and behaviors; and (3) a dimensional rating of the degree to which a patient matches each type. An explanation of these modifications in approach to diagnosing PD types and their justifications--including excessive co-morbidity among DSM-IV-TR PDs, limited validity for some existing types, lack of specificity in the definition of PD, instability of current PD criteria sets, and arbitrary diagnostic thresholds--are the subjects of this review.

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Available from: Carl C. Bell, Dec 25, 2014
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    • "The second criterion (Criterion B) dictates that an individual must also exhibit maladaptive personality traits based on a model of five dimensional personality domains and their accompanying set of three to seven facets. These trait domains include Antagonism, Psychoticism, Disinhibition, Negative Affectivity, and Detachment (American Psychiatric Association, 2011; Skodol et al., 2011), and are grounded in literature showing the empirical validity of dimensional models for maladaptive personality functioning (Harkness and McNulty, 1994; Krueger et al., 2011; Samuel and Widiger, 2008; Watson et al., 1994; Widiger and Simonsen, 2005; among others). This model has also shown strong associations with other models of personality such as the Personality Psychopathology Five (PSY-5) model (Anderson et al., 2013; see also Harkness et al., 2012), and the Five Factor Model (FFM) (Gore and Widiger, 2013; Thomas et al., 2013; Widiger et al., 2013). "
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    ABSTRACT: The DSM-5 Section III includes a hybrid model for the diagnosis of personality disorders, in which sets of dimensional personality trait facets are configured into personality disorder types. These PD types resemble the Section II categorical counterparts with dimensional traits descriptive of the Section II criteria to maintain continuity across the diagnostic systems. The current study sought to evaluate the continuity across the Section II and III models of personality disorders. This sample consisted of 397 undergraduate students, administered the Personality Inventory for the DSM-5 (Krueger et al., 2012) and the Structured Clinical Interview for the DSM-IV Axis II Disorders–Personality Questionnaire (First et al., 2002). We examined whether the DSM-5 Section III trait facets for the PDs would be associated with their respective Section II counterparts, as well as determining whether additional facets could augment the prediction of the Section II disorders. Results revealed that, generally, the DSM-5 Section II disorders were most strongly associated with their Section III traits. Results also showed evidence to support the addition of facets not included in the Section III diagnostic criteria in the prediction of most disorders. These results show general support for the Section III model of personality disorders, however, results also show that additional research is needed to replicate these findings.
    05/2014; 216(3). DOI:10.1016/j.psychres.2014.01.007
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    • "The initial DSM-5 trait model proposed was rationally derived and comprised of six domain level traits (Skodol et al., 2011, p. 37): negative emotionality: ''Experiences a wide range of negative emotions (anxiety, depression, guilt/shame, worry etc.), and the behavioral and interpersonal manifestations of those experiences.'' Detachment: ''Withdrawal from other people, ranging from intimate relationships to the world at large; restricted affective experience and expression; limited hedonic capacity .'' "
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    ABSTRACT: Important changes in how personality is conceptualized and measured are occurring in clinical psychology. We focus on 1 aspect of this work that industrial psychologists have been slow to embrace, namely, a new trait model that can be viewed as a maladaptive counterpart to the Big 5. There is a conspicuous absence of work psychology research emerging on this trait model despite important implications for how we understand personality at work. We discuss objections to the trait model in a work context and offer rejoinders that might make researchers and practitioners consider applying this model in their work. We hope to stimulate discussion of this topic to avoid an unnecessary bifurcation in the conceptualization of maladaptive personality between industrial and clinical settings.
    Industrial and Organizational Psychology 03/2014; 7(1). DOI:10.1111/iops.12114 · 0.65 Impact Factor
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    • "to schizotypal PD although closely related) and Siever, Torgersen, Gunderson, Livesley, and Kendler's (2002) consideration of the borderline endophenotype. As noted by Skodol et al. (2011), some of this reasoning was part of the Work Group's rationale for retaining schizotypal and borderline PDs as diagnostic prototypes in the DSM-5 system. "
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