Integrating normal and abnormal personality structure: a proposal for DSM-V.
ABSTRACT The personality disorders section of the American Psychiatric Association's fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is currently being developed. The purpose of the current paper is to encourage the authors of DSM-V to integrate normal and abnormal personality structure within a common, integrative model, and to suggest that the optimal choice for such an integration would be the five-factor model (FFM) of general personality structure. A proposal for the classification of personality disorder from the perspective of the FFM is provided. Discussed as well are implications and issues associated with an FFM of personality disorder, including validity, coverage, feasibility, clinical utility, and treatment implications.
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ABSTRACT: Personality disorders have a complex relationship with the law that in many ways reflects their complexity within the clinical and research communities. This paper addresses expert testimony about personality disorders, outlines how personality disorders are assessed in forensic cases, and describes how personality disorders are viewed in different legal contexts. Reasons are identified why personality disorders are not generally accepted as significant mental illness within the legal system, including high incidence of personality dysfunction in criminal populations, frequent comorbidity of personality disorders making it difficult to determine direct causation, and difficulty determining where on a continuum personality traits should be defined as illness (or not). In summary, the legal system, to a significant degree, mirrors the clinical conception of personality disorders as not severe mental diseases or defects, not likely to change, and most often, under volitional control.Dialogues in clinical neuroscience. 06/2013; 15(2):203-11.
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ABSTRACT: This article provides a brief history of the development of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, and how it relates to the proposed fifth edition to be published in 2013. Of particular emphasis is Axis II and how this axis is likely to be restructured. The reconceptualization of the nosology for personality disorders has been controversial since the publication of the DSM-III-R (Wilson, 1993 ). In both the clinical and academic communities, ongoing debate about diagnostic classification of personality disorders has been common. One recurrent theme among the deliberations on diagnosis and personality disorder focuses on the question of whether distinct (categorical) diagnoses exist or whether diagnoses are dimensionally related to each other in some empirically determined way. The proposed changes for Axis II in the DSM-5 are likely to bridge the gap between these two arguments by revamping the overall criteria and discarding the three currently used diagnostic clusters. The resulting nosology proposes six personality disorders with common factors in Criteria A and Criteria B. However, a major concern and a continuing problem not likely to be resolved in this edition is the symptom resemblance of borderline personality disorder and bipolar disorder. This article suggests some ways the revised DSM might affect mental health nursing practice.Issues in Mental Health Nursing 09/2012; 33(9):598-604.
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ABSTRACT: Assessment of personality is one of the key yet most difficult issues in the study of violent behavior. Recent research on intimate-partner violence highlights the need to describe offender typologies in order to tailor interventions to their needs. The Millon Clinical Multiaxial Inventory-III (MCMI-III) is commonly used in clinical and forensic settings, and Grossman facets are the latest additions to this instrument. They allow a more molecular diagnosis and may provide greater predictive ability when assessing violence. This study examines MCMI-III Grossman facets in 175 partner-violent men in prison. The results suggest the existence of three personality profiles that differ in their personality pathology severity, from lower pathological (Group 1; 27%) to greater pathological (Group 3; 30%). Subjects in Group 3 are more likely to show pathologies related to paranoid, sadistic, antisocial, negativistic, and borderline facets, which are all related to violent behavior. This group reported significantly more psychological aggression and minor sexual coercion (using the Conflict Tactics Scales-2, CTS-2), however, no differences regarding physical violence were found. Implications of these findings for interventions with intimate partner violence perpetrators are discussed. KEYWORDS. Partner-violent men. Personality disorders. Personality facets. Forensic assessment. Ex post facto study.International Journal of Clinical and Health Psychology 09/2012; 12(3):389-404. · 2.79 Impact Factor