Article

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

ABSTRACT

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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    • "Moreover, some specific forms of PD (i.e., paranoid, schizoid, dependent, histrionic, and narcissistic), were diagnostic categories in consideration of being omitted, in part citing reasons due to the insufficient levels of epidemiological and/or evidence describing pathophysiological mechanisms for these disorders, and questionable clinical utility (Skodol et al., 2011). Yet the DSM–5 Task Force and Work Group were unable to achieve consensus regarding the proposed hybrid model of 5 PD types, to be rated dimensionally, and thus 10 specific PD categories were retained from the DSM–IV–TR (Skodol et al., 2011). PD in the general population is common; studies from the United Kingdom of Great Britain (England, Wales, and Scotland), Norway, and Australia indicate the prevalence of any categorical PD range between 4.4% (Coid, Yang, Tyrer, Roberts, & Ullrich, 2006) and 13.4% (Torgersen, Kringlen, & Cramer, 2001). "
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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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