A Paradigm Shift: From a Categorical to Dimensional Diagnostic Model of Personality Disorder

Abstract

This thesis discusses the possibility of a paradigm shift in the conceptualization of personality disorders (PDs), and eventually all psychological disorders, from categorical to dimensional. It examines the three main types of models utilized for diagnosing PDs. These main types are: the categorical model, where symptoms are organized in a check list based on categories; the dimensional model, where symptoms are organized on a spectrum rather than in a list; and the hybrid model, which is a combination of the two. It focuses on the strengths and weaknesses of each model and how they are used to define and diagnose PDs. In conclusion, there are significant gaps in the empirical evidence pertaining to the practical applications of the dimensional and hybrid models, therefore, a change in diagnostic criteria is not yet advised. Only when these gaps have been filled can a paradigmatic shift from a categorical to a dimensional conceptualization of PDs, and eventually all psychological disorders, occur.3

Kişilik Bozukluklarında ICD-11 ve DSM-5 Alternatif Modelin Karşılaştırmalı İncelenmesi

“…According to these views, the dimensional approach brings a natural classification in the diagnosis of personality disorders, while the categorical approach creates artificial distinctions (Gøtzsche-Astrup and Moskowitz 2015, Bach, et al 2017, Flory 2020). The dimensional approach in personality disorders makes it possible to evaluate the specific situation for each patient and allows for specific treatments depending on this (Green 2015). When examined, it is seen that the new diagnostic models have some common points.…”

“…Although there is no common language in understanding the level of impairment in the two guidelines, a classification system based on severity can be interpreted as having the advantage of simplifying the process of identifying a personality disorder. It can be said that this is a feature that can facilitate both the clinician's relationship with the client and the understanding of the individual's difficulties (Millon et al 2010, Green 2015, Bach and First 2018.…”