Assessment and Diagnosis of Personality Disorder: Perennial Issues and an Emerging Reconceptualization

Abstract

This chapter reviews recent (2000)(2001)(2002)(2003)(2004)(2005) personality disorder (PD) research, focusing on three major domains: assessment, comorbidity, and stability. (a) Substantial evidence has accrued favoring dimensional over categorical conceptualization of PD, and the five-factor model of personality is prominent as an integrating framework. Future directions include assessing dysfunction separately from traits and learning to utilize collateral information. (b) To address the pervasiveness and extent of comorbidity, researchers have begun to move beyond studying overlapping pairs or small sets of disorders and are developing broader, more integrated common-factor models that cross the Axis I-Axis II boundary. (c) Studies of PD stability have converged on the finding that PD features include both more acute, dysfunctional behaviors that resolve in relatively short periods, and maladaptive temperamental traits that are relatively more stable-similar to normal-range personality traits-with increasing stability until after 50 years of age. A new model for assessing PDand perhaps all psychopathology-emerges from integrating these interrelated reconceptualizations.

Personality pathology in purging disorder and bulimia nervosa

“…This approach reflects increasing evidence for the validity of dimensional over categorical approaches to personality pathology. 11 Although the lack of consistent personality differences in the literature suggests that women with PD and BN may share similar anxious and impulsive personality traits, evidence for differential associations between these traits and eating disorder features may reflect distinctions between the disorders with important treatment implications.…”

Personality Disorders and the Five-Factor Model among French Speakers in Africa and Europe

“…3 Several studies have tried to capture PDs using a large variety of instruments in normal and clinical samples [4][5][6][7] ; however, at the moment there is still no consensus on one particular dimensional model to assess PDs. However, Clark 1 suggested the use of the FFM or some variant of the FFM because it has acquired the status of a reference model for the description of normal personality traits and is widely accepted.…”

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

“…However, this percentage reflects the number of individuals who sought treatment and received a diagnosis for a PD; it does not include the individuals who do not seek help but are afflicted with a PD. Research shows that PDs are associated with reduced quality of life and dysfunction in almost every area with which health care providers are concerned (Clark, 2007) and therefore should be accorded the most effective and efficient diagnostic model and treatment options possible.…”

“…The categorical approach is currently the 8 approach used by clinicians and has been since its original publication in 1980; however, empirical evidence has been collecting for decades showing that the structure of PDs can better be described using a dimensional approach (Clark, 2007). One survey reports that 74% of experts think the DSM-IV-TR categorical model of PDs should be replaced, 87% believe personality pathology is dimensional in nature, and 70% indicated that a hybrid model of PDs is the most desirable alternative to the categorical model (Morey et al, 2014).…”